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I want YOU to lower the dose!

by Lisa Chamoff, Contributing Reporter | October 22, 2014
From the September 2014 issue of HealthCare Business News magazine


The registry launched in May 2011. As of the end of June, 642 facilities have contributed data on 10.9 million exams.

Aharon of Medic Vision says it’s disappointing that the new regulations are related only to reporting dose levels, not setting specific targets for lowering dose. In Israel, where Medic Vision is based, there are guidelines for radiation levels and 80 percent of the scanners are already equipped with dose reduction capabilities.

“I think the authorities are missing the point, because eventually what you want to get is a low dose scan, not just the reporting of it,” Aharon says. “I think that regulations should also look at radiation levels. The main goal would be better served if they had defined some thresholds.”

Rodriguez, of MITA, says the Smart Dose Standard was developed during the economic downturn, when many hospitals were not buying new scanners. The organization has since been working to raise awareness on the issue, and find ways to get these standards put into practice. “It’s our sense that hospitals are going to do everything they can to be compliant,” Rodriguez says.

Ongoing debate: Does the tube have an impact on dose?
There may be a misconception — though perhaps not as widespread as it used to be — that the X-ray tube is what impacts the dose, not the CT scanner. Laura Hafner, the senior director of global sales and marketing for Dunlee, a Philips subsidiary that manufactures X-ray tubes, says the scanner is what controls the dose given to the patient, and that the OEMs may be fueling the misconception a bit.

“Regardless of what type of tube you are using, whether it is a GE manufactured tube, each tube is going to have the same dose output depending on what the scanner tells that tube to produce,” Hafner says. “Part of GE’s sales strategy (is), I think, to put a little bit of that fear and doubt that if you do not use the GE-manufactured tube, your patients are going to be receiving more dose. You can see that in some of the messages they include in the patient records.”

Denison, of GE, says this is not true, and that the X-ray output from a tube for a given mA (milliamperes of current) and kV (kilovolts of potential) is inherently dependent on the design of the tube.

“There may be differences in the total flux of the X-rays as well as in the power spectrum of the X-rays, both of which affect the exposure to the patient,” Denison says. “When GE designs tubes, we measure the exposure to the patient according to standard methods. From those measurements, made on several tubes and several CT systems, we can determine the output profile of the tube/system combination.”

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