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DOI: 10.1055/s-0041-106071
Implementation of Dose Monitoring Software in the Clinical Routine: First Experiences
Einführung einer Dosis-Monitoring-Software in den klinischen Alltag: Erste ErfahrungenPublication History
19 May 2015
17 July 2015
Publication Date:
30 September 2015 (online)
![](https://www.thieme-connect.de/media/roefo/201601/lookinside/thumbnails/roefo-2502_10-1055-s-0041-106071-1.jpg)
Abstract
Purpose: Radiation exposure of the public as a result of medical imaging has significantly increased during the last decades. To have a tool to register and control patient dose exposure, we implemented dose monitoring software at our institution and first connected our computed tomography (CT) scanners.
Materials and Methods: CT dose data from July 2014 to February 2015 was retrospectively analyzed using dose monitoring software. We evaluated a number of scans above predefined dose thresholds (“alerts”), assessed reasons for alerts and compared data of two CT scanners, one located close to the emergency room (“emergency CT scanner”) and one mainly used on an outpatient basis (“clinical routine CT scanner”). To check for statistically significant differences between scanners, chi-square-tests were performed.
Results: A total of 8883 scans were acquired (clinical routine CT scanner, n = 3415; emergency CT scanner, n = 5468) during which 316 alerts were encountered (alert quota, 4 %). The overall alert quota ranged from 2 – 5 % with significantly higher values for the clinical routine CT scanner. Reasons for alerts were high BMI (51 %), patient off-centering (24 %), scan repetition (11 %), orthopedic hardware (9 %), or other (5 %). Scan repetition was necessary significantly more often with the emergency CT scanner (p = 0.019), while high BMI, off-centering and orthopedic hardware were more frequently seen with the clinical routine CT scanner (for all, p < 0.05). There was a good correlation between high body weight and dose above threshold (r = 0.585).
Conclusion: Implementation of dose monitoring software in the clinical routine was successfully accomplished and provides important information regarding patient radiation protection.
Key Points:
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Implementation of dose monitoring software in the clinical routine can be successfully accomplished.
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Dose notifications are due to human error or patient-specific factors.
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Dose monitoring software provides important information regarding radiation protection of patients.
Citation Format:
• Heilmaier C, Zuber N, Bruijns B et al. Implementation of Dose Monitoring Software in the Clinical Routine: First Experiences. Fortschr Röntgenstr 2016; 188: 82 – 88
Zusammenfassung
Ziel: Die Strahlenbelastung der Bevölkerung durch medizinische Bildgebung hat in den letzten Jahrzehnten deutlich zugenommen. Um die Strahlenbelastung der Patienten systematisch aufzeichnen und kontrollieren zu können, wurde in unserem Institut eine Dosis-Monitoring-Software installiert und zunächst mit den Computertomografen (CTs) verbunden.
Material und Methoden: Mithilfe der Dosis-Monitoring-Software wurden die Dosisdaten von zwei CTs zwischen Juli 2014 und Februar 2015 retrospektiv ausgewertet. Das eine CT befindet sich neben der Notaufnahme („Notfall-CT“), das andere CT wird überwiegend für stationäre und ambulante Patienten verwendet („Routine-CT“). Die Daten wurden im Hinblick auf die Anzahl der Untersuchungen mit Dosiswerten oberhalb festgelegter Schwellenwerte („Alerts“) ausgewertet und die Ursachen für diese für beide CTs analysiert. Um signifikante Unterschiede zwischen beiden Geräten festzustellen, wurden Chi-Quadrat-Tests durchgeführt.
Ergebnisse: Insgesamt wurden 8883 Untersuchungen akquiriert (Routine-CT: 3415, Notfall-CT: 5468). Hierbei wurden 316 Alerts registriert (Quote: 4 %). Die Quote der Alerts schwankte zwischen 2 und 5 % zwischen den Monaten und Geräten, wobei am Routine-CT signifikant mehr Alerts nachgewiesen wurden. Ursachen für die Alerts waren hoher BMI (51 %), ungenaue Lagerung der Patienten im Isozenter (24 %), Untersuchungswiederholungen (11 %), Artefakte durch einliegendes Osteosynthesematerial (9 %) oder andere Gründe (5 %). Scanwiederholungen waren signifikant häufiger am Notfall-CT notwendig (p = 0,019), während hoher BMI, ungenaue Patientenlagerung oder einliegendes Osteosynthesematerial öfter Alerts am Routine-CT verursachten (für alle p < 0,05). Es zeigte sich eine gute Korrelation zwischen dem BMI und den Dosiswerten über dem Schwellenwert (r = 0,585).
Schlussfolgerung: Eine Dosis-Monitoring-Software kann erfolgreich in den klinischen Alltag eingeführt werden und liefert wichtige Informationen betreffend den Strahlenschutz der Patienten.
Kernaussagen:
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Eine Dosis-Monitoring-Software kann erfolgreich in den klinischen Alltag eingeführt werden.
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Dosiswarnungen sind entweder durch menschliche Fehler oder patientenspezifische Faktoren bedingt.
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Durch eine Dosis-Monitoring-Software werden wichtige Informationen betreffend den Strahlenschutz der Patienten gewonnen.
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