Digital Repeat Analysis; Setup and Operation

Abstract

Since the emergence of digital imaging, there have been questions about the necessity of continuing reject analysis programs in imaging departments to evaluate performance and quality. As a marketing strategy, most suppliers of digital technology focus on the supremacy of the technology and its ability to reduce the number of repeats, resulting in less radiation doses given to patients and increased productivity in the department. On the other hand, quality assurance radiographers and radiologists believe that repeats are mainly related to positioning skills, and repeat analysis is the main tool to plan training needs to up-skill radiographers. A comparative study between conventional and digital imaging was undertaken to compare outcomes and evaluate the need for reject analysis. However, digital technology still being at its early development stages, setting a credible reject analysis program became the major task of the study. It took the department, with the help of the suppliers of the computed radiography reader and the picture archiving and communication system, over 2 years of software enhancement to build a reliable digital repeat analysis system. The results were supportive of both philosophies; the number of repeats as a result of exposure factors was reduced dramatically; however, the percentage of repeats as a result of positioning skills was slightly on the increase for the simple reason that some rejects in the conventional system qualifying for both exposure and positioning errors were classified as exposure error. The ability of digitally adjusting dark or light images reclassified some of those images as positioning errors.

Digital Radiography Reject Analysis: Data Collection Methodology, Results, and Recommendations from an In-depth Investigation at Two Hospitals

“…1 This problem has been further compounded by the lack of the software infrastructure necessary to centrally compile data for radiology departments that have multiple digital-capture devices. 2 Quality assurance (QA) tools such as digital dashboards and device clustering software platforms are now available from some manufacturers (Carestream Health at http://www. carestreamhealth.com/).…”

Managing Repeat Digital Radiography Images—A Systematic Approach and Improvement

“…The efficiency of such process is low, and the continued implementation of quality assurance creates a large burden to the limited human resources of a radiology department. Although automated methods [5,9,13] have been developed for the collection and analysis of repeat images, this type of analysis is influenced by several factors including radiologic technologists' performance and radiographic capabilities. Furthermore, radiologic technologists may be compelled to collect the information involuntarily, which negatively influences the accuracy of information [9].…”

“…Although automated methods [5,9,13] have been developed for the collection and analysis of repeat images, this type of analysis is influenced by several factors including radiologic technologists' performance and radiographic capabilities. Furthermore, radiologic technologists may be compelled to collect the information involuntarily, which negatively influences the accuracy of information [9]. Past studies have also revealed that the implementation of such data collection methods for quality assurance is not easy, even in a digitized environment [5,14].…”

“…In the past, calculation of the number of repeat images was primarily performed manually [3,[9][10][11][12]. The efficiency of such process is low, and the continued implementation of quality assurance creates a large burden to the limited human resources of a radiology department.…”

Maintaining Quality Control Using a Radiological Digital X-ray Dashboard

“…[1][2][3][4][5][6][7][8] There are several peer-reviewed articles addressing the question or need for a form of higher level quality assessment in the digital Xray department, but none is offering a software solution or a simple means of supporting managers and those responsible for overseeing the quality of digital X-ray imaging in becoming more effective and efficient in delivering the intended service. [9][10][11][12][13] At the beginning of digital projection radiography, repeats, dose, and usage were only manageable by manually scribing ledgers or by printing to film and keeping every exposure as in the traditional workflow fashion. Both methods sacrificed workflow at the department level to enable digital radiographic imaging.…”