Cloud-Based CT Dose Monitoring using the DICOM-Structured Report: Fully Automated Analysis in Regard to National Diagnostic Reference Levels

Abstract

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...

The evolution of radiation dose over time: Measurement of a patient cohort undergoing whole-body examinations on three computer tomography generations

“…Only a few studies have used similar approaches to assess data from a large database, showing a promising and easy to use tool for audit and dose optimization purposes [20,21]. Boos et al processed and analyzed 36,523 acquisitions using a cloud-based system, showing a local radiation saving of 50%, when compared to the national diagnostic reference level, showing the same trend as in our study [22]. Another large cohort study by MacGregor et al with 36,996 examinations, showed a CTDI vol reduction of 22% over a period of 3 years [23].…”

Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know

“…This goal can only be achieved if the interventionalist is capable of identifying high-dose procedures and is attentive to individual risk factors in patients [62–65]. As mentioned before, a high body mass index (BMI) and previous radiation exposures are among the most important individual risk factors of patients.…”

“…Thus, high-dose procedures are uncommon in routine practice, but do occur in complex endovascular procedures. The interventionalist has, therefore, to be aware of dose monitoring tools which nowadays are an integral part of modern angiographic equipment [5, 63, 65–68]. In state-of-the-art angiographic equipment, the interventionalist gets real-time information on dose in terms of the following parameters: KERMA at reference point ( K ref ), KERMA area product (KAP) and fluoroscopy time.…”

Q-Bot: automatic DICOM metadata monitoring for the next level of quality management in nuclear medicine

“…Several applications have recently been developed that allows for monitoring and retrieving DICOM header information, which makes it possible to generate statistics related to a specific modality or generic features in a modality-independent way [19][20][21][22]. Moreover, radiation exposure monitoring of patients using DICOM information was also introduced [23][24][25][26] including the possibility to detect irregular radiation doses in the case of CT and digital coronary angiography (DCA) procedures. In addition, highlighted DICOM metadata elements are recommended to be monitored regularly to verify the appropriate use of SUV as an imaging biomarker when considering a successful multicenter PET/CT study [27].…”