Bayer HealthCare’s Radimetrics enterprise platform, which monitors radiation dose and contrast media dose, is transforming radiology departments. Medical Imaging Technology explores the radiation dose management aspect with one of its users, Professor Michael Forsting, director of the Institute of Diagnostic and Interventional Radiology and Neuroradiology at University Hospital Essen.

Managing radiation doses is something of a balancing act. Reducing the dose to zero may sound beneficial, but, without at least some exposure, no image could be produced. At the same time, too much radiation compromises patient safety by exposing people to dangerous X-ray beams.

"The secret behind everything is to find the lowest radiation dose delivering the best quality of imaging you need to perform diagnostic work," says Professor Michael Forsting, director of the Institute of Diagnostic and Interventional Radiology and Neuroradiology at University Hospital Essen, Germany.

The dangers of radiation have been known for as long as physicians have been using CT scans. But getting the balance right has become more important than ever. In 2007, researchers at the US National Cancer Institute calculated that almost 30,000 future cancer cases might be caused by CT scans. In an age where patients are increasingly conscious of medical procedures and their possible side-effects, these concerns need addressing.

Dose management with Radimetrics

"Patient awareness is dramatically increasing," Forsting says. "So we think it’s absolutely necessary to monitor radiation doses. Each day, our task is to reduce that dose and optimise our scanning protocols."

Without a tool that allows radiologists to track individual doses across different patients, protocols and scanners, this task is almost impossible. But the introduction of the Radimetrics enterprise platform, a dose management system from Bayer HealthCare, has made these comparisons achievable with the click of a mouse.

"The Radimetrics software is the only software I know that allows us to do this very easily," Forsting says. "We can now create certain sheets with certain protocols that allow us to see when the radiation exceeds certain limits, or if there’s been a protocol violation. Physical implementation of the technology is done by the company and is integrated in our quality management system. You don’t need special IT expertise to implement it, and using it is extremely easy."

Important findings

According to Forsting, the software has produced plenty of interesting results.

"What we learned first was that, depending on the CT scanner you use, even if you use exactly the same protocol, you can deliver different radiation doses," he says. "This means we have certain scanners that are performing at low radiation-dose level and others using higher radiation to get the same quality of images.

"The second thing we learned is that even if you have a really sophisticated quality management system and really sophisticated protocols, sometimes these protocols are not used. During the same scan on different patients, you suddenly learn that radiation doses differ."

These are important findings. By seeing the various mistakes that occur, radiology departments can eliminate protocol violations and continue to improve the quality of their service. And the opportunities are truly global.

"The next step, if you optimise your protocols in your department, is to define benchmarks beyond your own site," Forsting says. "My next goal would be to compare different sites, CT scanners and protocols around the world to determine what the right benchmark is. This software means we can have certain groups working together around the globe to reduce radiation down to the lowest level."