Carestream and Bayer Collaborate to Manage Dose

Document created by adina.schoeneman Employee on Oct 12, 2016
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Major Hospital, Major Health Partners



Just in time to help comply with the EURATOM Directive, Carestream has become a reseller of Bayer’s Radimetrics™ Enterprise Platform, which can collect data from most of the common radiology sources of radiation, incl. CT, X-Ray, Mammography, PET/CT and interventional. New EURATOM regulatory standards on radiation dose monitoring and reporting go into effect for the EU on February 6, 2018. Regulations are also being put in place in other regions throughout the world.


Why Bayer.
Carestream chose to work with Bayer for this effort because the focus on monitoring patient radiation dose is important due to the increased use of modalities such as CT for diagnosis, which impart has significantly higher dose than conventional X-Rays.
Much of the new concern about radiation exposure is on behalf of children, who are most likely to be at risk of radiation-induced cancer over their lifetimes. As seen in the chart below, the risk of fatal cancer increases dramatically as dose climbs above 0.02 millisieverts (mSv).


Comparison of Doses from Sources of Exposure


Source of exposureDose
Dental x-ray0.005 mSv
100g of Brazil nuts0.01 mSv
Chest x-ray0.014 mSv
Transatlantic flight0.08 mSv
Nuclear power station worker average annual occupational exposure (2010)0.18 mSv
UK annual average radon dose1.3 mSv
CT scan of the head1.4 mSv
UK average annual radiation dose2.7 mSv
USA average annual radiation dose6.2 mSv
CT scan of the chest6.6 mSv
Average annual radon dose to people in Cornwall7.8 mSv
CT scan of the whole spine10 mSv
Annual exposure limit for nuclear industry employees20 mSv
Level at which changes in blood cells can be readily observed100 mSv
Acute radiation effects including nausea and a reduction in white blood cell count1000 mSv

Dose of radiation which would kill about half of those receiving it in a month



5000 mSv

Without comparison data, hospitals can’t manage dose.
A recent study from the JAMA Intern Med showed a 5x variation in median dose (from 4 to 19 mSv) among hospitals for CT scans of 1,582 patients with suspected kidney stones, for which the optimum dose is 4 mSv. As radiology professionals, we expect small variations in equipment, but major differences resulting in unnecessary exposure are not acceptable. There are a number of initiatives already underway to address this issue. Hospitals are expanding their quality control of exam protocols and analyzing dose to reduce the amount of radiation exposure to patients in accordance with the ALARA (As Low As Reasonably Achievable) principle. In addition, regulations such are EURATOM are being put in place. 



Lifetime Fatal Cancer Risks from Diagnostic Medical Exposures X-ray examinations
Diagnostic procedureTypical effective doses (mSv)Equivalent period of natural background radiation 1Lifetime additional risk of fatal cancer per examination 2
Limbs and joints (except hip)< 0.01< 1.5 days1 in a few million
Teeth (single bitewing)< 0.01< 1.5 days1 in a few million
Teeth (panoramic)0.011.5 days1 in 2 million
Chest (single PA film)0.023 days1 in a million
Skull0.0711 days1 in 300,000
Cervical spine (neck)0.082 weeks1 in 200,000
Hip0.37 weeks1 in 67,000
Thoracic spine0.74 months1 in 30,000
Pelvis0.74 months1 in 30,000
Abdomen0.74 months1 in 30,000
Lumbar spine1.37 months1 in 15,000
Barium swallow1.58 months1 in 13,000
IVU (kidneys and bladder)2.514 months1 in 8000
Barium meal316 months1 in 6700
Barium follow316 months1 in 6700
Barium enema73.2 years1 in 3000
CT head21 year1 in 10,000
CT chest83.6 years1 in 2500
CT abdomen/pelvis104.5 years1 in 2000

How Radimetrics helps with dose management
Radimetrics connects to your existing PACS information and automatically calculates patient doses. It further helps with compliance automation by facilitating protocol management, email dose alerts, interactive dosimetry training and providing EU dose reporting templates for submission to authorities. Radimetrics can help provide the data institutions need to improve their practices allowing them to generate diagnostic quality images more safely, consistently and efficiently, in line with radiation standards and regulation. For example:

  • The medical physicist benefits from near real-time tracking, monitoring and reporting and automation of routine administrative tasks.
  • The radiologist benefits from tools that can help identify variation from protocols and scanner operation.
  • The technologist gains confidence from tools that help the department define an imaging procedure that better meets patient needs. Date-range dose alerts can warn if thresholds are exceeded. Benchmarking helps select dose effective scanners.
  • The administrator gains valuable multi-modality utilization data. This helps informs new scanner investments with real-world performance data



If you would like to learn more about Radimetrics for your enterprise, let us know!





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