Radiation Exposure

Although there are efforts to create a technological and procedural solutions (see California Bill 1237 and FDA efforts) for determining exposure to ionizing radiation exposure during diagnostic imaging procedures, these will fall short for many different reasons. Some can be traced to calculating the effective absorbed dose which is a function of multiple parameters ranging from the imaging system (amperage, voltage and efficiency of the system generating the radiation), the patient (size, obesity and exposed tissues/organs), and the expertise of the technologist setting up the patient.

The shortcommings should not stop the process of getting imaging vendors to include data from the machine in the Dicom header but they also need to focus more on the whole process of taking images. Radiologist can have a lot of input into the selecting the most appropriate modality, protocol, and use of contrast media. The technologists can ensure that the region of interest is not exceeded and the amperage and voltage are tweaked to deliver a good image with low radiation exposure. The vendors can provide training and built in protocols to optimize the image and area of interest.

The overarching philosophy governing the imaging group can ensure that radiologist and technologist agree on making the patient’s welfare central to their imaging service. Sharing the images with other facilities (Health Information Exchanges (HIE) and RHIOs) can reduce unnecessary re-imaging. Only participation with groups such as LeapFrog and regional HIEs will help move groups and organizations to to better and truly patient-centered care.