Screening radiation exposure for quality assurance

Quality assurance for planned radiation exposure situations (e.g. Digital Radiography, Computed Tomography or Radio Fluoroscopic studies) requires the application of examination-specific scans protocols. These are tailored to patient age or size, body region and clinical indication for ensuring that the dose applied to each patient is as low as reasonably achievable for the clinical purpose of the image acquisition (ALARA principle). The European legal framework--2013/59/EURATOM--points that health authorities will be more pervasive on inspecting the dosimetry applied to patients. This paper discusses these legal alterations and presents an interoperable distributed system for dose monitoring, which is compliant with legal procedures and the IHE Radiation Exposure Monitoring profile (REM). The system combines the most representative stakeholders affected and directly interested in the patient radiological protection: patients, radiologists, practitioners, health authorities, and ethics committee. The system is capable of gathering, in real-time, dose information applied to the patient and storing it in a regional or national wide dose registry. The paper addresses which information should such systems hold and which should be accessed, from each stakeholder perspective. Furthermore, the system may detect irregular dose patterns, which could indicate dose abuses, and signal those findings to the appropriate stakeholders.