rpdir-l11 qa web
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IAEAInternational Atomic Energy Agency
RADIATION PROTECTION INDIAGNOSTIC AND
INTERVENTIONAL RADIOLOGY
L11: Quality Assurance
General lecture
IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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IAEA
11: Quality Assurance 2
Topics
Quality Assurance definition.
QA Management and responsibilities
Outline of a Quality Assurance andRadiation Protection program for
diagnostic radiology
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IAEA
11: Quality Assurance 3
Overview
• To become familiar with the specific
requirements related to QA concepts,
radiation protection in diagnostic radiology
and procedures for reviewing and assessingthe overall effectiveness of radiation
protection.
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IAEAInternational Atomic Energy Agency
Part 11: Quality AssuranceGeneral lecture
Topic 1: Quality Assurance Definition
IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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IAEA
11: Quality Assurance 5
Quality assurance programs (I)
• A quality assurance program in diagnostic
radiology, as defined by the WHO, is an
organized effort by the staff to assure that
the diagnostic images produced are of sufficiently high quality to provide adequate
diagnostic information at the lowest possible
cost and with the least possible exposure of the patient to radiation
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IAEA
11: Quality Assurance 6
Quality assurance programs (II)
• Registrants and licensees shall establish a
comprehensive Quality Assurance program
for medical exposures with the participation
of appropriate qualified experts in radiationphysics, taking into account the principles
established by the WHO and the PAHO
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IAEA 11: Quality Assurance 7
Quality assurance programs (III)
QA programs for medical exposures shallinclude:
• Measurements of the output (e.g., dose,
image quality, etc.) of the radiationgenerators and imaging devices at the timeof commissioning and periodically thereafter
• Verification of the appropriate physical andclinical factors used in patient diagnosis (or treatment)
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IAEA 11: Quality Assurance 8
Quality assurance programs (IV)
QA programs for medical exposures shallinclude:
• Written records of relevant procedures and
results• Verification of the appropriate calibration and
conditions of operation of dosimetry and
monitoring equipment• Regular and independent quality audit of theQA program
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IAEA 11: Quality Assurance 9
Quality assurance and quality control
• QA programs are designed to ensure that theradiology equipment can yield the desiredinformation. They include:• Quality control techniques used to test the
components of the radiological system and verify
that the equipment is operating satisfactorily
• Administrative procedures or management actionsdesigned to verify that:
• the quality control techniques are performedproperly and according to a planned timetable,
• the results of these techniques are evaluatedpromptly and accurately,
• the necessary corrective measures are taken inresponse to these results.
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IAEA 11: Quality Assurance 10
Quality administration procedures
• Quality administrative procedures
also include:
• the assignment of responsibility for
quality assurance actions• the establishment of standards of
quality for equipment in the facility
• the provision of adequate training
• the selection of the appropriate
equipment for each examination.
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IAEA 11: Quality Assurance 11
QA Programs (VIII)
• Responsibilities for certain quality controltechniques and corrective action may beassigned to personnel qualified throughtraining and experience, such asconsultants, qualified medical physicists
• Authorities at the state, federal, andinternational level can also play a key role
in encouraging the implementation of effective quality control and assuranceprograms
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IAEAInternational Atomic Energy Agency
Part 11: Quality Assurance
General lecture
Topic 2: Outline of a QA and RP program
IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology
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IAEA 11: Quality Assurance 13
Outline of a quality assurance and radiation
protection program for diagnostic radiology (I)
• Policy statement
• Organization and responsibilities
• Quality Assurance (and Radiation
Protection) Committee
• Radiation Protection Officer (these duties
could be assumed by the medical physics
expert, the radiologist or the radiographer)
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IAEA 11: Quality Assurance 14
Outline of a quality assurance and radiation
protection program for diagnostic radiology (II)
• Medical Practitioner (Radiologist, other
Physicians)
• Qualified Expert in Diagnostic radiology
Physics (Medical Physicist)
• Justification and optimization of radiological
procedures
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IAEA 11: Quality Assurance 15
Outline of a quality assurance and radiation
protection program for diagnostic radiology (III)
• Patient dosimetry and image quality evaluation
• Reject analysis
• Quality control procedures
• Acceptance test and commissioning
• Constancy tests
• Status tests
• Verification of RP and QC equipment and material
• Follow up of the corrective actions proposed
• Staffing levels and responsibilities
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IAEA 11: Quality Assurance 16
Acceptance test
• The acceptance test of the
equipment after installation should
be performed by the local medical
physicist in the presence of thesupplier to confirm that the
equipment actually conforms to the
technical specifications
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IAEA 11: Quality Assurance 17
Commissioning
• Commiss ion ing is theprocess of acquiring all the
data from equipment that isrequired to make it clinicallyuseable in a specificdepartment. Thiscommissioning test providesthe baseline values for theQC procedures
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IAEA
End of Warranty (Acceptance) Test
• A second test, similar to the acceptance test,
should be performed about 30 days prior to
the end of the warranty period
• This assures that the equipment is stillperforming according to specification
• This also provides the manufacturer time to
correct items which do not meetspecifications at no cost to the purchaser
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IAEA 11: Quality Assurance 19
Outline of a quality assurance and radiation
protection program for diagnostic radiology (IV)
• Patient dosimetry and image qualityevaluation
• Education and training
• Safety rules and procedures• Purchasing procedure for diagnostic radiology equipment
• Use of Diagnostic radiology equipment and safety devices
• Individual exposure monitoring
• Calibration of measurement instruments• Inspection and maintenance of diagnostic radiology
equipment
• Workplace Monitoring
O li f li d di i
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IAEA 11: Quality Assurance 20
Outline of a quality assurance and radiation
protection program for diagnostic radiology (V)
• Quality audits
• Arrangements for individual monitoring andhealth surveillance
• Records• The authorization certificate
• Name of the person responsible for the QAprogram.
• Individual staff doses
• Results of area surveys
O tli f lit d di ti
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IAEA 11: Quality Assurance 21
Outline of a quality assurance and radiation
protection program for diagnostic radiology (VI)
• Records (cont.)
• Results of the calibration and verification of the
measurement instruments.
• Results of acceptance and quality control tests.
• Patient dosimetry results and comparison with
diagnostic reference levels (DRL’s).
• Inventory of X ray systems.
O tli f lit d di ti
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IAEA 11: Quality Assurance 22
Outline of a quality assurance and radiation
protection program for diagnostic radiology (VII)
• Records (cont.)
• Incident and accident investigation reports.
• Audits and reviews of the QA and radiation
safety program.
• Installation, maintenance and repair work.
• Follow-up testing after maintennce and repair
work• Facility modification.
• Training provided (initial and continuous)
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IAEA 11: Quality Assurance 23
Where to Get More Information (I)
• Radiation Protection and Safety of Radiation Sources:
International Basic Safety Standards, Revision of IAEA
Safety Series No. 115, IAEA, Vienna Austria, 2011
• ICRP 73. Radiological Protection and Safety in Medicine.
Annals of the ICRP, 26(2), 1996.• Quality Control in Diagnostic Radiology, Gray JE. et al.
http://diquad.com/QC%20Book.html
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IAEA 11: Quality Assurance 24
Where to Get More Information (II)
• European guidelines on quality criteria for diagnostic radiographicimages, EUR 16260 report, (Luxembourg, EC), 1996.
http://www.sprmn.pt/legislacao/ficheiros/EuropeanGuidelineseur16260.
• European guidelines on quality criteria for diagnostic radiographic
images in pediatrics, EUR 16261 report, (Luxembourg, EC), 1996.http://www.e-
radiography.net/regsetc/European_guide_children_extract.pdf
• Quality criteria for computed tomography, EUR 16262 report,
(Luxembourg, EC), 1997.
http://w3.tue.nl/fileadmin/sbd/Documenten/Leergang/BSM/European_G
uidelines_Quality_Criteria_Computed_Tomography_Eur_16252.pdf