AJR: Researchers develop automated dose index reporting application
Researchers have created a dose index reporting application (DIRA) for CT studies that extracts dose information, can be integrated with any existing CT scanner and may eventually lead to automated quality control to improve patient safety, according to a study published in the November issue of the American Journal of Roentgenology.

George Shih, MD, of the department of radiology at Weill Cornell Medical Center in New York City, and colleagues wanted to test whether the DIRA system could help improve the cumbersome process of tracking CT dose index (CTDI) with manufacturer-generated screen captures.

They developed DIRA using a Linux server running customized software that automatically extracts information from the image of the CTDI report, converting it to an easily processed numeric form and then correcting for patient size.

A random group of 518 CTDI reports were processed by DIRA, which had 100 percent accuracy in extracting dose index information.

“This system greatly facilitates digital dose index reporting and makes it possible to provide a longitudinal record of the healthcare radiation exposure estimate in an individual patient’s health record,” wrote the authors.

While they noted that no studies have definitively implicated CT in cancer-related deaths, the authors pointed to studies showing increased overall cancer risk associated with CT and said estimates are that up to 1.5 to 2 percent of all current cancers in the U.S. may be attributed to CT studies.

Because of these risks, identifying trends in CT radiation exposure is important, but difficult because of the nature of tracking the CTDI.

The results of the study show DIRA is useful in this process, and the researchers’ short-term goal is to use it to promote radiation safety awareness.

“Our long-term goal is to provide patients with a longitudinal record of their healthcare-related radiation exposure estimates,” wrote the authors. “Studies about radiation-induced cancer have been performed and some researchers believe that the effects of radiation may be cumulative throughout a patient’s lifetime.”

The study team is now working on an automated quality control module to catch inappropriate protocols or detect system errors. “Automated quality control will likely become extremely important when more quality and pay-for-performance measures are used for reimbursement,” they wrote. “Indeed, the Centers for Medicare & Medicaid Services has already instituted a Physician Quality Reporting System reporting of radiation exposure or exposure time during radiology fluoroscopy procedures. Such measures may eventually be extended to include CT and other diagnostic imaging studies with ionizing radiation.”