RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY

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Slide 1 :

RADIATION PROTECTION IN DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY L11: Quality Assurance General lecture IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology

Slide 2 :

11: Quality Assurance 2 Topics Quality Assurance definition. QA Management and responsibilities Outline of a Quality Assurance and Radiation Protection program for diagnostic radiology

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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 assessing the overall effectiveness of radiation protection.

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Part 11: Quality Assurance General lecture Topic 1: Quality Assurance Definition IAEA Training Material on Radiation Protection in Diagnostic and Interventional Radiology

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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 operating a facility to ensure that the diagnostic images produced are of 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

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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 radiation physics taking into account the principles established by the WHO and the PAHO

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11: Quality Assurance 7 Quality assurance programs (III) QA programs for medical exposures shall include: Measurements of the physical parameters of the radiation generators and imaging devices at the time of commissioning and periodically thereafter Verification of the appropriate physical and clinical factors used in patient diagnosis (or treatment)

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11: Quality Assurance 8 Quality assurance programs (IV) QA programs for medical exposures shall include: 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 reviews of the QA program

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11: Quality Assurance 9 Quality assurance and quality control QA programs are designed to ensure that the radiology equipment can yield the desired information. 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 actions designed to verify that: the quality control techniques are performed properly and according to a planned timetable, the results of these techniques are evaluated promptly and accurately, the necessary corrective measures are taken in response to these results.

Slide 10 :

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.

Slide 11 :

11: Quality Assurance 11 QA Programs (VIII) Responsibilities for certain quality control techniques and corrective measures may be assigned to personnel qualified through training and experience, such as consultants or industrial representatives from outside the facility Authorities at the state, federal, and international level can also play a key role in the implementation of effective quality control and assurance programs

Slide 12 :

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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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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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, Hospital Physicist) Justification and optimization of radiological procedures

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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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11: Quality Assurance 16 Acceptance test The acceptance test of the equipment after installation should be performed by the supplier in presence of the local medical physicist to confirm that the equipment actually performs at the level described in the technical specifications agreed upon by the manufacturer and the purchaser.

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11: Quality Assurance 17 Commissioning Commissioning is the process of acquiring all the data from equipment that is required to make it clinically useable in a specific department. This commissioning test will give the baseline values for the QC procedures

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11: Quality Assurance 18 Outline of a quality assurance and radiation protection program for diagnostic radiology (IV) Patient dosimetry and image quality evaluation 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

Slide 19 :

11: Quality Assurance 19 Outline of a quality assurance and radiation protection program for diagnostic radiology (V) Quality audits Arrangements for individual monitoring and health surveillance Records The authorization certificate Name of the person responsible for the QA program. Individual staff doses Results of area surveys

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11: Quality Assurance 20 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 guidance (or reference) levels (DRL’s). Inventory of X ray systems.

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11: Quality Assurance 21 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. Facility modification. Training provided (initial and continuous)

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11: Quality Assurance 22 Where to Get More Information (I) Quality Assurance in Diagnostic Radiology. World Health Organization. Geneva, 1982. International Basic Safety Standards for Protection Against Ionizing Radiation and for the Safety of Radiation Sources. Safety Series115, IAEA, 1996. ICRP 73. Radiological Protection and Safety in Medicine. Annals of the ICRP, 26(2), 1996. NCRP 99, Quality Assurance for Diagnostic Imaging, 1988.

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11: Quality Assurance 23 Where to Get More Information (II) European guidelines on quality criteria for diagnostic radiographic images. Report EUR 16260, 1996. Quality Criteria for Diagnostic Radiographic Images in Pediatrics, (Office for Official Publications of the European Communities, Luxembourg), Report EUR 16261, 1996. Quality Criteria for Computed Tomography. Report EUR 16262, 1999.

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