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Dr. Donald P. Frush

Q&A with Dr. Donald P. Frush; A more personalized approach to pediatric CT exams

by John R. Fischer , Staff Reporter
From the March 2018 issue of DOTmed HealthCare Business News magazine

While CT protocols can provide a template for how to image certain parts of the body, they can leave a lot to be desired in terms of optimizing the scan for the individual patient being examined. The indication for the exam, the size and gender of the patient and the necessary image quality for an accurate diagnosis are all important variables that don’t always get consideration.

In order to allow for consideration of these variables and others, Dr. Donald P. Frush and his colleagues at Duke Medical Center have devised a quantitative method that simplifies the personalization of CT scans. HealthCare Business News spoke to him about what this method brings to the table, how AI could eventually raise the bar on what they’re already accomplishing and the vital role of manufacturers in bringing these capabilities to imaging facilities.

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HCB News: Why is consistency important in the way pediatric patients receive CT scans?

Dr. Donald P. Frush: If we talk about CT scans, one of those risks is radiation. One other would be contrast administration, but oftentimes the risk profile of CT is focused on radiation. There is some variability in both of those things. For example, some people may tolerate or be able to use a little bit lower image quality and render sufficient diagnoses. Some people may need higher image quality, thus the radiation dose would vary with each of those.

There’s not a specific amount or dose or particular image quality. I think when it comes to consistency you are informed about what you need to do in your practice. You are informed about the kind of image quality you need and you have adjusted your CT scanning to provide that level of image quality, minimizing the amount of radiation that’s there. It’s sort of adhering to that.

That consistency should be for all your protocols. Over time, you shouldn’t do things differently. That may vary in a small practice in Wyoming versus a children’s hospital in Philadelphia versus a university-based program in Dallas.

It’s accountability and what you do and how you define what you need and what risks you minimize in getting there. It’s informed best practice and maintained throughout your CT practice and over time. That’s kind of what consistency is. Sometimes, when people say you should be consistent with X, Y and Z, everyone assumes they should do the same thing. It’s not quite that simple.

HCB News: You and your colleagues have devised a quantitative method for ensuring quality scans with proper radiation dose. What factors are involved in the use of this method?
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