By Aine Cryts

Ryan Lee, MD, section chief of neuroradiology at Philadelphia’s Einstein Healthcare Network, is helping to reduce radiation dose therapy by using a combination of software and hardware, along with evidence-based medicine. His team at Einstein Healthcare Network has reduced radiation while preserving and even sometimes improving the quality of images.

Reducing the amount of radiation his team administers improves patient safety, adds Lee, whose current research interests include artificial intelligence, clinical decision support, and health economics. AXIS Imaging News recently discussed the topic of reducing radiation dose with Lee. What follows is a lightly edited version of that conversation.

AXIS Imaging News: Why did you decide to focus on reducing radiation dose therapy?

Ryan Lee: It was an opportunity to tackle an issue that was previously not addressed. Software and hardware can create an opportunity for real change on reducing radiation dose. Early on in my career, radiation dose reduction wasn’t on anyone’s radar.

AXIS: What additional training do radiologists need to view low-dose images?

Lee: If done correctly, none. However, some forms of technology that allow reduction in dose, such as model-based iterative reconstruction, can translate to images that look different. That can require orientation and education as to ways to work with those images.

Adopting a combination of technology that reduces dose exposure with one that regulates variability ensures consistency across scanners. Einstein Healthcare Network, for instance, uses a Philips CT Iterative Model Reconstruction (IMR) to help manage dose. In addition, we use Philips iPatient to help personalize dose management and achieve patient-centric imaging.

AXIS: What else is important in your effort to reduce radiation dose?

Lee: Keep in mind, it’s important to establish network-wide standards and effectively train staff. It takes a mutual commitment to get buy-in from all the stakeholders to achieve consistency across the imaging value chain. At Einstein Healthcare Network, we created a radiation dose optimization committee to standardize this process and address obstacles to implementation.

AXIS: Can you provide a specific example of reducing radiation dose that includes a patient?

Lee: Radiation dose reduction really affects all patients, and not necessarily just one cohort, as everyone can benefit from less radiation. However, pediatric patients are particularly sensitive to radiation. They can also be at higher risk for certain types of cancer. Thus, reducing radiation dose is particularly important for that group.

For patients with cancer and pregnant women, interestingly enough, the radiation dose techniques might affect them the least. With older patients who have cancer, we’d pay less attention to the dose. That’s because the risks of getting cancer from radiation would be far less in most cases than the harmful effects of the malignancy they have. For pregnant patients, we’d most likely find an alternative to CT to avoid radiation altogether.

However, in the specific case where there’s no alternative, then radiation dose reduction techniques can be beneficial.

Aine Cryts is a writer for AXIS Imaging News. Questions and comments can be directed to chief editor Keri Forsythe-Stephens at kstephens@medqor.com