Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine.

August 20, 2019

Pearls: Protocol Optimization in the Era of Informatics

Image Wisely features “pearls of wisdom” on radiation safety written by one of our members. Please read and forward these pearls as appropriate to your websites and social media followers.

Pearl #1
The Digital Imaging and Communications in Medicine (DICOM) header is text hidden at the beginning of every medical image that contains patient, study, series, and image data. The Radiation Dose Structure Report (RDSR) provides accounting of all radiation exposures made during a study along with relevant dose metrics, but it is not easily human readable and requires sophisticated software to examine and mine. The right expertise can harness the DICOM data to direct and accelerate optimization tasks.

Pearl #2
The Qualified Medical Physicist (QMP) brings together knowledge of patient population, study indication, and physics associated with acquisition parameters to recommend appropriate changes to reduce this variability to acceptable levels. Once changes are dictated by a protocol committee, they must be implemented on the scanners and subsequent impact must be determined. It is then the role of the QMP or radiologist to weigh the success of the protocol change.

Pearl #3
It may appear that all data necessary for optimization are in the DICOM data, but this is not the case. Lack of DICOM image quality metrics represents a large hole in the framework needed for data-driven optimization, and human beings must provide image quality data during the protocol optimization process until such metrics are developed, validated, and implemented.

The pearls are taken from this JACR study: Protocol Optimization in the Era of Informatics


View additional pearls »


Image Wisely encourages practitioners to optimize the amount of radiation used in
medically necessary imaging studies and to eliminate unnecessary procedures

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