Safety Corner, v1.3
Radiation Dose Monitoring
Radiation Safety and Patient Radiation Dose are of paramount importance to the Department of Radiology and Medical Imaging at the University of Virginia Health System. Recently, the Federal Drug Administration (FDA) adopted an initiative on several fronts to assure that there is a consistent process for Diagnostic Imaging to be universally safer for all of patients. Furthermore, the FDA set forth regulations that require imaging equipment vendors to adopt safeguards to prevent patients from receiving an unusually high radiation dose. Many equipment vendors have developed and installed Dose Alerting features on Computed Tomography (CT) scanners and Angiographic Imaging Equipment. These tools are for instantaneous feedback to the Radiologists and Radiology Technologists to make them aware of possible unsafe conditions at the time of the radiation dose delivery. However, systematic and statistically relevant radiation exposure data still needs to be acquired to reduce the overall risk and burden on the entire population. Furthermore, while many of the scanners can now compute a “dose”, the imaging equipment is not an optimal place to keep this information and a central repository is needed.
These tools are for instantaneous feedback to the Radiologists and Radiology Technologists to make them aware of possible unsafe conditions at the time of the radiation dose delivery.
Even the International Atomic Energy Agency (IAEA) has introduced the concept of the “Smart Card” which is similar to a credit card that stores personal radiation dose information for the purposes of tracking. A search of the internet turns up web-based radiation risk tracking calculators, or even smart phone “apps” that record your radiation “dose”. Some of these programs are good, while others may deter a patient into refusing a necessary imaging exam. Therefore, these radiation values are best dealt with by systems and trained personnel who understand the implications of this complex data and can provide proper guidance through discussion with their patients.
The predicted risk of mortality (i.e. “death”) from cancer as a result of the radiation from a CT scan was predicted to be 0.1% in a recent study. This study brings to light the low “risk” of radiation induced cancer- and how low it is for a single CT study compared with other potential causes of mortality (e.g. Heart Disease, Accidents, etc.) that ranged from 5-7% during the same period of time. Nevertheless, we intend to track these quantities of radiation so that we are more aware of the amount of radiation we are delivering to our patients and continually work to improve the quality of our studies with lower radiation dose. The best study is the one that answers the medical question at hand while using the least amount of radiation.
The University of Virginia Health System has purchased a Radiation Dose Monitoring System to better monitor radiation dose across the Health System. The new system will become the backbone of Quality Control for the Radiation used in procedures and imaging exams and will provide a mechanism to more closely monitor cumulative patient exposures. This information will be readily available to health care providers and their patients as they consider the most effective and safest diagnostic and treatment plan.