Method and apparatus of determining a radiation dose quality index in medical imaging

• US 8,412,544 B2
• Filed: 03/30/2011
• Issued: 04/02/2013
• Est. Priority Date: 10/25/2006
• Status: Active Grant

• Current Assignee: Bruce Reiner
• Original Assignee: Bruce Reiner
• Inventors: Reiner, Bruce
• Primary Examiner(s): Phongsvirajati, Sind
• Application Number:
  US13/064,522
• Publication Number:
  US 20110270623A1
• Time in Patent Office: 734 Days
• Field of Search: 705 2- 3, 600/300, 348/62
• US Class Current: 705/3
• CPC Class Codes: G16H 30/40 for processing medical images, e.g. editing
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

The present invention relates to a method and apparatus which quantifies radiation safety in medical imaging through the creation and analysis of objective data for each individual imaging procedure with respect to acquisition parameters, calculated radiation dose, and clinical data related to imaging examination selection and performance. The present invention also calculates a cumulative radiation dose based upon an individual patient'"'"'s entire medical record, along with occupational and environmental exposures, to calculate a dynamic cumulative radiation-induced carcinogenesis risk. The present invention provides reforms to improve patient safety, quality and accountability, by creating a technology which simultaneously records and tracks objective data referable to radiation safety, medical imaging quality, and accountability among the various stakeholders and technologies in use. This quantifiable data is referred to as the Radiation Dose Quality Index (RDQI), and creates an objective, data-driven measure of quality and safety as it relates to medical practice.

Claims

1. A computer-implemented method for measuring radiation dose exposure and image quality in an imaging examination on a patient, comprising:

retrieving patient information from a database, and displaying said patient information on a display;

compiling radiation iatrogenic risks to the patient using a processor;

utilizing decision support to obtain comparative data from said database to determine examination selection, said decision support including retrieving from said database and displaying on said display, additional information regarding report findings and radiation data attributable to prior imaging studies;

deriving radiation dose exposure and carcinogenesis risk to the patient utilizing said decision support additional information, using said processor;

deriving estimated radiation dose exposure to the patient for the imaging examination, including patient-specific data, using said processor;

receiving an inputted selection of an imaging examination based upon said derivation of estimated radiation dose exposure;

creating an optimal imaging examination protocol of said imaging examination to maximize radiation dose reduction, image quality and diagnostic accuracy, using said processor; and

displaying said optimal imaging examination protocol on said display, based upon a derived host institution technology, staffing, and performance data, using said processor;

wherein said optimal imaging examination protocol includes acquiring a test image using standard/default acquisition parameters, introducing noise into said test image, determining a minimum quality threshold (MQT) of image quality, calculating acquisition parameters for the imaging examination, performing the imaging examination, and determining an examination specific radiation dose quality index.

2. The method of claim 1, further comprising:

inputting the patient'"'"'s biometrics, using a biometrics system, into said database to retrieve said patient information.

3. The method of claim 1, wherein said patient information includes prior clinical, laboratory, and imaging examination data on the patient.

4. The method of claim 3, wherein said imaging examination data includes a series of examinations and patient-specific data related to individual examination radiation dose, cumulative radiation dose, and radiation iatrogenic risk.

5. The method of claim 4, wherein compiling said radiation iatrogenic risks further comprises:

performing analytics on a carcinogenesis risk associated with prior imaging studies, estimated environmental radiation exposures, and deterioration risk to the patient from radiation, using said processor.

6. The method of claim 5, wherein said decision support further comprises:

inputting clinical data into said database, said clinical data including clinical indication, past medical/surgical history, current medical problems, ongoing treatment, historical imaging studies, patient profile, imaging examination type and positioning, anatomic region, radiologist and clinician profiles, and supporting technologies.

7. The method of claim 6, wherein said database is an outside institutional database, and said additional information is exported electronically to an in-house database.

8. The method of claim 6, wherein deriving said radiation dose exposure further comprises:

deriving, using said processor, individual examination radiation dose exposures, cumulative patient radiation dose exposures, estimated environmental radiation dose exposures, radiation-induced carcinogenesis risk, cumulative carcinogenesis risk, and additional radiation risk.

9. The method of claim 8, wherein deriving said radiation dose exposure further comprises:

deriving, using said processor, estimated radiation dose exposures, estimated cost estimates, comparative clinical value, options for radiation dose reduction, options for enhancing clinical value, options for minimizing cost, and comprehensive cost-benefit analysis.

10. The method of claim 9, wherein deriving estimated radiation dose exposure to the patient, using said processor, includes estimated radiation dose for conventional CT, estimated radiation dose for low dose CT, and estimated radiation dose for ultra-low dose CT.

11. The method of claim 10, wherein said optimal imaging examination protocol includes acquisition parameters, CT kernel, collimation, image processing, and noise reduction filters.

12. The method of claim 11, wherein said optimal imaging examination protocol further includes institutional-specific protocol optimization, regional protocol optimization, and multi-institutional protocol optimization.

13. The method of claim 11, further comprising:

electronically ordering and scheduling said imaging examination.

14. The method of claim 13, further comprising:

determining optimal acquisition parameters using a just-noticeable-difference (JND) metric protocol, using said processor, said JND metric protocol including;

acquiring said test image by one of using said standard/default acquisition parameters using said imaging device, or by measuring actual radiation exposure using a sensor;

introducing said noise as computer-derived noise into said test image using low dose acquisition parameters, using said processor;

progressively increasing said noise into said test image until a pre-determined minimum quality threshold (MQT) score is reached and equivalent to a predetermined JND, using said processor;

determining a perceptual and derived image quality, using said processor, for radiologist review and approval; and

calculating, using said processor, said acquisition parameters which will produce said desired image quality using said predetermined JND.

15. The method of claim 14, wherein said MQT score is determined by said processor, based upon clinical parameters, patient profile, imaging examination being performed, technology utilized, and individual radiologist profile.

16. The method of claim 14, further comprising:

dynamically adjusting imaging quality requirements of said acquisition parameters to produce said desired image quality during said imaging examination, using said processor.

17. The method of claim 14, wherein said predetermined JND is 1.5 JND.

18. The method of claim 14, further comprising:

repeating said calculating step at multiple levels within an anatomic region of interest during said imaging examination, to dynamically optimize said acquisition parameters, using said processor.

19. The method of claim 18, further comprising:

calculating a comprehensive examination radiation dose exposure of said imaging examination, using said processor; and

recording said comprehensive examination radiation dose exposure in said database.

20. The method of claim 19, further comprising:

comparing said calculated comprehensive examination radiation dose exposure of said imaging examination, with said derived estimated radiation dose exposure for the imaging examination based upon standard/default acquisition parameters, using said processor.

21. The method of claim 20, presenting data to an imaging provider and referring physician regarding said comparative analytics at a time of imaging examination order entry and said imaging examination protocol.

22. The method of claim 20, further comprising:

recording quality-centric metrics in said database, including at least one of anatomic coverage, positioning, collimation, contrast resolution, spatial resolution, density and measurement calibration, noise, image processing and reconstruction, artifacts, registration of disparate datasets, motion, contrast enhancement; and

pooling said quality-centric metrics to calculate a comprehensive quality score, using said processor.

23. The method of claim 20, further comprising:

comparatively analyzing derived radiation dose exposure and image quality by creating a mathematical ratio of image quality divided by radiation dose exposure, using said processor, so that a higher the value, a greater the efficiency of radiation dose exposure and image quality.

24. The method of claim 23, further comprising:

creating a standard metric of a quality per unit dose, as a quantitative measure of image quality divided by said radiation dose exposure.

25. The method of claim 20, further comprising:

calculating an exam-specific radiation dose quality index (RDQI) score, using said processor, which reflects a total examination radiation dose exposure and an objective measure of image quality, and recording said RDQI in said database.

26. The method of claim 25, further comprising:

applying specialized noise reduction filters and/or imaging processing algorithms to imaging dataset from said imaging examination, using said processor, to decrease noise and enhance contrast resolution.

27. The method of claim 26, further comprising:

applying computerized decision support to an analysis of said imaging dataset.

28. The method of claim 27, further comprising:

analyzing differences in user performance, and in RDQI scores to maximize clinical outcomes.

29. The method of claim 28, further comprising:

modifying said optimal imaging examination protocol and acquisition parameters, in accordance with a professional profile of said user, using said processor.

30. The method of claim 29, further comprising:

automatically identifying said optimal acquisition parameters as standard/default acquisition parameters to the technologist prior to said imaging examination.

31. The method of claim 28, further comprising:

performing administrative analyses, using said processor, including at least one of mean radiation dose according to imaging examination type, mean quality scores according to imaging examination type, qualitative analyses, comprehensive examination quality scores, and mean MQT scores, with respect to modality, anatomy, clinical indication and technology utilized.

32. The method of claim 31, further comprising:

tracking, analyzing and storing in said database, at least one of technical and clinical parameters related to radiation dose exposure, patient safety and clinical outcomes, said clinical parameters including tumor characterization, radiation treatment, clinical response, complications, and additional treatment, to assess performance in radiation therapy.

33. The method of claim 32, further comprising:

correlating, using the processor, said radiation dose exposure with measures of clinical quality, to define therapeutic outcomes.

34. The method of claim 32, further comprising:

combining RDQI scores in databases from multiple institutions, for meta-analysis, to provide a comparative assessment of individual stakeholder groups, technologies, and institutional providers, and establish best practices guidelines.

35. The method of claim 34, further comprising:

correlating said meta-analysis of institutional providers with reference peer groups to provide consumers with objective data, which are categorized in accordance with specific medical imaging examinations or patient profiles.

36. The method of claim 35, further comprising:

applying said meta-analysis to third party payers; and

displaying objective image quality and safety data for prospective or existing customers, such that individual payers'"'"' performance related to that of competitors, can be determined.

37. A non-transitory computer-readable medium which includes instructions for measuring radiation dose exposure and image quality in an imaging examination on a patient, comprising:

retrieving patient information from a database, and displaying said patient information on a display;

compiling radiation iatrogenic risks to the patient using a processor;

utilizing decision support to obtain comparative data from said database to determine examination selection, said decision support including retrieving from said database and displaying on said display, additional information regarding report findings and radiation data attributable to prior imaging studies;

deriving radiation dose exposure and carcinogenesis risk to the patient utilizing said decision support additional information, using said processor;

deriving estimated radiation dose exposure to the patient for the imaging examination, including patient-specific data, using said processor;

receiving an inputted selection of an imaging examination based upon said derivation of estimated radiation dose exposure;

creating an optimal imaging examination protocol of said imaging examination to maximize radiation dose reduction, image quality and diagnostic accuracy, using said processor; and

displaying said optimal imaging examination protocol on said display, based upon a derived host institution technology, staffing, and performance data, using said processor;

wherein said optimal imaging examination protocol includes acquiring a test image using standard/default acquisition parameters, introducing noise into said test image, determining a minimum quality threshold (MQT) of image quality, calculating acquisition parameters for the imaging examination, performing the imaging examination, and determining an examination specific radiation dose quality index.

38. A computer system which for measuring radiation dose exposure and image quality in an imaging examination on a patient, comprising:

at least one memory which contains at least one program comprising the steps of;

retrieving patient information from a database, and displaying said patient information on a display;

compiling radiation iatrogenic risks to the patient using a processor;

utilizing decision support to obtain comparative data from said database to determine examination selection, said decision support including retrieving from said database and displaying on said display, additional information regarding report findings and radiation data attributable to prior imaging studies;

deriving radiation dose exposure and carcinogenesis risk to the patient utilizing said decision support additional information, using said processor;

deriving estimated radiation dose exposure to the patient for the imaging examination, including patient-specific data, using said processor;

receiving an inputted selection of an imaging examination based upon said derivation of estimated radiation dose exposure;

creating an optimal imaging examination protocol of said imaging examination to maximize radiation dose reduction, image quality and diagnostic accuracy, using said processor; and

displaying said optimal imaging examination protocol on said display, based upon a derived host institution technology, staffing, and performance data, using said processor; and

wherein said optimal imaging examination protocol includes acquiring a test image using standard/default acquisition parameters, introducing noise into said test image, determining a minimum quality threshold (MQT) of image quality, calculating acquisition parameters for the imaging examination, performing the imaging examination, and determining an examination specific radiation dose quality index; and

a processor which executes the program.