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3. Radiology > Quality Assurance > Flashcards

Quality Assurance Flashcards

1
Q

What is the purpose of quality assurance?

A

To ensure consistently adequate diagnostic info whilst radiation doses to its and other people are kept ALARP (takes into account IRMER17 and IRR17)

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2
Q

What does radiology quality assurance take into account?

A

Ionising Radiation Medical Exposure Regulations 17 (IREMR17) - pts

IRR17 - Ionising radiation regulations 17 - staff and others

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3
Q

What is a quality assurance programme?

A

This is found in every practice and covers the following:

  • procedures for radiographs - risk assessments, rules, contingency plans
  • staff training
  • x-ray equipment
  • pt dose
  • image processing
  • display equipment
  • image quality

OUTLINES WHO CAN TAKE THEM, WHERE AND WHAT DO DO IF SOMETHING GOES WRONG

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4
Q

What are QAP created with?

A

Input from medical physics experts

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5
Q

What receptors do we reuse?

A

Digital

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6
Q

Since we reuse digital receptors what happens?

A

There will vie wear and tear and mishandling so this will impact on the image quality and eventually will need replacing

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7
Q

How often should digital image receptors be checked?

A

Formally checked on regular basis - 3 monthly unless issue suspected sooner

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8
Q

What are the 3 digital image receptor checks?

A

THE RECEPTOR

IMAGE UNIFORMITY

IMAGE QUALITY

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9
Q

What do we check Digital image receptor for? (2)

A

we check for any visible damage by looking at it - look for scratches, check if its bent or creased
also check if its clean - no congealed saliva or disinfectant which can affect images

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10
Q

How do we check for image uniformity?

A

We expose the receptor to an unattenuated x-ray beam by placing receptor on table and aim X-ray tube at it and exposing it to the normal radiation dose and check if the resulting image is uniform

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11
Q

How do we know if our image is uniform on testing?

A

Will be a uniform grey colour across whole image

if not then we may see diff shades of grey

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12
Q

How do we test image quality?

A

Take radiograph of a test object and compare to baseline ideal image

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13
Q

What damage can we see on phosphor plates?

A

scratches
cracking
delamination

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14
Q

What will scratches appear like on phosphor plates?

A

White lines - can be fine or large

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15
Q

What will cracking appear like on phosphor plates?

A

Its a result of flexing and will look like a network of white lines (spider webbing)

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16
Q

Why does cracking appear on phosphor plates?

A

Happens because over time receptor is bent or mishandled in pts mouth and we get creasing and cracking along the phosphor layer and receptor - appears usually around edge or corner

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17
Q

What is delamination?

A

This is when there are white areas around the edge

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18
Q

How does delamination occur?

A

occurs when we get peeling away of the phosphor layer at the edges from being mishandled or getting wet and then drying out

19
Q

Why does less damage happen to solid state sensors?

A

All sensitive parts of receptor encased in sturdy plastic

20
Q

What damage can occur to solid state sensors?

A

can have white squares

white straight line

21
Q

What are the white squares in solid state sensors?

A

Dead pixels

22
Q

What are white lines on solid state sensors?

A

They are damage to whole line of pixels

23
Q

What does damage to film receptors appear like?

A

appears as black marks due to sensitisation of radiographic emulsion - when we mishandle the image or it is damaged then silver halide crystals in radiograph emulsion get sensitised

24
Q

Why can damage to film appear as white?

A

If the emulsion has been scraped off - the scratch is so bad it has removed emulsion rather than sensitising it

25
Q

What does a nail mark look like?

A

cresent shaped
well defined
superimposed on tooth

on digital its white but on film its black

26
Q

What can an image uniformity check show?

A

Any damage to receptor such as scratches, cracking or delamination

27
Q

How do we know an image has been over collimated?

A

the edge of the image has been cut of due to X-ray tube not being lined up properly with the receptor

28
Q

How do we carry out quality analysis of receptor image quality?

A

step wedge test

29
Q

What is the step wedge test?

A

this is where we use a test object to check image quality/contrast - it can be self made or bought

30
Q

How do we make a step wedge tester?

A

Wooden spatula and lead foil

- 1 wrap of lead foil…2 wraps… 3 wraps like a step until 6 wraps (so all inc thicknesses)

31
Q

How do we do step wedge test?

A

take step wedge and place receptor underneath and then expose it and we will get an image that is attenuated to different degrees

32
Q

What radiation exposure is used for step wedge test?

A

Normal clinical exposure - adult mandibular molar PA AND RESULTING IMAGE IS COMPARED TO BASELINE

33
Q

How do we analyse step wedge test results?

A

Compare it to baseline - we must be able to see 6 steps

there will be most attenuation –> least attenuation as only single layer of foil

34
Q

How do we know the receptor is undamaged?

A

Very clear defined areas if there is damage then not good contrast to differentiate between area

35
Q

How often do we do step wedge test?

A

Daily - every morning

36
Q

What is the aim of allaying assurance of clinical image quality?

A

To ensure radiograph are consistently adequate for diagnostic purposes

37
Q

What does QA of clinical image quality consist of ? (3)

A

IMAGE QUALITY RATING

IMAGE QUALITY ANALYSIS

REJECT ANALYSIS

38
Q

What is image quality rating?

A

This is where we grade the image

39
Q

What is image quality analysis?

A

This is where we review images to calculate the success rate and identify any trends for suboptimal images (is it the dentist, does It occur in the morning?)

40
Q

How often is image quality analysis carried out?

A

Periodically - every 4 months review last 150 images

41
Q

What is reject analysis?

A

This is where we record and analyse each unacceptable image - what caused it to be suboptimal and non diagnostic? we need to then adress this and prevent from happening again

42
Q

What is the new recommended QA system for clinical image quality?

A

DIGANOSTICALLY ACCEPTABLE (A)

DIAGNOSTICALLY NOT ACCEPTABLE (N)

43
Q

What does diagnostically acceptable mean?

A

no errors or minimal errors in either pt prep, exposure, positioning, image receptor processing or image reconstruction and of a sufficient image quality to answer the clinical q

MINIMAL ERRORS IN ALL COMPONENTS THAT IS SUFFICENT IN ANSWERING OUR CLINICAL Q

44
Q

What does diagnostically not acceptable mean?

A

errors in pt perp, exposure, positioning, image receptor processing or image reconstructing making the image diagnostically unacceptable

3. Radiology (12 decks)

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