Moores B M, Charnock P, Ward M
Integrated Radiological Services Ltd, Unit 188, Century Building, Tower Street, Brunswick Business Park, Liverpool L3 4BJ, UK.
Radiat Prot Dosimetry. 2010 Apr-May;139(1-3):422-9. doi: 10.1093/rpd/ncq004. Epub 2010 Feb 8.
Practical and philosophical aspects of radiation protection in diagnostic radiology have changed very little over the past 50 y even though patient doses have continued to rise significantly in this period. This rise has been driven by technological developments, such as multi-slice computed tomography, that have been able to improve diagnostic accuracy but not necessarily provide the same level of risk-benefit to all patients or groups of patients given the dose levels involved. Can practical radiation protection strategies hope to keep abreast of these ongoing developments? A project was started in 1992 in Liverpool that aimed to develop IT driven quality assurance (QA)/radiation protection software tools based upon a modular quality assurance dose data system. One of the modules involved the assessment of the patient entrance surface air kerma (ESAK) for an X-ray examination that was based upon the use of calibrated X-ray tube exposure factors to calculate ESAK as well as collecting appropriate patient details (age, sex, weight, thickness etc). The package also contained modules for logging all necessary equipment performance QA data. This paper will outline the experience gained with this system through its transition from a local application on a stand alone PC within the department to the current web-based approach. Advantages of a web-based approach to delivering such an application as well as centrally storing data originating on many hospital sites will be discussed together with the scientific support processes that can be developed with such a system. This will include local, national and international considerations. The advantages of importing radiographic examination details directly from other electronic storage systems such as a hospital's radiology information system will be presented together with practical outcomes already achieved. This will include the application of statistical techniques to the very large data sets generated. The development of new examination QA performance indicators will be discussed. The application of web-based IT tools for QA and radiation protection in diagnostic radiology is already opening up the possibility of developing new and improved scientific support services as well as research possibilities in radiological informatics. These will be outlined together with areas for possible future development by the medical physics community.
在过去50年里，尽管这段时间患者剂量持续显著上升，但诊断放射学中辐射防护的实践和哲学层面变化甚微。这种上升是由技术发展推动的，比如多层螺旋计算机断层扫描，它能够提高诊断准确性，但鉴于所涉及的剂量水平，未必能为所有患者或患者群体提供同等水平的风险效益。切实可行的辐射防护策略能否跟上这些持续的发展？1992年在利物浦启动了一个项目，旨在基于模块化质量保证剂量数据系统开发由信息技术驱动的质量保证（QA）/辐射防护软件工具。其中一个模块涉及对X射线检查的患者体表空气比释动能（ESAK）进行评估，该评估基于使用校准的X射线管曝光因子来计算ESAK以及收集适当的患者详细信息（年龄、性别、体重、厚度等）。该软件包还包含用于记录所有必要设备性能QA数据的模块。本文将概述该系统从部门内独立个人电脑上的本地应用向当前基于网络的方法转变过程中所获得的经验。将讨论基于网络的方法来交付此类应用以及集中存储源自多个医院站点的数据的优势，以及可以用这样一个系统开发的科学支持流程。这将包括本地、国家和国际层面的考量。将介绍直接从其他电子存储系统（如医院的放射学信息系统）导入放射检查详细信息的优势以及已经取得的实际成果。这将包括对所生成的非常大的数据集应用统计技术。将讨论新的检查QA性能指标的制定。基于网络的信息技术工具在诊断放射学中的QA和辐射防护应用已经为开发新的和改进的科学支持服务以及放射信息学研究可能性开辟了道路。这些将与医学物理界未来可能的发展领域一同概述。
