The Medical Physicist: Part of the Team

As the annual number of imaging procedures increases, the role of the medical physicist is expanding. Today, the physicists are not only essential to ensuring the safe and effective use of radiologic technology, but they are also playing a greater role in maintaining compliance with state and federal regulations and accreditation requirements for radiology.

At a recent expert panel meeting, Mahadevappa Mahesh, MS, PhD, Chief Physicist at Johns Hopkins Hospital, discussed the increasing responsibilities of medical physicists, as they are becoming an important member of the radiology team.

“I feel strongly that the role of the medical physicist is evolving,” said Dr. Mahesh. “We used to do backend work, mainly evaluating equipment. We still do so in the evening, but often nobody knows who the physicist is unless something goes wrong. There is a requirement now to have a protocol team and this team is generally comprised of the radiologist, physicist, and technologist. As a result, physicists are on the front line, working with the team, and I think that dynamic has completely evolved our role.”

As new CT imaging technologies emerge, the focus is increasingly on radiation dose management. Understanding that radiation doses vary substantially, depending on the specific equipment and exams, and even across institutions; a concerted team effort which includes medical physicists to collect and analyze exposure data is warranted. Serving as a radiology team advisor is a critical role of the medical physicists as new regulations are implemented and enforced.

Dr. Mahesh discussed the role of medical physicists and new technology in managing radiation dose with Lawrence Tanenbaum, MD, Vice President and Chief Technology Officer, Medical Director Eastern Division, Director of CT, MRI, and Advanced Imaging, RadNet Inc. View video.

One dose-monitoring technology being incorporated into clinical practice is the NEXO[Dose]® Multi-Modality Radiation Informatics software offered by Bracco. The fully automated, vendor-neutral software is capable of tracking and monitoring radiation exposure in real time, improving efficiency and patient safety. Other equipment manufacturers have developed similar software, including Bayer’s Radimetrics™ Radiation Dose Management Solution, Guerbet’s Dose&Care® digital solution, and GE’s DoseWatch Explore.

Bracco’s NEXO [DOSE] Multi-Modality Radiation Informatics is a single-server, fully automated system that streamlines reporting and documentation with easy access to enterprise-wide radiation dosing data, real-time alerts to assist with identification and correction of outliers, and a centralized database to implement performance improvement initiatives.

There are numerous benefits to radiation-dose tracking; experts agree collecting this data is a best practice that can improve policies and inform personalized clinical decision making. For example, cumulative radiation-exposure data can help alleviate patient concerns about risks associated with such exposure. Additionally, with clinicians and healthcare systems obligated to observe ALARA guidelines to minimize radiation exposure; dose tracking software can help optimize protocols, reduce unnecessary exposure, and help ensure facility compliance with regulations. Medical physicists are actively involved in this process, acting as drivers of dose-monitoring data collection and analysis.

“The physicist can be a key person but has to be supported by administrators and physicians. Ideally, a medical physicist should be key in driving dose monitoring because he or she understands the factors which go back to the radiation dose, including the parameters that are changing or may be impacting things,” said Dr. Mahesh.

The utility of radiation-dose management systems has been validated across large healthcare networks, pointed out Ryan Lee, MD, Section Chief of Neuroradiology and Vice Chair of Safety and Quality at the Einstein Healthcare Network. “Radiation dose monitoring software is the key. Without it, you really have no way of knowing what is going on between the scanners. Prior to that, all we got was a DLP report on the specific scan. There was no way to tally what was happening on a more global basis between scanners, departments, and sites. So, the first piece of puzzle for us was to have software that allowed us to pull that information.”

With the dose monitoring software and assistance from their medical physicists, Einstein’s radiology department has reduced variability in the radiation dose exposure by monitoring dashboards that show practice variations occurring at different sites within their network.  This has allowed the entire group to adjust imaging protocols, as necessary. Additionally, detecting and removing outliers from the datasets is assisted with the incorporation of analytics.  The team at Einstein is looking at ways to integrate contrast utilization data into the same software, with the goal of creating new dashboards that can correlate the different input factors, such as radiation dose, pressure, and patient body habitus.  

Perhaps the most valuable role played by the medical physicist is ensuring radiation dose is balanced with image quality. Excessively high doses pose a significant safety risk to patients, while too-low doses may result in poor image quality and require additional studies. In this capacity, the medical physicist works with the rest of the radiology team to balance patient safety and image quality needs while ensuring a personalized approach to patient care.

Daniele Marin, MD, Medical Director of Multi-Dimensional Image Processing Laboratory at Duke University Medical Center, and Dr. Mahesh discussed this balancing act in this video.

The views, information, or opinions expressed in the video(s) or article(s) above are solely those of the individuals involved and do not necessarily represent those of Bracco Diagnostics Inc. (“BDI”). The primary purpose of this video(s) or article(s) is to educate and inform. This information does not constitute medical or other professional advice or services.

EmpowerCTA®+ Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerCTA®+ Injector System is indicated for the vascular administration of contrast and flushing media in conjunction with computed tomography (CT) scanning of the body with an optional interface to a CT scanner and an optional calculator for glomerular filtration rate (GFR).

The Extravasation Detection Accessory (EDA™) is an optional accessory and is indicated for the detection of extravasations of ionic and nonionic contrast during CT procedures using a power injector.

Protocols have been independently developed and are not intended as medical advice. Bracco and Bracco Injeneering S.A. shall not be responsible for any physicians’ reliance on these or any other products.

 

CONTRAINDICATIONS:

The EmpowerCTA®+ Injector System is not intended for use as a long-term infusion pump, nor is it intended to be used to inject any agents other than contrast or flushing media. Do not attempt to use the Injector for any other purpose (such as chemotherapy or drug infusion). The EmpowerCTA+ Injector System should not be used to inject substances into nonvascular body cavities. Any applications of the EmpowerCTA+ Injector System other than those described in its Operator Manual are inappropriate and should not be attempted.

Not all products available in all global markets.

EmpowerCTA+ is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); EmpowerCTA+ Email: empowerinfo@diag.bracco.com; Website: https://www.braccoimaging.com/us-en/products/injectors-informatics/empowercta

EmpowerCTA+ is manufactured for Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. http://imaging.bracco.com

 

EmpowerMR® Injector System

Caution: Federal law restricts this device to sale by or on the order of a physician.

INDICATIONS:

The EmpowerMR® Injector System is indicated for vascular administration of contrast media and flushing media in conjunction with magnetic resonance imaging (MRI).

Protocols have been independently developed and are not intended as medical advice and Bracco shall not be responsible for any physicians’ reliance on these or any other protocols.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products available in all global markets.

EmpowerMR is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Bldg. H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; Customer Service: 1-877-BRACCO 9 (1-877-272-2269); Professional Services: 1-800-257-5181 (Option 2); Website: https://www.braccoimaging.com/us-en/products/injectors-informatics/empowermr

EmpowerMR is manufactured by Bracco Injeneering S.A., Avenue de Sevelin 46, CH – 1004 Lausanne, Switzerland. http://imaging.bracco.com

 

NEXO® Contrast Management System

Intended Use:

The NEXO® Contrast Management System is a server-based application intended to be used as a data-management and visualization system. The NEXO Contrast Management System is able to read, store, share, compare/relate, as well as graphically display data and injection programs coming from RIS, PACS and multiple enabled EmpowerCTA® Injector Systems. This device provides users with record-lists, graphics and reports about data and performances.

This device is intended for retrospective and statistical data management and visualization. It is not intended for real-time data visualization, diagnostic applications or for any other use for which the device is not indicated. This device is only to be operated by and under quasi-continuous supervision of qualified and trained staff in an appropriate licensed healthcare facility.

The NEXO Contrast Management System is compatible with the EmpowerCTA Injector System version 8.0, and EmpowerCTA®+ Injector System version 9.0 and higher.

Bracco Injeneering S.A. reserves the right at any time and without notice, to change the specifications and features described herein, or to change the production or adjust the product described.

Not all products available in all global markets.

NEXO is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO questions: Nexo.Answers@diag.bracco.com; NEXO U.S. Technical Service and Support: Phone: 888-670-7701; Fax: 609-514-2448; NEXO Email:  customer.support@acistmedical.com; Website: https://imaging.bracco.com/us-en/products/injectors-informatics/nexo

NEXO is manufactured by Bracco Injeneering S.A., Avenue de Sévelin 46, CH-1004 Lausanne, Switzerland. http://imaging.bracco.com

 

NEXO [DOSE]® Multi-Modality Radiation Informatics

Intended Use:

NEXO [DOSE]® Multi-Modality Radiation Informatics is a server-based application that acquires, stores, and reports radiation dose index data from medical imaging procedures.

NEXO [DOSE] Multi-Modality Radiation Informatics is intended to be used by qualified medical personnel only.

NEXO [DOSE] is distributed by Bracco Diagnostics Inc.; 259 Prospect Plains Road, Building H; Monroe Township, NJ 08831 USA; Phone: (800) 631-5245; Fax: (609) 514-2424; NEXO [DOSE] Customer Service: 1-877-BRACCO 9 (1-877-272-2269); NEXO [DOSE] questions: Nexo.Answers@diag.bracco.com; Website: https://imaging.bracco.com/us-en/products/injectors-informatics/nexo-dose NEXO [DOSE] Technical Support provided by PACSHealth, L.L.C: 1-877-299-6587

NEXO [DOSE] is manufactured by and is licensed from PHS Technologies Group, L.L.C, 32531 N. Scottsdale Road, Suite #105-282, Scottsdale, AZ 85266; a wholly-owned subsidiary of PACSHealth, L.L.C.

Not all products available in all global markets.

 

About Bracco Injeneering S.A.

Bracco Injeneering S.A., located in Lausanne, Switzerland, is the most recently added Business Unit of Bracco Imaging. Bracco Injeneering is committed to develop the best-in-class integrated injection solutions with a strong heritage in research and innovation. It provides quality solutions for state-of-the-art radiology centers, offering proven injection technology, built on Bracco Imaging’s expertise.

Thanks to this strengthened product portfolio, including the CT Exprès® 3D Contrast Media Delivery System, EmpowerCTA+ Injector System, EmpowerMR Injector System, NEXO Contrast Management System and NEXO [DOSE] Multi-Modality Radiation Informatics, Bracco Imaging will be able to focus on constant innovation, not only for devices, but also for software development and data management.

CT Exprès, EmpowerCTA, EmpowerMR, IRiSCT, NEXO and NEXO [DOSE] are registered trademarks of Bracco Injeneering S.A.

EDA and FastLoad are trademarks of Bracco Injeneering S.A.

These are representative images from reference studies; individual results may vary.

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