Quality control (QC) in medical imaging is an ongoing process and not just a series of infrequent evaluations of medical imaging equipment. The QC process involves designing and implementing a QC program, collecting and analyzing data, investigating results that are outside the acceptance levels for the QC program, and taking corrective action to bring these results back to an acceptable level. The QC process involves key personnel in the imaging department, including the radiologist, radiologic technologist, and the qualified medical physicist (QMP). The QMP performs detailed equipment evaluations and helps with oversight of the QC program, the radiologic technologist is responsible for the day-to-day operation of the QC program. The continued need for ongoing QC in digital radiography has been highlighted in the scientific literature. The charge of this task group was to recommend consistency tests designed to be performed by a medical physicist or a radiologic technologist under the direction of a medical physicist to identify problems with an imaging system that need further evaluation by a medical physicist, including a fault tree to define actions that need to be taken when certain fault conditions are identified. The focus of this final report is the ongoing QC process, including rejected image analysis, exposure analysis, and artifact identification. These QC tasks are vital for the optimal operation of a department performing digital radiography.
While ultrasound guided prostate brachytherapy has gained wide acceptance as a primary treatment tool for prostate cancer, quality assurance of the ultrasound guidance system has received very little attention. Task Group 128 of the American Association of Physicists in Medicine was created to address quality assurance requirements specific to transrectal ultrasound used for guidance of prostate brachytherapy. Accurate imaging guidance and dosimetry calculation depend upon the quality and accuracy of the ultrasound image. Therefore, a robust quality assurance program for the ultrasound system is essential. A brief review of prostate brachytherapy and ultrasound physics is provided, followed by a recommendation for elements to be included in a comprehensive test phantom. Specific test recommendations are presented, covering grayscale visibility, depth of penetration, axial and lateral resolution, distance measurement, area measurement, volume measurement, needle template/electronic grid alignment, and geometric consistency with the treatment planning computer.
Task Group 154 (TG154) of the American Association of Physicists in Medicine (AAPM) was created to produce a guidance document for clinical medical physicists describing recommended quality assurance (QA) procedures for ultrasound (U.S.)-guided external beam radiotherapy localization. This report describes the relevant literature, state of the art, and briefly summarizes U.S. imaging physics. Simulation, treatment planning and treatment delivery considerations are presented in order to improve consistency and accuracy. User training is emphasized in the report and recommendations regarding peer review are included. A set of thorough, yet practical, QA procedures, frequencies, and tolerances are recommended. These encompass recommendations to ensure both spatial accuracy and image quality.
Radiography remains the most widely used imaging modality throughout the world. Additionally, while it has been demonstrated that a quality control (QC) program, especially in mammography, improves image quality, weekly technologist QC testing might be lacking even where there is clinical qualified medical physicist (CQMP) support. Therefore, the International Atomic Energy Agency (IAEA) developed simple QC phantoms that can easily be used on a regular basis (daily/weekly) for radiography and mammography. These are simple in design and use materials that are easily accessible in most parts of the world. A software application is also developed that automatically analyzes images and Digital Imaging and Communications in Medicine (DICOM) header information. It exports data to a comma‐separated values (CSV) file that is read by a Microsoft Excel® spreadsheet for documentation and graphical analysis. The phantom and the software were tested in four institutions (in Costa Rica and the United States of America) both on computed radiography and direct digital mammography and radiography systems. Data were collected over a 3‐year period. No corrective actions were taken on the data, but service was performed on two of the units. Results demonstrated noise that could be attributed to suboptimal placement of the phantom and incorrect data being put into the DICOM header. Preliminary evaluation of the IAEA methodology has demonstrated that it can provide meaningful QC data that are sensitive to changes in the imaging systems. Care must be taken at implementation to properly train personnel and ensure that the image data, including the DICOM header, are being correctly transmitted. The methodology gives the opportunity for a single CQMP to provide QC services even to remote sites where travel is prohibitive, and it is feasible and easy to implement.
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