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The Culture of Dose

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Participants at the annual UKRC conference.

When it comes to medical imaging, dose management is key. Success lies in many different elements, from medical physics to oncology, working well together.

X-rays, a form of ionizing radiation, allow physicians to see inside the human body without invasive surgery. Computed tomography (CT) scans – essentially a series of x-rays, reconstructed into detailed images of the anatomy – are commonplace procedures in hospitals all over the world. Patients undergoing these procedures are exposed to low levels of radiation.

Managing the dose of radiation a patient is exposed to becomes part of a trade-off for physicians with regard to image quality. Higher radiation leads to a clearer image, which could in turn lead to a more confident diagnosis. A very low dose, meanwhile, may be insufficient. Striking the balance between dose and quality has therefore become an important part of a patient’s treatment plan.

It is commonplace for physicians to follow the ALARA principle – As Low As Reasonably Achievable – when imaging patients, but more can be done to optimize the dose-quality balance in the hospital.

According to Dawn Phillips, Radiation Dose Management leader at GE Healthcare, good dose management comes from strong leadership. “Good dose management comes from teams having access to the latest training and the time to be able to implement the best for the patient,” she said. “Backing for that time and training comes from leaders being supportive and understanding that an organization cannot be the best at this unless it gives its staff the opportunity to refresh their skills, think about what works and implement it.”

The data now being harvested from medical imaging scanners is changing the way doctors and healthcare professionals work. The radiation emitted by X-ray and CT scanners is now being quantified. This is where efficient radiation dose management comes into play and can make all the difference. By carefully looking at the dose of radiation a patient has been exposed to, doctors can manage dose and maximize the benefits they receive from treatment.

But effectively managing radiation dose requires more than expertise. Hospitals are now tuning in to the fact that dose management is an important part of any imaging plan, and are devoting medical physics teams to the task. A medical physics team is a hospital’s front line when managing the hospital machinery that emits radiation. A strong in-house team gives any hospital the edge, in comparison to a team that works from the outside. They will know the hospital inside out and understand the challenges their colleagues face when managing different doses for different patients.

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Alison Maw, Directorate Manager, Clinical Radiology, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary: “A dose management strategy should be led by a team. It is a multidisciplinary activity. The experience of medical physicists, radiographers and radiologists in a hospital should be combined to develop the best solution for patient safety.”

In addition the team can be adapted to include different specialists including, for example, cardiologists for a cath lab.

At UKRC 2015 at the ACC in Liverpool, UK on the 29th June, GE Healthcare hosted a seminar to discuss what feeds into a system that gives the best patient outcomes. See what was discussed here.

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