Know thy dose

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知道thy药量

Brendon Nafziger, DOTmed News Associate Editor | March 14, 2013
From the March 2013 issue of HealthCare Business News magazine

Since last summer, California’s 2,500 to 3,000 radiologists have been doing things a bit differently. On July 1, the California dose-reporting law (SB-1237) went into effect. Among other things, it requires radiologists to report the radiation dose from CT scans in patients’ reports. This means reporting the computed tomography index volume (CTDI vol) and doselength product (DLP), clipping the unit’s protocol page onto the interpretive report, and sending the data straight to PACS, if the machine is able to do that.

“When they actually dictate their interpretive report, it was not common for radiologists to dictate the dose,” Bob Achermann, the executive director of the California Radiology Society, tells DOTmed Business News about the change.

The immediate prompt for the bill was likely an incident that came to light more than three years ago. Cedars Sinai in Los Angeles had inadvertently exposed patients to eight times the recommended dose during brain perfusion CT scans, causing some patients to suffer hair loss and radiation burns.

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The incident also occurred during a period that saw heightened public and scientific interest in medical radiation. For the past decade researchers had been uncovering what they claim are links between CT exposure, especially in childhood, and future cancers. A study by David Brenner of Columbia University published in a 2007 issue of the New England Journal of Medicine said that CT scans could account for 1.5 to 2 percent of all cancers in the United States.

Although these studies are not without their critics, they have helped create a climate characterized by “radiation hysteria,” in the words of one speaker at the Radiological Society of North America’s annual meeting in November.

Hysteria or not, the rest of the country might follow California’s lead. While the Golden State is, so far, the only one with the dose-reporting statute, legislatures and health departments in the other 49 have been looking over the bill, according to Neil Singh, a consultant with Ascendian Healthcare. “We know that all of the other states have asked for a copy of the California mandate,” he tells DOTmed News. “(Nothing’s) out in stone yet, but it’s coming.”

Vendors respond
Vendors are also making a big push for software to help providers manage their dose. At RSNA 2012, three announcements came out around this. One is that Bayer Healthcare (which owns Medrad) bought, for an undisclosed sum, Radimetrics, which makes the eXposure dose-tracking program. Agfa and Sectra also both said they were bringing out their own dose-monitoring software, to compete with ones already on the market from Radimetrics, GE and PACSHealth.

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