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

by John R. Fischer, Senior Reporter | March 09, 2018
CT Pediatrics X-Ray
From the March 2018 issue of HealthCare Business News magazine

HCB News: Could this quantitative approach be implemented into scanning software some day?

DF: Absolutely! It takes some work. It would take more protocols to be done. It would take integration with manufacturers to build this either into their equipment, or to provide information that installation could be put on there. It would take some time to do that.

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The first thing is that people need to accept this is what we need to do. People don’t like to change unless they have to, or unless there’s some reward or motivation. Then, the broad medical community says, ‘Hey, in being accountable for what we do, we have to have all these elements. It needs to be personalized based on the size of the patient. It needs to be personalized based on what the radiologist is looking for in image quality. It needs to be personalized in terms of what are the risks. Should a different technique be used for a different 15-year-old girl than a 15-year-old boy?’

All of those things need to come together because we are responsible for those things. It’s getting the community to accept that all of these elements are important and moving in that direction.

This is sort of an early work to say this can be done and once it’s embraced and accepted, then other places can begin to work on that concept of those components, all being important in protocol development.

HCB News: Is dose customization an area where deep learning algorithms are poised to change CT scans?

DF: Yes, absolutely. If we can take the human model, and if the machine can learn to do what humans do, then, for example, if a person looks at 100 CT scans of something and detects something in a certain period of time, the machine can look and say, ‘OK. They were much better when the scan was this way and they were much worse when the scan was this way and here are all the elements that contribute to the poorer performance and here are all the elements that contribute to better performance.’

HCB News: What needs to happen to move this approach to imaging forward?

DF: In order to do this right, it is going to require some teamwork and cooperation. People need to understand this is not just radiologists or pediatric radiologists looking at CT scans. This is a community that is increasingly invested in computational sciences, in deep learning, in IT, in medical physics and so on. It’s an expanded view. It’s intimately involved with the manufacturers. If manufacturers are not onboard, then changes will happen much slower. So, industry is a really important part of this.

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