1. Why radiation dose monitoring matters
Every X-ray, Computed Tomography (CT), fluoroscopy and mammography exam delivers a small, targeted radiation dose. Managed machine by machine, these doses stay invisible across a busy imaging department, preventing clinical teams from seeing cumulative patient exposure. A dedicated system makes that dose fully visible and actionable — driven by two priorities that matter to every hospital and clinic:
Adhering to the ALARA (As Low As Reasonably Achievable) principle — identifying anomalies, optimising exam protocols and tracking practice improvements to protect patients from unnecessary cumulative exposure.
Meeting statutory recording and reporting obligations — such as the European EURATOM 2018 directive, which mandates that hospitals capture, analyse and justify patient radiation exposure.
2. What is a DACS?
A DACS (Dose Archiving and Communication System) is a centralised software solution that automatically collects, archives and analyses the radiation dose delivered to patients across all imaging modalities.
Instead of manually checking individual modalities, a DACS pools department- or institution-wide data by parsing DICOM Radiation Dose Structured Reports (DICOM-SR / RDSR) generated directly by the imaging systems. Unlike error-prone Optical Character Recognition (OCR) — which can misread critical numbers (such as an “8” as a “0” on older systems) — a true DACS extracts raw digital dose data directly from the metadata, ensuring absolute data integrity.
Once captured, the DACS cleanses, normalises and reconciles highly heterogeneous exam descriptions across scanner models, translating them into standard codes so figures can be compared and audited objectively. Its two core purposes:
- Regulatory compliance — audit-ready, standardised exports and reports directly compliant with national nuclear-safety regulators.
- Quality assurance — active dose-reduction workflows, tracking median dose trends over time and establishing clinical benchmarks.
3. The regulatory drivers & global standards
Hospitals must legally justify and audit their medical exposures under international radiation-protection frameworks.
- Diagnostic Reference Levels (DRLs) — built directly into the system as standard safety benchmarks, designated differently by country:
- NRD (Niveau de Référence Diagnostique) — France & Belgium
- DRN (Diagnostisch Referentieniveau) — Netherlands
- DRW (Diagnostische Referenzwerte) — Germany
- LDR (Livello di Riferimento Diagnostico) — Italy
- DRL (Diagnostic Reference Level) — Switzerland / United Kingdom
- National authority integration — tailored to the exact requirements of the local radiation authority:
- AFCN / FANC (Federal Agency for Nuclear Control) — Belgium
- ASN (Autorité de Sûreté Nucléaire) — France
- BfS (Bundesamt für Strahlenschutz) — Germany
- ISIN — Italy
- BAG / OFSP — Switzerland
- High-granularity reporting — modern regulations (such as Belgium's AFCN CT mandate) require detailed, sequence-by-sequence dose reporting — distinguishing topograms, scan phases and contrast-enhanced segments — rather than just a single cumulative number.
- Institutional accreditation — DACS data serves as vital proof for strict international accreditation bodies, such as Accreditation Canada, which require institutions to formally track repeated exams and rejected images.
- Justification workflows — clinical teams must record and securely archive justifications whenever an exam's dose exceeds local or national alert levels.
4. Key capabilities to look for in a DACS
A highly effective DACS must deliver clinical utility beyond basic spreadsheet generation. Look for these essential features:
Captures dose in real time across CT, conventional radiography (CR/RX), fluoroscopy (RF), mammography (MG), angiography/interventional (XA), nuclear medicine (NM) and PET.
- Conventional & fluoroscopy — DAP (Dose Area Product) with irradiation and fluoroscopy times.
- CT — CTDIvol, DLP (Dose Length Product) and SSDE (Size-Specific Dose Estimate), adjusted for the patient's actual size.
- Mammography — AGD (Average Glandular Dose) mapped against breast compression thickness and tissue density.
Automated generation and direct export of the exact, compliant XML/Excel reporting tables required by your national regulator (e.g. FANC/AFCN).
Compares exposures recorded in the DICOM-SR against the images actually archived in your PACS — instantly highlighting rejected images (where the patient was irradiated but no image was kept), so you can target specific machines or operators for training.
Instantly flags high-dose exams. For interventional suites, configure critical patient-safety alerts (e.g. an alert at 3 Gy and a high-priority warning at 7 Gy Air Kerma) to trigger immediate follow-up for potential tissue reactions.
Real-time, auto-refreshing TV or web views displaying the latest exposures and their compliance with safety norms.
Machine learning scans the database to identify the root causes behind dose increases — for example, whether a specific machine model or operator is statistically driving up DLPs.
5. The Telemis solution: INTUITUS DACS
Telemis delivers advanced radiation safety through INTUITUS DACS, an integrated, highly intuitive module of the broader INTUITUS Healthcare Business Intelligence suite.
The all-inclusive Telemis promise
- No modality connection fees — a flat subscription model connects an unlimited number of irradiating modalities (including operating theatres, interventional suites and nuclear medicine) at no added cost.
- Unlimited customisation & training — our medical engineers continuously build, refine and adapt your dashboards, KPIs and reports to your institutional needs and regulatory changes throughout the contract, free of charge.
Exceptional technical integrity
- Contextual PACS integration — bidirectional integration with your Telemis PACS lets radiologists launch DACS analysis in one click from the diagnostic viewer, or inject dose values and justifications straight into RIS reports.
- Privacy by design (GDPR/DPIA compliant) — patient names are never extracted or stored; dates of birth are reset to 1 January of the birth year, and all cloud traffic is securely pseudonymised and audited.
- Measurable ROI — in Belgian hospitals such as EpiCURA, INTUITUS DACS demonstrated that all radiation levels of CT were safely below the national P50 benchmark, letting the hospital legally bypass heavy, mandatory annual protocol-optimisation workflows. (see our case study, Radiation protection & compliance: how INTUITUS DACS automates dose reporting)