Protocol omschrijving niet (altijd) herleidbaar uit resultaten tabel #1
Description
In de WAD_SR dosismodule wordt de dosis op studyniveau opgeteld en weggeschreven in de DB.
Hiervoor wordt de studydescription gebruikt, maar ik vraag me af of dit altijd de beste keuze is. Voor protocoloptimalisatie zou je namelijk het liefst de naam van het CT acq protocol willen gebruiken; afhankelijk van de lokale configuraties bestaat er namelijk niet altijd een 1-op-1 koppeling tussen acq protocol en studydescription.
Op onze afdeling kunnen er namelijk bij 1 aangevraagd onderzoek (studydescription uit werklijst/RIS bijv: “SKELET 3FASE + SPECT/CT”) meerdere CT acquisitieprotocollen worden gebruikt, afhankelijk van leeftijd of gewicht.
Zou het niet beter zijn om configurabel te maken welk veld wordt gebruikt voor de protocolbeschrijving? Voorbeeld van zo’n dataset voor onze Symbia Intevo-6 (zie ook onderaan voor volledige SR):
Acquisition Protocol = Topogram
Acquisition Protocol = LD Skelet Th
In dit geval zou je de CT dosis willen wegschrijven onder omschrijving “LD Skelet Th”. Geen idee hoe je dan om moet gaan met de topogrammen… misschien configurabel maken of deze dosis wordt opgeteld bij het CT-protocol (DLP nemen uit “CT Dose Length Product Total”) of wordt verwaarloosd (alleen DLP nemen uit specifieke “DLP” property van de gespecificeerde CT container). Je “verliest” dan weliswaar een klein beetje dosis, maar voor protocol-optimalisatie lijkt me dit verschil niet relevant.
Verder is het misschien handig om "CTDIw Phantom Type" te vermelden in de resultaten?
Voorbeeld SR:
X-Ray Radiation Dose SR Document
Patient : ----------------^--------^^ (F, 19000101, #1234567)
Referring Physician : -----^-
Manufacturer : SIEMENS (Symbia T6, #89918)
Completion Flag : COMPLETE
Verification Flag : UNVERIFIED
Content Date/Time : 20150616 140829.171000
<CONTAINER:(,,"X-Ray Radiation Dose Report")=SEPARATE>
<has concept mod CODE:(,,"Procedure reported")=(P5-08000,SRT,"Computed Tomography X-ray")>
<has concept mod CODE:(,,"Has Intent")=(R-408C3,SRT,"Diagnostic Intent")>
<has obs context CODE:(,,"Observer Type")=(121007,DCM,"Device")>
<has obs context UIDREF:(,,"Device Observer UID")="89918">
<has obs context TEXT:(,,"Device Observer Name")="INTEVO">
<has obs context TEXT:(,,"Device Observer Manufacturer")="SIEMENS">
<has obs context TEXT:(,,"Device Observer Model Name")="Symbia T6">
<has obs context TEXT:(,,"Device Observer Serial Number")="89918">
<has obs context TEXT:(,,"Device Observer Physical Location during observation")="AMC Rad">
<has obs context DATETIME:(,,"Start of X-Ray Irradiation")="20150616140708.781000">
<has obs context DATETIME:(,,"End of X-Ray Irradiation")="20150616140807.562000">
<has obs context CODE:(,,"Scope of Accumulation")=(113014,DCM,"Study")>
<has properties UIDREF:(,,"Study Instance UID")="1.3.51.0.1.1.145.117.36.171.11000599.1000880">
<contains CONTAINER:(,,"CT Accumulated Dose Data")=SEPARATE>
<contains NUM:(,,"Total Number of Irradiation Events")="2" ({events},UCUM[1.4],"events")>
<contains NUM:(,,"CT Dose Length Product Total")="118.56" (mGycm,UCUM[1.4],"mGycm")>
<contains CONTAINER:(,,"CT Acquisition")=SEPARATE>
<contains TEXT:(,,"Acquisition Protocol")="Topogram">
<contains CODE:(,,"Target Region")=(T-D3000,SRT,"Chest")>
<contains CODE:(,,"CT Acquisition Type")=(113805,DCM,"Constant Angle Acquisition")>
<contains CODE:(,,"Procedure Context")=(P5-0808E,SRT,"CT without contrast")>
<contains UIDREF:(,,"Irradiation Event UID")="1.30160115061512424651500000008">
<contains CONTAINER:(,,"CT Acquisition Parameters")=SEPARATE>
<contains NUM:(,,"Exposure Time")="5.28" (s,UCUM[1.4],"s")>
<contains NUM:(,,"Scanning Length")="448" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Nominal Single Collimation Width")="0.5" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Nominal Total Collimation Width")="3" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Number of X-Ray Sources")="1" ({X-Ray sources},UCUM[1.4],"X-Ray sources")>
<contains CONTAINER:(,,"CT X-Ray Source Parameters")=SEPARATE>
<contains TEXT:(,,"Identification of the X-Ray Source")="A">
<contains NUM:(,,"KVP")="110" (kV,UCUM[1.4],"kV")>
<contains NUM:(,,"Maximum X-Ray Tube Current")="20" (mA,UCUM[1.4],"mA")>
<contains NUM:(,,"Mean X-Ray Tube Current")="20" (mA,UCUM[1.4],"mA")>
<contains TEXT:(,,"Comment")="Internal technical scan par...">
<contains CODE:(,,"Device Role in Procedure")=(113859,DCM,"Irradiating Device")>
<has properties TEXT:(,,"Device Name")="Symbia T6">
<has properties TEXT:(,,"Device Manufacturer")="SIEMENS">
<has properties TEXT:(,,"Device Serial Number")="89918">
<contains CONTAINER:(,,"CT Acquisition")=SEPARATE>
<contains TEXT:(,,"Acquisition Protocol")="LD Skelet Th">
<contains CODE:(,,"Target Region")=(T-D3000,SRT,"Chest")>
<contains CODE:(,,"CT Acquisition Type")=(P5-08001,SRT,"Spiral Acquisition")>
<contains CODE:(,,"Procedure Context")=(P5-0808E,SRT,"CT without contrast")>
<contains UIDREF:(,,"Irradiation Event UID")="1.30160115061512424651500000009">
<contains CONTAINER:(,,"CT Acquisition Parameters")=SEPARATE>
<contains NUM:(,,"Exposure Time")="20.67" (s,UCUM[1.4],"s")>
<contains NUM:(,,"Scanning Length")="413.5" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Nominal Single Collimation Width")="2" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Nominal Total Collimation Width")="12" (mm,UCUM[1.4],"mm")>
<contains NUM:(,,"Pitch Factor")="1" ({ratio},UCUM[1.4],"ratio")>
<contains NUM:(,,"Number of X-Ray Sources")="1" ({X-Ray sources},UCUM[1.4],"X-Ray sources")>
<contains CONTAINER:(,,"CT X-Ray Source Parameters")=SEPARATE>
<contains TEXT:(,,"Identification of the X-Ray Source")="A">
<contains NUM:(,,"KVP")="130" (kV,UCUM[1.4],"kV")>
<contains NUM:(,,"Maximum X-Ray Tube Current")="89" (mA,UCUM[1.4],"mA")>
<contains NUM:(,,"Mean X-Ray Tube Current")="43" (mA,UCUM[1.4],"mA")>
<contains NUM:(,,"Exposure Time per Rotation")="0.6" (s,UCUM[1.4],"s")>
<contains CONTAINER:(,,"CT Dose")=SEPARATE>
<contains NUM:(,,"Mean CTDIvol")="2.81" (mGy,UCUM[1.4],"mGy")>
<contains CODE:(,,"CTDIw Phantom Type")=(113691,DCM,"IEC Body Dosimetry Phantom")>
<contains NUM:(,,"DLP")="116.28" (mGycm,UCUM[1.4],"mGycm")>
<contains TEXT:(,,"Comment")="Internal technical scan par...">
<contains CODE:(,,"Device Role in Procedure")=(113859,DCM,"Irradiating Device")>
<has properties TEXT:(,,"Device Name")="Symbia T6">
<has properties TEXT:(,,"Device Manufacturer")="SIEMENS">
<has properties TEXT:(,,"Device Serial Number")="89918">
<contains CODE:(,,"Source of Dose Information")=(113856,DCM,"Automated Data Collection")>