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Mayo Clinic is initiating a new imaging exam tracking system that, among other things, enables a comprehensive view of a patient's radiation exposures over time.

Believed to be one of the first of its kind, the new computerized tracking system can replace time-consuming manual tracking processes used in many medical centers.

The DICOM Index Tracker (DIT), designed and architected by Steve G. Langer, Ph.D. at Mayo Clinic in Rochester, is being developed at Mayo Clinic in Arizona in cooperation with Arizona State University. DIT tracks all the information available in the images contained in a patient's imaging studies (including dose, scanner utilization and other information) and compiles it into an accessible format.

William Pavlicek, Ph.D., Chair, Section on Diagnostic Physics at Mayo Clinic in Arizona, said that in the past 20 years there has been a migration to digital imaging for medical tests and as a result patient records contain a fairly accurate history of the radiation dose they've received. Yet, accessing dosage amounts from medical records had to be done manually — he said there has been a struggle to collect all of this information into a central repository. At the same time, the need to track dosages has become greater because of efforts within the medical community to lower radiation doses over time.

The DICOM index tracker centralizes digital images information from tests such as mammography, CT scans, nuclear medicine, cardiac catheterization, etc. The information can then be sorted by patient or procedure to assess the radiation dose and the number of treatments. Equally important, the system has alerting features built in to ensure dosages are within limit guidelines set by the American Academy of Radiologists.

Dr. Pavlicek said the development of DICOM is an evolutionary step for radiology.

"For the first time we can monitor all the patient records in a centralized fashion and we can review quality assurance guidelines efficiently and conveniently," Dr. Pavlicek said. "The benefit for the patient is consistency and continuing to provide an environment that is completely safe which includes the feeling that they are receiving the minimum amount of radiation to achieve a diagnosis."

Dr. Langer adds:

"While the DICOM standard has been around since 1993, every year new supplements are added to the base standard. This makes it challenging to use a fixed database designed to construct patient radiation (or other) queries, because how and where this information is encoded varies from scanner version to version. What makes DIT unique is that it "learns" about new scanner versions as they are encountered, and builds up a knowledge base to enable a standard set of queries."

The DICOM Index Tracker is being used at both Mayo Clinic in Arizona and Mayo Clinic in Rochester. More than 1.5 million imaging tests are conducted at the three Mayo Clinic sites each year.

A team led by ASU associate professor Teresa Wu, Ph.D. and assistant professor Muhong Zhang, Ph.D., both in School of Computing, Informatics and Decision Systems Engineering, collaborated with the Mayo Clinic Department of Radiology to develop the tool.

Source: Mayo Clinic