Real-Time Patient Radiation Dose Monitoring System Used in a Large University Hospital

Development of minimum data set and dashboard for monitoring adverse events in radiology departments

Background

To reduce the risk of errors, patient safety monitoring in the medical imaging department is crucial. Interventions are required and these can be provided as a framework for documenting, reporting, evaluating, and recognizing events that pose a threat to patient safety. The aim of this study was to develop minimum data set and dashboard for monitoring adverse events in radiology departments.

Material and methods

This developmental research was conducted in multiple phases, including content determination using the Delphi technique; database designing using SQL Server; user interface (UI) building using PHP; and dashboard evaluation in three aspects: the accuracy of calculating; UI requirements; and usability.

Results

This study identified 26 patient safety (PS) performance metrics and 110 PS-related significant data components organized into 14 major groupings as the system contents. The UI was built with three tabs: pre-procedure, intra-procedure, and post-procedure. The evaluation results proved the technical feasibility of the dashboard. Finally, the dashboard's usability was highly rated (76.3 out of 100).

Conclusion

The dashboard can be used to supplement datasets to obtain a more accurate picture of the PS condition and to draw attention to characteristics that professionals might otherwise overlook or undervalue.

Radiation dose management system in computed tomography procedures: a systematic review

A systematic literature review was carried out to explore articles that reported the use of radiation dose management systems (RDMSs) in computed tomography (CT). The preferred reporting items for systematic review and meta-analysis flow chart were used to screen articles in PubMed, EBSCOhost, Web of Science, SCOPUS and Cochrane Library. A total of 1041 articles were retrieved and screened. After evaluation against criteria, 38 articles were selected and synthesised narratively. The results revealed that several RDMSs have been used in CT. The review also indicated that the use of RDMSs has promoted the implementation of diagnostic reference levels for dose optimisation. A RDMS, such as DoseWatch, is associated with compatibility challenges and failure in data transmission, while manual RDMSs are cumbersome and prone to data entry errors. Thus, a robust automated RDMS that is compatible with the different CT systems would provide efficient CT dose management.

Proper Management of the Clinical Exposure Index Based on Body Thickness Using Dose Optimization Tools in Digital Chest Radiography: A Phantom Study

In radiography, the exposure index (EI), as per the International Electrotechnical Commission standard, depends on the incident beam quality and exposure dose to the digital radiography system. Today automatic exposure control (AEC) systems are commonly employed to obtain the optimal image quality. An AEC system can maintain a constant incident exposure dose on the image receptor regardless of the patient thickness. In this study, we investigated the relationship between body thickness, entrance surface dose (ESD), EI, and the exposure indicator (S value) with the aim of using EI as the dose optimization tool in digital chest radiography (posterior-anterior and lateral projection). The exposure condition from the Korean national survey for determining diagnostic reference levels and two digital radiography systems (photostimulable phosphor plate and indirect flat panel detector) were used. As a result, ESD increased as the phantom became thicker with constant exposure indicator, which indicates similar settings to an AEC system, but the EI indicated comparatively constant values without following the tendency of ESD. Therefore, body thickness should be considered under the AEC system for introducing EI as the dose optimization tool in digital chest radiography.

FEASIBILITY OF DISPLAYED EXPOSURE INDEX IN IEC STANDARD FRAMEWORK AS A DOSE OPTIMISATION TOOL FOR DIGITAL RADIOGRAPHY SYSTEMS

International Electrotechnical Commission (IEC) established the framework for the use of exposure index (EI) for evaluating the exposure conditions with various digital systems. In this study, we investigated the feasibility of EI, as per the IEC, by comparing the EIs obtained through manual calculated and that displayed on the console of two computed radiography (CR) and digital radiography (DR) systems with radiation beam qualities of RQA3,5,7 and 9. As a result, both two systems indicated an uncertainty of less than 20% for both calculated and displayed EI with all beam qualities except displayed EI obtained by RQA3. However, the displayed EI values were different even under the same exposure conditions because of the characteristics of the imaging receptor materials, such as BaFI or CsI, of two systems. Therefore, when an operator attempts to introduce displayed EI for managing radiation dose, it is essential to understand the characteristics of the digital system.