Method and apparatus of providing a radiation scorecard

• US 8,538,776 B2
• Filed: 10/25/2007
• Issued: 09/17/2013
• 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:
  US11/976,518
• Publication Number:
  US 20080103834A1
• Time in Patent Office: 2,154 Days
• Field of Search: 705 2- 3
• US Class Current: 705/3
• CPC Class Codes: A61B 6/5294 involving using additional data, e.g. patient information, image labeling, acquisition parameters
• CPC Class Codes: A61B 6/542 involving control of exposure
• CPC Class Codes: A61B 6/545 involving automatic set-up of acquisition parameters
• CPC Class Codes: G06Q 10/0637 Strategic management or analysis, e.g. setting a goal or target of an organisation; Planning actions based on goals; Analysis or evaluation of effectiveness of goals
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• 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
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

The present invention relates to a method to measure, record, analyze, and report cumulative radiation exposure to the patient population and provide automated feedback and recommendations to ordering clinicians and consultant radiologists. The data provided from this “radiation scorecard” would in turn be automatically recorded into a centralized data repository (radiation database), which would be independent to the acquisition site, technology employed, and individual end-user. Retrospective analysis can also be performed using a set of pre-defined scorecard data points tied to the individual patient'"'"'s historical medical imaging database, thereby allowing for comprehensive (both retrospective and prospective) medical radiation exposure quantitative analysis. Patient safety can be improved by a combination of radiation dose reduction, exposure optimization, rigorous equipment quality control (QC), education and training of medical imaging professionals, and integration with computerized physician order entry (CPOE).

Claims

1. A computer-implemented method of providing a radiation scorecard for controlling radiation dose exposure to an individual comprising:

calculating, using a processor of a computer system, an entrance skin dose and effective dose to a patient, for a predetermined medical procedure;

calculating, using said processor, an area of irradiation to said patient;

calculating, using said processor, an effective radiation dose to said patient using a radiation detector, for said medical procedure, as a summation of a product of an entrance skin dose times fractional organ doses stored in a database, times critical organ dose weighting factors retrieved from said database, wherein said medical procedure is an imaging examination using an imaging device;

storing said effective dose for said patient, in said database;

deriving, using said processor, a cumulative radiation dose for said patient which is compared against a maximum radiation exposure amount safe for said patient;

calculating, using said computer, said radiation dose exposure from said comparison, to result in optimized radiation dose exposure parameters for said patient;

deriving a patient radiation scorecard including said cumulative radiation dose, said maximum radiation exposure amount, and said optimized radiation dose exposure parameters, and storing said patient radiation scorecard in said database;

retrieving comparable data to an examination profile, which contains patient data retrieved from said database on said patient, on said radiation dose exposure from said database;

comparing said comparable data to said patient data on said radiation dose exposure from said imaging examination profile;

displaying said optimized radiation dose exposure parameters and corresponding radiation dose exposure calculations derived from said comparison using said processor, on a display; and

identifying technology options including alternative imaging examinations or alternative examination protocols, to minimize said radiation dose exposure to said individual patient.

2. The method of claim 1, further comprising:

compiling, using said processor, one of a clinician, radiologist, administrator, or technologist scorecard based on compliance with at least said minimization in said radiation dose exposure.

3. The method of claim 1, further comprising:

automatically calculating, using said processor, an organ specific dose, effective dose, and comparative dose for said patient prior to said imaging examination.

4. The method of claim 1, further comprising:

forwarding automated alerts to a plurality of parties when predefined thresholds are reached relative to deficiencies in at least one of technology, protocol, or acquisition parameters.

5. The method of claim 1, further comprising:

receiving the examination order for said imaging examination;

displaying the imaging examination profile on a display of a computer system, said imaging study exam examination profile which contains the patient data retrieved from a said database on the individual said patient;

retrieving said patient radiation scorecard from said database;

compiling a clinician radiation scorecard, using said processor, which includes at least said optimized radiation dose exposure parameters, and said technology options to minimize said radiation dose exposure.

6. The method of claim 5, further comprising:

obtaining an ultra-low dose image during said imaging examination using said imaging device;

correlating, using said processor, said ultra-low dose image with a visual discrimination model to determine said radiation dose exposure parameters;

cross-referencing, using said processor, said radiation dose exposure parameters with radiation data in said database of said computer system, to obtain comparable data;

displaying options on a display of said computer system to maximize radiation dose exposure reduction based on said comparable data;

selecting, using said processor, optimum radiation dose exposure parameters for said patient based on said maximized radiation dose exposure reduction; and

inputting said optimum radiation dose exposure parameters into said imaging device.

7. The method of claim 6, wherein said correlation of said ultra-dose image with said visual discrimination model is to quantify an amount and location of noise in said image;

and

wherein said radiation dose exposure is calculated based on said amount of said noise and a predefined image quality threshold.

8. The method of claim 6, further comprising:

performing, using said processor, an image analysis on an image obtained during said imaging examination using said imaging device;

storing said image and said image analysis in a quality assurance database of said computer system;

correlating, using said processor, said image and said image analysis with quality data on images stored in said database;

creating an image quality score of said image, using said processor, based on said correlation; and

using the highest image quality scores as technical defaults for a subsequent imaging examination, using said processor.

9. The method of claim 8, further comprising:

informing a user by electronic means, that education or training is required when said image quality score is below a predetermined threshold.

10. The method of claim 9, further comprising:

forwarding automated alerts to users when said image quality score is below another predetermined threshold.

11. The method of claim 8, wherein said radiation detector includes computed radiography or direct radiography devices.

12. The method of claim 8, wherein an entrance skin dose is calculated using said processor, by utilizing information from a calibrated dose area product (DAP) device installed on said imaging device or a point dosimeter.

13. The method of claim 8, wherein said entrance skin dose and said effective dose are calculated using said processor, using information from an point air-ionization chamber measuring air-kerma within a calibration dose area product (DAP) device.

14. The method of claim 8, wherein said entrance skin dose is calculated using said processor, using screen-film speed information from said imaging device, or radiation exposure index values provided by digital radiography systems in conjunction with reference values estimated by said processor for an imaging examination.

15. The method of claim 1, further comprising:

calculating said effective dose in mammography, using said processor, as a summation of individually calculated effective dose estimates for each imaging examination performed on said individual.

16. The method of claim 8, further comprising:

calculating, using said processor, said radiation dose exposure in computed tomography, using indirect measurements from plastic phantoms and stored in said database.

17. The method of claim 8, wherein said radiation dose exposure in nuclear medicine is provided from said database which includes data on a type and dose of radiopharmaceutical utilized.

18. The method of claim 8, wherein said imaging examination comprises:

collecting data from a radiation source during said imaging examination, using said imaging device;

transferring said data obtained from said radiation source to said database using said processor, and cross-referencing said data with a medical history on said individual, using said processor, to create a time-stamped radiation profile of said patient.

19. The method of claim 18, wherein said comparison of said radiation dose exposure against said maximum radiation exposure amount stored in said database, performed by said processor, is for a predetermined anatomic region/critical organ.

20. The method of claim 18, wherein said data from said radiation source is stored in a centralized local, regional, or national database.

21. The method of claim 18, wherein said radiation source includes external radiation data monitoring sources imbedded within said imaging device or said therapeutic device, or is attached to the patient.

22. The method of claim 18, wherein said radiation data monitoring source is connected to a biometrics device which establishes an identity of the patient, and which ensures proper linkage between data on said radiation dose exposure and said medical history stored on said patient.

23. The method of claim 18, further comprising:

storing data from said radiation data monitoring source, including a date and a time of exposure, a duration of radiation exposure, an amount of radiation dose, a geographic location of said patient, an anatomic area of exposure, an energy profile of said radiation dose exposure, and a geographic location of said radiation dose exposure to said patient during a predetermined time interval, in said database.

24. The method of claim 18, further comprising:

creating a real-time, temporal, topographical three dimensional anatomic map, using said processor, said map which illustrates an epicenter of said maximum exposure and a relative decay in said radiation dose exposure from said epicenter, that depicts said radiation dose exposure over time for said patient.

25. The method of claim 8, further comprising:

recording an environmental radiation dose exposure and an occupational radiation dose exposure and storing said environmental and occupational radiation dose exposures in Said database for analysis.

26. The method of claim 25, further comprising:

determining a directionality of radiation dose exposure using said processor, to establish and correlate said radiation dose exposure with environmental factors, to determine an extent and a direction of contamination to identify patients requiring emergent medical care and prophylaxis.

27. The method of claim 8, further comprising:

periodically analyzing examination orders by said clinician, and said corresponding radiation dose exposure to said patient, using said processor; and

comparing said analysis, using said processor, to other clinicians to include in said clinician scorecard.

28. The method of claim 27, further comprising:

notifying said clinician of required remedial education and training when said analysis shows an effect on patient safety or diagnostic efficacy.

29. The method of claim 9, wherein said user is a radiologist.

30. The method of claim 9, wherein said user is a technologist.

31. The method of claim 30, wherein said technologist analyzes productivity, image quality, retake/reject statistics, radiation dose exposure parameters, type of image processing utilized, and patient adverse outcomes.

32. The method of claim 8, wherein said administrator scorecard includes analysis, using said processor, of performance and adherence of clinicians, technologists, radiologists, departments, and technologies utilized, as well as technology selection and integration, to local, regional, national, and international standards.

33. The method of claim 32, further comprising:

creating a customized patient profile, using said processor, including all radiation dose exposures on said patient and potential alternative examinations, and a historical review of said cumulative radiation dose exposure, all of which is used to determine future medical decisions, including screening and preventative measures, consultative services, and provide direct feedback and educational programs to the patient.

34. The method of claim 8, further comprising:

incorporating quality control metrics on said radiation detector and compliance with industry and community safety standards, into said radiation scorecard, using said processor, to determine radiation safety measures specific to said radiation detector which are utilized.

35. The method of claim 2, further comprising:

periodically delivering said radiation scorecards, using electronic means, to said clinician, radiologist, administrator and technologist, said scorecards including trending analyses and comparisons with local, regional, and national counterparts.

36. The method of claim 8, further comprising:

storing in said patient radiation scorecard in said database, said medical history and radiation history of said patient, technical components of said imaging examination performed, specialized radiation dose exposure reduction techniques employed, radiation dose savings, mean radiation dose for alternative and same type imaging studies, mean radiation dose in local, regional, and national reference standards, itemized imaging examination and radiation dose exposure history, cumulative lifetime radiation dose exposure calculations, calculation of lifetime carcinogenesis risk, clinical profile of said patient, and quality assurance ramifications of said imaging examination to said patient.

37. The method of claim 8, further comprising:

receiving and storing adjustments to image acquisition parameters of said imaging device which performs said imaging examination on said patient, such that image quality thresholds are not exceeded and said patient receives only the minimum radiation dose exposure required for said imaging examination.

38. The method of claim 8, further comprising:

selectively providing different radiation dose exposure parameters derived by said processor, to different areas of a body of a patient during said imaging examination.

39. The method of claim 38, further comprising:

identifying an area of concern using said processor, and calculating differential radiation dose exposure parameters using said processor, to ensure detectability of said area of concern, while maintaining relatively lower but acceptable quality parameters in a remaining portion of said imaging examination.

40. The method of claim 7, further comprising:

obtaining said ultra-low dose image in a series of images from said imaging device to said computer system, such that a cross-sectional image is obtained and stored in said database;

determining an amount of said noise in pixels of each of said images using said processor; and

determining said optimum radiation dose exposure parameters using said processor, to maintain a predetermined quality threshold.

41. The method of claim 40, wherein sequential dose adjustment is used.

42. The method of claim 5, further comprising:

recommending selected imaging examination profiles, using said processor, based on said patient'"'"'s medical history, prior radiation dose exposure, appropriateness criteria, susceptibility to radiation injury, pediatrics, past history of therapeutic radiation, and genetic profiles with risk.

43. The method of claim 5, wherein said comparable data includes data on patients of a same imaging study exam profile, and comparable size.

44. The method of claim 37, wherein said optimum acquisition parameters are based on a patient'"'"'s body mass index, clinical indication, and imaging study exam type.

45. The method of claim 5, further comprising:

using said processor to query said database to determine an appropriateness of said imaging examination based on said medical history of said patient.

46. A computer system which provides a radiation scorecard for controlling radiation dose exposure to an individual, comprising:

a radiation detector, including an imaging device or a therapeutic device, for detecting radiation dose exposure on an individual;

at least one memory containing at least one program comprising the steps of;

calculating, using a processor of the computer system, an entrance skin dose and effective dose to a patient, for a predetermined medical procedure;

calculating, using said processor, an area of irradiation to said patient;

calculating, using said processor, an effective radiation dose to said patient using a radiation detector, for said medical procedure, as a summation of a product of an entrance skin dose times fractional organ doses stored in a database, times critical organ dose weighting factors retrieved from said database, wherein said medical procedure is an imaging examination using an imaging device;

storing said effective dose for said patient, in said database;

deriving, using said processor, a cumulative radiation dose for said patient which is compared against a maximum radiation exposure amount safe for said patient;

calculating, using said computer, said radiation dose exposure from said comparison, to result in optimized radiation dose exposure parameters for said patient;

deriving a patient radiation scorecard including said cumulative radiation dose, said maximum radiation exposure amount, and said optimized radiation dose exposure parameters, and storing said patient radiation scorecard in said database;

retrieving comparable data to an examination profile which contains patient data retrieved from said database on said patient on said radiation dose exposure from said database;

comparing said comparable data to said patient data on said radiation dose exposure from said imaging examination profile;

displaying said optimized radiation dose exposure parameters and corresponding radiation dose exposure calculations derived from said comparison using said processor, on a display;

identifying technology options including alternative imaging examinations or alternative examination protocols, to minimize said radiation dose exposure to said individual patient; and

the processor configured to execute the program.

47. A non-transitory computer readable medium whose contents cause a computer system to execute instructions of a program, the program comprising the steps of:

calculating, using a processor of the computer system, an entrance skin dose and effective dose to a patient, for a predetermined medical procedure;

calculating, using said processor, an area of irradiation to said patient;

calculating, using said processor, an effective radiation dose to said patient using a radiation detector, for said medical procedure, as a summation of a product of an entrance skin dose times fractional organ doses stored in a database, times critical organ dose weighting factors retrieved from said database, wherein said medical procedure is an imaging examination using an imaging device;

storing said effective dose for said patient, in said database;

deriving, using said processor, a cumulative radiation dose for said patient which is compared against a maximum radiation exposure amount safe for said patient;

calculating, using said computer, said radiation dose exposure from said comparison, to result in optimized radiation dose exposure parameters for said patient;

deriving a patient radiation scorecard including said cumulative radiation dose, said maximum radiation exposure amount, and said optimized radiation dose exposure parameters, and storing said patient radiation scorecard in said database;

retrieving comparable data to an examination profile, which contains patient data retrieved from said database on said patient, on said radiation dose exposure from said database;

comparing said comparable data to said patient data on said radiation dose exposure from said imaging examination profile;

displaying said optimized radiation dose exposure parameters and corresponding radiation dose exposure calculations derived from said comparison using said processor, on a display; and

identifying technology options including alternative imaging examinations or alternative examination protocols, to minimize said radiation dose exposure to said individual patient.