8. Quality Control in Digital Radiography Flashcards
1
Q
Why is QC still needed in DR?
A
o Even when machines are initially set up
to perform properly, performance can
degrade over time.
o The combination of human and
machine can improve performance, but
at the same time can magnify errors.
o How is it possible to know whether the
imaging operation is going badly or
efficiently without active and objective
measurements of performance
2
Q
Visible, on-going effort to collect
information about an imaging operation
A
Quality Control
3
Q
Visible, on-going effort to collect
information about an imaging operation
A
Quality Control
4
Q
Seeks to get the most efficient
performance from both the imaging
facility and the physician.
A
Quality Control
5
Q
QC can detect:
A
o Malfunctions o Unpredictability o Inefficient use of radiation o High fluoroscopic outputs o Radiation not reaching receptor o Inadequate filtration o Oversized collimation
6
Q
Goals of a QC Program
A
o Obtain acceptable image with least possible radiation exposure to patients & staff o Attempt to identify problems before they appear on patient films o Without QC, problems only detected on patient films
7
Q
Components of quality control
A
- Acceptance Testing
- Establishment of baseline performance
- Diagnosis of changes in performance
- Verification of correction of deterioration
8
Q
First opportunity to determine whether
the imaging equipment meets the
requirements of state and federal
regulatory agencies
A
Acceptance Testing
9
Q
Special features written in the purchase
contract
A
Acceptance Testing
10
Q
Conducted before used for patients
A
Acceptance Testing
11
Q
Conducted in the presence of vendor
service engineer, so it can be corrected
immediately if possible
A
Acceptance Testing
12
Q
Used to establish baseline performance
A
Acceptance Testing
13
Q
Limits of maximum deviation from
normal before initiating corrective
action
A
Diagnosis of changes in performance
14
Q
If corrective action is taken, verify that the performance has returned to normal levels by conducting the usual test plus some additional comprehensive test
A
Verification of correction of
deterioration
15
Q
Quality image that makes accurate
diagnosis possible
A
Diagnostic quality
16
Q
Can be described in terms of
contrast, resolution, and noise
A
Diagnostic quality
17
Q
o Image containing information required by Radiologist for correct interpretation o Goal minimize exposure while maintaining acceptability o High exposure films often have excellent appearance o Cardboard cassettes
A
Acceptable image
18
Q
still uses
conventional radiographic equipment
so basic radiography quality control
resting is still needed
A
Computed radiography
19
Q
Computed Radiography & Quality Control
A
o Calibration of the generator o Collimation o Beam alignment o Linearity of exposure o Spatial resolution (focal spot)
20
Q
The end product in radiography is the
image and accurate report of _____
A
findings
21
Q
Therefore for film, the processor function, screen contact and artifact avoidance was ____
A
critical
22
Q
With digital radiography the computer monitor, image transfer and image receptor plate become the ____ areas for quality assurance
A
critical
23
Q
Quality of the report
and the communication
between radiologist
and clinicians
A
Physician’s interpretation of the images
24
Q
Flowchart of the steps involves in
performing a DR exam
A
Process Map
25
Other QA activities are accomplished
through interactions between the
technologist and the patient
Process Map
26
Exam is explained o the patient
Process Map
27
Verify the patient identified in
the request, anatomy to be
examined, pregnancy status
and allergies
Process Map
28
A simple QC method is to include a
_____ on the exam request that the
RT annotates to indicate that all these
actions were taken
checklist
29
An organized effort by the staff operating a
facility to ensure that the diagnostic images
produced are of a sufficiently high quality so
that they consistently provide adequate
diagnostic information at the lowest possible
cost and with the least possible exposure of the
patient to radiation
Quality assurance program
according to World Health
Organization (WHO)
30
Objectives of QA Program
```
o To maintain optimal quality of
diagnostic images;
o To reduce unnecessary radiation
exposure to patient and staff;
o To be cost effective
```
31
The primary goal of a radiology _____ is
to ensure the consistent provision of prompt
and accurate diagnosis of patients
QA program
32
QA program has many facets, including
1. Quality Control tests
2. Administrative procedures
3. Preventive maintenance procedures
4. Training
33
An integral part of quality assurance
Quality Control
34
```
Involves specific actions designed to
keep measurable aspects of the process
involved in manufacturing a product
(image) or providing a service within
specified limits.
```
Quality Control
35
Quality Control is summarized in four principal steps:
1. Acceptance Testing to detect defects in
equipment that is newly installed or has
undergone major repair
2. Establishment of baseline performance of the equipment (commissioning test)
3. Detection and diagnosis of changes in
equipment performance before they
become apparent in images
4. Verification that the causes of
deterioration in equipment
performance have been corrected
36
The frequency of any QC test depends on the
| following variables:
o The inherent variability of the process
or equipment
o The age, reliability, and frequency of
use of the equipment
o The criticality of the element in the
imaging chain
37
These procedures are design to verify that QC
| testing is effective, ie.
```
I. The test are performed reqularly and
correctly,
II. The results evaluated promptly and
accurately
III. And the necessary action taken
```
38
```
They include recommendations
regarding the responsibility for quality
assurance action, staff training,
equipment standards, and the selection
of the appropriate equipment for each
examination
```
Administrative Procedure
39
These are performed on regularly scheduled basis with the goal of preventing breakdowns due to equipment failing without warning signs
detectable by monitoring.
Preventive Maintenance Procedure
40
Preventive Maintenance Procedure includes
1. Visual inspection of the mechanical and
electrical characteristics of the x-ray
system assuring cleanliness with respect
to spilling of contaminants in the
examination room.
2. Following the manufacturer’s
recommended procedures for cleaning
and maintenance of the equipment.
3. Regular inspection and replacement of
switches and parts that routinely wear
out or fail
41
```
The QA program include the means to
provide appropriate training for all
personnel with QA responsibilities to
ensure each meet a minimum level of
competency to perform QC test
correctly and consistently
```
Training
42
```
Personnel in the QA program who are
responsible to oversight of the QA
program, setting the goals and
direction, determining policies, and
assessing the effectiveness of QA
activities
```
Quality Assurance Committee
43
They have an overall documented
strategy with clearly defined work plans to achieve the goals and objectives of
the radiology department
Quality Assurance Committee
44
Quality Assurance Committee Includes:
```
o Medical physicist
o Radiologist
o Biomedical engineer
o Medical imaging technologist (MIT)
and Radiographer
o Information Technology (IT)
Technician
```
45
An individual who is competent to
independently practice in one or more of the
subfields in medical physics
Medical Physicist
46
Medical Physicist
```
-Advising the facility on radiation
protection of the patient, staff, and
members of the public
-Conducting tests to ensure the safety
and proper performance of imaging
equipment used
-Assignment of bio-medical engineering
service staff for corrective maintenance
or preventive actions
-Training of personnel utilized for quality
control
- Develop and implement a radiation
protection program
```
47
A medical doctor who specializes in the
diagnosis and treatment of disease and injury
by using medical imaging technologies
Radiologist
48
Radiologist
```
-Determine the overall quality of the
output image
-Select the technologist to be the
primary QC technologist, performing
the prescribed QC tests
- Ensure that appropriate test equipment
and materials are available to perform
the QC tests
- Ensuring that medical physicists and
radiographers have adequate training
and continuous education
```
49
```
use their
knowledge of modern biological
principles in their engineering principle
to design and develop devices and
procedures that solve medical and
health-related problems
```
Biomedical Engineer
50
Biomedical Engineer are involve in:
o Corrective and preventive
maintenance
o Fault reporting
51
Medical Imaging Technologist (MIT) &
| Radiographer
```
-Ensuring that the appropriate protocol
and technique factors are used for
requested examination
- Ensuring that the QC tests are
performed, interpreted, and recorded
appropriately
- Perform all the checks for the daily,
monthly, and quarterly QC testing of
equipment
- Report faults immediately any deviation
in trend of equipment performance to
QA manager
- Undertaking additional continuous
education courses
```
52
A key element of any digital facility that
intends to store, review and distribute
images electronically or using hard
copy
Information Technology (IT) Technician
53
Information Technology (IT) Technician
Maintenance of the integrity of system
databases to ensure continuous and
accurate operation of the information
system
54
QA PROGRAM DRAWBACK
- Costly
| - Personnel
55
```
The QA program is based on, planning,
delegating responsibility, training and
purchasing the proper equipment, then
establishing a high standard of quality and
maintaining it.
```
Costly
56
Personnel drawbacks
o Unclear responsibility
o Lack of qualification
o Lack of commitment to perform QC
test
57
Any program lacking genuine interest from its
staff and initiated only to satisfy a regulatory
requirement is _____ to produce optimal
results
unlikely
58
issues in any work
| environment are very important
Health and safety
59
All heads of department are responsible
for ensuring that injury or sickness, due
to working conditions, is kept to a
minimum
Health and safety
60
To make the environment as safe as
| possible, make certain the following:
```
o Regular maintenance
inspections are carried out
o Safety procedures are followed
o Adequate staff instruction is given
o Safety equipment is readily available
```
61
promote the effective use of
radiation for a diagnostic outcome
trough achieving and maintaining appropriate image quality and
reduction of patient dose
Quality Assurance
62
```
An established ___ program monitor the
imaging process from start to finish and
reveal potential problems that may
otherwise go unrecognized, through a
sequences of QC tests
```
QA
63
_____ in medical imaging is a rapidly
evolving concept and each facility is
encouraged to continually pursue ways
to improve and expand its program
QA
