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.
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.”
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