In the rapidly evolving field of radiology, managing and reporting patient radiation dose has become more critical than ever. With the increasing reliance on imaging technologies such as CT scans and Digital X-rays, the potential risks associated with radiation exposure have garnered significant attention. This has led to the development of updated guidelines and best practices aimed at minimizing radiation dose while ensuring diagnostic accuracy.

In this article, we will simplify these major guidelines, offering practical insights for radiology professionals to enhance patient safety and align with the latest standards. Moreover, it explains how Rology’s On-demand Solution; “Automated Patient Radiation Dose Reporting Service,” can be helpful to radiology departments and centers to comply with the evolving accreditation requirements and standards.

The Importance of Radiation Dose Management

Radiation dose management is pivotal in balancing the benefits of medical imaging with the risks associated with radiation exposure. According to the International Commission on Radiological Protection (ICRP), the recommended dose limit for occupational exposure is 20 mSv per year, averaged over five years, with no single year exceeding 50 mSv [1].

For patients, diagnostic reference levels (DRLs) are used as a guide, varying depending on the type of imaging modality, with specific values recommended by the European Commission and the American College of Radiology [2]. As medical imaging becomes more sophisticated, so does the need for precise dose management to protect patients from unnecessary exposure. Regulatory bodies and accreditation organizations are increasingly focusing on radiation safety, which makes it imperative for radiology departments to adopt robust dose management strategies.

Key Expectations and Requirements by the Accrediting Bodies

Accrediting bodies and regulatory organizations in the MENA and Arab region are aligning their requirements with international standards, such as those set by the International Atomic Energy Agency (IAEA) and other global health organizations. This includes the adoption of Diagnostic Reference Levels (DRLs) and the requirement for accurate radiation dose reporting to ensure that patient exposures remain within acceptable limits for specific procedures.

In addition, accrediting organizations in the region stress the importance of dose optimization, which involves adjusting radiological procedures to achieve the necessary diagnostic quality while minimizing radiation exposure. This is particularly crucial in the MENA region, where variability in radiation practices has been observed. Regular dose audits and the use of advanced dose management systems are recommended to monitor and optimize radiation doses across various imaging modalities [3-5]. In addition, continuous education and training for radiology staff are critical components of radiation safety. Accrediting bodies emphasize the need for ongoing professional development to keep healthcare providers informed about the latest dose optimization techniques and safety protocols [6].

Which Dose Quantities are Used for Setting DRLs?

DRLs should be set in terms of the practical dose quantities used to monitor practice. These dose metrics should be easily measurable. The following are commonly used terms [7]: 

• For Radiography: Air kerma-area product (PKA) and entrance surface air kerma (Ka,e) are recommended DRL quantities.
• For CT: Volume computed tomography dose index (CTDIvol) and dose length product (DLP) are recommended quantities.
• For Mammography and Breast Tomosynthesis: The recommended DRL quantity is one or more of incident air kerma (Ka,i), entrance surface air kerma (Ka,e), or mean glandular dose (DG), with the choice of quantity depending on local practices. 
• For Nuclear Medicine: DRLs are set in activity administered to patients, and/or in administered activity per kg of body mass [7].
• For Dental Intra-oral Radiograph:, The recommended quantity is incident air kerma (Ka,i), and PKA for dental panoramic radiography.
• For Fluoroscopy and Interventional Radiology Procedures: Air kerma at patient entrance reference point (Ka,r), fluoroscopy time, and number of images are recommended as useful additional DRL quantities (a multiple DRL).

Radiation Dose to Adults  – ACR [13]

Simplified Guidelines for Radiation Dose Management

• ALARA (As Low As Reasonably Achievable) Principle
  The ALARA principle remains the cornerstone of radiation dose management. It encourages minimizing radiation exposure to the lowest possible levels without compromising the quality of diagnostic information. Radiology professionals should continually evaluate and adjust protocols to ensure doses are kept at a minimum [8].
• Standardization of Imaging Protocols
  Implementing standardized imaging protocols across the department ensures consistency in radiation dose levels. This includes optimizing protocols for different patient sizes, ages, and clinical indications, which can significantly reduce unnecessary radiation exposure [9].
• Utilize Dose Monitoring and Reporting Tools
  Leveraging automated dose monitoring and reporting tools allows for real-time tracking of patient radiation exposure [10].
• Regular Training and Education
  Continuous education and training for radiology staff on the latest radiation safety guidelines are crucial [11].
• Engage in Quality Assurance Programs
  Participating in quality assurance programs helps radiology departments maintain high standards of patient safety. These programs often include regular audits of radiation doses and adherence to national and international guidelines [12].

Rology’s Solution; Automated Patient Radiation Dose Reporting Service

In line with these guidelines, Rology, a leading teleradiology platform, introduces a groundbreaking FDA-cleared feature that integrates seamlessly with the imaging modalities and HIS at a zero-setup cost. This integration enables fully automated operational efficiency, enhancing the quality and speed of medical imaging services. One of the standout offerings from Rology is the Automated Patient Radiation Dose Reporting Service. This on-demand service addresses the growing concerns around radiation exposure by providing accurate and timely reports on patient radiation doses.

Here’s why this service is a game-changer for radiology departments:

• Patient Safety: Automated dose reporting ensures that patient radiation exposure is continuously monitored and managed, aligning with the latest safety standards.
• Standardization: The service offers standardized dose reporting, making it easier to comply with accreditation, regulation, and certification requirements.
• Quality Assurance: By integrating dose reporting into the radiology workflow, departments can maintain high-quality imaging services without the need for manual intervention.
• No Hardware or Software Upgrade Needed: Rology’s solution is designed to integrate smoothly into existing workflows without requiring additional hardware, software upgrades, or the use of extra dose cards, reports, or attachments.

By incorporating Rology’s Automated Patient Radiation Dose Reporting Service, radiology departments can significantly enhance their radiation safety protocols, ensuring compliance with updated guidelines and improving overall patient care.

If your healthcare facility is interested in leveraging Rology’s cutting-edge technology to streamline workflows and improve diagnostic accuracy, we invite you to learn more and get in touch with us. Get started today to explore how we can support your needs and help you achieve excellence in radiological services.