Dose management in radiology. Review of the technological status

The Euratom directive 2013/59 ("EU directive for radiation protection") has to be implemented into national law by spring 2018 and requires a complete recording of patient dosages and relevant parameters. Additionally, a medical physics expert has to be consulted for each radiological examination above a defined threshold. A complete recording of the dosage administered from all modalities and optimization of the radiological procedures should result in a reduction of the total dosage. This can be achieved by automated systems that incorporate not only the detection of the dose parameters but also the evaluation and analysis of these data. When provided with warning levels such a system should be able to inform or warn the operator when dose thresholds have been exceeded or even better inform the operator about possible excess dosages before an examination. Depending on the information provided by the modality, dose management systems can operate at different levels in the picture archiving and communication system (PACS), radiological and hospital information systems (RIS/HIS) or with the header information of a digital imaging and communications in medicine (DICOM) image and evaluate and analyze this data. A practicable use of such systems is only possible by close cooperation of medical personnel, medical physicists and information technology (IT) administrators. Various systems are available commercially or free but an individual adaptation of these systems is useful and necessary, depending on the requirements of the radiology practice or hospital.