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The aim of this work is to present the gray detector, a web-based patient radiation dose monitoring software developed to answer on health protection of individuals against the dangers of ionizing radiation in relation to medical exposure, (Council Directive 2013/59/Euratom) This software provides to capture, track and report radiation dose directly from any imaging device or PACS, completely vendor neutral solution, and it is the simple yet scalable way to document dose, set reference levels, benchmark performance, manage protocols and identify outliers. The solution gives the possibility to integrate all the information about the dose with the data in RIS: in this way there is the possibility to context the dosimetric data and to follow the optimization of the radiologic risk management and the ratio risk/benefit of the image. Gray detector manages all diagnostic modality tracking and archiving all dosimetry data: CT, Mammography, Interventional, Cardiovascular, Radiography and Nuclear Medicine. It is compatible with DICOM SR and DICOM MPPS messages, Query & Retrieve DICOM image header (for non MSSP/SR DICOM modality), to extract all relevant information from dose and maximize data collection, crossing the fundamental data stored in the RIS database. All data collected can be viewed through customizable charts or exported according to standard formats gray detector has an “alert system”, that gives the possibility to send email and display messages when the modality gives an over dose, based on DRL The integration of the gray detector with information systems, may improve clinical quality performance in diagnostic imaging

To demonstrate how a PACS integrated dose monitoring system, Gray Detector, can help to monitor client dose in a breast screening program, ultimately facilitating the optimisation of acquisition parameters in order to enhance image quality and minimise the dose BreastCheck, The National Breast Screening Program evaluated the RIS-PACS integrated dose monitoring system Gray Detector. For each projection of a screening examination, the displayed average glandular dose (AGD), compression force, compressed breast thickness, selected automatic exposure control (AEC) mode, kV and mAs were recorded. Preliminary data have been collected for three months which have enabled comparison of a number of mammography system types and comparison between systems of the same type, in terms of dose, compression force and other key characteristic parameters. Patient dose data collected so far confirm the results of our annual dose survey. All the mammography systems were monitored on a daily basis. The daily presentation of data provides a useful QA tool, highlighting potential problems with individual mammography systems and illustrating the dependency of client dose on other clinical parameters such as compressed breast thickness and compression force. This will enable standardisation of the acquisition technique in order to reduce client dose and optimize the image quality. A summary of these preliminary results will be presented. The Gray Detector software provides useful functionality for monitoring key parameters of the breast screening examination including in particular, the AGD which may be used to monitor and improve clinical quality performance in the screening program.