MITA Smart Dose Interventional


The MITA Smart Dose Interventional standard offers healthcare providers a reference to identify key features which contribute to enhance patient care and to help manage patient radiation dose delivery while still enabling the system to provide sufficient image quality needed by the physician. MITA Smart Dose Interventional, or XR 31 Standard Attributes on X-ray Equipment for Interventional Procedures describes eight attributes that should be taken into consideration when performing risk management evaluations on existing stationary x-ray interventional equipment.

MITA Smart Dose Interventional includes the following key features that were introduced over the course of the past decade and which are now considered state-of-the-art:

  • Dosimetric Indications: Dose information displayed to the operator during the procedure can increase the dose awareness and enable interventionists to monitor the dose to the patient in real time.
  • Added Filters:Insertion of filters into the x-ray beam aims to reduce the amount of low energy photons which will not serve to produce an image but can be directly absorbed by the patient’s skin, increasing the risk of adverse reactions.
  • Range of Air Kerma Rates in Fluoroscopy: The equipment will include at least three selectable dose rates that permit the interventionists to tailor the dose to the imaging task at the lowest dose that matches the complexity of each phase of the interventional procedure.
  • Last-Image-Hold (LIH): The most recently acquired image will be displayed after termination of irradiation thus potentially reducing the need for additional fluoroscopy
  • Virtual Collimation: The equipment will provide a graphical display of the position of the collimator blades on the LIH image while the collimator blades are adjusted, without irradiation.
  • Stored Fluoroscopy: The equipment will provide the capability to store at least 300 frames of the most recent fluoroscopic-imaging sequence, allowing for replay and review during the procedure.
  • Variable Pulsed Fluoroscopy: For fluoroscopy, the equipment will provide at least three different pulse rates, selectable by the user thus enabling the interventionist to tailor the dose to the imaging task. The appropriate pulse rate for each segment of an interventional procedure is determined by the rate of anatomical motion, the specific imaging task, and by the operator’s ability to adapt to lower temporal resolution.
  • Digital X-ray Imaging Device: For almost all dose ranges used in radiography and fluoroscopy, this technology provides a better dose efficiency compared to image intensifier systems.


  1. What is MITA Smart Dose Interventional?

MITA Smart Dose Interventional is a technology standard that promotes the use of x-ray interventional equipment designed to help a health care provider optimize the radiation dose a patient receives. MITA Smart Dose Interventional includes eight features: Dosimetric Indications, Added Filters, Range of Air Kerma Rates in Fluoroscopy, Last-Image-Hold (LIH), Virtual Collimation, Stored Fluoroscopy, Variable Pulsed Fluoroscopy and Digital X-ray Imaging Device. For additional details, you can download the MITA Smart Dose Interventional standard, under its technical name NEMA XR 31-2016.

  1. What does this mean for my facility?

This standard offers you an opportunity to evaluate your fixed interventional equipment against key attributes to manage effectively the radiation dose to your patients

  1. How do I know if my interventional machine is compliant?

You can refer to the instructions for use accompanying your equipment and also contact your manufacturer’s service representative who will assist you in the conformity assessment of your equipment against the standard XR 31-2016.

  1. What does this mean for the patient?

Each of the attribute described in the XR 31-2016 is intended to offer an additional means to manage the radiation dose thus leaving one more degree of freedom to the physician to reduce the dose to the patient, when appropriate, and minimize the risk of tissue reaction that may arise during prolonged interventional procedures.

  1. What do I need to do if my machine isn’t compliant?

Review the conformity assessment of your device with the risk manager or the personnel competent in radioprotection in your hospital. Then, contact your manufacturer’s account manager representative to share the results of the conformity assessment and discuss with him/her the different possible avenues to upgrade your installation.

  1. Why did MITA write this standard?

MITA prepared the XR 31-2016 standard to inventory the most acknowledged dose management attributes featured on equipment manufactured over the last decade in order to assist health care professionals in the evaluation of their equipment regarding the means available to manage the radiation dose to patient. This will enable health care professionals to consider the opportunity to upgrade their equipment with additional dose management capabilities.

  1. Is this another Smart Dose CT or NEMA XR 29-2013?

No. While the focus of both XR 29 and XR 31 is patient safety and dose mitigation, these are different standards that cover different equipment.