Radiology Department, Complutense University, 28040, Madrid, Spain.
Institute of Medical Physics, Hospital Nuremberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany.
Eur Radiol. 2022 Aug;32(8):5525-5531. doi: 10.1007/s00330-022-08675-w. Epub 2022 Mar 16.
The terms "notifications" and "alerts" for medical exposures are used by several national and international organisations. Recommendations for CT scanners have been published by the American Association of Physicists in Medicine. Some interventional radiology societies as well as national authorities have also published dose notifications for fluoroscopy-guided interventional procedures. Notifications and alerts may also be useful for optimisation and to avoid unintended and accidental exposures. The main interest in using these values for high-dose procedures (CT and interventional) is to optimise imaging procedures, reducing the probability of stochastic effects and avoiding tissue reactions. Alerts in X-ray systems may be considered before procedures (as in CT), during procedures (in some interventional radiology systems), and after procedures, when the patient radiation dose results are known and processed. This review summarises the different uses of notifications and alerts to help in optimisation for CT and for fluoroscopy-guided interventional procedures as well as in the analysis of unintended and accidental medical exposures. The paper also includes cautions in setting the alert values and discusses the benefits of using patient dose management systems for the alerts, their registry and follow-up, and the differences between notifications, alerts, and trigger levels for individual procedures and the terms used for the collective approach, such as diagnostic reference levels. KEY POINTS: • Notifications and alerts on patient dose values for computed tomography (CT) and fluoroscopy-guided interventional procedures (FGIP) allow to improve radiation safety and contribute to the avoidance of radiation injuries and unintended and accidental exposures. • Alerts may be established before the imaging procedures (as in CT) or during and after the procedures as for FGIP. • Dose management systems should include notifications and alerts and their registry for the hospital quality programmes.
“通知”和“警报”这两个术语在多个国家和国际组织中被用于医疗照射。美国医学物理学家协会发布了 CT 扫描仪的建议。一些介入放射学学会以及国家当局也发布了透视引导介入程序的剂量通知。通知和警报也可用于优化以及避免非故意和意外照射。使用这些值进行高剂量程序（CT 和介入）的主要目的是优化成像程序，降低随机效应的概率并避免组织反应。在进行程序之前（如 CT 中）、进行程序期间（某些介入放射学系统中）以及在已知并处理患者辐射剂量结果之后，可以考虑 X 射线系统中的警报。这篇综述总结了通知和警报的不同用途，以帮助优化 CT 和透视引导介入程序，并分析非故意和意外的医疗照射。本文还包括在设置警报值时的注意事项，并讨论了使用患者剂量管理系统进行警报、其注册和随访的好处，以及针对个别程序的通知、警报和触发水平之间的差异，以及用于集体方法的术语，如诊断参考水平。关键点：
用于计算机断层扫描（CT）和透视引导介入程序（FGIP）的患者剂量值的通知和警报允许提高辐射安全性，并有助于避免辐射损伤以及非故意和意外照射。
警报可以在成像程序之前（如 CT 中）或在程序期间和之后（如 FGIP）建立。
剂量管理系统应包括通知和警报及其登记，以用于医院质量计划。
