Delivering on dose reduction promises

System shows 41% lower dosage than others

With more than 60 years in radiology, Zwanger-Pesiri is one of the largest non-hospital-based radiology practices in the USA. Among its 60 radiologists the number of specialties include interventional, neuro, abdominal and cardiovascular radiology as well as musculoskeletal, breast and vascular imaging.

Photo: Delivering on dose reduction promises

With such a diverse, large patient base, and many radiologists to manage, workflow is a key consideration, which is why the DX-D 300 DR system, with its Cesium Iodide detector technology and immediate image availability, was chosen.

Workflow was the initial driver
‘We installed our first Agfa HealthCare DR solution, the DX-D 300, in our Elmont site in August 2013. We chose it primarily because the workflow was so efficient, it was easy for the technolgists to set up and images were quickly available. At the time, Agfa HealthCare was telling me about its dose reduction capabilities but, to be frank, I didn’t really believe them. They kept on about it, so we set up a study to compare results.‘We had two competitive units from other suppliers on the same site, so that provided the ideal opportunity to test what they said.’

Study parameters
The aim was to determine if the DX-D 300 needed less exposure and patient dose than two other systems used at Zwanger-Pesiri Radiology. It also compared doses used to those used for similar exams in other facilities, based on available published studies*. It comprised PA Chest, Lateral Skull and AP Hand exposures taken on phantoms used to simulate patient exposures.In each case the phantom was positioned just as a patient would be and the standard exposure made.

41 percent average dose reductions
Results showed that, while the amount varied depending on the type of exam, the average dose on most was 41% lower with the Agfa HealthCare system versus the other systems – an admittedly unexpected result for Zwanger-Pesiri.

‘Much to my surprise, the DX-D 300 was able to provide high image quality at a lower dose,’ Dr Mendelsohn said. ‘For me, that’s great in one way and possibly bad in another. It’s good because we can promote our commitment to dose reduction to our patients and now have the figures to prove it, but,’ he adds laughingly, ‘it could possibly be bad, because the company will want to raise the price we pay! Although, to be honest, I would be prepared to pay a little more for the level of dose reduction we achieved. Agfa HealthCare has done a really wonderful job with it.’

A compelling story
‘Dose reduction has become a very compelling story; all radiologists need to be cognitive of is patient dose and aware that patients are becoming better informed and will increasingly ask questions,’ Dr Mendelsohn said. ‘Change will ultimately be driven from the grass roots rather than by radiologists because our financial model does not currently place a premium on it.’

Dr Mendelsohn acknowledges that, with the advent of Cesium Iodide phosphor detectors and Musica imaging processing software used with the DX-D 300 solution, the firm can now achieve the best of both worlds – significant dose reduction while radiologists still gain high quality images with which to work.

‘With so many sites, and such a large population to serve, our biggest challenge is one of workflow,’ says Jeanine Sartorelli, Zwanger-Pesiri’s Chief Technical Officer. ‘To meet demand, we have a lot of teams that rotate across our sites, so ease of use when switching between solutions is paramount.’

A happy patient is the ultimate aim. ‘With the advent of Google and other information sites, patients are more knowledgeable and more prepared to question their dose exposure,’ Janine explains. ‘It’s great to be able to say that we are using the lowest possible dose for their images. With the automation and accuracy offered by the DX-D 300 with Cesium Iodide detectors and Musica, we can speed them through the process and make it easier for referrers to access their information.’


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