DICOM dose: Capture and reporting

Abstract

An increasing fraction of imaging equipment is capable of measuring its own X-ray output. Quality management processes in diagnostic and interventional radiology require access to patient exposure data. DICOM now provides tools for communicating dosimetric and related data in a comprehensive manner. A first-generation structured report (RDSR), optimized for fluoroscopically guided procedures, was released as part of the 2007 DICOM Standard. Similar structures for mammography and computed tomography are in the 2008 Standard. The RDSR is a DICOM object that is created and managed separately from the creation and storage of images. Even if images are discarded (e.g. fluoroscopy, rejected radiographs), the RDSR will record all of the radiation used during a procedure. All of the data in a RDSR is in public fields, each identified by a DICOM tag or unique concept name. The RDSR always contains patient and examination data, total dose data for the entire procedure. For interventional procedures, the RDSR also contains technical, geometric, and dosimetric data for each individual irradiation. RDSRs are designed to be distributed on a network and captured by free-standing dosemanagement ACTORS as well as by RIS and PACS. The IHE Radiation Exposure Monitoring (REM) Profile gives additional guidance and supplies use cases for RDSR handling. In addition RDSRs can also be stored within an imaging system and manually downloaded. This paper will focus on interventional systems including examples of dose modeling for individual patients. Many additional uses for the RDSR are foreseen. These include monitoring the use of radiation during conventional procedures (e.g. chest radiography) as part of a facility quality management program; and the development of reference levels. © 2009 Springer-Verlag.