At the International Symposium on Multidetector-Row CT in Washington, DC, it was acknowledged that the field of Radiology has progressed a great deal over the years. Through the continuation of advancing CT image quality and managing radiation dosage, radiology, along with the assistance of imaging informatics can establish this specific science into medical practice.
Radiology institutions may use informatics to scale a practice’s CT images alongside national data, thus issuing a viable means of reviewing not only equipment, but staff productivity as well. The University of Maryland provides an example of this:
"We've created an informatics platform to collect data from radiologists and technologists that includes a feedback category on image quality. The feedback we get from the data allows us to fine-tune our performance. The entire department benefits from it, as it provides management support and quality control,” said Dr. Eliot Siegel.
Siegel also notes the differences in CT image quality across the U.S. as radiologists have their own opinions of what makes a quality image. Even the RSNA’s booklet on radiology terminology, RadLex, doesn’t necessarily offer an answer to the problem. It uses all kinds of terms to rate image quality such as "nondiagnostic," "limited" (unable to offer any insight), "diagnostic" (ordinary quality, usable), and "exemplary" (should be the standard).
“Payors don't take CT image quality into consideration except at a basic ‘yes’ or ‘no’ accreditation level, and the current accreditation process is limited in its ability to assess and document image quality. Right now, it's 'pick your best exams every three years, and we'll pass or fail you,” said Siegel.
Tracing CT image quality is crucial because not only does it maximize patient care and precision in diagnosis, but also helps calculate the transaction between radiation exposure, dose, and quality.
"If we don't have a mechanism to determine image quality and we don't have a way to determine how to improve it, then it's going to be difficult to optimize dose,” mentioned Siegel.
Tracing CT image quality is also useful in the respect that it allows users to evaluate the equipment itself.
"Image quality data can help determine when it's time to get a new CT scanner. And if a practice has multiple scanners, it can help determine when to put patients on the better scanner and when to use the less optimal scanner,” added Siegel.
Siegel also cites most radiologists don’t frequently assess CT image quality and urges a routine methodology to be set in place.
This is the premise behind informatics tools as they utilize the tracing of several quality images on a consistent basis, paint an entire picture on the productivity levels of the department, and offer pertinent feedback, creating a type of quality report card.
Siegel suggests that every image should be assessed by the technologist, the radiologist, and an automated assessment through a computer-based diagnosis, thus allowing technicians to compare and improve their work and review and rate images on the scanner.
Regardless, radiologists must evaluate CT image quality regularly.
"Quality assessment shouldn't just be part of a three-year accreditation cycle. It should be a continuous process,” finished Siegel.
