HealthData Management - November 2012

show to technicians, radiologists, referring physicians and patients.

Advocate has been working with GE Healthcare as an early partner in GE Blueprint for Low Dose, a free consulting program that helps major health systems (whether or not they’re GE customers) to benchmark their dose levels and analyze potential reduction strategies.

“For years the goal has been image qual-
ity,” says Ken Denison, who leads GE’s low-
dose strategy “Now we’re seeing a shift to
image utility—the lowest possible dose that
gives a useful image.”
Over the past two and a half years, Advo-
cate has spent millions to upgrade 47 out of
51 CT scanners (from GE and other vendors)
to low-dose platforms, and it’s implement-
ing GE’s Dose Watch software to track doses.

Anastos says that act alone helps reduce the doses, much like writing down what you eat, the first step in many a successful diet, causes you to eat less. The software also suggests new parameters for any exam settings that will otherwise result in excess radiation dose. Anastos expects the software to be fully implemented by early 2014.

Image reconstruction

Denison says a new approach to image reconstruction software makes it possible to get adequate image quality while dramatically lowering dose. The old technique, called filtered back projection, was fast and efficient, but it relied on simplified assumptions about the scanner’s optics and detector geometry and took only one pass through the raw data, resulting in a noisy image.

The new technique, model-based iterative reconstruction, creates a much more precise mathematical model of what the scanner does, and then recomputes the data multiple times. MBIR can produce less noisy images while dropping radiation dose 75 percent or more. GE’s Veo software, which uses MBIR, was approved by the FDA last year.

Advocate doesn’t yet include dose information in its EHR. “Most of the radiology systems don’t talk well with the inpatient medical record systems,” Anastos says.

Clinicians will have a major educational task on their hands. “It’s taken years for the public to understand what is or isn’t a normal cholesterol or blood pressure reading,” Anastos says. “You can’t just give someone a number.”