Understanding Radiation Dosage and the Benefits of Medical Imaging with Dr Donald Frush

11/14/24 • 58 min

In this episode of the Frame by Frame: Rethink Imaging podcast, host Chris St. John sits down with Dr. Donald Frush to explore the complexities of cumulative radiation dose and its impact on patient care.
Dr. Donald Frush is a renowned expert in radiation safety and dose optimization and serves as a Radiologist at Duke University Medical Center. Here, he shares his wisdom with Chris from his extensive experience spanning over 25 years in advancing radiation protection in medical imaging.
The discussion explores the delicate balance between minimizing radiation exposure and ensuring high-quality imaging, emphasizing the critical role of optimization and justification in modern radiology.
Dr. Frush also shares his insights into managing recurrent imaging in both acute and chronic conditions, highlighting the importance of balancing diagnostic accuracy with radiation safety. The conversation later moves into pediatric considerations, both on a technical and emotional level, with the pair covering the development of imaging protocols and the emerging role of AI in dose management.
Tune in to discover how modern technologies are reshaping radiology, reducing radiation exposure, and improving patient outcomes.
Chapters

00:00 - Intro02:02 - How Doctor Frush Entered Radiology04:17 - Basics of Radiation in Medical Imaging08:07 - The ALARA Principle: Keeping Radiation Low10:16 - The Evolution of Radiation Dose Management12:04 - Key Technologies in Dose Management15:35 - Balancing Image Quality with Radiation Dose
17:36 - The Team Approach to Radiation Protection
20:41 - Resources for Healthcare Providers on Radiation Safety26:20 - Recurrent Imaging and Cumulative Risk28:05 - Acute vs. Chronic Needs32:43 - Real-World Examples and Challenges in Recurrent Imaging35:32 - Optimizing Imaging Protocols42:33 - The Future of AI in Pediatric Imaging44:36 - Effective Communication about Radiation Risks47:05 - The Emotional Impact of Radiation Decisions in Pediatrics51:34 - Sincerity Goes a Long Way53:43 - Why Say: “It’s Nice to See You”?59:14 - The Thankless Yet Vital Task of Radiation Protection01:05:43 - Highlighting the Value of Imaging01:08:24 - Outro Frame by Frame: Rethink Imaging Podcast is handcrafted by our friends over at: fame.so

Previous Episode

Behind the Measures: Understanding CMS Quality Standards with Dr. Lee Fleisher

Dr. Lee Fleisher drops into the latest episode of Frame by Frame: Rethink Imaging podcast. Host Chris St. John shares a dynamic conversation with Dr. Fleisher, a visionary in healthcare policy who has helped shape the standards that impact the care of millions across the United States.From the creation of the National Quality Strategy to groundbreaking decisions on quality measures and patient safety standards, this episode delves into Dr. Fleisher's relentless commitment to raising the bar in healthcare.
The pair’s chat also provides a deep dive into the intersections of policy, practice, and patient impact, with Dr. Fleisher illuminating the path to a more sustainable, quality-driven healthcare system.Join us for an inspiring look at the real-world impact of policy, transparency, and quality measurement on the future of healthcare, and learn more about Dr. Fleisher’s current work at Rubrum Advising, focusing on navigating CMS regulations.Chapters

00:00 - Intro05:49 - From Childhood Dreams to Healthcare Leadership05:17 - From Peer Review to Peer Learning07:01 - Transplant Research and CMS Involvement08:55 - A Shift in Focus: Cardiac Patients and Quality Standards12:40 - A Legacy in Quality Measures and Public Health16:14 - How Quality Measures are Made: A Collaborative Process
22:55 - Evaluating and Endorsing Quality Measures
26:31 - Challenges and Evolution of Healthcare Quality Standards30:10 - What are Accountable Care Organizations (ACOs)32:15 - Lessons from the Pandemic35:11 - Challenges in Specialty Compliance with Quality Measures39:00 - From Quantity to Quality43:46 - Leveraging Technology to Reduce Reporting Burden45:50 - The Story Behind Rubrum Advising52:29 - The Universal Foundation54:17 - OutroFrame by Frame: Rethink Imaging Podcast is handcrafted by our friends over at: fame.so

Next Episode

Target-Based Dose Optimization: Enhancing Image Quality and Patient Safety | Dr. David Larson

In this episode of the Frame by Frame: Rethink Imaging podcast, host Chris St. John welcomes Dr. David Larson, an esteemed leader in radiology and a passionate advocate for healthcare improvement. David is the Acting Chair and Executive Vice Chair of the Department of Radiology at Stanford University, and among many other points, he lays out the three pillars of CT radiation dose optimization in this episode.
The show also covers the evolution from peer review to peer learning in radiology, the complexities of size-adjusted dose optimization, and the role of multi-disciplinary collaboration in creating sustainable radiology practices.
In terms of improving the field as a whole, the pair share ideas around moving beyond merely hitting acceptable ranges with dose optimization and instead, setting targets and hitting them with absolute consistency.
The discussion focuses on the development of imaging protocols, emphasizing the importance of balancing technological advancements with effective management strategies.
Tune in to learn how innovative approaches and a target-based mindset are crucial for advancing radiology practices in today's evolving landscape.
Chapters

00:00 - Intro02:59 - Demystifying Socio-Technical Systems in Healthcare05:17 - From Peer Review to Peer Learning07:27 - Why Dose Matters in Radiology11:56 - The Importance of Size-Adjusted Dose14:22 - Real-World Dose Optimization18:09 - Automated Tube Current Modulation
20:52 - Enhancing Dose Control
22:29 - The Collaborative Equation: Radiologists, Physicists, and Technologists26:43 - Fine-Tuning Image Quality Across Use Cases29:54 - Dose Optimization for Smaller Hospitals33:02 - The Key to Effective Training in Radiology39:18 - Process Control: The Heart of Optimization44:12 - Preparing for New Radiology Technologies46:11 - Navigating Regulatory Changes49:25 - Misconceptions in CT Optimization51:25 - The Role of Administrators in Dose Optimization54:14 - A Lover’s Quarrel: Professional Debates in Radiology55:39 - OutroFrame by Frame: Rethink Imaging Podcast is handcrafted by our friends over at: fame.so