Author: mh/ktg

Related content: Knowledge, CT, Workflow

Targeted Education instead of Big Brother

Dose tracking facilitates radiographers’ daily routine and allows specific staff education on dose issues.

Session Topic: EU 4 European CT dose repository
Session Date: Friday, March 3rd 2017
Presentation Code: A-474
Presentation Title: How do dose tracking tools change the practice of radiographers?
Name of Speaker: Shane Foley; University College Dublin/Ireland
Congress: ECR 2017, Vienna

“Dose tracking systems are still quite in their infancy,” said Shane Foley, University College Dublin. A sample of ten pediatric centers in Europe showed that only four of them have a dose tracking (DT) system installed – and only one center uses it to optimize their CT protocols. Foley outlined the impact and benefits of DT for radiographers in their daily routine.

Protocol optimization

CT scanners often have more than 200 different protocols stored. Many of these protocols are pre-set and run automatically. The big variety is difficult to track manually, said Foley. DT allows systematic reviewing of existing CT protocols: Which are the most frequently used ones, and are they used appropriately? “This is really useful to educate the staff,” he said.

DT automatically identifies ‘dose outliers’ – that is CT examination exceeding or undercutting appropriate dose values – and can stratify by scanner, by examination type, by radiographer, or by day/time. “This sounds a bit like a Big Brother situation,” said Foley. “But it actually allows targeted education if needed.”

Dose Reference Levels – DRL

DT tools automatically collect dose data for all CT examinations. The collected information can easily be analyzed by patient characteristics like sex, age or body weight. This allows creating own local DRLs that should be reviewed every year, as Foley recommended, whereas national DRLs deserved an update maybe every five years.

Real-time dose monitoring

Real-time notifications about dose outliers may pop-up directly on screen in the examination room. This increases the radiographers’ awareness for dose issues, but a fatigue must be avoided: “If there are too many dose alerts, the staff might just click them away,” explained Foley. Customizing dose alerts by adjusting them to patient size reduces the frequency of alerts. Radiographers may easily insert the reason for a dose outlier, for example by an easy-to-use drop-down menu.

Risk-benefit communication

“Having dose tracking available, the dose issue gets more visible to people,” said Foley. “There is a lack of knowledge among all medical professions.” Dose data assists with informal consent and helps identifying high-risk patients.

Equipment issues

Benchmarking scanners becomes easy with a DT system. Comparing different scanners for the same procedure clearly identifies those machines that are working on lowest average dose. When this is known, patients with increased radiation risk may be directed to a dedicated low-dose scanner. Scanner benchmarking also helps to identify equipment issues early and to make decisions about scanner repair or exchange.