por Carol Ko
, Staff Writer | September 05, 2013
From the September 2013 issue of HealthCare Business News magazine
Texas is leading the charge on radiation dose legislation that experts expect will be the increasing norm in the future. The law, a revision of earlier legislation from 2010, specifies that CT systems must be accredited through an approved modality-specific or facility-wide accreditation process.
The new law also sets specific dose reference protocols very similar to those practiced in Europe. If the administered dose levels exceed the threshold, facilities must report to various agencies within five, 10 or 15 business days, depending on the error.
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But apart from state-mandated legislation, dose reduction will be impossible without widespread hospital buy-in and standardization. For the effort to truly succeed, major associations such as the American Academy of Family Physicians and the American Academy of Pediatrics will also need to put their full weight behind the message.
“Hospitals should have brochures on dose for people to read in their waiting rooms or handed out like a HIPPA form — just to increase their awareness of what they’re getting. Handouts can increase understanding about CT radiation exposure without causing parents to refuse studies’” says Siegel.
Taking the thinking out of dose
The most crucial aspect of dose reduction has more to do with what technologists aren’t required to learn — in other words, automated features on the machine that reduce dose without the need for extra education or training. “Honestly, it starts and ends with the technology,” says Stahre.
Training and education are important aspects of dose reduction, but what if manufacturers could create a CT scanner that doesn’t need high dose, eliminating problems on the technician side? Vendors are hard at work trying to make this possibility a reality.
For example, iterative reconstruction uses algorithms to reduce image noise, significantly reducing dose while improving image quality. GE offers its model based image reconstruction technology, Veo, while Siemens offers its own iterative reconstruction feature called SAFIRE.
And Siemens also offers CarekV, a feature introduced in 2012, that helps select the optimal kV level for the image acquisition. “The technologist wants to do the right thing, but is the scanner helping them to do it?” asks Jakub Mochon, product manager at Siemens Healthcare.
Studies in Radiology and Investigative Radiology indicate that this new feature has led to a decrease in dose by 28 percent, and its efficacy is further confirmed by Siegel, who says that the technology in combination with iterative reconstruction has helped reduce her median dose from 5.7 to 2.7 in her own practice. “It takes the guesswork out based on size,” says Siegel.