The ACR’s TRIADTM software, installed locally at each participating facility, anonymizes, formats, and transmits data to the DIR.

You can begin the installation process once DIR registration is complete for each facility contributing CT exam data. Facilities that wish to prepare ahead of time can review the hardware and software requirements. Once you are ready to begin, consult the TRIAD support site for detailed instructions. TRIAD can be downloaded to a stand-alone PC or server; you do not need to build a new server.

Alternatively, if you have dose monitoring software from a third-party vendor you can consult the list of DIR-certified software partners to see if your vendor is already approved to send data using TRIAD on your behalf.

TRIAD Domain Activation

Once you receive the e-mail notice that we have approved your facility to send DIR data, you must activate the domain with valid NRDR login credentials. NRDR does not issue generic credentials and passwords for domain activation. Rather, any NRDR user registered in Manage User Profiles for your registered facility can provide his or her own user name and unique password to activate the domain. 

Note: If you plan to have someone from your IT department activate the domain page, use the Manage User Profiles page to create a Service User account for them. This account can submit data for all facilities under a corporate account.


After TRIAD is installed and activated, the CT scanners must be mapped at the console. We prefer you send data directly from your CT scanners, however, DIR can also receive data from your PACS or third party-dose monitoring software. Please do not batch or manually send data; rather, set your scanners to auto-send to the TRIAD installation. 

Note: If you’d like to transmit data from your PACS, please contact the NRDR Help Desk and we will make an appointment to walk you through the setup process.

The standard required content for data transmission to TRIAD for DIR is the Radiation Dose Structured Report (RDSR) and localizer.  DIR accepts secondary capture (or dose screen) because, at the time DIR started, there were many old scanners that were not able to produce RDSRs and we wanted to accommodate those scanners. The ACR uses 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.

Note: Manufacturers update their software from time to time and these updates may change how the data in the secondary capture look. Maintaining the OCR software is extremely resource-intensive and unreliable. Since the implementation of the XR-29 standard, most scanners are capable of generating RDSRs.  Therefore, the ACR has decided not to invest the resources to update the OCR software. 

Note: Some scanners that are able to produce RDSRs can only send both RDSRs and secondary captures. This is fine. In these instances, the DIR will ignore the secondary captures/dose screens and only read the data from RDSRs.

After you begin transmitting data, log in to NRDR and confirm that your data have been received by the DIR for your facility. You can review the volume of exams received using the Summary of Data Submitted report, and you can see which scanners are successfully submitting data using the Scatterplot Over Time or Boxplot by Scanner reports.

DIR Data Dictionary

The data dictionary lists all DICOM and Structured Report data field tags, concept names, values, and descriptions that we attempt to collect during data transmission.

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