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AAPM Reports - Quality Control in Diagnostic Radiology
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Report No. 074 - Quality Control in Diagnostic Radiology (2002)

Category: Reports

In 1977, the American Association of Physicists in Medicine (AAPM) published a quality assurance protocol aimed at providing guidance to a radiologic technologist involved in the implementation of a quality assurance (QA) program in diagnostic radiology. Since the time of that writing, diagnostic radiology has undergone fundamental changes that have directly influenced the requirements of such a program. Equipment has become more complex with the maturation of digital radiography and fluoroscopy. We have witnessed the proliferation of mid-frequency generators from primarily portable operations to standard radiographic-fluoroscopic systems and to cardiac imaging and digital subtraction angiography. Our ability to test radiographic systems without invasive measurement has developed along with the computer industry, making possible the capture of test data directly into a database running on a laptop computer. In 1994, the AAPM published a task group report on the Role of the Clinical Medical Physicist in Diagnostic Radiology.1 That document includes this statement: A primary responsibility of the medical physicist in an imaging program is the development and supervision of a quantitative quality assurance program. The responsibility for establishment of a quality control (QC) program has clearly moved out of the domain of the radiologic technologist and into that of the diagnostic medical physicist. The diagnostic medical physicist must be knowledgeable in current equipment designs, intended use, and the appropriateness of the various test instruments that may be used in performance evaluation. The diagnostic medical physicist acts as a local expert on Joint Commission on Accreditation of Healthcare Organizations (JCAHO), state, and federal requirements concerning quality control, equipment performance, and radiation safety. As such, the medical physicist needs to be able to provide a well designed QC program that addresses the needs of the clinic by assuring consistent optimal image quality, a safe work environment, and compliance with the various regulatory agencies, all at a reasonable cost to the institution. The intent is for this report to be used by the consulting or resident diagnostic medical physicist. As such, it will not provide instructions for how to perform individual tests. Reference will be made, however, to where the reader may find such information and which resources the authors have found to be most helpful. We shall restrict our recommendations to the identification of which parameters are essential for a given type of x-ray imaging equipment and what minimum performance criteria should be met in order to achieve acceptable image quality. The report will outline the essential components of a QC program in diagnostic radiology that can be used by the diagnostic medical physicist as a guide when designing such a program for a given clinical operation. Specific tests will be recommended for most of the common radiological imaging equipment found in a typical, large radiology department. A rationale for determining efficient testing frequencies 1 based on criticality and track record of the equipment is also included. Programs may be tailored to meet the needs of any individual clinic by including only the tests that are appropriate for the equipment at that clinic. It is the responsibility of the reader to be familiar with state and local regulations, which may contradict these recommendations. Also, federal regulations cited as references in this work are subject to change. The task group recognizes that the availability of a standard set of forms for data collection is of significant interest to the audience of this report. Several such comprehensive forms are under development at the time of this writing. However, in the interest of brevity, they were not included in this report.

ISBN: 978-1-888340-33-4

Keywords: Quality Control, Testing
Diagnostic X-ray Imaging Committee Task Group #12

S. Jeff Shepherd, Pei-Jan Paul Lin, John M. Boone, Dianna D. Cody, Jane R. Fisher, G. Donald Frey, Hy Glasser, Joel E. Gray, Arthur G. Haus, Lance V. Hefner, Richard L. Holmes, R. J. Kobistek, F. N. Ranallo, P. L. Rauch, R. P. Rossi, J. Anthony Seibert, K. J. Strauss, O. H. Suleiman, Joel R. Schenck, Stephen K. Thompson

Committee Responsible: Radiography and Fluoroscopy Subcommittee

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