I think in NHS we need a consistent approach of recording, monitoring & comparing radiation exposure to patients from Radiology modalities--CT, CR/DR, Flouroscopy, Angiography etc
I do believe that REM profile adoption by modality & PACS vendors are key to this concept. I believe that we may need "black boxes" to support legacy modalities until such time that all modalities adopt REM.
In future: 1. Modalities will create and transmit DICOM dose objects.(Acquisition Modality Actor for REM profile) 2. PACS systems will store and manage DICOM dose objects. (Image Manager/Archive Actor for REM profile) 3. Dose Reporting Systems --which may be part of a PACS solution or independent system but able extract information from a PACS which is REM compliant--.(Dose Reporter Actor for REM profile) 4. National or regional repositories may receive dose objects submitted by dose reporting systems.(Dose Registry Actor for REM profile)
27th April Meeting will define the direction for NHS/global direction for Radiation Dose Monitoring with some very high profile speakers discussing this issue.
SESSION 2: Moderator— Mr. Richard Bulmer (Group Secretary) Dr. William Saywell (Treasurer) 10.50 National Radiation Dose Monitoring Requirements—Mr. Niall Monaghan (Radiation Protection Advisor) 11.10 Automated recording of radiation dose from modalities—Dr. David Clunie (IHE) 11.30 Role of PACS in radiation dose monitoring--Professor Mats Nilsson, Medical Radiation Physics Skane University Hospital, Sweden (Speaker Sponsored by Sectra) 11.50 REM Profile(IHE) for populating a national dose Registry—Mr. Steve Massey--PACSHealth
National CT dose comparison is now becoming a a trend globally (Sweden, Ireland, US etc). I understand there are discussions going on in UK too about a national dose registry. Mr. Niall Monaghan will discuss this on 27th April. It is important that we recognise that dose data can be automatically populated from modalities(without manual dose information population by radiographers)--Dr. David Clunie & Prof Mats Nilsson will discuss how this can be done. Mr. Steve Massey will talk about the importance of REM profile of IHE is building a national dose registry.
Trusts need to future proof their investments: 1. Modalities MUST support REM profile 2. 2013-15 PACS replacements MUST support REM profile--as Image Managers 3. If and when HPA acquires a national dose registry then --Trusts can simply buy a Dose Information Reporter to extract the dose information from the REM compliant PACS.
Here is my recent column in Auntminnie on the issue of radiation dose monitoring, as I believe that this is a global issue can can be resolved with global approach to standards. I am grateful to our 4 speakers at the Spring meeting who provided the global direction to standards.
posted on Wednesday, June 06, 2012 - 01:20 pm
Ian Chell at the Department of Health (Health Protection) convened a working party last year to look at several topics including digital dose data and dose analysis and reporting systems.
The working party has now completed an information paper which I have attached here.
The working party included representatives from the BIR/RCR radiation protection committee, the diagnostic radiology and radiation protection SIGs of the IPEM, the SRP, the SoR and IHE UK.
There are two key recommendations included in this paper, which are:
Key recommendation 1: Ensure that any new X-ray/CT equipment, PACS or dose analysis system meets interoperability standards so that digital dose data can be collated on a local, regional or national basis in order to assist optimisation.
Key recommendation 2: That the clinical and scientific validity of some of the features on offer are examined before implementation.
For more information please read the attached paper.
"If buying a PACS Ensure that the PACS conforms to the IHE Radiation Exposure Monitoring (REM) integration profile as an Image Manager/Archive (in addition to acting as an Image Manager/Archive in any other profiles).
If buying an X-ray or CT modality Ensure that the X-ray or CT modality conforms to the IHE REM integration profile as an Acquisition Modality.
If buying a dose analysis and reporting system Ensure that the system conforms to the IHE REM integration profile as a Dose Information Consumer and a Dose Information Reporter. "
Clear support for REM profile of IHE has been identified in the paper. This will automate & standardise dose recording in the NHS. This also provide clear direction to modality & PACS vendors about the direction for R&D.