Digital Radiography Summit Focuses on Safety Measures for Pediatric Imaging

On Feb. 4, the Alliance for Radiation Safety in Pediatric Imaging expanded the Image Gently initiative (www.imagegently.org) to digital radiography exams (standard x-ray technology) by hosting a Digital Radiography Summit at the Mallinckrodt Institute of Radiology at Washington University in St. Louis.

The summit bought together nearly 70 representatives from medical facilities, educational institutions, the U.S. Food and Drug Administration, 12 professional associations and 10 equipment manufacturers organized through the Medical Imaging Technology Alliance (MITA). The summit provided a forum to discuss the expanded use of digital radiography in pediatric examinations and develop guidelines to increase safety measures. Leading medical imaging experts provided information regarding digital radiography challenges, updated radiation safety protocols, new dose management guidelines and future educational opportunities.


“The summit is a first step in the expansion of the Image Gently to address the most commonly performed imaging procedures. Standard x-rays utilize far less radiation than advanced imaging procedures such as CT, but because they are so commonly performed, present a significant opportunity to document, monitor and where appropriate, lower the radiation dose that children receive each year from medical imaging. We are very encouraged by the progress made at this meeting,” said Steven Don, MD, a summit organizer, head if the Image Gently CR/DR initiative, and associate professor of radiology at Mallinckrodt Institute of Radiology.


AAPM, IEC Work to Unify CR/DR Radiation Dose Indexes


The American Association of Physicists in Medicine (AAPM) and the International Electrotechnical Commission (IEC) agreed to work together to create a unified standard for computed radiography and digital radiography exposure indexes. Currently, different equipment manufacturers may use varying exposure indexes which can lead to confusion, particularly for medical imaging professionals who use different equipment at various sites.


”Maintaining consistent exposure index standards is critical for pediatric patients and the medical imaging personnel. A unified standard would help providers deliver appropriate radiation dose for each procedure, help ensure that patients receive a consistent radiation dose regardless of equipment make, and reinforce a consistent baseline quality of care,” said J. Anthony Seibert, PhD, FAAPM, professor of radiology at University of California, Davis Medical Center, and president-elect of the AAPM.


ACR to Establish Pediatric Dose Registry


An additional summit discussion focused on the importance of tracking pediatric exams. Currently, there isn’t a pediatric digital radiography dose registry in the United States. To address this gap, the American College of Radiology (ACR) announced that it will work with meeting organizers to develop a registry to track children’s exposure to radiation. A CR/DR subcommittee of the Image Gently campaign will be formed to work with the ACR.


“This is an important step forward to develop national benchmarks for quality and optimizing dose for this modality. The ACR is committed to ensuring that all patients, particularly children, receive safe appropriate care. This pediatric dose registry in digital radiography will join the CT dose registry in providing valuable feedback to participating practices in optimizing the radiation dose that Americans and in particular children receive each year from imaging studies,” said Richard L. Morin, PhD, chair of the ACR Dose Index Registry and chair of the ACR Safety Committee.


Expanded Technologist Education


Expanding educational opportunities was also on the summit’s agenda. Understanding that digital radiography educational materials are limited, educators and equipment manufactures agreed to collaborate and form a digital radiography educational workgroup led by Susan John, MD, chair of radiology at University of Texas Medical School at Houston.


“More robust and standardized education opportunities for radiologic technologists are vital steps toward ensuring safe, consistent care, regardless of market size or geographic location. All imaging stakeholders need to work together to ensure that patients receive safe, consistent care,” said Greg Morrison, R.T. (R), CNMT, CAE, chief operating officer of the American Society of Radiologic Technologists.


Overall CR/DR Radiation Reduction


Digital radiography exams are the world’s most common diagnostic medical imaging procedures. In addition to providing the radiology team with detailed anatomical views, the technology offers a wide variety of images, increased atitude for exposure techniques and the ability to post-process images. Nevertheless, medical imaging professionals have to be cautious when performing pediatric digital imaging procedures because children are more sensitive to radiation than adults.

“The summit was a very successful first step in educating radiologists, radiologic technologists, medical imaging physicists, the FDA and manufacturers of digital radiography equipment about the unique problems faced by those using this equipment for children’s imaging in daily practice,” said Marilyn Goske, MD, chair of the Alliance and Silverman Chair for Radiology Education at Cincinnati Children’s Medical Center. “The Alliance looks forward to continued work with all medical professionals, educators and vendors in moving forward to ensure that pediatric patients receive only the necessary dose for their indication and that there are consistent, reliable protocols in place to help achieve this goal.


About the Alliance for Radiation Safety in Pediatric Imaging

Founded by the Society for Pediatric Radiology, the American College of Radiology, the American Society of Radiologic Technologists and the American Association of Physicists in Medicine, the Alliance for Radiation Safety in Pediatric Imaging is comprised of 54 organizations working together to reduce unnecessary radiation exposure from imaging examinations in children. It represents more than 600,000 health care professionals.