Dose Index Registry

The ACR Dose Index Registry (DIR) is one of eight registries that comprise the National Radiology Data Registry (NRDR). The DIR enables facilities to compare their dose indices data against regional and national values and to delve into details about scanner and device performance within and across facilities to ensure safe and high-quality exam performance for optimal patient care.

Published summary reports and real-time online reports let participants view aggregate performance data, pinpoint outlier exams, and identify performance patterns for further investigation. DIR performance reports facilitate implementation of quality improvement efforts and the database is used to explore a variety of topics for presentations and publications to advance the science and practice of radiology. 

The DIR offers quality measures to help fulfill Merit-based Incentive Payment System (MIPS) reporting requirements. Participation also meets Maintenance of Certification (MOC) Part IV  requirements of the American Board of Radiology (ABR) and the Joint Commission’s dose benchmark requirement .


  1. Accurate exam and procedure name mapping is critical for DIR participating facilities to gain insight into their radiation dose levels overall and to obtain accurate comparisons with national benchmarks to drive quality improvement. View the second of our 3-part webinar series, All About Mapping, to learn from national experts about mapping methods for CT and fluoroscopy and best practices and pitfalls to avoid. Watch now.
  2. American College of Radiology® (ACR®) Dose Index Registry diagnostic reference levels for common pediatric CT scans can help imaging facilities and providers optimize radiation dose used in children’s imaging. Read the article.

New DIR Modules

The DIR has expanded beyond CT!  A new DIR Fluoroscopy module now enables facilities to gain insight about their fluoroscopy procedure dose performance. Efforts are underway to offer more modules including DIR Digital Radiography and DIR Nuclear Medicine.  Check out the DIR Features Knowledge Base article to learn about new module developments.

Facilities participating in one DIR module, can submit dose data to the other modules at no additional cost. 

NRDR Portal Login

Need assistance?                                    Visit NRDR Support to view the Knowledge Base user guide or place a help ticket

Have an urgent issue?                            Call us: 1-800-227-5463, ext. 3535

How to Participate

Visit the NRDR Knowledge Base article DIR Startup Guide for a  step-by-step approach to DIR participation—from assembling your team to reviewing your reports.  

Already a NRDR participant? Add the DIR to your facility registration. Only one registration is required to participate in any of the DIR modules.

Core Documents

Related Resources

Dose Index Registry Acknowledgements

The "Automated size-specific CT dose monitoring program: Assessing variability in CT dose" is courtesy of Duke University Clinical Imaging Physics Group. The details of the approach can be found in Christianson O, Li X, Frush DP, Samei E. Automated patient-specific CT dose monitoring system: assessing variability in CT dose. Medical Physics 39(11): 7131-7139. 2012.

The processing of non-RDSR dose screens for the Dose Index Registry is courtesy of PixelMed Publishing, LLC. The open source code of the PixelMed dose-related tools can be found at

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