In this article, I would like to take you through some of the key requirements of dose management systems. One of the key elements of the system is to alert the user to abnormal radiation doses. Some dose management solutions don’t meet all compliance requirements. They’re very complex and some hospitals get 300 alerts per month and many of those alerts are false that makes radiation dose compliance very stressful for many hospitals.

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Important Notes

  • DMS (Dose management systems) are very useful software tools for patient exposure monitoring, optimization, compliance with DRLs (diagnostic reference levels) and quality assurance.
  • DMS can help fulfill the dosimetric aspects of the European Directive 2013/59/Euratom.
  • The EuroSafe WG analyzes the DMS requirements and provides recommendations for users.

Clinical radiation protection includes some unique tasks supported by DMS:

  • Collecting dosimetric data to establish local or national DRLs or typical (average) dose values
  • Checking compliance with DRLs (diagnostic reference levels) 
  • Preventing, diagnosing and helping to report unwanted exposures
  • Optimizing patient exposure, especially in the field of computed tomography (CT) and interventional radiology (IR).
  • Structured integration of dose documentation, reporting and tracking
  • Notification when local or national warning levels are exceeded
  • Local, regional or national patient exposure criteria for procedures and modalities

Transferring data to a DMS database can be done in a variety of ways, but should be automated. Depending on the systems is being used, direct network connections to imaging modalities, picture archiving and communication systems (PACS), and radiological information systems (RIS) are recommended.

It should be ensured that each modality dose descriptor and relevant examination parameters used, including on-device information, are transferred to the DMS database to enable targeted assessment.

Manually recorded dose descriptors are always problematic, as this method has the potential to store incorrect or unhelpful values in the database. This is a situation that often occurs in practice, leading to incorrect values in a DMS.

An IT infrastructure where all dosimetry data is automatically linked to the image or automatically transferred to a RIS or PACS is an effective solution. It is necessary to organize a systematic quality control procedure to ensure the accuracy of the transmitted data.

In CT scanners and interventional workplaces, all radiation parameters are usually stored together with image information in DICOM headers or RDSR (Radiation Dose Structured Report). Here, however, the problem is often that essential dose information is stored as secondary screenshots in older systems.

Therefore, it is also necessary for advanced DMSs to be able to extract text and numbers from this information. It requires an efficient OCR (Optical character recognition) system to recognize the text compatible with the respective device in order to assign the information correctly.

Older generation systems may also require data transfer procedures to be activated using the Modality Performed Procedure Step (MPPS). DMS should be able to correctly assign information which is sent in the form of the Radiation Dose Structured Report (RDSR) and dosimetric data extracted from DICOM image headers to the corresponding examinations, series or images.


Reference: Radiation dose management systems—requirements and recommendations for users from the ESR EuroSafe Imaging initiative