March 08, 2021

DIR Is Moving to Exclusive Support of Radiation Dose Structured Report

Since 2011, the ACR Dose Index Registry (DIR) has helped clinicians and facilities improve the quality of patient care by collecting CT dose data through automated data transmission and leveraging that data to provide feedback on specific dose indices to participants and to establish national benchmarks.

ACR® TRIAD software, installed locally at each participating facility, anonymizes, formats and transmits data to the DIR. In the past, there have been two methods for data transmission to TRIAD for DIR:

  • Secondary capture. The DIR currently accepts secondary capture (or dose screen) because, at the time the DIR started, some of the old scanners were unable to produce structured reports. The ACR uses Optical Character Recognition (OCR) software to read the data that comes from secondary captures. However, the process of parsing the dose screen using OCR might not produce consistent and correct data, depending on the scanner manufacturer.
  • Radiation Dose Structured Report (RDSR). The preferred mechanism for data transmission to TRIAD for the DIR is the RDSR. Dose reporting via RDSR is standardized and automated to come directly from scanners or PACS via ACR TRIAD software. TRIAD works with a wide variety of scanners and has successfully retrieved RDSRs from more than 900 different models across all major, and some smaller, manufacturers.

RDSR Now Required for New DIR Participants

Beginning in 2021, new participants registering for the DIR are required to send dose records only using the RDSR. Secondary capture images can be sent in addition to the RDSR but will not be accepted as the sole means of transmission.

Existing DIR participants will still be able to send secondary capture as their sole transmission method; however, the registry does intend to disable this support later in 2021.

If your facility has been using secondary capture to submit records to the DIR, it’s easy to switch to RDSR and improve your data accuracy. Please reach out to the TRIAD support team ( if you need assistance in the conversion process.

For more information, please see the article DIR Data Collection and Submission Using TRIAD™ in the NRDR Support Knowledge Base.