Diagnostic Radiology Notes

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Presentation QA Xray eqpmnt CRT04208 · Radiology Quality Assurance START READING NOTES Study Presentation QA Xray eqpmnt using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic QUALITY ASSURANCE INTRODUCTION CHOOSING X-RAY EQUIPMENT Resources available Making the choice GENERATOR Fluctuations in main electrical supply Example of Specifications or Requirements for the choosing of X-ray equipment. Number Description Description continue… Minimum Technical Specifications or Requirements continue… ACCEPTING OF NEW X-RAY EQUIPMENT TESTS THAT CAN BE DONE FOR X-RAY EQUIPMENT ACCURACY OF TIMER TEST FREQUENCY OF TEST METHOD EVALUATION A 0.1sec exposure produced 6 spots for a single pulsed unit using a 60Hz mains supply. QUALITY ASSURANCE X-RAY EQUIPMENT AT BUGANDO MEDICAL CENTRE INTRODUCTION The aim of this experiment is to provide: The technical information and testing routines that will allow simple care, maintenance and testing to be carried out on basic X-ray equipment. An insight into the choosing and accepting of basic X-ray equipment. The term “X-ray equipment” covers generator, tube stand and Bucky. Specific types of equipment considered are general purpose, tomography, portable and mobile. CHOOSING X-RAY EQUIPMENT Identify your need; the following are the common needs to identify into the choosing of X-ray equipment:- General purpose, fluoroscopy, specialized, mobile. Generator (design/output). To suite power supply. kV, mA, time rangers. Tube mounting (overhead/column). Table (tilting, fixed, floating top, Bucky). Upright Bucky. Anticipated patient through put. Resources available -Power -Space -Maintenance and repair -Finance Manufacture warranty -Warranty period -Warranty cover -Determine responsibility Supplier services -Installation -Initial QC tests -Maintenance -Repairs -Parts -Speed of response Making the choice Establish your specifications requirements. Review manufacturer’s specifications. Make a short list of suitable equipment. Submit your requirements to the selected manufacturers for quotations. Review quotations. Make selection. Ensure that you have the written agreement of the manufacturer or supplier, to supply and install the equipment chosen, at the price quoted and that there are no hidden extras. GENERATOR A generator is a device which is used to produce electric energy. It is part of the electrical system of an X-ray machine which determines radiation output. Any inconsistency in radiation output will adversely influence the quality of the radiograph. The kV, mA and time must be consistent on all settings. Many factors can influence the radiation output, the ones to be considered are: Fluctuations in the main electrical supply. Inconsistency or inaccuracies in kVp, mA and time. Fluctuations in main electrical supply Most X-ray units have a mains compensator that automatically compensates for mains fluctuations. However, in some less sophisticated units, this must be done by hand. The radiographer must always check the mains compensator meter before making an exposure and make any corrections necessary. Example of Specifications or Requirements for the choosing of X-ray equipment. The following Requirements were made for the choosing of X-ray equipment at Bugando Medical Centre (BMC): Number BMC/HQ/G/2018-2019/15/LOT-02 Quantity One machine Delivery schedule (shipment) in weeks 10 weeks Description X-ray stationary floor mounted digital X-ray System (High Powered Xray Unit for General Radiography with Digital Flat Panel Technology) Description continue… Minimum Technical Specifications or Requirements: Generator: Max. output power: 80kW or more Min. kV: 40kV or less Max. kV: 150kV or more Min. mA: 10mA or less Max mA: 630mA or more mAs range: 0.5mAs to 800mAs Exposure time: 0.001sec to 9.0sec or more Automatic Exposure Control (AEC) Number of focal spots: at least 2 Minimum Technical Specifications or Requirements continue… Floor Mounted Tube Support: Longitudinal movement of X-Ray tube: min. 2950mm Transversal movement of X-Ray tube: min. 1400mm Vertical movement of X-Ray tube: min. 1400mm Rotation of the X-Ray tube around horizontal axis: min. 1500C/1800C Rotation of the X-Ray tube around vertical axis: min. 1200C Auto-positioning Function Synchronization movement of the X-Ray tube support unit and Bucky stand Synchronization movement of the X-Ray tube support unit and Bucky table Minimum Technical Specifications or Requirements continue… X-ray Tube: Focal spots: at least 0.6/12mm or less Max anode heating capacity: 140kHU or more Max X-ray tube voltage: 125kV or more Multi-function touch screen control Wireless Flat Panel Detector with Bucky table FDP size: at least (43 x 43) +/- 1cm Pixel size: at least 139 x 139 µm Matrix size: at least 3052 x 2540 Scintillator: Csl Battery type: Lithium-ion Minimum Technical Specifications or Requirements continue… Wireless Flat Panel Detector with Bucky stand: FDP size: at least (35 x 43) +/- 1cm Pixel size: at least 139 x 139 µm Matrix size: at least 3052 x 2540 Scintillator: Csl Minimum Technical Specifications or Requirements continue… Digital Radiography Computer System for Radiographer: At least 19” medical grade display, user interface touch panel/ mouse Software for patient identification, entry, viewing, image processing and post-processing (brightness, rotation, inversion, zoom, pan and measurements) DICOM performance, print and store functions UPS Minimum Technical Specifications or Requirements continue… Accessories: Voltage Stabiliser UPS for digital system (where applicable) Lead glass: at least 100 x 80cm DAP meter Laser Printer (min. 320DPI and print at least 3 sizes of films online 10 x12, 10 x 14, 11 x 14, 8 x 10 and 14 x 17inches. Re-installation and Backup software Minimum Technical Specifications or Requirements continue… Documents: Service and operation manuals in English language for all items supplied in this lot. Execution guidance or installation drawings Certificates of compliance to safety norms and standards and/or trial tests results at manufacturer’s facility. Minimum Technical Specifications or Requirements continue… Warranty: At least 2 years warranty for all items supplied in this lot Training: Provide appropriate training at installation location or site in English language for effective and problem free use of the equipment included in this LOT. Training programme shall be submitted by the Bidder in the tender and should include schedule, duration, title and description of training materials. ACCEPTING OF NEW X-RAY EQUIPMENT Upon completion of the installation and before accepting responsibility for the new equipment, you must check that Specifications of equipment installed are the same as that ordered. Installation

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Determining the customer’s precise requirements Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Aims of the Course The course is aimed at helping the student to provide diagnostic information of a high degree and accuracy. It enable the student to produce a diagnostic image at a minimum cost and hence improve the cost effectiveness of a diagnostic department The medical imaging department is a very costly hospital department to run, any programme of monitoring which encompasses imaging as well as processing equipment is an invaluable aid to ensuring that top-quality images are being produced in the most cost-effective way. Such a monitoring programme is often referred to as a quality assurance or quality control programme Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & IMAGING INTRODUCTION Quality assurance in Radilogy & Imaging department refers collectively to all aspects of a Diagnostic Radiography & Imaging service, e.g. patient scheduling, radiation protection of patients, staff and general public, preventive maintenance and the care of instruments, methodology, data interpretation and records keeping, and thing which contribute directly or indirectly to the overall quality of a Diagnostic Radiography & Imaging service in a hospital. Quality Control, refers to a single component of the system and is usually applied in relation to a specific instrument and its performance. Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging INTRODUCTION Quality Assurance (QA) therefore, encompasses a range of activities that enable department to achieve and maintain high levels of accuracy and a high degree of skill; expertise despite changes in procedure and recording methods The overall management program, put in place to ensure that a comprehensive range of quality control activities work effectively A quality Assurance program should be comprehensive, looking at all aspects of the work involved in producing high quality radiographs. This program should be cost effective and achieve its aims Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging INTRODUCTION The radiographer should take responsibility of setting up, running, evaluating and taking remedial action and ensure program run routinely effectively Areas in which a radiographer should influence quality assurance / control e.g., in the x-ray department ( darkroom, sorting bench, reception, filling) and in clinical areas (proper x-ray requisition) Quality control:- The means by which, each area of interest is monitored and evaluated Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Aim of Quality Assurance Increasing awareness, interest and understanding of quality assurance issues Enable radiographers to establish and continue to carry out an effective quality assurance program Provide a comprehensive knowledge, advice and experience in quality control methods Provide the knowledge and skills to carry out basic care and maintenance of imaging equipment Raise standards Reduce imaging costs Improve job satisfaction Improve health and safety issues Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging The benefits of Quality Assurance and Quality Control A reduction in the number of 'repeat' radiographs. A reduction in the radiation dose to the public. Improvement in the rate of flow of patients through the department. Good quality radiographs, consistently produced. Standardization of radiographic results from one processor to the next. Automatic processor and imaging equipment reliability, with efficiency maintained. A more informed selection of future equipment can be made because of accurate knowledge of the reliability of existing apparatus Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging A Good Quality Assurance system should fulfill four requirements Establishes standard operating procedures (SOPs) for each step of the Radiographic projections, ranging from receiving of request form to equipment performance validation; Defines administrative requirements, such as mandatory recordkeeping, data evaluation, and internal audits to monitor adherence to SOPs; Specifies corrective actions, documentation, and the persons responsible for carrying out corrective actions when problems are identified; Sustains high-quality employee performance Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Quality Assurance in Radiology & Imaging Defines In Radiology & Imaging , quality assurance involves the entire testing process: Pre-analytical, e.g. Validation of request form Analytical (testing), Post-analytical processes. … Assess the effectiveness of the Departmental policies and procedures. Identify and correct problems. Assure the accurate, reliable, and prompt reporting of test results N/B Essential to all aspects of health care and Radiograph results that are accurate, reliable and timely Determining the customer’s precise requirements Ensuring that all resources, facilities and skills required to meet the customer's requirements are available Planning, documenting and implementing management procedures to ensure that the customer’s requirements are met consistently Ensuring that staff are trained and provided with the resources to do the job right the first time Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging How do we Achieve Quality Performance in Radiology and Imaging Department Quality is Achieved by:- Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging How do we Achieve Quality Performance in Radiology and Imaging Department Quality is Achieved by:- Ensuring that all activities are undertaken correctly Ensuring that when things go wrong effective corrective action is taken to avoid repetition of errors Undertaking regular reviews and audits of all processes Total and organized commitment from management Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Quality Control/ Quality Assurance Management system to guarantee integrity of data Everybody’s business Goal is value addition Management strategy Quality Control Measurement used to check quality of analytical data Restricted to a specific area and performed Goal is error prevention Error detection methodology Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Health and Safety Health and safety issues in any work environment are

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging 1 CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging 1 using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Determining the customer’s precise requirements Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging 2025 Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Aims of the Course The course is aimed at helping the student to provide diagnostic information of a high degree and accuracy. It enable the student to produce a diagnostic image at a minimum cost and hence improve the cost effectiveness of a diagnostic department The medical imaging department is a very costly hospital department to run, any programme of monitoring which encompasses imaging as well as processing equipment is an invaluable aid to ensuring that top-quality images are being produced in the most cost-effective way. Such a monitoring programme is often referred to as a quality assurance or quality control programme Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & IMAGING INTRODUCTION Quality assurance in Radilogy & Imaging department refers collectively to all aspects of a Diagnostic Radiography & Imaging service, e.g. patient scheduling, radiation protection of patients, staff and general public, preventive maintenance and the care of instruments, methodology, data interpretation and records keeping, and thing which contribute directly or indirectly to the overall quality of a Diagnostic Radiography & Imaging service in a hospital. Quality Control, refers to a single component of the system and is usually applied in relation to a specific instrument and its performance. Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging INTRODUCTION Quality Assurance (QA) therefore, encompasses a range of activities that enable department to achieve and maintain high levels of accuracy and a high degree of skill; expertise despite changes in procedure and recording methods The overall management program, put in place to ensure that a comprehensive range of quality control activities work effectively A quality Assurance program should be comprehensive, looking at all aspects of the work involved in producing high quality radiographs. This program should be cost effective and achieve its aims Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging INTRODUCTION The radiographer should take responsibility of setting up, running, evaluating and taking remedial action and ensure program run routinely effectively Areas in which a radiographer should influence quality assurance / control e.g., in the x-ray department ( darkroom, sorting bench, reception, filling) and in clinical areas (proper x-ray requisition) Quality control:- The means by which, each area of interest is monitored and evaluated Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Aim of Quality Assurance Increasing awareness, interest and understanding of quality assurance issues Enable radiographers to establish and continue to carry out an effective quality assurance program Provide a comprehensive knowledge, advice and experience in quality control methods Provide the knowledge and skills to carry out basic care and maintenance of imaging equipment Raise standards Reduce imaging costs Improve job satisfaction Improve health and safety issues Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging The benefits of Quality Assurance and Quality Control A reduction in the number of 'repeat' radiographs. A reduction in the radiation dose to the public. Improvement in the rate of flow of patients through the department. Good quality radiographs, consistently produced. Standardization of radiographic results from one processor to the next. Automatic processor and imaging equipment reliability, with efficiency maintained. A more informed selection of future equipment can be made because of accurate knowledge of the reliability of existing apparatus Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging A Good Quality Assurance system should fulfill four requirements Establishes standard operating procedures (SOPs) for each step of the Radiographic projections, ranging from receiving of request form to equipment performance validation; Defines administrative requirements, such as mandatory recordkeeping, data evaluation, and internal audits to monitor adherence to SOPs; Specifies corrective actions, documentation, and the persons responsible for carrying out corrective actions when problems are identified; Sustains high-quality employee performance Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Quality Assurance in Radiology & Imaging Defines In Radiology & Imaging , quality assurance involves the entire testing process: Pre-analytical, e.g. Validation of request form Analytical (testing), Post-analytical processes. … Assess the effectiveness of the Departmental policies and procedures. Identify and correct problems. Assure the accurate, reliable, and prompt reporting of test results N/B Essential to all aspects of health care and Radiograph results that are accurate, reliable and timely Determining the customer’s precise requirements Ensuring that all resources, facilities and skills required to meet the customer's requirements are available Planning, documenting and implementing management procedures to ensure that the customer’s requirements are met consistently Ensuring that staff are trained and provided with the resources to do the job right the first time Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging How do we Achieve Quality Performance in Radiology and Imaging Department Quality is Achieved by:- Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging How do we Achieve Quality Performance in Radiology and Imaging Department Quality is Achieved by:- Ensuring that all activities are undertaken correctly Ensuring that when things go wrong effective corrective action is taken to avoid repetition of errors Undertaking regular reviews and audits of all processes Total and organized commitment from management Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Quality Control/ Quality Assurance Management system to guarantee integrity of data Everybody’s business Goal is value addition Management strategy Quality Control Measurement used to check quality of analytical data Restricted to a specific area and performed Goal is error prevention Error detection methodology Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging Health and Safety Health and safety issues in any

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging – ACCESSORY EQUIPMENT Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging EQUIPMENT REQUIRED Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging – ACCESSORY EQUIPMENT 2024/2025 Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT AIM To provide the knowledge and practical skills necessary to establish and carry out a quality control program for accessory equipment OBJECTIVES Understand and carry out quality control procedures, evaluation and recommend action Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT COLLIMATOR Visual inspection Accuracy of scales Change a light bulb Light beam / X-ray beam alignment and centring Lead shutter efficiency The collimator (light beam diaphragm), provides the radiographer with an easy to use , accurate, method of controlling the size of the x-ray field and placing it over the area of interest, thus reducing the radiation dose to the patient and improving the quality of an image The collimator receives much use and is vulnerable to knocks, often resulting in inaccuracy of the light beam / X-ray beam coincidence, blown light bulbs, electrical and mechanical problems Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging ACCESSORY EQUIPMENT VISUAL INSPECTION Rotation. Stability Knobs for shutter control Accuracy of shutter setting Shutter chain drive Shutters Housing Window Light timer Timer switch Cables Plugs Light bulb Light / x-ray beam alignment Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT ACCURACY OF THE SCALE TEST The aperture size scales on the collimator used to set the aperture size, so it is advisable to make sure that the scales are accurate Inaccuracy of scales may lead to inaccurate collimation FREQUENCY OF TEST 6 monthly EQUIPMENT REQUIRED Collimator to be tested 100cm rule 2024/2025 Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT ACCURACY OF THE SCALE TEST METHOD Set 100cm focus to tabletop distance Using the 100cm FFD scale on the collimator, set various aperture sizes with the light on and measure the resultant light areas at table top level Compare with setting on the collimator EVALUTION Light area measured should be the same as the setting on collimator ACTION If settings are not accurate and the solution is not a simple one, call an x-ray engineer File a report Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY & Imaging ACCESSORY EQUIPMENT CHANGING A LIGHT BULB A light bulb can fail at any time without waning. It is important then, to have the correct spare bulb readily available Staff should be capable of replacing a faulty bulb FREQUENCY As necessary EQUIPMENT Suitable light bulb Cloth or tissue Screwdriver Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT CHANGING A LIGHT BULB METHOD Switch off the power Remove relevant collimator housing Check that spare is the correct type Before removing the old bulb, check to see if the replacement bulb must be fitted a specific way round Replace faulty bulb with the new one If the bulb is of the quartz type, ensure that it is not handed with bare fingers, as body oil on the bulb will shorten its life Replace housing and tighten screws Test Ensure that the spare bulb is replaced as soon as possible Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT LIGHT BEAM / X-RAY BEAM ALIGNMENT TEST The purpose of the light in a collimator is to allow more accurate collimation of the x-ray beam. The light must coincide with the x-ray beam. The light beam relies on the accurate positioning of the light bulb and angled mirror inside the collimator Should either the mirror or light bulb be dislodged, then errors in collimation could occur, resulting in areas of interest being excluded from the field, or too large an area being irradiated FREQUENCY OF TEST 6 monthly As necessary Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT LIGHT BEAM / X-RAY BEAM ALIGNMENT TEST EQUIPMENT REQUIRED One 24x 30 cm loaded cassette Alignment test tool, commercially made test tools are available, but a simple alternative is to use eight coins or four paper clips Lead marker or ninth coin METHOD Make sure that the table is level and the central ray at 90° to the tabletop Place a loaded cassette on the tabletop face up Set a FFD of 100cm Switch on the collimator light Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT LIGHT BEAM / X-RAY BEAM ALIGNMENT TEST METHOD Centre to the middle of the cassette Collimate to within the edge of the cassette, leaving a 3cm border all round, that is outside the light field Place the coins in pairs, so that, where the coins touch, coincides with the edge of the light area All four borders of the light must be marked in this way Place the lead marker within one corner of the light field so that the film can be related to the light /x –ray field and hence the collimator shutters Make an exposure sufficient to blacken the film Process the film Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT LIGHT BEAM / X-RAY BEAM ALIGNMENT TEST Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY ACCESSORY EQUIPMENT GRID The purpose of the grid is to reduce the amount of low energy photons reaching the detector. Although the quality of the image is improved, it does mean a significant increase in exposure, and therefore dose to the patient. A grid looks like a simple thin sheet of soft metal, but it is in fact a precision made of equipment and easily damaged.

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Assurance and Quality Control of X-ray EQUIPMENT CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Assurance and Quality Control of X-ray EQUIPMENT using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Quality Assurance and Quality Control of X –RAY EQUIPMENT Quality Assurance and Quality Control of X –RAY EQUIPMEN The peak potential of the x-ray generator affects quality of the x-ray beam and exposure to the patient. Quality Assurance and Quality Control IN DIAGNOSTIC RADIOGRAPHY Quality Assurance and Quality Control OF X –RAY EQUIPMENT Quality Assurance and Quality Control of X –RAY EQUIPMENT INTRODUCTION The term x-ray equipment covers generator, tube, cables, control panel, table, tube stand and bucky. It is important to ensure that all equipment is working efficiency and accurate records are kept Quality Assurance (QA) of medical diagnostic x-ray equipment means systematic actions necessary to provide adequate confidence to the end-user(s) that a medical diagnostic x-ray equipment will perform satisfactory in compliance with safety standards specified by the Competent Authority. Quality Assurance and Quality Control of X –RAY EQUIPMENT INTRODUCTION Quality Assurance Programme The goal of QA Program is to ensure the accuracy of the diagnosis. The minimum radiation dose should be delivered to the patient to achieve the objective of the diagnostic or interventional procedures. Quality Assurance and Quality Control of X –RAY EQUIPMENT INTRODUCTION QA programme begins with the performance evaluation of diagnostic x-ray equipment at the manufacturing stage and then acceptance testing after the installation of X-ray equipment at user’s institution(s) to ensure its conformity with the specifications. The QA tests should be carried out thereafter at regular intervals (periodicity-once in two years) and also after repairs of the equipment or when equipment malfunction is suspected. Quality Assurance and Quality Control of X –RAY EQUIPMENT Objective / Aim of Quality Assurance (QA) To provide the technical information and testing routine that will allow simple care, maintenance and testing to be carried out on basic x-ray equipment. To provide an insight into the choosing and accepting of basic x-ray equipment To provide technical knowledge and practical skills to carry out simple cleaning, maintenance and testing on x-ray equipment Optimum image quality of radiological procedures with minimum possible dose to the patient(s) Quality Assurance and Quality Control of X –RAY EQUIPMENT Why QA in Diagnostic Radiology? The routine QA tests are necessary to ensure that the functional performance of the equipment is similar to its baseline values and within the tolerance values as specified by regulatory body These tests should be performed by qualified service personnel(s) at user institution(s). These tests should be performed at regular intervals (once in two years) and at major repairs of X-ray equipment. Quality Assurance and Quality Control of X –RAY EQUIPMENT Choosing x- ray Equipment Identify your Need General purpose, fluoroscopy, specialised mobile Generator (design / output To suite power supply Alignment FFD (SID) x – Ray Table Mechanical Electrical Alignment Quality Assurance and Quality Control of X –RAY EQUIPMENT Choosing x- ray Equipment Making the Choice Establish your specification requirements Review manufacturer’s specifications Submit your requirements to the selected manufacturers for quotations Make selection Quality Assurance and Quality Control of X –RAY EQUIPMENT Accepetance of New X- ray Equipment Specifications of equipment installed are the same as that ordered Installation has been carried out as stated in the contract Installation is complete and equipment is working efficiency and to your satisfaction All accessory equipment has been supplied and is in good order Operating manual has been supplied and is the correct one Quality Assurance and Quality Control of X –RAY EQUIPMENT Quality Assurance Tests for Diagnostic X-ray Equipment Generator Radiation output reproducibility (output radiation intensity is the same each time when the same exposure is made because it can affect patient dose and image quality.) Constancy of radiation output at different mA settings Accuracy of kVp Accuracy of timer X- Ray Tube and High tension (HT) Cables Electrical Tube Support Mechanical Quality Assurance and Quality Control of X –RAY EQUIPMENT Quality Assurance Tests for Diagnostic X-ray Equipment Generator A generator is part of the electrical system of an x-ray machine which determines radiation output. Any inconsistency in radiation output will adversely influence the quality of the radiograph The kV, mA and time must be consistent on all settings. Many factors can influence the radiation output. The ones to be considered are:- Fluctuations in the main electrical supply Inconsistency or inaccuracies in kVp, mA and time Quality Assurance and Quality Control of X –RAY EQUIPMENT Quality Assurance Tests for Diagnostic X-ray Equipment Fluctuation in Main Electrical Supply Most x-ray units have a mains compensator that automatically compensates for mains fluctuations The Radiographer must always check the mains compensator meter before making an exposure Quality Assurance and Quality Control of X –RAY EQUIPMENT Quality Assurance Tests for Diagnostic X-ray Equipment Congruence of radiation and optical fields Central beam alignment Accuracy of Accelerating Tube Potential Timer Accuracy Linearity of radiation output Reproducibility of radiation output Total filtration Radiation leakage through tube housing Exposure rate at tabletop Fluoroscopic image quality parameters Quality Assurance and Quality Control of X –RAY EQUIPMENT X ray–light beam alignment and centring Improper beam alignment and centring will impact the radiographic image. The set light field needs to align well with the X ray beam area in order to limit the radiation field to the necessary size and to not miss any parts because of possible misalignments. Therefore, the objective of this test is to ensure the coincidence and alignment of the collimated light field with the X ray field. Another aspect is the coincidence of the crosshairs of the collimated light beam with the centre of the X ray beam, which is the origin point of the image Quality Assurance and Quality Control of X –RAY EQUIPMENT Congruence of Radiation and Optical Fields The X-ray field must be aligned with the light field so that the

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Control Assurance CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Control Assurance using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Definition Introduction Quality Control Assurance vi)Staff training and education: QUALITY CHEKS IN U/S QUALITY CONTROL ASSURANCE Definition Quality assurance: Is a broad process for preventing quality failure. Quality control: Is a procedure or set of procedures intended to ensure that a manufactured products or performed services adheres to a defined set of quality criteria. Quality control assurance: Is the combination of quality assurance, the process or set of processes used to measures and assure the quality. Introduction Is crucial to ensure accurate and reliable diagnostic results Equipment Calibration: Regular calibration of radiology and imaging equipment is essential to maintain accurate and consistent measurements. Calibration ensures that the equipment is operating within specified tolerances and provides reliable results. Quality Control Assurance ii)Image quality testing: Image quality testing involves assessing the performance of the imaging system to ensure optimal image quality. This includes evaluating spatial resolution, contrast resolution, noise levels and artifacts. Testing should be performed regularly using appropriate phantoms or tests objects. Quality Control Assurance iii)The radiation output testing: For equipment that utilizes ionizing radiation such as X-ray machines periodic testing of radiation output is necessary. This ensures that the equipment is delivering the required radiations dose accurately, avoiding both overexposed and underexposure. Quality Control Assurance iv)Quality assurance protocols: Implementing quality assurance protocols specific to each modality on type of radiology and imaging equipment is essential. These protocols define the steps and procedures to follow to maintain consistent quality in imaging procedures data acquisition and analysis. Quality Control Assurance v)Compliance with regulatory and accreditation standards; Radiology and imaging facilities must adhere to relevant regulatory guidelines and accreditation standards. These standards often includes, requirements for equipment performance maintenance and quality control. vi)Staff training and education: Proper training and education of personnel operating and maintaining radiology and imaging equipment are vital to ensuring quality control. Staff should be knowledgeable about the equipment capabilities proper usage and maintenance procedures to prevent errors and maintain quality standards. Quality Control Assurance vii)Documentation and records keeping Maintaining detailed records of quality control tests, maintenance activities and equipment performance is essential. Documentation should include dates, results any corrective actions taken and follow up measures. This information aids in tracking equipment performance over time and facilitates troubleshooting and analysis of any deviations or issues. Quality Control Assurance viii)Peer review and continuous improvement: Implementing a peer review process for image interpretation and quality control measures. Regular peer review sessions encourage collaboration feedback and continuous improvement insuring accurate and reliable diagnosis Quality Control Assurance By implementing comprehensive quality control assurance measures, radiology and imaging facilities can maintain the integrity of their diagnostic services improve patient safety and enhance the overall of care provided. QUALITY CHEKS IN U/S The quality checks in ultrasound involves: a)Image quality: Asses the image quality produced by the u/s unit. This can be done by evaluating the clarity resolutions and overall visibility of the structure in the u/s image. The focus should be on ensuring that the unit provides clear image with sufficient detail. Quality Control Assurance b)Calibration: Regular calibration of the u/s unit is essential to maintain accuracy in the measurements and image interpretation. Calibration check includes verifying the accuracy of measurement such as distance,depth,and areas. This can be done using calibration phantom. Quality Control Assurance c)Transducers: The performance of the transducer (probe) is crucial for accurate imaging .Quality checks for the transducer includes: checking any physical damage or deterioration, ensuring proper coupling with the patient, and evaluating the transducer for any signs of wear and tear or degradation of the image quality. Quality Control Assurance d)Equipment maintenance: Routine maintenance of the ultrasound unit is necessary to ensure optimal performance, this includes checking and cleaning various components such as cables, connect and control panels, regular software updates and servicing should also be part of the maintenance routine. ← PREVIOUS TOPICNEXT TOPIC →VIEW ALL MODULE NOTESVIEW SEMESTER NOTESVIEW ALL LEVEL NOTESALL DIAGNOSTIC RADIOLOGY NOTES Need These Notes as PDF? Need a clean, well-formatted PDF copy for offline study, revision or printing? Request the complete notes directly through WhatsApp. GET WELL-FORMATTED PDF NOTES

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality Management in Radiographic Services CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality Management in Radiographic Services using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Quality Management in Radiographic Services RADIOLOGY QUALITY ASSURANCE Enabling: Apply quality management in providing quality radiographic services Sub-enabling task: Apply quality management in providing quality radiographic services Objectives At the end of this sessions Learner must be able to: Describe quality, quality control and quality assurance Describe Objectives of quality control and quality assurance of x-ray and dental machine Explain radiography QC test components Describe test that are important to internal quality and/or safety at radiography departmentQuality Quality refers to the degree of excellence or the standard of something. It indicates how well a product, service, or process meets specified requirements or expectations For example, in manufacturing, quality might mean producing defect-free items that satisfy customer needsQuality in radiology Quality in radiology refers to the ability of imaging systems and processes to produce clear, accurate, and reliable diagnostic images. High-quality radiology ensures that images meet clinical requirements while minimizing patient exposure to radiation.Quality Control Quality Control is the process of ensuring that products or services meet predetermined standards and specifications. It involves inspection, testing, and checking at various stages of production to identify defects or nonconformities and take corrective actionsQuality Control In Radiology Quality Control in radiology involves routine testing and monitoring of imaging equipment to ensure optimal performance. This includes checking for artifacts, calibrating machines, and verifying radiation doses. QC is essential for maintaining image clarity and reducing unnecessary radiation exposureQuality Assurance Quality Assurance refers to the systematic approach of ensuring that quality standards are met throughout the production or service delivery process Quality Assurance can also be defined as a systematic, planned process that (includes QC) focuses on the overall quality system including procedures, documentation, safety, and training.Quality Assurance In Radiology Quality Assurance (QA) in Radiology refers to a systematic process of ensuring that the entire diagnostic imaging workflow encompassing equipment, procedures, staff performance, and the overall patient experience meets predefined standards of quality, safety, and accuracy. It includes developing protocols, training staff, and implementing procedures to prevent errors and ensure consistent quality. Quality Assurance aims to optimize workflow, enhance patient care, and ensure compliance with safety standards• Unlike Quality Control (QC), which focuses primarily on monitoring and testing the equipment and technical performance, Quality Assurance is a broader, more comprehensive approach that ensures all elements of radiology practice contribute to delivering high-quality diagnostic services• QA in radiology encompasses everything from the initial patient scheduling, imaging, interpretation of results, and reporting, to post-procedure follow-up. It also includes continuous monitoring and improvement processes to enhance the overall standard of care.•The goal of QA is to improve patient outcomes, optimize diagnostic accuracy, minimize errors, and ensure compliance with safety regulationsThe objectives of quality control (QC) in X-ray imaging and Dental The objectives of quality control (QC) in X-ray imaging are essential for ensuring safety, accuracy, and efficiency. Maintain Image Quality: QC Ensure that we Maintain high diagnostic value of images (sharpness, contrast, density).X-ray images are clear, accurate, and suitable for diagnostic purposes by minimizing artifacts and distortions• Radiation Safety: Ensure exposure parameters are accurate and optimal (ALARA principle). Calibration of machines helps to avoid underexposure/overexposure. Protect patients and staff by monitoring and minimizing unnecessary radiation exposure through regular equipment checks. Equipment Performance or Operational performance: QC helps to verify that X-ray machines are functioning optimally by conducting routine tests, such as Regularly test x-ray tube output, timers, alignment, and image receptors•Error Reduction: Identify and address equipment malfunctions or deviations early to prevent diagnostic errors and repeat examinations Regulatory Compliance: QC helps us adhere to national and international standards for radiology equipment and procedures (Meet national and international standards e.g., TAEC, IAEA).• Cost-Effectiveness: Reduce operational costs by preventing equipment breakdowns and minimizing the need for repeat imaging.Objectives of Quality Assurance of X-ray Dental Machine Quality Assurance is a systematic, planned process that includes QC and focuses on the overall quality system including procedures, documentation, safety, and training1. Ensure Radiation Safety: Protect patients, operators, and the public by keeping radiation doses as low as reasonably achievable (ALARA). Maintain Image Quality: Ensure high-quality, consistent diagnostic images for accurate interpretation and diagnosis.3. Monitor Equipment Performance: Regularly check and calibrate parameters like kVp, mA, exposure time, and alignment to ensure optimal functioning. Prevent Equipment Failure and Errors: Detect and address potential malfunctions early through preventive maintenance, reducing downtime.5. Comply with Legal and Regulatory Standards: Adhere to local and international safety standards (e.g., TAEC, WHO, IAEA) and maintain inspection-ready documentation. Ensure Staff Competence: Train radiology staff and operators in QA protocols and radiation safety measures for consistent best practices.7. Support Continuous Improvement: Analyze performance and incident data to improve processes. Encourage feedback and review procedures regularly. Foster a culture of regular audits, updates, and enhancements in protocols to align with evolving technologies and standards.8. Promote Cost Efficiency: Lower operational costs by reducing wastage, optimizing machine use, and extending equipment life. Establish a Quality System: Develop standardized protocols for imaging procedures. Ensure consistency across staff and departments.Radiography Quality Control Test Components Beam Alignment and Collimation: This verifies that the X-ray beam is properly aligned with the light field and that collimation is accurate, minimizing unnecessary radiation exposure to the patient. Radiation Output and Exposure Factors: Tests ensure the X-ray tube is producing the correct radiation output as determined by kilovoltage peak (kVp), milliampere-seconds (mAs), and exposure time.3. Exposure Timer Accuracy: This verifies that the exposure timer is accurately controlling the duration of X-ray exposure, which is critical for achieving proper image density. Half Value Layer (HVL): This test determines the amount of filtration needed to reduce the intensity of the X-ray beam by half, ensuring patient protection and optimal image quality.5. Reproducibility and kVp Accuracy: These tests check the consistency of X-ray output and the accuracy of kVp settings, ensuring consistent image quality across

DIAGNOSTIC RADIOGRAPHY · NTA LEVEL 4 · SEMESTER TWO Quality, Quality Control, and Quality Assurance CRT04208 · Radiology Quality Assurance START READING NOTES Study Quality, Quality Control, and Quality Assurance using the sections below. Use the topic navigation to continue through Radiology Quality Assurance. Contents of This Topic Quality, Quality Control, and Quality Assurance in Radiographic Services Introduction What is Quality in Radiography? Key Aspects of Quality in Radiography Why Does Quality Matter? Quality Control (QC) in Radiography Key QC Tests in Radiography Common QC Tools & Devices Why QC Matters QC Tests & Procedures in Radiography 2. Equipment Calibration Tests 3. Image Receptor & Processing Checks 5. Repeat Image Analysis Quality Assurance (QA) in Radiography 2. Scope of QA in Radiography: 3. Components of a QA Program: 4. Regulatory Standards: 5. QA vs. QC in Radiography (Visual Comparison): 6. Benefits of QA: Components of a Quality Assurance (QA) Program in Radiography 2. Equipment Maintenance & Monitoring 4. Image Quality & Repeat Analysis 6. Documentation & Record Keeping 8. Continuous Improvement Differences Between QC and QA QC 3. Key Activities 4. Goal Importance of QA/QC in Radiography 2. Enhances Diagnostic Accuracy 4. Cost Efficiency 6. Enhances Patient Trust & Satisfaction Barriers to Effective Quality Management in Radiology 3. Technological Advancements 5. Cultural & Organizational Barriers Overcoming QA/QC Challenges Case Study – Reducing Repeat Rates Through QA/QC QA/QC Interventions: Results (After 6 Months): Key Takeaways: Conclusion Final Thought: Quality, Quality Control, and Quality Assurance in Radiographic Services Ensuring Excellence in Diagnostic Imaging Jonathan.C.Shija Introduction Radiographic services play a critical role in modern healthcare, aiding in accurate diagnosis and treatment planning. Quality in radiography ensures patient safety, diagnostic reliability, and operational efficiency. Quality Control (QC) and Quality Assurance (QA) are systematic approaches to maintain and improve standards. What is Quality in Radiography? Definition: Quality in radiography refers to the degree of excellence in diagnostic imaging services, ensuring that: Images are diagnostically accurate (clear, detailed, and free from artifacts). Procedures are safe for patients and staff (following ALARA—As Low As Reasonably Achievable—principles). Services are efficient, consistent, and patient-centered. Key Aspects of Quality in Radiography Diagnostic Value High-resolution images with optimal contrast, density, and minimal noise. Correct anatomical coverage and positioning (e.g., no missing critical structures). Radiation Safety Minimal dose exposure while maintaining image quality (ALARA compliance). Proper shielding and collimation to avoid unnecessary radiation. Operational Efficiency Reduced repeat rates (avoiding retakes saves time and reduces patient dose). Proper workflow (e.g., minimal waiting times, organized reporting). Patient & Staff Satisfaction Comfortable experience for patients (clear communication, minimal discomfort). Ergonomics and safety for radiographers (e.g., reducing occupational radiation exposure). Regulatory Compliance Meets national/international standards (e.g., AERB, MQSA, ISO, ICRP). Documentation and audit readiness. Why Does Quality Matter? Misdiagnosis risks (e.g., poor-quality images may miss fractures or tumors). Patient harm (excessive radiation, repeated exposures). Legal and financial consequences (non-compliance with regulations). Quality Control (QC) in Radiography Definition: "QC refers to the set of routine technical procedures that ensure radiographic equipment, materials, and processes consistently produce high-quality images with minimal radiation exposure." Objectives of QC: Maintain optimal image quality (contrast, resolution, noise). Detect equipment malfunctions early (e.g., tube leakage, calibration drift). Minimize patient dose by reducing retakes. Ensure compliance with safety standards (e.g., AERB, ICRP). Key QC Tests in Radiography Test Category Examples Frequency Equipment Performance kVp/mA accuracy, timer consistency, beam alignment Monthly/Annual Image Receptors CR/DR plate scratches, ghost image checks Weekly Processor Quality Sensitometry (if using film) Daily Viewing Conditions Monitor calibration (DICOM GSDF) Quarterly Common QC Tools & Devices Ionization chambers (for dose measurements). Pinhole cameras (focal spot size evaluation). Test objects (e.g., Leeds TOR/CDR for resolution). Densitometers (for film processing consistency). Why QC Matters Patient Safety: Prevents overexposure due to equipment errors. Cost Savings: Reduces repeat examinations and wasted resources. Regulatory Compliance: Mandatory for accreditation (e.g., NABH, ISO 9001). QC Tests & Procedures in Radiography Daily/Weekly QC Checks Purpose: Monitor consistency in imaging and processing. Visual Inspection: Check X-ray tubes, cables, and detectors for damage. Ensure cleanliness of cassettes/DR detectors. Darkroom (if using film): Clean processor rollers. Check chemical levels and temperature. Laser Printer (if applicable): Verify uniformity and artifact-free prints. 2. Equipment Calibration Tests Purpose: Ensure accurate exposure parameters. kVp and mA Accuracy: Use a kVp meter to verify output vs. selected settings. Measure mA linearity across different settings. Timer Accuracy: Test short exposure times (e.g., 0.01s–0.1s) with a spinning top test. Beam Alignment & Collimation: Light field vs. radiation field alignment (should match within ±2% of SID). Collimator centering test (using a star pattern tool). 3. Image Receptor & Processing Checks Purpose: Maintain digital/film image quality. CR/DR Plates: Erase ghost images regularly. Check for scratches or delamination. Sensitometry (for film processors): Daily sensitometric strips to monitor density, contrast, and base fog. Detector Uniformity (for DR): Acquire a blank image to check for dead pixels or uneven sensitivity. Spatial Resolution & Contrast Tests Purpose: Evaluate diagnostic capability. Resolution Test Tools: Line pair phantoms (e.g., 2–5 lp/mm for general radiography). Low-Contrast Detectability: Use a contrast-detail phantom (e.g., CDRAD or Leeds test objects). 5. Repeat Image Analysis Purpose: Identify common causes of retakes. Track reasons (e.g., positioning errors, exposure inaccuracies). Calculate repeat rate (goal: <5% for most departments). Radiation Output Monitoring Purpose: Ensure patient and staff safety. Dose Area Product (DAP) meter checks. Half-Value Layer (HVL) test (verifies beam filtration). Quality Assurance (QA) in Radiography Definition of QA: "A systematic approach to ensure consistent, high-quality diagnostic imaging while minimizing risks to patients and staff." Key Goal: Prevent errors rather than detect them (proactive vs. reactive). 2. Scope of QA in Radiography: Equipment: Regular maintenance, calibration, and performance checks. Personnel: Training, competency assessments, and continuing education. Processes: Standardized protocols for imaging, reporting, and patient handling. Outcomes: Monitoring diagnostic accuracy, repeat rates, and patient dose audits. 3. Components of a QA Program: Policies & Procedures: Documented protocols for each exam type (e.g., chest X-ray, mammography). Equipment Management: Scheduled QC tests (e.g., kVp accuracy, beam alignment). Patient Dose Optimization: Follow ALARA (As Low As Reasonably Achievable) principles.