Management of Acquisition Protocols
Management of Acquisition Protocols (MAP) supports the collection of scan protocols from acquisition modalities, their review on a protocol manager and re-distribution to modalities. Protocol managers are permitted to edit attributes marked safe by the creating modality. Such attributes will likely include protocol names, dose notification thresholds, and series names for generated images.
Improve Quality of Care
- Good, consistent image quality depends on good protocols, used consistently
- MAP helps monitor protocols in use (and detect variants)
- MAP helps distribute preferred, consistent protocols
Improve Workflow Efficiency
- Hanging Protocols, Image Processing, Reporting Workflow, etc. depend on consistent series names, procedure codes, etc.
- MAP helps create and manage such consistency
- Managing dose depends on managing protocols
- Variations in protocols results in variations in dose
- Summarizing data depends on consistent tagging
- Determining your average throughput for each type of procedure depends on good naming and coding
The transactions are based on storage, query and retrieval of DICOM® objects containing scan procedure protocols and protocol approvals. Although the profile is agnostic to the type of modality, as of 2018 DICOM has published the specification for CT Protocol Storage. DICOM work is in progress to support XA and MR protocols. When those are published they will also be incorporated into the Profile.
- Modalities may send protocols for review and receive distributed protocols and approvals.
- PACS systems may store sets protocols
- Protocol management workstations may retrieve, review, approve and make minor edits to protocols.
Actors & Transactions:
Profile Status: Trial Implementation
- DICOM PS 3.3: A.82.2 CT Defined Procedure Protocol IOD
- DICOM PS 3.3: A.82.3 Protocol Approval IOD
- DICOM PS 3.17 Annex AAAA Protocol Storage Examples and Concepts (informative)
- DICOM PS3.18 Section 6.10: RS Non-Patient Instance (NPI) Storage
Sample RFP Language
Although several patterns of implementation of the MAP Profile are possible, IHE expects that:
- the Acquisition Modality Actor will be implemented in scanners,
- the Protocol Archive Actor will be implemented in PACS, VNAs and/or Protocol workstations, and
- the Protocol Manager Actor will be implemented in Protocol workstations, Dose workstations, and/or RIS systems
Questions to ask vendors:
- Do you plan to implement IHE’s Management of Acquisition Protocols (MAP) profile? If so, when?
- Do you plan to test your implementation of MAP at an upcoming IHE Connectathon? If so, when?
Example RFP Requirements:
- The CT scanner shall support the IHE Management of Acquisition Protocols (MAP) profile as the Acquisition Modality actor.
- The VNA shall support the IHE Management of Acquisition Protocols (MAP) profile as the Protocol Archive actor.
- The protocol management workstation shall support the IHE Management of Acquisition Protocols (MAP) profile as the Protocol Manager actor.
- Scheduled Workflow [SWF.b] has an Assisted-Protocol Setting Option that would benefit from management of protocol labels.
- Portable Data for Imaging [PDI] could be used to export/import DICOM protocol instances to media for sharing with another facility or organization. (e.g., protocols for multiple models in a given clinical trial, reference protocols for a particular diagnostic task, or a full backup catalog of protocols)
- Radiation Exposure Monitoring [REM] could be used on the protocol manager to coordinate a dose reduction program with protocol management.
- CT protocol optimization: teams and costs
Siegelman, Jenifer RQW, and Dustin A. Gress. "Radiology stewardship and quality improvement: the process and costs of implementing a CT radiation dose optimization committee in a medium-sized community hospital system." Journal of the American College of Radiology 10, no. 6 (2013): 416-422.
Szczykutowicz, Timothy P., Robert K. Bour, Myron Pozniak, and Frank N. Ranallo. "Compliance with AAPM Practice Guideline 1. a: CT Protocol Management and Review—from the perspective of a university hospital." Journal of applied clinical medical physics 16, no. 2 (2015): 443-457.
Szczykutowicz, Timothy P., and Myron Pozniak. “A Team Approach for CT Protocol Optimization”. The Journal for the Association of Medical Imaging Management: Radiology Management 2016 Nov/Dec Issue. Available at http://www.radiologymanagement-digital.com/radiologymanagement/11122016
- Protocol Review and Management
Cody, Dianna D., Tyler S. Fisher, Dustin A. Gress, Jr RR Layman, Michael F. McNitt-Gray, Jr RJ Pizzutiello, and Lynne A. Fairobent. "AAPM medical physics practice guideline 1. a: CT protocol management and review practice guideline." Journal of applied clinical medical physics 14, no. 5 (2013): 3-12.
Kofler, James M., Dianna D. Cody, and Richard L. Morin. "CT protocol review and optimization." Journal of the American College of Radiology 11, no. 3 (2014): 267-270.
Szczykutowicz, Timothy P., Annelise Malkus, Amanda Ciano, and Myron Pozniak. "Tracking patterns of nonadherence to prescribed CT protocol parameters." Journal of the American College of Radiology 14, no. 2 (2017): 224-230.
Szczykutowicz, Timothy P., and Jenifer Siegelman. "On the same page—physicist and radiologist perspectives on protocol management and review." Journal of the American College of Radiology 12, no. 8 (2015): 808-814.
Sachs, Peter B., Kelly Hunt, Fabien Mansoubi, and James Borgstede. "CT and MR Protocol Standardization Across a Large Health System: Providing a Consistent Radiologist, Patient, and Referring Provider Experience." Journal of digital imaging 30, no. 1 (2017): 11-16.
Szczykutowicz, Timothy P., Robert Bour, Frank Ranallo, and Myron Pozniak. "The Current State of CT Dose Management Across Radiology: Well Intentioned but Not Universally Well Executed." American Journal of Roentgenology (2018): 1-4.
- Physics Perspective
Szczykutowicz, Timothy P., Robert K. Bour, Nicholas Rubert, Gary Wendt, Myron Pozniak, and Frank N. Ranallo. "CT protocol management: simplifying the process by using a master protocol concept." Journal of applied clinical medical physics 16, no. 4 (2015): 228-243.
Sookpeng, S., C. J. Martin, and D. J. Gentle. "Comparison of different phantom designs for CT scanner automatic tube current modulation system tests." Journal of radiological protection 33, no. 4 (2013): 735.
McKenney, Sarah E., J. Anthony Seibert, Ramit Lamba, and John M. Boone. "Methods for CT automatic exposure control protocol translation between scanner platforms." Journal of the American College of Radiology 11, no. 3 (2014): 285-291.
Favazza, Christopher P., Xinhui Duan, Yi Zhang, Lifeng Yu, Shuai Leng, James M. Kofler, Michael R. Bruesewitz, and Cynthia H. McCollough. "A cross-platform survey of CT image quality and dose from routine abdomen protocols and a method to systematically standardize image quality." Physics in Medicine & Biology 60, no. 21 (2015): 8381.
Solomon, Justin B., Olav Christianson, and Ehsan Samei. "Quantitative comparison of noise texture across CT scanners from different manufacturers." Medical Physics 39, no. 10 (2012): 6048-6055.
- Protocol Management Systems
Szczykutowicz, Timothy P., Nicholas Rubert, Daryn Belden, Amanda Ciano, Andrew Duplissis, Ashley Hermanns, Stephen Monette, and Elliott Janssen Saldivar. "A wiki-based solution to managing your institution’s imaging protocols." Journal of the American College of Radiology 13, no. 7 (2016): 822-824.
Grimes, Joshua, Shuai Leng, Yi Zhang, Thomas Vrieze, and Cynthia McCollough. "Implementation and evaluation of a protocol management system for automated review of CT protocols." Journal of applied clinical medical physics 17, no. 5 (2016): 523-533.
Zhang, Da, Cristy A. Savage, Xinhua Li, and Bob Liu. "Data-driven CT protocol review and management—experience from a large academic hospital." Journal of the American College of Radiology 12, no. 3 (2015): 267-272.
Szczykutowicz, Timothy P., Nicholas Rubert, Daryn Belden, Amanda Ciano, Andrew Duplissis, Ashley Hermanns, Stephen Monette, and E. JanssenSaldivar. "A wiki based CT protocol management system." Radiology Management 37, no. 6 (2015): 25-9.
November 27, 2018 Map Advocacy Meeting
Slides to be posted after meeting
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