Decreasing Dose and Increasing Success

October 22, 2014

A personal experience with dose that confirms the need for a push for mobile DR.

Many of us have to deal with major challenges in our lives, but nothing compares to the agony of a sick child. As any parent would, I would gladly take on my children’s health issues if it meant they could live normal, healthy lives.  

A year ago my teenage son Taylor was diagnosed with ulcerative colitis, an autoimmune disease in which the body attacks the large intestine. After months of sleepless nights, 104° temperatures, nonstop diarrhea, fatigue, extreme weight loss (he was 6’ 5” and 135 pounds), and no relief from any of the hardcore medications, his physician, mother, and I determined that his only option was surgery to remove his large intestine. 

The surgery went very well, and we were hopeful that he was on the road to recovery. But four days later when we took him home, he started feeling nauseous and experiencing major stomach pain. It became so severe that he started vomiting uncontrollably. We rushed him to the emergency room, where they wanted to do an immediate CT scan.[[{"type":"media","view_mode":"media_crop","fid":"28694","attributes":{"alt":"Brady Heiner","class":"media-image media-image-right","id":"media_crop_863815284520","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2930","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right; border-width: 0px; border-style: solid; margin: 1px;","title":"Brady Heiner, KLAS Research","typeof":"foaf:Image"}}]]

As someone who understands the amount of dose in a CT scan, I was hesitant to expose my child to another scan, but in a rush to make sure my son was going to be okay, I authorized it. The good news was that Taylor’s pain was being caused by a blockage, not a cyst or infection from the surgery. The bad news was that the blockage had to be freed.

Taylor was admitted to the hospital and monitored for a few days. The blockage was freed, and he started back on solid foods again, which brought on blockage number two, accompanied by the same extreme pain and uncontrollable vomiting. This time, the doctors decided to image Taylor using a portable X-ray machine instead of a CT unit. The machine was very old and looked like it had been on the front lines of a war. 

I wasn’t as worried about dose from the X-ray until it took three tries at multiple angles to get the right image. And because the machine was an analog system, the techs had to take the CR cassettes down to another floor to develop them and see if they had the right images.

What should have taken 15 minutes ended up taking more than an hour of back-and-forth checking and retaking of images. I asked the X-ray tech why they didn’t have a mobile digital X-ray (DR) and he said, “I sure wish we did. It would save us a tremendous amount of time and dose, especially with pediatric patients.”

There is a big push in radiology right now to lower dose from all modalities and still provide great images, and X-ray is no exception. KLAS has recently finished a deep-dive report into the world of mobile digital X-ray, “DR Mobile 2014,” with a major focus on pediatric imaging and lowering dose. While collecting data for this report, I was shocked to hear that some providers are experiencing up to 50% less dose with DR machines over their old analog systems. Vendors like FUJIFILM, Carestream, and Shimadzu have really excelled in pediatric imaging, with smaller detectors and many ways to lower dose.

In this report, providers share their experiences with portable DR vendors, including Siemens, GE, Shimadzu, Fuji, Carestream, Canon, and Philips. The report highlights provider experiences with pediatric imaging, Wi-Fi connectivity, reliability, and service, and it also sheds light on whether providers consider retrofitting a viable option for the future. For more information and to check out “DR Mobile 2014” for yourself, please click here.

P.S. This story does end well for Taylor. Even though he will always deal with challenges I can’t fathom, he is now healthy, strong, and looking forward to a bright future.