Quality Controls in Digital Mammography protocol of the EFOMP Mammo Working group.

This article aims to present the protocol on Quality Controls in Digital Mammography published online in 2015 by the European Federation of Organisations for Medical Physics (EFOMP) which was developed by a Task Force under the Mammo Working Group. The main objective of this protocol was to define a minimum set of easily implemented quality control tests on digital mammography systems that can be used to assure the performance of a system within a set and acceptable range. Detailed step-by-step instructions have been provided, limiting as much as possible any misinterpretations or variations by the person performing. It is intended that these tests be implemented as part of the daily routine of medical physicists and system users throughout Europe in a harmonised way so allowing results to be compared. In this paper the main characteristics of the protocol are illustrated, including examples, together with a brief summary of the contents of each chapter. Finally, instructions for the download of the full protocol and of the related software tools are provided.

Patient doses for barium meal examination in Serbia and Montenegro and potentials for dose reduction through changes in equipment settings.

Patient doses for barium meal examination performed at three general hospitals in Serbia and Montenegro were measured using a kerma-area product (KAP) meter. The results were analysed in order to obtain dose-related parameters. Although the observed doses were within the range reported in other studies, intra-hospital and inter-hospital dose variations were significant. Mean KAP values for total examination in three hospitals were 8.4, 24.4 and 13.9 Gy cm2, respectively. Contribution from fluoroscopy was greater than from radiography. Factors contributing to the increased dose delivery were determined and the recommendations on radiographic techniques were made. Changes in radiography settings allowed dose reduction up to 48% in the radiographic part of examination, that is, up to 12% in total dose without loss of image quality. In addition, fluoroscopy time was noted as the second major contributor to the dose variations. The results demonstrated the need for standardisation of practice for barium meal examination in the country.

First results on patient dose measurements from conventional diagnostic radiology procedures in Serbia and Montenegro.

The objective of this work is to assess patient doses for the most frequent X-ray examinations for the first time in Serbia and Montenegro. A total of 510 procedures for 11 different examination categories in 3 general hospitals were analysed. Mean and median entrance surface air kerma (ESAK) and kerma area product (KAP) values followed by mean effective doses were reported. Using X-ray tube output data, ESAK for each radiographic examination was calculated, as well as the effective dose for each patient. Except for chest PA examination, all estimated doses are less than stated European and International Atomic Energy Agency (IAEA) reference levels for simple radiographic examinations. For complex examinations involving fluoroscopy and radiography total KAP was measured and contributions from fluoroscopy and radiography were assessed. The study of KAP confirms that the dose level for complex fluoroscopy investigations is closely related to the technique and individual patient variation in terms of fluoroscopy time and number of radiography exposures. The obtained values are comparable to those reported in the UK. Survey data are aimed aid development of a national quality control and radiation protection programme for medical exposures.

A survey of patient doses from conventional diagnostic radiology examinations: first results from Serbia and Montenegro.

Diagnostic reference levels provide framework to reduce variability. The aim of this study is to establish, for the first time, a baseline for national diagnostic reference levels in Serbia and Montenegro for the most common X-ray examination types. Measurements of patient dose using kerma-area product meter and entrance surface air kerma assessment were performed on at least ten patients for each examination type, in each of 16 randomly selected hospitals in Serbia and Montenegro, so that a total of 3,026 procedures for nine different examination categories were included in the survey. Exposure settings and individual data were recorded for each patient. Mean, median and third quartile values of patient doses are reported. Results have shown wide variation of mean hospital doses, with factor of four for barium enema to 23 for thoracic spine radiography. Entrance surface air kerma were compared with previously published diagnostic reference levels (DRL) proposed by Commission of European Communities (CEC). Doses for all studied examination types except chest radiography were within European DRL. The reasons for dose variation are discussed. Survey data are aimed to help in development of an on-going national quality assurance and quality control programme in diagnostic radiology. The findings emphasize the importance of regular patient dose measurement to ensure that patient doses are kept as low as reasonable achievable.