Radiation dose tracking in computed tomography: Red alerts and feedback. Implementing a radiation dose alert system in CT

Crowley, Claire; Ekpo, Ernest U.; Carey, Brian W.; Joyce, Stella; Kennedy, Conor; Grey, T.M.; Duffy, Brian C.; Kavanagh, Richard G.; James, Karl; Moloney, Fiachra; Normoyle, B.; Moore, Niamh; Chopra, R; O'Driscoll, Jessica C; McEntee, Mark F.; Maher, Michael M.; Connor, Owen J. O’

doi:10.1016/j.radi.2020.06.004

Cited by 11 publications

(10 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Herein, patient mispositioning “off-center” counted for 30% of the total justification used by our CT radiographers. A similar finding was reported by [ 9 ]. It is well known that patient mispositioning compromises CT tube current modulation function [ 14 ], leading indirectly to increased patient exposure [ 15 ].…”

Section: Discussionsupporting

confidence: 92%

“…While patient size is a mutual finding on both the prospective and retrospective dose management tools, high scan length due to added delay scan or to cover pathology or because of a combined study as well as arms in the field of view were frequently reported in the prospective dose management tool together with technical errors. The justifications reported by our CT radiographers’ using the retrospective (DOET TQM) dose management tool seem to be matching to a certain degree the justification reported by [ 9 ] using their retrospective DoseWatch platform.…”

Section: Resultssupporting

confidence: 80%

“…The explanatory comment is often referred to as diagnosis reason or justification. While valuable, implementation of CT Dose Notification on a CT system console for real-time use is challenging [ 9 ]. More so if a clinic is to utilize both the prospective CT Dose Notification system and a retrospective dose monitoring tool to aid in patient dose optimization.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Challenges Associated with Effective Implementation of CT Dose Check Standards and Radiation Monitoring Index in Computed Tomography: Healthcare Sector Experience

et al. 2022

View full text Add to dashboard Cite

Computed tomography (CT) radiation dose management tools should be used whenever possible, particularly with the increasing demand for acquiring CT studies. Herein, we aim to assess the advantages and challenges faced with implementing two CT dose management tools. A second aim was to highlight CT examinations exceeding dose notification values (NVs) and define the common set of causes. A total of 13,037 CT examinations collected over a six-month period, were evaluated, using two independent CT dose management tools, a CT Dose Notification prospective-view tool (PVT) following CT Dose Check standards and a retrospective statistical-based view tool (RSVT). Dose NVs were set to twice the Local Diagnostic Reference Levels. There was a significant discrepancy between dose NV counts registered with prospective (4.15%) and retrospective (7.98%) tools using T-Test. A core difference is the dose configuration setup, with PVT and RSVT being dose per series and whole study, respectively. Both prospective and retrospective dose management tools were equally useful despite their technical difference. Configuring the CT prospective dose notification check tool using NVs that is based on DRLs has limitations, and one needs to establish dose NVs per series to overcome this technical hurdle. Technical challenges make the implementation of CT Dose Check standards puzzling.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Resultssupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Challenges Associated with Effective Implementation of CT Dose Check Standards and Radiation Monitoring Index in Computed Tomography: Healthcare Sector Experience

et al. 2022

View full text Add to dashboard Cite

show abstract

“…imaging of a wrong body part or imaging the wrong patient). Crowley et al have described the advantages of a radiographer feedback to help in the management of dose alerts [ 23 ].…”

Section: Alerts For Unintended and Accidental Medical Exposuresmentioning

confidence: 99%

Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

et al. 2022

View full text Add to dashboard Cite

The terms “notifications” and “alerts” for medical exposures are used by several national and international organisations. Recommendations for CT scanners have been published by the American Association of Physicists in Medicine. Some interventional radiology societies as well as national authorities have also published dose notifications for fluoroscopy-guided interventional procedures. Notifications and alerts may also be useful for optimisation and to avoid unintended and accidental exposures. The main interest in using these values for high-dose procedures (CT and interventional) is to optimise imaging procedures, reducing the probability of stochastic effects and avoiding tissue reactions. Alerts in X-ray systems may be considered before procedures (as in CT), during procedures (in some interventional radiology systems), and after procedures, when the patient radiation dose results are known and processed. This review summarises the different uses of notifications and alerts to help in optimisation for CT and for fluoroscopy-guided interventional procedures as well as in the analysis of unintended and accidental medical exposures. The paper also includes cautions in setting the alert values and discusses the benefits of using patient dose management systems for the alerts, their registry and follow-up, and the differences between notifications, alerts, and trigger levels for individual procedures and the terms used for the collective approach, such as diagnostic reference levels. Key Points • Notifications and alerts on patient dose values for computed tomography (CT) and fluoroscopy-guided interventional procedures (FGIP) allow to improve radiation safety and contribute to the avoidance of radiation injuries and unintended and accidental exposures. • Alerts may be established before the imaging procedures (as in CT) or during and after the procedures as for FGIP. • Dose management systems should include notifications and alerts and their registry for the hospital quality programmes.

show abstract

“…These tools allowed us to monitor these values during a preselected period, which can help to identify changes in the scanning protocols. They allowed, as well, the export of data for further processing by means of analysis software (Crowley et al 2020).…”

Section: Data Collection and Validationmentioning

confidence: 99%

Dose-Tracking Software: A Retrospective Analysis of Dosimetric Data in CT Procedures

Buono

Capussela²,

Loffredo

et al. 2022

Health Physics

View full text Add to dashboard Cite

The increasing use of ionizing radiation in healthcare is causing growing alarm about radiation protection of patients and the doses they receive during procedures. Radiation dose assessment for patients in radiodiagnostic procedures is the subject of interest in view of the recent Italian D.Lgs 31 July 2020, n. 101 (Decreto Legislativo 31 luglio 2020, n. 101) and one of its most important focuses is the prescription to provide patient exposure information as an integral part of the examination report. Dose monitoring systems are therefore essential for the collection of the dosimetric data. In order to analyse potential and critical issues of these software, different systems, adopted at the Antonio Cardarelli Hospital in Naples, were employed. Data extracted from the DoseWatch software (GE Healthcare) and Gray Detector (EL.CO. S.r.l. Healthcare Solutions, Italy) and relating to several protocols adopted for computed tomography (CT), were retrospectively analysed for the purpose of identifying critical issues in the data acquisition and recording phase, comparing with Italian nationwide diagnostic reference levels (DRLs), as provided for in regulatory provisions for radiation safety. Multiphase examinations were also included in this study. Once the distributions of volumetric CT Dose Index (CTDI vol ) and dose-length product (DLP) were determined for each acquisition phase and total DLP (DLP tot ) for each examination, the 25 th , 50 th and 75 th percentiles were calculated for each distribution and then compared with the relevant Italian nationwide DRLs. In addition, to improve protocol optimization and dose reduction the magnitude of the CT acquisition settings chosen in each procedure was evaluated. In conclusion, these systems allow accurate analysis of radiation dose according to equipment and protocol over time. For the application of optimization measures, a constant use of the dose tracking software is required, which can be translated into actions on scan parameters and prospective data analysis. Health Phys. 122(4):548-555; 2022

show abstract

Radiation dose tracking in computed tomography: Red alerts and feedback. Implementing a radiation dose alert system in CT

Cited by 11 publications

References 15 publications

Challenges Associated with Effective Implementation of CT Dose Check Standards and Radiation Monitoring Index in Computed Tomography: Healthcare Sector Experience

Challenges Associated with Effective Implementation of CT Dose Check Standards and Radiation Monitoring Index in Computed Tomography: Healthcare Sector Experience

Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

Dose-Tracking Software: A Retrospective Analysis of Dosimetric Data in CT Procedures

Contact Info

Product

Resources

About