Daniel L. Rubin MD, Presenter: Research grant, General Electric Company

Dominik Fleischmann MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bracco Group Research support, General Electric Company

Vijaykalyan Yeluri MS, Abstract Co-Author: Employee, General Electric Company

Perry Frederick PhD, Abstract Co-Author: Employee, General Electric Company

Robert J. Herfkens MD, Abstract Co-Author: Nothing to Disclose

We have developed an approach to real-time CT dose monitoring and reporting, with code to extract dose information, a database of patient doses, and report generation modules. While our current approach requires systems to produce Dose SR objects, this is an emerging DICOM standard that is expected to soon gain wider adoption in all vendor systems. Other institutions could implement similar approaches.

Given the recent high-profile cases of excessive radiation exposure to patients undergoing diagnostic imaging, it is crucial that institutions begin monitoring the radiation dose from their imaging equipment. We developed an approach to real-time monitoring and reporting of CT radiation dose.

Our CT scanner (Discovery CT 750 HD; GE medical systems) was adapted to output patient dose information as DICOM SR objects (“Dose SR”). We developed a utility in Java that extracts the dose values, the exam procedure, and patient information from the SR objects and stores them in a local database. We set up a Linux server to receive, store, and generate reports from the dose information extracted from Dose SR. We developed a utility to query the dose database to mine it for trends in dose in populations and in individual patients. We confirmed the accuracy of dose recording and reporting using a sample data that we obtained from the vendor.

Our system permits continuous monitoring of our CT equipment and is crucial to our patient safety program. Our system will also facilitate data sharing with national dose registries. It is our hope that similar approaches will be deployed nationally. One limitation is that our approach requires that the scanner outputs the information in Dose SR objects. Many older scanners only output dose information on secondary capture images, requiring optical character recognition (OCR) to extract dose information. This may not be completely reliable and should be validated before being adopted.

Rubin, D, Fleischmann, D, Yeluri, V, Frederick, P, Herfkens, R, Toward Real-time Monitoring for Patient Safety: Recording, Extracting, and Reporting CT Radiation Dose Using New DICOM Standards.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009550.html