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Program Information

Good, Bad and Ugly of Patient Exposure and Dose Tracking


M Rehani
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M Kalra

M McNitt-Gray




M Rehani1*, M Kalra1*, M McNitt-Gray2*, (1) Massachusetts General Hospital, Boston, MA, (2) UCLA School of Medicine, Los Angeles, CA

Presentations

7:30 AM : Overview of dose and procedure tracking: What, why and how? - M Rehani, Presenting Author
7:50 AM : How dose tracking affects protocol optimization in tertiary healthcare centers - M Kalra, Presenting Author
8:10 AM : Experience at UCLA in dose tracking and implications - M McNitt-Gray, Presenting Author

TU-A-201-0 (Tuesday, August 1, 2017) 7:30 AM - 8:30 AM Room: 201


Tracking of radiological procedures and dose has been gaining increasing momentum during the last decade due to statutory, regulatory and accreditation issues as well as increased interest in dose information. Tracking systems are either for tracking of individual patient’s or for tracking of doses of group of patients. The “Good” aspects of tracking include availability of information on doses that was not available before. When used locally as an audit tool, these systems can provide information about an institution’s own doses, which can help in strengthening the process of justification and protocol optimization in imaging. Systems such as the ACR Dose Index registry provide information that allows protocol optimization on a more regional and national level and also open up areas for research. The “Bad” parts include an overemphasis on dose, bias resulting in process of prescribing (or diverting) radiological examinations based on knowledge of previous exposures or doses, and possibly unnecessary concerns about an increase in physician’s workload in dealing with patient (and physician) inquiries (which may not always be bad). The “Ugly” part may be our lack of knowledge regarding the utility of the tracking cumulative dose values (especially for doses in the stochastic effect range); the setting of alert levels on these tracking systems with color coding based on the accumulated values; and the potential for regulatory actions with enforcements where professional and clinical judgement would be more appropriate. The futuristic aspects include having dose information in millions of patients that can help in epidemiological studies in correlating radiation effects.

The experience from two major centers in US (MGH and UCLA) in clinical situations as also from outside US in dealing with patient doses and protocol optimization indicates utility of exercise.

Learning Objectives:
1. To understand different aspects of tracking of patient doses and of exposure history
2. To learn about good, bad and ugly aspects based on experiences gained in recent years
3. To lean about future challenges in the area of patient dose tracking

Handouts


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