The ACR’s recent introduction of the “cmbX” designation in the Dose Index Registry (DIR) is a meaningful step forward. By separating combination studies, the DIR now allows for more accurate mapping to combination RPIDs—or, when necessary, assignment to RPID88 to remove them from the “unmapped” category. But as many facilities are now discovering, this improvement… Read More
Streamlining cmbX Mapping in the ACR Dose Index Registry
Background On February 17, 2026 the American College of Radiology (ACR) announced an important enhancement to the Dose Index Registry (DIR): the introduction of a “combination study” designation, identified by the cmbX prefix in Study Descriptions. This change represents a meaningful improvement in how the DIR handles multi-part or combined CT exams. The Challenge While… Read More
Important DIR Update – Combination Exam Mapping Changes
To my Dose Registry Clients and Friends, The DIR recently announced changes in how the NRDR maps combination CT studies. In my opinion, this is one of the most significant and welcome changes to the DIR in years. See the link immediately below. https://nrdrsupport.acr.org/support/solutions/articles/11000135515-dir-improves-the-accuracy-of-combination-exams-for-ct The article explains changes to how the DIR records and processes… Read More
CTDIvol vs DLP – a simple explanation
What do they represent? CTDIvol is based on measurements obtained when scanning either a 16cm or 32 cm phantom. Essentially, it represents scanner output. DLP is derived from CTDIvol, but incorporates a scan length component. Both function as reasonable proxies for absorbed dose but do not represent the actual patient dose. In other words, if… Read More
DIR Corporate-level Aggregate Reports Are Back- Update
As I wrote previously, access to Corporate level Aggregate DIR reports were several restricted after the NRDR changed the organizational structure for facilities submitting data. One of the biggest changes was the establishment of the “Corporate” account under, and to, which all child sites would be assigned. Initially, the Corporate level Aggregate reports were not… Read More
Dose Registry Support Services – Our Story
At my direction, our facility began submitting CT dose data to the ACR’s Dose Index Registry® (DIR) in early 2013. During the following months I learned to use the DIR to identify dose reduction opportunities, and lower our CT doses. In August 2105 The Joint Commission (TJC) updated its diagnostic imaging Elements of Performance requiring… Read More
Tailored DIR Analysis; Is your current solution providing less for more?
The Dose Index Registry (DIR) is a powerful, flexible tool from which facilities can learn a great deal. The most common use is to use the DIR’s dose comparison reports identify dose reduction opportunities: Never before have facilities been able to identify dose reduction opportunities so easily. But, there is so much more to glean… Read More
Providing Low-cost, Tailored & Unique Services to Community Hospitals and Radiology Groups
The Dose Index Registry (DIR) is a powerful, flexible tool from which facilities can learn a great deal. The most common use is to use the DIR’s dose comparison reports identify dose reduction opportunities: Never before have facilities been able to identify dose reduction opportunities so easily. But, there is so much more to glean… Read More
Dose Registry Support Services Success Stories
Here are recent examples of the successes two of our sites reported to their radiation safety committees. This first example is a chart showing one facility’s average monthly Total DLP for its Chest Angio studies from early 2016 through Q1 2018. Overall, this site reduced its average Total DLP for its Chest Angio studies by… Read More
Conference Speaking Engagement: Dose Index Registry – Tips, Tricks, and Lessons Learned
I just returned from having presented at the Health Connect Partners 2017 Radiology & Imaging Conference. My topic: Using the DIR to Meet TJC’s Dose Incident Identification & Review Requirements. During the presentation I gave an overview of the DIR and shared what we’ve learned from having participated in it for four years, including specific… Read More
Dose Registry Support Services 