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The Other Clouds: Dose Reduction and Workflow

Both modality and software system vendors showed their latest tools for reducing and recording radiation dose at RSNA 2010. While imaging organizations have always been cognizant of radiation dosing and worked to provide diagnostic images with as small of a dose as possible, the topic has received widespread attention, with the entire issue taking on a much higher profile in the past 24 months or so.

The elusive part is that dose reduction means different things to different people in radiology. Radiologists are concerned about staying current on imaging protocols to reduce dose, determining whether an alternate exam may provide the information needed with less or no radiation and working with referring doctors so they can make better decisions when ordering exams. Technologists must become familiar with the dose reduction tools available on the equipment they use to obtain images and to stay current on how to perform exams while exposing patients to as little radiation as possible. Imaging management must ensure systems are in place to make sure technologists have the tools they need and follow through with using them properly. The industry must provide systems and quality training to bring newer dose reduction tools and techniques into wider use.

It’s no simple task to make all those things happen—that’s where things get cloudy.

Radiology workflow is another area that’s obviously important but remains pretty cloudy. Now that most facilities have PACS and RIS, other aspects of the imaging process that do not fit neatly into that workflow stand out as problems. From accessing prior images and patient history to communicating urgent findings and sharing images and reports over a wide area, digital radiology workflow encompasses numerous components that present challenges to incorporate into digital workflow. Vendors face a difficult challenge of integrating those aspects of workflow into current systems. It’s another area that has not cleared up just. Both workflow and dose reduction will require the attention of imaging leaders in the coming year.

— Jim Knaub is editor of Radiology Today.