Abstract
Purpose:Three patient radiation dose monitoring and tracking (PRDMT) systems have been in operation at this institution for the past 6 months. There are useful information that should be disseminated to those who are considering installation of PRDMT programs. In addition, there are “problems” uncovered in the process of estimating fluoroscopic “peak” skin dose (PSD), especially, for those patients who received interventional angiographic studies and in conjunction with surgical procedures.Methods:Upon exporting the PRDMT data to Microsoft Excel program, the peak skin dose can be estimated by applying various correction factors including; attenuation due to the tabletop and examination mattress, table height, tabletop translation, backscatter, etc. A procedure was established to screen and divide the PRDMT reported radiation dose and estimated PSD to three different levels of threshold to assess the potential skin injuries, to assist patient follow‐up, risk management and provide radiation dosimetry information in case of “Sentinel Event”.Results:The Radiation Dose Structured Report (RDSR) was found to be the prerequisite for the PRDMT systems to work seamlessly. And, the geometrical parameters (gantry and table orientation) displayed by the equipment are not necessarily implemented in the “patient centric” manner which could result in a large error in the PSD estimation. Since, the PRDMT systems obtain their pertinent data from the DICOM tags including the polarity (+ and − signs), the geometrical parameters need to be verified.Conclusion:PRDMT systems provide a more accurate PSD estimation than previously possible as the air‐kerma‐area dose meter become widely implemented. However, care should be exercised to correctly apply the geometrical parameters in estimating the patient dose. In addition, further refinement is necessary for these software programs to account for all geometrical parameters such as the tabletop translation in the z‐direction in particular.
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