Radiation dose management solution
- Register, save & track radiation dose information
- Compare against national DRLs (diagnostic reference levels)
- Recall patient dose passports
- Optimize your patient dose and improve quality
What is DOSE?
DOSE is a dose management solution that automatically monitors, evaluates and reports the radiation dose that patients receive for multi-facility, multi-modality and multi-vendor imaging environments.
The solution provides direct insight into the daily dose management, the clinical image quality and the performance of your department. It assures regulated reports and provides an efficient pro-active solution to the labour-intensive regulatory compliance monitoring. In this way, DOSE assists the users to improve quality and maintain patient safety in medical imaging.
Why DOSE?
The dose management software, DOSE, developed by Qaelum, is one of the most powerful and flexible systems of its kind. Since its commercialisation started around 2012 the software has continuously improved. DOSE is the core product of our company, into which all the know-how and energy of our employees flows! The quality is also reflected in the product classification of a class IIb medical device. To our knowledge, DOSE is the only product of its type on the market that has achieved this high classification. DOSE is the optimal solution for automated quality management in medical imaging.
DOSE Support & Services
In addition to product quality, flawless implementation, and smooth project management, the best support is also of pivotal importance. For this reason, we have our own project management and medical physics teams with decades of experience in this field. Dedicated Applications Specialists provide our customers with a training solution tailored to meet the requirements of each individual site. Our constant and fast support will solve every issue that occurs as fast as possible.
DOSE Certifications and Data Protection
As quality is of the utmost importance to us, Qaelum is a medical device manufacturer adhering to ISO 13485:2016 standards for Medical Devices. We also hold ISO 27001:2022 certification for Information Security. DOSE is also certified as CE class IIb.
Compliance with international data protection regulations, as well as your internal IT guidelines, are top priorities for Qaelum.
Legal Conformity
With DOSE you will always be on the safe side, conforming to local legislation. Special consideration is given to the best possible implementation of national regulations. It is very important to us that the daily work is not burdened by additional tasks, so DOSE informs the users automatically of any adverse events, e.g. via pop-up window or E-mail. Subsequently it’s possible to directly enter predefined or individual reasons or justifications for an event.
DOSE allows you to continuously capture all radiation dose data to evaluate compliance. Our solution works with a ‘traffic light’ system, which informs you on Diagnostic Reference Levels (DRLs). Whenever the achievable or acceptable regulatory levels are surpassed, the study or series will be flagged orange or red respectively to allow for further investigation.
With DOSE you set up unique combinations and monitor progress intuitively for key factors like peak skin dose, kerma-area product (KAP), air kerma at reference point, … You can set notifications on individual parameters that exceed a pre-set threshold, but also on cumulative parameters within a specific time interval. Whenever the pre-set threshold is exceeded, a notification is generated. This can be accompanied by an email to the person responsible for these events in order that they are notified quickly and can perform the required actions.
DOSE also helps to achieve compliance with the Joint Commission requirements for CT and fluoroscopy.
Team and Role Management
DOSE has an extensive, but easy to use team and role management system. This allows the operators to use the dose management system effectively, letting them concentrate on their respective core tasks. In addition, user access can be limited to specific data and devices by an administrator.
For example, our concept of live dashboards enables immediate feedback regarding dose and quality. The technician has the possibility to directly comment on the performed exam and justify a potential high dose or decreased image quality. All these comments can be collected inside one report and can be used to personalize additional training per technician. Comments can also be useful to save time when investigating outliers.
PACS, HIS and RIS Integration
DOSE works optimally with PACS, HIS and RIS systems via standardized interfaces. With one click in DOSE, the user can jump directly to the complete study in the PACS and vice versa. This considerably simplifies the work of physicians, radiologists and medical physicists. Justifications, comments or dose values can be exchanged automatically and radiation dose passports can be called up across program boundaries. The patient passport contains all registered dose information from this particular patient, including the type and number of studies they have had and the interval between these studies. By doing so, you can easily track the patient’s cumulative dose and imaging history.
Advanced CT Analysis
Even advanced CT analysis becomes child’s play with DOSE. The software extracts all relevant information from available data and calculates advanced parameters such as SSDE. Considering that basic dosimetric parameters like CTDIvol are measured on phantoms, segmenting the actual images to get closer to the patient size allows for a better dosimetric approach. Other parameters that can have a great influence on the patient dose are visualized by means of clearly arranged graphics, for example, the tube current modulation, the patient positioning or the calculation of blind scanning. Blind scanning should be avoided since the CT scanner does not know exactly how to behave or what dose to use in the blind area. This problem is evaluated by DOSE since it calculates blind scanning and displays it on the localizer.
Image Quality Analysis
An applied radiation dose must always be perceived in relation to the image quality. Therefore, Qaelum is constantly working to include helpful tools to analyze image quality. With the Global Noise Level (GNL) we offer a scientifically described image quality index, which allows a direct evaluation and outlier detection by performing a multiparameter analysis.
Virtual Dose CT and Virtual Dose IR
DOSE calculates effective dose for all ionizing radiation modalities for the standard settings of each examination. For an even more detailed analysis, very powerful tools are optionally available with Virtual Dose CT and Virtual Dose IR. The examination parameters can be adjusted directly and several scenarios can be simulated using different phantoms (from infants to adults, as well as various stages of pregnancy).
Peak Skin Dose
DOSE enables the calculation of Peak Skin Dose from interventional procedures and displays this on a coloured dose map and an elliptical phantom. Based on the peak skin dose values, the system automatically provides information on which deterministic effects can be anticipated and which follow-up recommendations can be communicated to both patient and clinician.
Nuclear Medicine
We have a lot of experience in the field of nuclear medicine and we offer extensive functionality and tools in this area, including logbook management (contamination, waste, purity of pharmaceuticals, etc.), as well as advanced dosimetry. Effective dose and organ doses are calculated automatically based of the conversion factors made available by the International Commission on Radiological Protection (ICRP). Dose conversion factors can also be edited per case to depict the condition of the patient or the type of examination in a more accurate way. Data sources can be the hotlab management system, the NIS or RIS or even the PACS.
Contrast Media Management
Do you want to get a quick overview of the consumption and costs of the contrast media used in your organization? DOSE’s contrast media management makes it very easy to perform in-depth analysis and obtain detailed information on the contrast media quantities used at various levels. Qaelum works directly with various manufacturers.
Analysis of Rejected Images
The radiation exposure of studies that have been rejected due to errors or quality defects is unfortunately often not taken into account and does not appear in the patient radiation dose passport. DOSE not only helps to automatically record these dose values, but also offers extensive possibilities for error analysis. In this way, users can gain insight into whether the device configuration should be checked or whether operator training might also be required.
US & MRI Integration
Even modalities without ionizing radiation, such as ultrasound and magnetic resonance imaging, can be easily implemented and extensively analysed by DOSE. Room utilization and workflow analysis can be carried out in seconds, providing valuable information, e.g. whether it is relevant to purchase a new modality and with which equipment manufacturers the hospital staff work most efficiently. Numerous graphs and dashboards are available for this purpose.
Management Tools
The moment evaluation graph allows you to simultaneously see the number of studies and the applied dose on a particular day and time. The statistical overview reveals differences in dose during the day versus night, morning versus afternoon and week versus weekend.
In addition, our software also provides workload analysis graphs, which monitor the (in)activity of different modalities. This tool can be used to optimize the use of your modality and the number of technicians per device.
Moreover, DOSE provides a centralized logbook where all the relevant events related to the modalities can be registered and followed-up. This is an easy way to have an overview of all your quality controls and technician visits, as well as to store and track the resulting reports. The origin of potential issues identified in device analysis can be found by simply going through the logged events of that device.
Product feature
Recently, additional electronic clinical quality measures (eCQM) have been proposed by Centers for Medicare & Medicaid Services (CMS) that hospitals and critical care centers participating in the Hospital Inpatient Quality Reporting (IQR) program should adopt.
“Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults (Hospital Level—Inpatient)” is one of these additional measures, which analysis is fully supported by the Qaelum dose management solutions. Using a validated algorithm, it allows you to
- simplify the setup of the needed software to calculate the needed CMS metrics
- better understand your current situation on excessive radiation dose and inadequate image quality
- gather insights that can help you understand where and how you can improve your outcome most
- automate internal reporting of the calculated metrics
- define and implement documented improvement plans
References
Participation at Conferences
Dedulle A, Fitousi N, Bosmans H. "The potential win of including the patient size in large scale outlier analysis for chest radiography". European Congress of Radiology , ECR 2022, 2 – 6 March 2022 (online) & 13 – 17 July 2022, Vienna, Austria.
Dedulle A, Bosmans H, Fitousi N. "Influence of administered contrast on the water equivalent diameter for CT abdomen". Congress of Radiological Society of Northern America, RSNA, 28 November – 3 December 2021, Chicago, USA.
Dedulle A, Fitousi N, Bosmans H. "Assessment of blind scan in chest CT examinations". European Radiation Protection Week, ERPW, 22 – 24 November 2021, Vienna, Austria.
Dedulle A, Bosmans H, Jacobs J, Fitousi N. "Impact of contrast and respiration conditions on the calculation of water equivalent diameter". Joint Conference of the OGMP, DGMP and SGSMP Dreilandertagung der Medizinischen Physik, 19 – 21 September 2021, Germany (online).
Dedulle A, Fitousi N, Bosmans H. "Accuracy estimation of advanced dosimetric calculations for radiography". Joint Conference of the OGMP, DGMP and SGSMP Dreilandertagung der Medizinischen Physik, 19 – 21 September 2021, Germany (online).
Dedulle A, Fitousi N, Bosmans H. "Evaluation of positioning in pediatric head CT examinations". Joint Conference of the OGMP, DGMP and SGSMP Dreilandertagung der Medizinischen Physik, 19 – 21 September 2021, Germany (online).
Dedulle A, Bosmans H, Jacobs J, Fitousi N. "Assessment of noise reference levels in abdomen CT". European Congress of Medical Physics, ECMP 2021, 17 – 19 June 2021, Turin, Italy (online).
Dedulle A, Bosmans H, Jacobs J, Fitousi N. "Multi-parameter analysis for dose and noise evaluation in clinical abdomen CT examinations". European Congress of Medical Physics, ECMP 2021, 17 – 19 June 2021, Turin, Italy (online).
Dedulle A, Fitousi N, Bosmans H. “Influence of spectrum and patient size on dose conversion factors for chest radiography”. European Congress of Radiology , ECR 2021, 3 – 7 March 2021, Vienna, Austria (online).
Dedulle A, Fitousi N, Bosmans H. "Primary results of large-scale size-specific dosimetry in chest radiography". European Congress of Radiology, ECR 2021, 3 – 7 March 2021, Vienna, Austria (online).
Fitousi N. “Supply and commissioning of an RDMS to meet all your needs”, European Congress of Radiology, ECR 2020, 15 - 19 July 2020, Vienna, Austria (online congress).
Fitousi N, Bosmans H, Dewilde S, Zhang XQ, Dedulle A, Jacobs J. “Analysis of cumulated effective doses in medical imaging”, European Congress of Radiology, ECR 2020, 15 - 19 July 2020, Vienna, Austria (online congress).
Dedulle A, Houbrechts K, Fitousi N , Jacobs J, Bosmans H. “First SSDE reference values for pediatric head CT examinations”, European Congress of Radiology, ECR 2020, 15 - 19 July 2020, Vienna, Austria (online congress).
Dedulle A, Houbrechts K, Bosmans H, Demaerel P, Fitousi N. “Protocol selection in pediatric head CT examinations: would a size measurement better support pediatric versus adult protocol selection?”, European Congress of Radiology, ECR 2020, 15 - 19 July 2020, Vienna, Austria (online congress).
Dedulle A, Fitousi N, Bosmans H. “Dose outlier investigation in initiatives of chest radiography optimization: the add-on value of patient size information”, European Congress of Radiology, ECR 2020, 15 - 19 July 2020, Vienna, Austria (online congress).
Dedulle A, Bosmans H, Jacobs J, Fitousi N. “Evaluating proposed dose and noise levels for chest CT”, Optimisation in X-ray and Molecular Imaging, OXMI 2020, 22 - 24 June 2020, Gothenburg, Sweden (online webinar).
Dedulle A, Houbrechts K, Jacobs J, Bosmans H, Fitousi N. “Is the standard age classification correct for pediatric head CT examinations?”, Optimisation in X-ray and Molecular Imaging, OXMI 2020, 22 - 24 June 2020, Gothenburg, Sweden (online webinar).
Dedulle A, Jacobs J, Bosmans H, Fitousi N. “Combining dose, size and image quality to identify outliers in CT examinations”, Belgian Hospital Physicists Association Symposium, BHPA 2020, 7-8 February 2020, La Louviere, Belgium.
Fitousi N, Dedulle A, Jacobs J, Bosmans H. “Can CT image truncation cause false dose alerts in a dose management system?”, 61st annual meeting of the American Association of Physicists in Medicine, AAPM 2019, 14 July - 18 July 2019, San Antonio, Texas, USA.
Dedulle A S L, Rahimzadeh S, Fitousi N, Bosmans H, Jacobs J. “Evaluating the use of a noise index to identify outliers in CT examinations”, European Congress of Radiology, ECR 2019, 27 February - 3 March 2019, Vienna, Austria.
Dehairs M, Fitousi N, Rogge F, Marshall N, Struelens L, Jacobs J, Bosmans H. “Influence of phantom model on peak skin dose mapping in pediatric interventional cardiology”, European Congress of Radiology, ECR 2019, 27 February - 3 March 2018, Vienna, Austria.
Dedulle A, Fitousi N, Zhang G, Jacobs J, Bosmans H. “Evaluation of large-scale patient specific dosimetry in conventional chest imaging”. Annual Meeting of the Radiological Society of North America, RSNA 2018, 25 - 30 November 2018, Chicago, Illinois, USA.
Dedulle A, Jacobs J, Bosmans H, Fitousi N. “Influence of image truncation on the calculation of Water Equivalent Diameter in Computed Tomography examinations”, European Congress of Medical Physics, ECMP 2018, 23 – 25 August 2018, Copenhagen, Denmark.
Dedulle A, Fitousi N, Jacobs J, Bosmans H. “Calculation of the patient size for abdominal radiography in terms of Water Equivalent Diameter”, European Congress of Medical Physics, ECMP 2018, 23 – 25 August 2018, Copenhagen, Denmark.
Dedulle A, Fitousi N, Zhang G, Bosmans H. “Calibration and validation of a Monte Carlo framework for general radiology”, World Congress on Medical Physics & Biomedical Engineering, IUPESM 2018, 3 – 8 June 2018, Prague, Czech Republic.
Dedulle A S L, Fitousi N, Zeppelin Z, Petit V, Zhang G, Jacobs J, Bosmans H. “The effect of patient size on organ-dose conversion factors for chest radiography”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria. DOI: http://dx.doi.org/10.1594/ecr2018/C-2349
Dedulle A S L, Moussalli F, Jacobs J, Fitousi N. “Evaluating the effect of image truncation in the calculation of water equivalent diameter”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria.
Dedulle A S L, Binst J, Lemmens K, Jacobs A, Fytousi N, Bosmans H. “Can routine clinically used scan protocols performed on CTDI test objects predict patient dose”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria. DOI: http://dx.doi.org/10.1594/ecr2018/C-2347
Dedulle A, Fitousi N, Jacobs J, Bosmans H. “A methodology to determine patient size in terms of Water equivalent diameter for conventional chest x-ray examinations”, Belgian Hospital Physicists Association Symposium, BHPA 2018, 2-3 February 2018, Charleroi, Belgium.
Dedulle A, Fitousi N, Bosmans H, Jacobs J. “A methodology to calculate the Water Equivalent Diameter for chest radiography: a step closer to personalized dosimetry with a dose monitoring platform”, Annual Meeting of the Radiological Society of North America, RSNA 2017, 26 November - 1 December 2017, Chicago, Illinois, USA.
Fitousi N, Rogge F, Miniati F, Jacobs J. “Effect of tube angulation on peak skin dose during interventional procedures”, UK Radiological and Radiation Oncology Congress, UKRCO 2017, 12- 14 June 2017, Manchester, UK.
Dedulle A, Fitousi N, Bosmans N. “Comparison of a size-adjusted versus a standard-size approach for dosimetric calculations”, UK Radiological and Radiation Oncology Congress, UKRCO 2017, 12- 14 June 2017, Manchester, UK.
Dedulle A, Fitousi N, Lopez-Rendon X, Petit V, Zhang G, Jacobs J, Bosmans H. “The potential win of patient-specific dosimetry”, Belgian Hospital Physicists Association Symposium, BHPA 2017, 3-4 February 2017, Ghent, Belgium.
Fitousi N, Rogge F, Miniati F, Jacobs J. “Correlation of peak skin dose with geometrical and dosimetric parameters from interventional procedures”, European Congress of Radiology, ECR 2016, 2-6 March 2016, Vienna, Austria.
Fitousi N. “Patient dose tracking systems: A new way of managing patient dose”, 22nd International Conference on Medical Physics, ICMP 2016, 9-12 December 2016, Bangkok, Thailand
Participation at Conferences with Customers
Dedulle A, Fitousi N, De Bruecker Y, Cannie M, Houben A, Roland T, Vanreppelen C, Willocxand M, Bosmans H. "Scanning outside the localizer borders in chest CT: a multicenter study". European Congress of Radiology, ECR 2022, 2 – 6 March 2022 (online) & 13 – 17 July 2022, Vienna, Austria.
Little K, Jacobs J, Fitousi N, Robins M, Carpenter J, Rupe A, Hintenlang D. “Implementation of CT protocol management software to detect deviations from master protocols”, Annual meeting of the American Association of Physicists in Medicine, AAPM 2020, 12 – 16 July 2020, Vancouver, Canada (virtual meeting).
Binst J, Verhoeven H, Lemmens K, Jacobs A, Jacobs J, Dewilde S, Marshall N, Bosmans H. “15 years of remotely controlled daily quality control in digital mammography”, International Workshop on Breast Imaging, IWBI2020, 25 – 27 May 2020, Leuven, Belgium (online meeting).
Tsapaki V, Fitousi N, Niotis D, Triantopoulou C, Maniatis P. "Patient dose management systems: Our experience in the CT department", European Congress of Medical Physics, ECMP 2018, 23 – 25 August 2018, Copenhagen, Denmark.
Little K, Jiang X, Yang X, Fitousi N, Hintenlang D. “Effect of KVp, Reconstruction Kernel/filter, and image thickness on water equivalent diameter”, 60th annual meeting of the American Association of Physicists in Medicine, AAPM 2018, 29 July – 2 August 2018, Nashville, Tennessee, USA.
Hintenlang D, Little K, Jiang X, Yang X, Fitousi N. “Evaluation of Fluoroscopic Dose Metrics Predicted by Dose Management Software”, 60 th annual meeting of the American Association of Physicists in Medicine, AAPM 2018, 29 July – 2 August 2018, Nashville, Tennessee, USA.
Binst J, Dedulle A, Marshall N, Fitousi N, Bosmans H. “Use of a dose monitoring system in routine QA and individual patient dosimetry”, Belgian Hospital Physicists Association Symposium, BHPA Symposium 2018, 2 - 3 February 2018, Charleroi, Belgium.
Binst J, Dedulle A, Marshall N, Fitousi N, Bosmans H. “Five achievements made possible with the tools of a dose management system, and five major tasks of individual patient dosimetry that benefit from a dose management system”, IPEM conference on Dose Management in Radiological Practice, 4 th October 2017, Birmingham, UK.
Tsapaki V, Fitousi N, Caracappa P, Jacobs J, Papailiou I. “CT chest and abdomen organ doses estimation using a dose management tool”, 59 th annual meeting of the American Association of Physicists in Medicine, AAPM 2017, 30 July – 1 August 2017, Denver, Colorado, USA.
Examples of customers' participation at conferences using DOSE
Saltybaeva N, Alkadhi H. “Clinical dose reference levels: developing and application”, European Congress of Radiology, ECR 2019, 27 February - 3 March 2019, Vienna, Austria.
Saltybaeva N. “The concept of local diagnostic reference levels (DRLs)”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria.
Samara E T, Sramek D, Hashagen C. “Implementation of a dose management system in mammography practice”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria.
Saltybaeva N, Alkadhi H. “Overranging dose reduction by dynamic collimators: evidence from clinical practice”, European Congress of Radiology, ECR 2018, 28 February - 4 March 2018, Vienna, Austria.
Scientific Journals
Dedulle A, Fitousi N, Jacobs J, Marshall NW, Bosmans H. "A methodology to estimate the patient diameter and thickness from thoracic and abdominal projection radiographs of adult patients". Phys Med Biol. 2021 Jul 7;66(14). doi: 10.1088/1361-6560/ac0d8c
Samara E, Tsapaki V, Sramek D. "Dose management software implementation in mammography". Physica Medica 2019, 68, 88-95.
Dedulle A, Fitousi N, Zhang G, Jacobs J, Bosmans H. Two-step validation of a Monte Carlo dosimetry framework for general radiology. Physica Medica 2018, 53, 72-79. DOI: https://doi.org/10.1016/j.ejmp.2018.08.005
Tsapaki V, Fitousi N, Salametis A, Niotis D, Papailiou I. Experience with the use of a dose management system in the everyday routine of a CT department. A touchstone or a millstone? Hell J Radiol 2018; 3(1): 17-26.
Fitousi N. “Patient dose monitoring systems: a new way of managing patient dose and quality in the radiology department”, Physica Medica, available online 27 June 2017. doi.org/10.1016/j.ejmp.2017.06.013
Recorded Webinar
Benefits of a dose management system: a hospital perspective
Dose Management Systems represent an efficient approach to quality in active radiology departments. Their rich data source and ingenious, automated processing have many practical applications, from informing patients or referring doctors at any moment about individual x-ray doses up to preparing optimization and justification projects. We will illustrate examples of Dose Management in
- Pediatric Radiology
- CT acquisitions
- Interventional Radiology
Speaker: Prof. Hilde Bosmans
Professor in Medical Physics in the KU Leuven & Head Medical Physics in the Radiology Department of the University Hospitals of Leuven, Belgium
Implementation of remote quality control and dose monitoring in a national breast screening program
Remote Quality Control and patient dose tracking represent an efficient approach to quality in mammography screening programs. Its implementation into clinical practice provides multiple advantages in meeting of regulations and standards, unification of examination procedures and ensuring consistency in quality on daily basis.
It will be illustrated benefits of having such system, particularly for those mammography units whereas there is not involvement of medical physicists.
Speaker: Prof. Vesna GershanProfessor at “Ss Cyril and Methodius University”, Faculty of Natural Sciences and Mathematics, Physics Department in Skopje, North Macedonia. |
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She is a clinically certified medical imaging physicist in Radiology and currently she is involved in several regional and national projects in the field of medical physics and radiation protection in Medicine.
She is responsible for establishing of Quality Assurance program in a national breast cancer screening program and head of the National Center for patent dose tracking and remote QC in mammography.
