Efficient quality assurance programs in radiology and nuclear medicine in Ostergotland, Sweden

Abstract

Owners of imaging modalities using ionizing radiation should have a documented quality assurance (QA) program as well as methods to justify new radiological procedures to ensure safe operation and adequate clinical image quality. This includes having a system for correcting divergences, written imaging protocols, assessment of patient and staff absorbed doses and a documented education and training program. In this work we review how some aspects on quality assurance have been implemented in the County of Östergötland in Sweden and our efforts to standardize and automate the process as an integrated part of the radiology and nuclear medicine QA-programs. Some key performance parameters have been identified by a Swedish task group of medical physicists to give guidance on selecting relevant quality assurance methods. These include low-contrast resolution, image homogeneity, automatic exposure control, calibration of air kerma-area product meters and patient-dose data registration in the radiological information system, as well as the quality of reading stations and of the transfer of images to the picture archive and communication system. IT-driven methods to automatically assess patient doses and other data on all examinations are being developed and evaluated as well as routines to assess clinical image quality by use of European quality criteria. By assessing both patient absorbed doses and clinical image quality on a routine basis, the medical physicists in our region aim to be able to spend more time on imaging optimization and less time on periodic testing of the technical performance of the equipment particularly on aspects which show very few divergences. The role of the Medical Physics Expert is rapidly developing towards a person doing advanced data-analysis and giving scientific support rather than one performing mainly routine periodic measurements. We conclude that both the European Council directive (1) and the rapid development towards more complex diagnostic imaging systems and procedures support this changing role of the Medical Physics professional. INTRODUCTIONThe European Council directive (1) imposes on their member states that all medical radiation exposures of patients should be as low as reasonably achievable and clinical image quality consistent with obtaining the required diagnostic information. This process is often denoted optimisation and includes many aspects of quality assurance, QA. The objective for performing quality assurance on radiological equipment is to ensure that the quality of the clinical images is consistently sufficient for accurate diagnosis and at the same time minimizing patient and occupational absorbed doses. Examples of QA are justifications of imaging procedures, having written protocols for all standard imaging procedures, selection and acceptance testing of new imaging equipment, periodic equipment quality control, adequate training of staff, assessment of patient doses or administrated activities and methods to properly manage high risk patients such as foetu...

Aceitabilidade de um futuro banco de objetos simuladores para controle de qualidade em medicina nuclear

“…0100-3984 © Colégio Brasileiro de Radiologia e Diagnóstico por Imagem tems in scintillation chambers, in the calibration of such devices, in the analysis of parameters for images reconstruction and capacity of lesions detection, and in the definition of the sensitive volume and other properties or characteristics of such systems. In this field, the following types of phantoms are most frequently utilized: quadrant bar phantoms; homogeneity phantoms, such as the Jaszczak type, with artifacts of different dimensions for the simulation of radiopharmaceuticals uptake, allowing a sepa-ORIGINAL ARTICLE rate evaluation of several tomographic conditions of nuclear medicine imaging systems (1,2) ; the Rollo phantom, utilized for evaluating contrast and spatial resolution; brain phantoms, such as the Hoffman 3-D Brain Phantom; cardiac phantoms and thyroid phantoms (3) . Certain phantoms may also function as dosimeters, whenever they contain materials such as thermoluminescent detectors or special polymer gels (4)(5)(6)(7)(8)(9) .…”

“…Certain phantoms may also function as dosimeters, whenever they contain materials such as thermoluminescent detectors or special polymer gels (4)(5)(6)(7)(8)(9) . Some of these objects, such as the Jaszczak type, are efficient for use in quality control of single photon emission computed tomography (SPECT) and positron emission tomography (PET) systems (2,6) .…”