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Can Data and Analytics Help Lower Radiation Dose?

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As more hospitals adopt DoseWatch to manage dose levels, GE Healthcare’s radiation management solution is seen as the optimum means to reduce patient exposure to radiation

Monitoring the exposure of hospital patients to ionizing radiation from medical imaging procedures is becoming a huge focus for Professor Casselman, Chairman of Radiology in St John’s Hospital, Bruges, Belgium.

“For me it’s about ethics. If we are giving patients a higher dose than is needed we are not doing our jobs properly” says Professor Casselman, who has held his current role since 2004 at St John’s Hospital, one of the largest in Belgium, which two months ago began using ‘DoseWatch’, GE’s dose management system.

“We have 930 beds in the main hospital and another 410 at two other sites– that’s a lot of patients. Controlling dose levels for those patients undergoing X-ray or CT exams is a huge responsibility, not least because they are increasingly asking us – just how much risk is there to me from radiation from this scan? In addition, the official Belgian radiation safety regulator is more and more specific with the information it needs.”

 

Why is dose necessary?

X-rays, a form of ionizing radiation, allowed us to see inside the human body without invasive surgery for the first time. CT scans – essentially a series of x-rays, reconstructed into detailed images of the anatomy, are commonplace procedures in hospitals all over the world. Both though, expose patients to low levels of radiation.

Radiation dose becomes part of a trade-off for physicians with regard to image quality. Higher radiation should lead to a clearer image, which can lead to a more confident diagnosis. A very low dose, meanwhile, may provide insufficient image quality to make a diagnosis, so striking the right balance between dose and image quality is important.

 

How dangerous is dose from medical imaging?

The question of risk from radiation exposure is much debated. Most of the existing data regarding cancer risk from radiation is based on exceptionally high doses, in atomic bomb survivors for example, where research has shown with some certainty that high doses of radiation do lead to increased risks of cancer.*

Some scientists believe that if this information is extrapolated down to the much lower doses given in a typical diagnostic x-ray exam, there is still a small risk.** Of course, any discussion of potential risks needs to be balanced against the benefits of diagnostics, in terms of the value of medical imaging to inform clinical diagnoses and treatment, the benefit to patients of enabling choices about long term health, and the sense of patient satisfaction generated by a clinical diagnosis.

Professor Casselman points out “With medical imaging we’re talking about very low levels of radiation, but no amount of radiation exposure is considered to be without risk. Imagine if a patient needs numerous diagnostic tests over a period of time, for example for a cancer patient, particularly a young one, the cumulative exposure may raise the level of risk. 

“Many physicians are taught to follow the ALARA principle – as low a dose as reasonably achievable – but up to now there has not been an effective hospital wide system to keep dose under control. DoseWatch*** is changing all that for us.” 

 

What is Dosewatch?

DoseWatch retrieves, tracks, and reports the radiation dose administered to patients during medical exams and automatically organizes the data for hospital leaders so they can easily and effectively monitor dose provision in their institution.

The system collects data in different ways – by imaging device, by the individual operator or by protocol, so it can compare and contrast the dose being administered in one exam to another from the past.

For Professor Casselman: “This means we can manage dose levels much more carefully than ever before. The system will email me when the dose exceeds a defined threshold for a specific exam, which means we know when there’s an ‘outlier’ – for example if unnecessary dose has been administered – so we can find out why, and make sure it’s corrected moving forward. 

“Imagine maybe if an x-ray is looking at two different parts of the body. Is the radiographer keeping his/her finger on the button as the x-ray tube moves from one part of the anatomy to the other? If so the patient is being exposed unnecessarily. This system will alert us to that, and we can put a stop to it”.

Agnes Berzsenyi from GE Healthcare explains: “DoseWatch is built on the principle that medical decisions should be informed by the best available data. This system allows healthcare providers to improve dose management holistically and over time by tracking and archiving their dosimetric data. Ultimately they can use the data to improve patient care by determining potential behavioural or systemic changes to how dose is managed at their institution. 

Professor Casselman concludes: “This is leagues ahead of other dose management solutions. It’s automatic, it doesn’t rely on our nurses having to manually record dose levels for each exam, it means we can help reduce errors and it allows us to constantly improve dose management for patients at St John’s.”

DoseWatch aligns with GE’s broader ‘Industrial Internet’ strategy, which aims to keep its industrial products relevant in a digital age.

The integration of complex physical machinery with networked sensors and software characterizes the Industrial Internet as it draws together fields such as machine learning, big data, the Internet of things and machine-to-machine communication to ingest data from machines, analyze it (often in real-time), and use it to adjust operations.

GE Healthcare has invested $2 billion over the next five years to improve operational and clinical processes in the healthcare industry. St John’s Hospital, the 100th customer to install DoseWatch globally, is a real-life example of the Industrial Internet in motion. 

There are now close to 200 DoseWatch installations in hospitals and clinics around the world.

 

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* – Radiation Effects Research Foundation
** – Health Physics Society

*** – Trademark of General Electric Company

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The Discovery CT750 HD offers both high image quality and multiple dose reduction features on one platform. It is able to perform both generalized and specialized clinical applications