The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory. Various ways of collecting dose data are available today, for example the Digital Imaging and Communication in Medicine ? Structured Report (DICOM-SR), optical character recognition and DICOM-modality performed procedure steps (MPPS). The DICOM-SR is part of the DICOM-standard and provides the DICOM-Radiation Dose Structured Report, which is an easily applicable and comprehensive solution to collect radiation dose parameters. This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. In this article, we discuss legal obligations, various ways to monitor dose data, current dose monitoring software solutions and future perspectives in regard to the EU Council Directive 2013/59/EURATOM.
Key Points:
??Automated, systematic dose monitoring is an important element in quality assurance of radiology departments.
??DICOM-RDSR-capable CT scanners facilitate the monitoring of dose data.
??A variety of commercial and non-commercial dose monitoring software tools are available today.
??Successful dose monitoring requires comprehensive infrastructure for monitoring, analysing and optimizing radiation exposure.
Citation Format:
??Boos J, Meineke A, Bethge OT et?al. Dose Monitoring in Radiology Departments: Status Quo and Future Perspectives. Fortschr R?ntgenstr 2016; 188: 443???450
Ziel: Ziel dieser Studie war die Implementierung eines Cloud-basierten CT-Dosismonitorings basierend auf dem DICOM-Structured Report (DICOM-SR) zur automatischen Überwachung der Dosisexposition im Hinblick auf die nationalen diagnostischen Referenzwerte (DRW). Material und Methoden: Zur automatischen Erfassung und Überwachung der CT-Dosisdaten wurde eine neuartige, in Kooperation mitentwickelte Software basierend auf dem DICOM-SR eingesetzt. Der DICOM-SR aller CT-Untersuchungen unserer Einrichtung zwischen 09/2011 und 03/2015 wurde automatisch anonymisiert und an einen Cloud-Server verschickt. Die Daten wurden automatisch im Hinblick auf die Körper-region, das Patientenalter und den korrespondierenden DRW für den volumetrischen Computertomografie-Dosis-Index (CTDI vol ) sowie für das Dosis-Längen-Produkt (DLP) analysiert. Ergebnisse: Datensätze von 36 523 CT-Untersuchungen (131 527 Scanserien) von drei verschiedenen CT-Geräten und einem PET-CT wurden analysiert. Insgesamt betrug der mittlere CTDI vol 51,3 % und das mittlere DLP 52,8 % der nationalen DRW. Bezogen auf die nationalen DRW betrugen CTDI vol und DLP für die Abdomen-CT 43,8 % und 43,1 % (n = 10 590), für die Schädel-CT 66,6 % und 69,6 % (n = 16 098) und für die Thorax-CT 37,8 % and 44,0 % (n = 10 387). Insgesamt überschritten 1,9 % der CT-Untersuchungen den CTDI vol und 2,9 % der Untersuchungen das DLP der nationalen DRW. Zwischen unterschiedlichen CT-Protokollen, die dem gleichen nationalen DRW zugeordnet wurden, variierte die Strahlenexposition um bis zu 50 %. Schlussfolgerung: Das implementierte, Cloudbasierte CT-Dosismonitoring basierend auf dem DICOM-SR ermöglicht eine automatische, umfassende Benchmarkanalyse im Hinblick auf die nationalen DRW. Insgesamt betrug die DosisexposiAbstract ! Purpose: To implement automated CT dose data monitoring using the DICOM-Structured Report (DICOM-SR) in order to monitor dose-related CT data in regard to national diagnostic reference levels (DRLs). Materials and Methods: We used a novel in-house co-developed software tool based on the DICOM-SR to automatically monitor dose-related data from CT examinations. The DICOM-SR for each CT examination performed between 09/2011 and 03/2015 was automatically anonymized and sent from the CT scanners to a cloud server. Data was automatically analyzed in accordance with body region, patient age and corresponding DRL for volumetric computed tomography dose index (CTDI vol ) and dose length product (DLP). Results: Data of 36 523 examinations (131 527 scan series) performed on three different CT scanners and one PET/CT were analyzed. The overall mean CTDI vol and DLP were 51.3 % and 52.8 % of the national DRLs, respectively. CTDI vol and DLP reached 43.8 % and 43.1 % for abdominal CT (n = 10 590), 66.6 % and 69.6 % for cranial CT (n = 16 098) and 37.8 % and 44.0 % for chest CT (n = 10 387) of the compared national DRLs, respectively. Overall, the CTDI vol exceeded national DRLs in 1.9 % of the examinations, while the DLP exceeded national DRLs in 2.9 % of the examinations. Betw...
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