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 optimizes 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 employees. Besides, it assures regulated reports that provide an efficient pro-active solution to the labour-intensive regulatory compliance monitoring.In this way, DOSE assists the users to maintain patient safety and quality in medical imaging.
DOSE is the most optimal solution for automated quality management in medical imaging. It gathers data from different sources within your facility and connects them to get an overall or detailed impression of the quality of your service. Qaelum are committed to the principles of ALARA (As Low As Reasonably Achievable) and constant quality improvement, we focus on automated patient radiation dose management, image quality assessment and lifetime learning of your staff.
DOSE Support & Services
Dedicated Applications Specialists provide our customers with a training solution tailored to meet the requirements of each individual site. Typically, a general product training at installation and a more personalised follow up training adapted to the needs of the user. Our team are always at hand to answer any specific questions.
As quality is of the utmost importance to us, Qaelum is a medical device manufacturer adhering to ISO-13485 and ISO-14971. DOSE has a number of certifications and quality labels including CE class IIb, CAMCAS level III (Canada) and FDA clearance for the US market.
VirtualDose enables you to estimate more accurately the effective dose and organ dose for a patient in a CT examination. A vast library of 25 anatomically correct phantoms is at your disposal: phantoms of several body sizes, different genders, pediatric phantoms and even different stages of pregnancy. Consequently, you can simulate the fetal dose in case of pregnancy more precise. VirtualDose is a very useful simulation tool to test 'what if' scenarios and to educate your staff.
For RX modalities, you can evaluate the rejected images at the device and give advice on how to optimize the training of your personnel.
The concept of live dashboards enables immediate feedback regarding dose and quality. The technician has the possibility to justify the performed exam by adding comments. All these comments can be collected inside one report and can be used to personalize additional training per technician.
Patient Dose Passport
Because DOSE is integrated in the PACS, you can easily request the patient dose passport. It 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 assess if it is still below achievable level.
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 a workload analysis graph, which monitors 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.
Blind scanning should be avoided since the CT scan doesn’t know exactly how to behave or what dose to use. This problem is evaluated by DOSE since it checks and measures blind scanning.
Size Specific Dose Estimate (SSDE)
Considering all dose calculations in CT are estimated on phantoms, they are not representative for every patient; because unlike a phantom, not all patients are equal in size. Consequently, DOSE aims to resolve this problem by doing a segmentation on the scout image and recalculating the patient’s real size.
Peak Skin Dose
Peak Skin Dose is a module applied for interventional radiology devices and estimates the maximum skin dose that is delivered during an interventional procedure. The information is represented in a Peak Skin Dose map, which uses color coded pixels to indicate the amount of radiation delivered to a particular area of skin. In addition, tube angulation, table movement, fluoroscopy dose, etc. are also monitored. Consequently, Peak Skin Dose is a perfect tool to optimize interventional procedures.
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.
Integrated reporting & exporting
- All data in the system can be exported to popular formats like MS Excel or PDF on study, modality or location level
- Reporting modules, i.e. Leapfrog reporting: automatic export to the different MS Excel Leapfrog templates with automated study selection and with auto-selection of the appropriate date range
- 600+ visualization and analysis components
- Creation of mini-websites with analysis components of interest for easy collaboration
The Joint Commission
DOSE helps achieve compliance with the Joint Commission requirements for CT and fluoroscopy.
With DOSE you set up unique combinations and monitor progress intuitively for key factors like skin dose, air kerma-area product (KAP), air kerma at a 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. Specifically, DOSE helps caregivers track patient’s cumulative radiation dose from multiple examinations. The system enables setting up a threshold and time period after the patient’s first examination, thus creating a standard for monitoring future dose based on your institution’s requirements and/or Joint Commission requirements. Reaching your compliance goals has never been easier.
Whenever the pre-set threshold is exceeded, a notification is generated. This can be accompanied by an email to the person in charge of these events in order to get notified quickly and perform the required actions.
More about the Joint Commission
- Integrated benchmarking with dynamic (i.e. local) and static (i.e. national) reference values
- Advanced mapping of the different Study Descriptions to the correct RadLex Playbook codes for uniform comparisons
- Use pre-defined populations or create your own for detailed benchmarking between devices
- Integrated with ACR DIR
Standardization and optimization of CT protocols is one of the corner stones of rigorous radiation protection plans! Due to the multitude of available protocols, the diversity over the different vendors and the complexity of these protocols, it is a very tedious and time-consuming process. The new Enterprise Protocol Management module of DOSE is a vendor-neutral solution to centrally manage and monitor the protocols of your CT scanners. This module allows professionals to perform the following tasks.
- define all the master protocols of your protocol tree with an easy to use, intuitive user interface. Elements that can be defined are: the protocol structure, key scanner settings, contrast details, and a corresponding Radlex code
- import existing protocol trees to speed up the configuration process
- link the individual protocols of different scanners to the master protocols
- identify differences in the implementation of master protocols on different scanners
- use pre-defined workflows to initiate and follow-up tasks for changing settings on the CT scanner
- to ensure access to the latest version of the different protocols for all the stakeholders, the module allows for re-publishing the protocols in user-definable templates, with actual radiation dose information included
- the public API of the module allows for a tight integration of the distributed, up-to-date protocols into the daily work environment of the technologists
- the module monitors modifications in the protocol tree of individual CT scanners. Additions, removals, or alterations of protocols are tracked. This helps to examine all of the changes and if they are permitted
- depending on the local situation, DOSE can connect to your CT scanners and automatically retrieve and analyze the protocol files
- in combination with DOSE, the overall usage of the scanner protocols is evaluated, and statistics are generated
- pre-defined rules identify protocols that have not been used recently or that have been applied to a different population than indicated by the master protocol
- changes of the protocol during an examination, trigger a notification to assist in the justification of inappropriate dose/performance
Participation at Conferences
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
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.
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