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Dose Management

  • Dose Management

Your Challenging Role in a Complex Environment

With new and evolving radiation dose regulations and standards, your responsibilities may extend even further than before.

These regulations and quality initiatives mean that you could be responsible for dose recording, threshold setting, and outlier reporting. Although the safe operation of your department rests on your shoulders, you may have time only for sporadic spot checks, which can be time-consuming, incomplete, and error-prone. Dose variability can be a persistent problem, with variations between patients, protocols, and users.

Broadly available technology such as PACS, RIS and scanner dose sheets provide a passive means of satisfying basic compliance requirements of dose recording, reporting and archiving. But because PACS are not designed to perform aggregate statistical evaluations, your ability to identify and differentiate between outliers and trends, adjust dosing, or improve dose consistency is limited.

Dose levels must be predictable and consistent between exams. This can be difficult to achieve without connecting the data from your PACS to a radiation dose management system. Once the dose distribution across all scans becomes visible, you have taken the first step towards active dose management. This requires more advanced tools for statistical process control and quality management.
 

How does your organisation achieve predictable, consistent dose levels?


The University of California reduced the number of high-dose abdomen exams by 50% within three months. Using RadimetricsTM, they collected 274,124 CT exams from 12 facilities. They found that the primary factors influencing dose variation were multiphase scanning and institutional protocol choices. They used this information to benchmark dose levels across all their medical centers and achieved a 50% reduction in high-dose abdominal exams (defined as exceeding the 75th percentile).*1

RadimetricsTM provides you with state-of-the-art capabilities to help you operationalize consistent production within defined dose tolerances. Advanced tools help you to add value and raise safety standards:

  • Protocol management, robust reporting, and interactive dosimetry to help you and your team identify and reduce outlier events
  • Customizable, interactive quality metrics assist with your quality assurance program
  • Multimodality support for objective dose information on a vendor-neutral platform
     
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Automated Capture

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Departmental Monitoring

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Quality Management

Automated Capture

RadimetricsTM helps automate routine administrative tasks, freeing your time for analysis.

This powerful tool provides you with holistic and near real-time tracking and monitoring. In addition, RadimetricsTM automated reporting helps you avoid time-intensive administrative tasks such as manually calculating peak skin dose or manually recording and transcribing contrast information in the final patient report, both of which can be error-prone and time consuming processes.

Departmental Monitoring

RadimetricsTM helps simplify dose management beyond basic dose reporting.

Information available from RadimetricsTM may be used to help you consistently identify outliers and trends, either through automated email alerts or case drill-down from your distribution charts. For audits, you can review all studies, utilizing aggregated data generated by the software – instead of depending on random spot checks. Armed with this information, the interactive dosimetry and protocol management tools help you reduce outlier events.

The University of California analyzed almost 200,000 exams for expected dose ranges, in line with the Joint Commission standard. Using RadimetricsTM, they obtained quartile ranges for six key CT imaging protocols, differentiated by adults and children as well as single and multi-phase CT.

Peking University First Hospital was able to reduce the number of CT protocols from 200 to 60. Using RadimetricsTM, the department was able to compare effective radiation doses between individual patients, patient groups, single sequences, as well as applications. This helped them to review CT protocols and eliminate redundant and obsolete protocols to reduce complexity, enhance dose consistency, and actively manage exposure.2

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Protocol Management helps you reduce variability between users and protocols by harmonizing the protocol library and reducing redundant, outdated or suboptimal scan protocols. It allows you to set alerts and apply notes, tracking alert occurrence over time, and documenting when corrective actions were taken.

RadimetricsTM provides you with a means to define dose reference levels (DRLs) by protocol, and monitor studies and dose distribution to remain within your defined tolerances. The system integrates with your existing IT and automates dose collection, monitoring and reporting.
Interactive dosimetry assists with training on scan range and scanner parameters. The impact of tube current modulation, scan range and many other parameters can be simulated and visualized.

RadimetricsTM provides objective dose information for multiple modalities on a vendor neutral platform. While CT is clearly a significant source of exposure by dose and procedure volume, other modalities, including mammography, nuclear medicine, and interventional radiology are also sources of radiation which add to the cumulative dose a patient may receive.
 

Enhanced Ability to Meet Quality Goals

With this integrated approach to radiation dose management through statistical process control, hospitals can use software tools to comply with requirements to implement a quality assurance program.

In addition to the other tools, interactive quality metrics available in RadimetricsTM can be fully customized to meet your needs.

In addition, the data provided by the RadimetricsTM Enterprise Platform products provide you with the information to confidentially and anonymously compare your data with benchmark dose levels and against other institutions found in dose registries. When you compare the performance of your department with that of other participating institutions this information provides you with context and allows you to monitor progress.

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References

* The results cited represent the outcomes achieved by the respective institution and are not necessarily representative of every site. Results will vary based on a site’s existing circumstances and the quality of the improvement programs adopted by the site.

1 Smith-Bindman R, Moghadassi M, Wilson N, Nelson TR, Boone JM, Cagnon CH, et al. Radiation doses in consecutive CT examinations from five University of California Medical Centers. Radiology. 2015; 277(1): 134-141.

2 Wang X. Necessity of radiation dose management system. Presented at: KCR 2016- The 72nd Korean Congress of Radiology and Annual Delegate Meeting of The Korean Society of Radiology. September 21-September 23, 2016. Seoul, Korea.