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Radiation Dose Tracking in Interventional Radiology: Challenges and Solutions

M Bostani*, T Oshiro , C Cagnon , M McNitt-Gray , David Geffen School of Medicine at UCLA, Los Angeles, CA


(Sunday, 7/29/2018) 3:00 PM - 6:00 PM

Room: Exhibit Hall

Purpose: In this work we describe challenges implementing a commercially available dose management software system for tracking doses from interventional radiology and cardiovascular procedures.

Methods: Specific data elements collected and tracked from fluoroscopy devices were: cumulative air-kerma, dose-area-product, and exposure time. Federal regulation requires dose data to be available for all units manufactured after 2006. Our project included six Philips, three Siemens and five GE interventional x-ray systems in Radiology and Cardiology, pushing dose data to Radimetrics (Bayer) dose management software. Though Radiation Dose Structured Report (RDSR) is the latest data format, preferred over data mining methods such as Optical Character Recognition (OCR), or extraction of DICOM header data elements, all three methods were necessary to accommodate the range of interventional equipment and Radimetrics capabilities.

Results: Specific challenges included systems not capable of RDSR or RDSR with missing data elements. Newly upgraded RDSR capable Philips systems had data field conflicts with Radimetrics RDSR requirements necessitating retrieval of study images from PACS to identify sending system. Siemens systems were not RDSR compatible but Radimetrics was used to retrieve dose data from PACS using OCR. Our GE systems generated neither RDSR, nor PACS dose reports, however, Radimetrics was able to extract dose information from image DICOM headers.

Conclusion: Despite industry attempts to standardize dose data formats across different X-Ray makes and models, our experience indicates there is more work to be done for practical plug-and-play dose data harmonization and compatibility. Current state of the art requires customized solutions using a variety of data formats. Experience in resolving data compatibility issues is an essential requirement that may be lacking in dose software vendors. Medical Physicists with a working knowledge of dose metrics, PACS, and RDSR can be invaluable in the implementation and validation processes.

Funding Support, Disclosures, and Conflict of Interest: Michael McNitt-Gray, Ph.D Departmental master research agreement, Siemens Health


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