Instituto de Investigación Sanitaria del Hospital Clínico San Carlos and Medical Physics Service, 28040, Madrid, Spain.
Department of Radiology, Medical School. Complutense University, 28040 Madrid, Spain.
Br J Radiol. 2022 May 1;95(1133):20211340. doi: 10.1259/bjr.20211340. Epub 2022 Mar 17.
Radiation dose management systems (DMS) are currently used to help improve radiation protection in medical imaging and interventions. This study presents our experience using a homemade DMS called DOLQA (Dose On-Line for Quality Assurance).
Our DMS is connected to 14 X-ray systems in a university hospital linked to the central data repository of a large network of 16 public hospitals in the Autonomous Community of Madrid, with 6.7 million inhabitants. The system allows us to manage individual patient dose data and groups of procedures with the same clinical indications, and compare them with diagnostic reference levels (DRLs). The system can also help to prioritise optimisation actions.
This study includes results of imaging examinations from 2020, with 37,601 procedures and 286,471 radiation events included in the radiation dose structured reports (RDSR), for computed tomography (CT), interventional procedures, positron emission tomography-CT (PET-CT) and mammography.
The benefits of the system include: automatic registration and management of patient doses, creation of dose reports for patients, information on recurrent examinations, high dose alerts, and help to define optimisation actions.The system requires the support of medical physicists and implication of radiologists and radiographers. DMSs must undergo periodic quality controls and audit reports must be drawn up and submitted to the hospital's quality committee.The drawbacks of DMSs include the need for continuous external support (medical physics experts, radiologists, radiographers, technical services of imaging equipment and hospital informatics services) and the need to include data on clinical indication for the imaging procedures.
DMS perform automatic management of radiation doses, produces patient dose reports, and registers high dose alerts to suggest optimisation actions. Benefits and limitations are derived from the practical experience in a large university hospital.
辐射剂量管理系统（DMS）目前用于帮助提高医学成像和介入中的辐射防护。本研究介绍了我们使用名为 DOLQA（质量保证在线剂量）的自制 DMS 的经验。
我们的 DMS 连接到马德里自治区 16 家公立医院大型网络中心数据存储库中的 14 台 X 射线系统，拥有 670 万居民。该系统允许我们管理个体患者剂量数据和具有相同临床指征的程序组，并将其与诊断参考水平（DRL）进行比较。该系统还可以帮助确定优化措施的优先级。
本研究包括 2020 年的影像学检查结果，其中包括 37601 例检查和 286471 次辐射事件，这些数据包含在辐射剂量结构化报告（RDSR）中，涉及计算机断层扫描（CT）、介入程序、正电子发射断层扫描-CT（PET-CT）和乳房 X 光检查。
该系统的优点包括：患者剂量的自动注册和管理、为患者创建剂量报告、关于重复检查的信息、高剂量警报，以及帮助确定优化措施。该系统需要医学物理学家的支持，并且需要放射科医生和放射技师的参与。DMS 必须进行定期质量控制，并且必须制定和提交审核报告给医院的质量委员会。DMS 的缺点包括需要持续的外部支持（医学物理专家、放射科医生、放射技师、影像设备的技术服务和医院信息服务）以及需要包含影像学程序的临床指征数据。
DMS 自动管理辐射剂量，生成患者剂量报告，并记录高剂量警报以提示优化措施。这些优点和局限性是从大型大学医院的实际经验中得出的。
