Implementing Effective Ways to Reduce and Track Radiation Dose for X-ray Exams

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El Camino uses two DRX-Revolutions as part of its conversion to DR technology.

El Camino Hospital has made dramatic decreases in patient dose in recent years. We use Bayer Radimetrics dose management software to track dose for all CT exams and we are now starting to collect dose for our room and portable X-ray exams and for fluoroscopy and interventional radiography procedures. We are especially proud of our accomplishments in the area of portable imaging, where we have made a significant reduction in dose.

We have lowered dose by replacing CR with DR technology—and by implementing software that enhances visualization and reduces the need for repeat exams.

We installed three new wireless DR portable systems that are used for imaging of critical care patients in our neonatal ICU, ER and OR as well as bedside exams for our main Mountain View campus. We have two Carestream DRX-Revolution portables and have retrofitted two existing mobile imaging systems with DR detectors to perform ER, OR and bedside exams at our Los Gatos campus.

Since critical care patients require more images than other patients, they benefit most from dose reduction as well as the enhanced image quality we are now able to provide to our physicians. We use grids for 90 percent of adult exams and our new imaging software lines up the grid with the tube head. This makes it much easier for technologists to achieve an excellent quality image and reduces the need for repeat exams. The grid improves details in the chest and abdomen as well as thicker body parts and provides better diagnostic data for physicians.

We now use a cesium iodide DR detector that fits into the incubator tray to image fragile neonatal ICU patients. This enables us to produce excellent quality images at a very low dose. Our imaging software includes pediatric settings that help technologists use the correct technique for each patient.

Both adult and pediatric critical care patients benefit from imaging software that helps enhance visualization of pneumothorax as well as tubes and lines by producing an image that is optimized to display the chest and tubes/lines from the original image. This also eliminates repeat exams and reduces dose.

Patient care is also improved by the higher power generators offered by modern portable X-ray systems. These generators enable us to image heavy or obese patients at a lower dose and provide better quality images at a lower dose for all our patients.

Have you converted all your X-ray imaging systems from CR to DR? As part of this transition, are you retrofitting existing systems, purchasing new DR systems or both?

Howard Sanford, R (MR), is the imaging operations manager at El Camino Hospital.