Evaluating the functionality of x-ray angiography systems based on DICOM structured reports

Purpose: To investigate the feasibility of evaluating the functionality of x-ray angiography systems based on detailed exposure data extracted from DICOM radiation dose structured reports (RDSR).

Methods: Structured reports provide information about each x-ray irradiation event (a fluoroscopy or acquisition series) part of a clinical procedure. This data was utilized to evaluate the functionality of angiography systems installed in three pediatric and adult cardiology suites, one abdominal radiology suite, and two neurology suites. Each suite was equipped with a monoplane or biplane system developed by Philips Healthcare (Best, The Netherlands). The structured reports were collected from these systems over a span of up to seven years, using a Conquest DICOM server and a custom parser.

Results: Selected applications are showcased: reviewing the clinical use of imaging protocols, characterizing the exposure geometry, monitoring the x-ray tube performance, and examining the automatic control logic. Notably, the method developed for evaluating the x-ray tube output based on structured reports exhibited excellent agreement with conventional output measurements (within the uncertainty margin) and theoretical predictions (within 5%). Furthermore, due to the large amount of procedural data analyzed, the findings related to the exposure geometry and beam quality can serve as a reference for typical exposure settings for different types of angiography procedures.

Conclusion: Evaluating the technical functionality of x-ray angiography systems based on structured reports is feasible. However, a considerable amount of clinical data is required for some analyses due to certain limitations of the current DICOM RDSR standard.