New Standards Combine Dose Mitigation, Reporting Features

A new set of management standards for CT equipment aims to help manufacturers comply with dose mitigation and reporting features.

The Medical Imaging and Technology Alliance (MITA)’s Smart Dose - formally known as XR-29 Standard Attributes on Computer Tomography (CT) Equipment Related to Dose Optimization and Management - was announced last month and combines four features of CT equipment that help optimize the management of radiation dose: DICOM Dose Structured Reporting, pediatric and adult reference protocols, CT Dose Check, and Automatic Exposure Controls.

“There are no new features in XR-29, but rather the idea was to pull dose mitigation and dose reporting features into one standard that manufacturers can note on their equipment as being compliant with,” Gail Rodriguez, executive director of MITA, said in an interview. “This was done with the hope that if you put those separate features into a standard it can help to drive adoption and utilization among healthcare and imaging providers.”

MITA’s announcement was backed by comments from both the Deputy Director for Radiological Health at the FDA and other industry leaders

“Above all, the medical imaging team that includes the manufacturers of imaging equipment are committed to putting the patient’s safety, health and welfare first,” Marilyn Goske, MD, of Cincinnati Children’s and Chair of the Image Gently campaign, said in a release. “The approval of this new CT standard represents another important step forward in ensuring patients, particularly children, have access to the safest, most advanced technology available.”

Equipment that meets the new Smart Dose standards will include:

• DICOM Dose Structured Reporting, which enables recording of post-exam dose information in a standardized electronic format.
• Pediatric and adult reference protocols, a set of pre-loaded parameters on a CT system that can be selected by the operator to complete a particular clinical task, such as capturing an image of the abdomen.
• CT Dose Check, which incorporates two features - dose notifications and dose alerts - that warn operators and physicians when dose exceeds established thresholds.
• Automatic Exposure Controls (AEC), which automatically adjust the amount of radiation within prescribed bounds as needed to achieve the desired image quality.

“This is a result of all of the imaging community working together,” Rodriguez said. “There is a galvanized effort to include new features on imaging scanners to reduce dose without sacrificing image quality.”

Since the new standards were announced, both Toshiba and Siemens have announced measures to comply with the new standards. Toshiba announced that all of its new Aquilion CT systems will meet the standards, and Siemens Healthcare announced that all of its new Somatom CT products will as well.

“It is our collective hope,” Rodriquez said, “that this will drive compliance, and help providers to say that they are doing everything that they can to make sure that patient safety is guarded.”