Proposal for New NM/PET Dose Reporting SR Supplement Work Item for WG3
Introduction.
DICOM WG 3 has determined that it is desirable to create a new SR IOD to be used for
reporting patient dose as it pertains to General Nuclear Medicine and PET Imaging
procedures.
The FDA and other agencies have recently begun increasing their requirements for how
radiation dosage is monitored, measured and administered to patients as part of imaging
procedures. While they are currently focused more on X-Ray based dose, it is reasonable
to assume that nuclear dose will receive more attention in the future. This is especially
important in PET, where the entire dose of a hybrid system will be of interest.
An example of the new interest in this topic can be found in a recent article in Radiology
(Radiology, Volume 251: Number 1 – April 2009. Huang et al, “Whole-Body PET/CT
Scanning: Estimation of Radiation Dose and Cancer Risk”), which looked at the radiation
dose and associated cancer risk due to common PET/CT imaging and concluded that
there is substantial risk to these procedures.
WG3 would like to be proactive in providing the necessary DICOM objects so that
vendors may plan for future implementations. Therefore, it is proposed that the DICOM
Committee approves a Work Item for the development of a new NM/PET Dose
Reporting SR Supplement, and request the WG 6 staff to assign a supplement number.
Limitations of Current Standard.
The current standard includes templates for other modalities (e.g. X-Ray), but not
Nuclear medicine. There are fundamental differences in the way the radiation dose is
delivered between X-Ray based systems and NM. In particular, the NM or PET imaging
system is not the source of the radiation, as it is for a CT, for example. The radiation dose
is created, measured and administered elsewhere, and the imaging system is just detecting
the radiation from the patient. Careful attention will need to be paid to workflow use
cases to allow for dose information to be provided by systems other than the imaging
system.
Description of Proposal.
Create a new supplement similar in scope to Supplement 94, to define a new NM/PET
Dose Reporting SR IOD.
Parts of Standard Affected.
P.S. 3.2: Update Table A.1-2.
P.S. 3.3: New IOD definition.
P.S. 3.4: Reference new SOP Class
P.S. 3.6: Define new SOP Class UID.
P.S. 3.16: New templates/CIDs as needed.
P.S. 3.17: New Use Cases.
It is not proposed to add new services, messaging or encoding.
Workload.
Commitments have already been received from GE (K. Vosniak/H. Solomon), Philips (J.
Pohlhammer), Siemens (T. Milo) to participate in development of the Supplement, and
David Clunie has volunteered to help.
It is anticipated that development of the supplement can be completed by late 2010.
Phone conferences and face-to-face meetings will be scheduled as needed to complete
development and reviews of the supplement.
Twelve hours of WG 6 meeting time over two to three occasions during 2010 and 2011
are expected to be consumed for the review and approval of public comment and letter
ballot text.