Patient Dose Management Solution Directly Integrated in the RIS: “Gray Detector” Software

Nitrosi, Andrea; Corazza, Andrea; Bertolini, Marco; Sghedoni, Roberto; Pattacini, Pierpaolo; Iori, Mauro

doi:10.1007/s10278-014-9715-y

Cited by 7 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The automated outlier detection procedure may also be implemented in a Radiology Information Systems (RIS) which is often used in conjunction with a Picture Archiving and Communication System (PACS). Such platforms have rudimentary CT dose monitoring modules that allow for computation of simple averages (e.g., of DLP) [24]. One could envision incorporating into these modules our outlier detection algorithm.…”

Section: Resultsmentioning

confidence: 99%

Detection of unwarranted CT radiation exposure from patient and imaging protocol meta-data using regularized regression

Chen

Paschalidis

Hatabu

et al. 2019

European Journal of Radiology Open

View full text Add to dashboard Cite

Background Variability in radiation exposure from CT scans can be appropriate and driven by patient features such as body habitus. Quantitative analysis may be performed to discover instances of unwarranted radiation exposure and to reduce the probability of such occurrences in future patient visits. No universal process to perform identification of outliers is widely available, and access to expertise and resources is variable. Objective The goal of this study is to develop an automated outlier detection procedure to identify all scans with an unanticipated high radiation exposure, given the characteristics of the patient and the type of the exam. Materials and methods This Institutional Review Board-approved retrospective cohort study was conducted from June 30, 2012 - December 31, 2013 in a quaternary academic medical center. The de-identified dataset contained 28 fields for 189,959 CT exams. We applied the variable selection method Least Absolute Shrinkage and Selection Operator (LASSO) to select important variables for predicting CT radiation dose. We then employed a regression approach that is robust to outliers, to learn from data a predictive model of CT radiation doses given important variables identified by LASSO. Patient visits whose predicted radiation dose was statistically different from the radiation dose actually received were identified as outliers. Results Our methodology identified 1% of CT exams as outliers. The top-5 predictors discovered by LASSO and strongly correlated with radiation dose were Tube Current, kVp, Weight, Width of collimator, and Reference milliampere-seconds. A human expert validation of the outlier detection algorithm has yielded specificity of 0.85 [95% CI 0.78-0.92] and sensitivity of 0.91 [95% CI 0.85-0.97] (PPV = 0.84, NPV = 0.92). These values substantially outperform alternative methods we tested (F1 score 0.88 for our method against 0.51 for the alternatives). Conclusion The study developed and tested a novel, automated method for processing CT scanner meta-data to identify CT exams where patients received an unwarranted amount of radiation. Radiation safety and protocol review committees may use this technique to uncover systemic issues and reduce future incidents.

show abstract

Section: Resultsmentioning

confidence: 99%

Detection of unwarranted CT radiation exposure from patient and imaging protocol meta-data using regularized regression

Chen

Paschalidis

Hatabu

et al. 2019

European Journal of Radiology Open

View full text Add to dashboard Cite

show abstract

“…DICOM tag data of each image was found on a Centricity CA1000 workstation (GE Medical Systems, Milwaukee, US). Tag 0018,115E revealed the information for DAP as well as tube voltage, tube current, radiation time, and distance from the source to the detector ( Figure 1 ) ( 8 ).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the Patient Effective Dose in Whole Spine Scanography Based on the Automatic Image Pasting Method for Digital Radiography

et al. 2016

View full text Add to dashboard Cite

Background:Whole spine scanography (WSS) is a radiologic examination that requires whole body X-ray exposure. Consequently, the amount of patient radiation exposure is higher than the radiation dose following routine X-ray examination.Objectives:Several studies have evaluated the patient effective dose (ED) following single exposure film-screen WSS. The objective of this study was to evaluate patient ED during WSS, based on the automatic image pasting method for multiple exposure digital radiography (APMDR). Further, the calculated EDs were compared with the results of previous studies involving single exposure film-screen WSS.Patients and Methods:We evaluated the ED of 50 consecutive patients (M:F = 28:22) who underwent WSS using APMDR. The anterior-posterior (AP) and lateral (LAT) projection EDs were evaluated based on the Monte Carlo simulation.Results:Using APMDR, the mean number of exposures was 6.1 for AP and 6.5 for LAT projections. LAT projections required more exposures (6.55%) than AP projections. The mean ED was 0.6276 mSv (AP) and 0.6716 mSv (LAT). The mean ED for LAT projections was 0.6061 mSv in automatic exposure control (AEC) and 0.7694 mSv in manual mode. The relationship between dose-area-product (DAP) and ED revealed a proportional correlation (AP, R2 = 0.943; LAT, R2 = 0.773). Compared to prior research involving single exposure screen-film WSS, the patient ED following WSS using APMDR was lower on AP than on LAT projections.Conclusion:Despite multiple exposures, ED control is more effective if WSS is performed using APMDR in the AEC mode.

show abstract

“…The RIS is a database used by radiologists to create and store a patient's medical data (Nitrosi et. al., 2014).…”

Section: Radiology Information Systemmentioning

confidence: 99%

Development of A Modified List for Standardized Study Descriptions in The Implementation of Dose Management Systems in Radiology

Alsofi¹,

Fiebich²

2020

juod

View full text Add to dashboard Cite

Diagnostic Radiology is an important field in medicine used as a diagnostic tool for diseases and injuries evaluation. However, exposure to high radiation doses could have negative impact on someone's health, therefore a dose management solution is needed to organize and coordinate the patient dose values. It is crucial to present the role of standardization study descriptions in the implementation of dose management systems in radiology. RadLex Playbook is one of the standardization study descriptions. With over 1000 CT scans the implementation of the mapping structure is very complicated. Therefore, a modified version is needed to reduce the number of examinations due to its possible problems through data mapping by suggesting a new list called "a reduced and embedded RadLex Playbook". To achieve this, three major systems were investigated. RIS (which was obtained from a German institute), DRL (using the German standardized study description) and RadLex Playbook. These systems were suggested to develop a strategy for data mapping and radiology procedure coded in different institutions. Direct mapping between RIS and DRL works only on specific institutionalized cases, therefore RadLex will act as an intermedium in between. Because RadLex has too many study descriptions, the suggested reduced list may help.

show abstract

Patient Dose Management Solution Directly Integrated in the RIS: “Gray Detector” Software

Cited by 7 publications

References 10 publications

Detection of unwarranted CT radiation exposure from patient and imaging protocol meta-data using regularized regression

Detection of unwarranted CT radiation exposure from patient and imaging protocol meta-data using regularized regression

Evaluation of the Patient Effective Dose in Whole Spine Scanography Based on the Automatic Image Pasting Method for Digital Radiography

Development of A Modified List for Standardized Study Descriptions in The Implementation of Dose Management Systems in Radiology

Contact Info

Product

Resources

About