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7.3. MONTHLY TESTS7.3.1. Safety and function checks of examination room and equipment7.3.1.1. Scope— Objective: To verify the mechanical and electrical operation of the mammography unit; to ensure that theimage acquisition information is correct.— Frequency: Monthly is desirable; quarterly and after any service, maintenance or software upgrades isessential.7.3.1.2. Instrumentation(1) Thermometer, preferably mounted on the wall of the digital mammography room.(2) Safety and function checklist (Chart 9 in Annex I).7.3.1.3. Methodology(1) Measure the temperature in the mammography acquisition room.(2) Visually inspect the unit for loose parts, cracks in the compression paddles, Bucky cleanliness and overallintegrity.(3) Check that all hoses and cables are free of breaks, crimps and knots. Hoses and cables should not be locatedunder heavy equipment.(4) Verify that the angulation indicator is working correctly.(5) Verify that the interlocks are working correctly.(6) Ensure that the gantry moves smoothly.(7) Ensure that panel switches, indicator lights and meters are functioning.(8) Ensure that the field light is functioning.(9) Ensure that the current technique chart is posted.(10) On the interpretation workstation, display a recent clinical image and verify that the time and date as well asthe facility identification are correct in the image annotation.(11) If printed films are produced, ensure that appropriate information appears on the films.(12) Check that the breast thickness indicator is accurate to ±5 mm 7 when using a compression force typically usedclinically (e.g. 80 N). Use the method recommended by the medical physicist.(13) Confirm that the face guard is present and not damaged.(14) Confirm that the automatic compression release and manual compression release will both work in the adventof a power failure.(15) Confirm the integrity of the operator shield.(16) Ensure that the cleaning solution for the breast support plate and compressor is available.(17) Verify any other functions that are specified for monthly monitoring by the equipment manufacturer.(18) Record the status of each item on the safety and function checklist (Chart 9 in Annex I) and the final outcomeon the monthly, quarterly and semi-annual checklist (Chart 2 in Annex I).7.3.1.4. Interpretation of results and conclusions(1) Room temperature should be in the range recommended by the manufacturer.(2) All mechanical and electrical items on the checklist should be in a satisfactory state of repair.(3) The time and date as well as the facility identification must be correctly displayed in the image annotation onthe interpretation workstation.7This is particularly important, since some digital mammography units may depend on this measurement to determine thetechnique factors.64
7.3.1.5. Recommendations and corrective actionsMany of the items on the checklist are essential for patient safety and for high quality diagnostic images. Itmay be necessary to add items to the list that are specific to particular equipment or procedures. These should beincluded on the monthly checklist and confirmed in subsequent evaluations. Time frames for correction of faults aredescribed in Table 8.(1) If the room temperature is not in the range recommended by the manufacturer, the air conditioning servicepersonnel should be called.(2) Items that are hazardous, inoperative or out of alignment, or that operate improperly, should be repaired byappropriate service personnel before any further patients are imaged.(3) Items missing from the room should be replaced immediately. Malfunctioning equipment should be reportedto the service engineer for repair or replacement as soon as possible.(4) If the time and date and the facility identification are not correctly displayed in the image annotation on theinterpretation workstation, correction by appropriate service personnel must be undertaken before any furtherpatients are imaged.TABLE 8. TIME FRAMES FOR CORRECTIVE ACTIONSItems requiring immediate actionbefore any further patients are imaged a1. Room temperature not controlled2. Loose parts present, paddles damaged or Bucky not clean3. Hoses or cables kinked or damaged5. Interlocks faulty10. Time, date and facility ID incorrect or not present on images14. Automatic and/or manual compression release not working16. Cleaning solution not availableItems requiring action within 30 daysof first identified failure a4. Angulation indicator not functioning6. Gantry motion not smooth7. Panel switches, indicator lights and meters8. Field light inoperative9. Current technique chart not posted12. Breast thickness indicator inaccurate13. Face guard absent or damaged15. Operator radiation shield damaged17. Overall integrity questionableaItem numbers are consistent with the methodology numbering (see Section 7.3.1.3).65
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X raysdel matrixCs scintillatorLine
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QUALITY ASSURANCE PROGRAMMEFOR DIGI
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IAEA HUMAN HEALTH SERIES No. 17QUAL
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FOREWORDThe application of radiatio
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An effective QA programme is necess
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The Integrating the Healthcare Ente
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technology. Systems containing othe
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X raysTop electrodea-Se layerCharge
Page 25 and 26: dose received by inhomogeneous real
Page 27 and 28: 2.3.8.1. Soft copy displayFlat pane
Page 29 and 30: 3. ELEMENTS OF HIGH QUALITY MAMMOGR
Page 31: — The ability to mask edges of ma
Page 34 and 35: Disposal orsaleNew facility(start h
Page 36 and 37: 4.2.3. Radiographer (mammography te
Page 38 and 39: 5.2.2. Electronic versus geometric
Page 40 and 41: To allow full utilization of the di
Page 42 and 43: 5.7. ARTEFACTSWhile the incidence o
Page 44 and 45: FIG. 10. Detector crystallization.
Page 46 and 47: FIG. 13. A more subtle example of a
Page 48 and 49: FIG. 16. An example of poor collima
Page 51 and 52: 7. RADIOGRAPHER’S QUALITY CONTROL
Page 53 and 54: 7.1. DAILY TESTS7.1.1. Monitor insp
Page 55 and 56: 7.1.3. Daily flat field phantom ima
Page 57 and 58: 7.1.4. Visual inspection for artefa
Page 59 and 60: 7.1.5. Laser printer sensitometry7.
Page 61 and 62: 7.1.6. Image plate erasure (CR syst
Page 63 and 64: FIG. 19. Modified TG18-QC pattern w
Page 65 and 66: FIG. 21. Radiologist workstation wi
Page 67 and 68: 7.2.1.6. Time frame for corrective
Page 69 and 70: 7.2.3. Weekly quality control test
Page 71 and 72: Note: It is not necessary to view t
Page 73 and 74: TABLE 7. TOLERANCES FOR IMAGING WEE
Page 75: 7.2.4.4. Interpretation of results
Page 79 and 80: artefacts are typically best seen w
Page 81 and 82: 7.3.3.5. Recommendations and correc
Page 83 and 84: 7.4.1.3. Methodology(1) Annotate th
Page 85 and 86: RECORD OF DIGITAL MAMMOGRAPHY REPEA
Page 87 and 88: (3) Including examinations of at le
Page 89 and 90: 7.5. SEMI-ANNUAL TESTS7.5.1. Comput
Page 91 and 92: 8. MEDICAL PHYSICIST’S QUALITY CO
Page 93 and 94: 8.1. NOTE ON IMAGE NAMING CONVENTIO
Page 95 and 96: (16) On any randomly selected patie
Page 97 and 98: FIG. 30. Positioning of bathroom sc
Page 99 and 100: (6) The target, filter, kV, grid, d
Page 101 and 102: (2) Stack the 20 and 25 mm PMMA sla
Page 103 and 104: TABLE 13. ACCEPTABLE AND ACHIEVABLE
Page 105 and 106: 8.5. DETECTOR PERFORMANCE8.5.1. Bas
Page 107 and 108: 8.5.2. Detector response and noise8
Page 109 and 110: the service engineer responsible fo
Page 111 and 112: (13) Using the annotation tool on t
Page 113 and 114: Breast supportPMMA slabBreast suppo
Page 115 and 116: (10) Place the thinner test object
Page 117 and 118: 8.6. EVALUATION OF SYSTEM RESOLUTIO
Page 119 and 120: TABLE 17. ACCEPTABLE FREQUENCIES AT
Page 121 and 122: 8.7. X RAY EQUIPMENT CHARACTERISTIC
Page 123 and 124: 8.7.2. Incident air kerma at the en
Page 125 and 126: 8.8. DOSIMETRY8.8.1. Mean glandular
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TABLE 21. ACCEPTABLE AND ACHIEVABLE
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FIG. 34. Suggested layout for ruler
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8.10. IMAGE DISPLAY QUALITYThe accu
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FIG. 35. Modified TG18-QC test patt
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8.10.1.5. Interpretation of results
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8.10.2. Monitor luminance response
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TABLE 22. MONITOR PERFORMANCE TOLER
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FIG. 38. Measurement of illuminatio
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8.11. LASER PRINTER8.11.1. Laser pr
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8.11.1.5. Recommendations and corre
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8.12.1.4. Interpretation of results
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iopsies are performed, a sink is of
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Appendix IISPECIFICATIONS OF TEST E
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TABLE 24. SPECIFICATIONS OF TEST EQ
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FIG. 40. Image acquired with a unif
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FIG. 43. The left hand image is par
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FIG. 45. A TG18-QC test pattern dis
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[29] ALSAGER, A., YOUNG, K.C., ODUK
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Annex IRADIOGRAPHER DATA COLLECTION
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Chart 2 — DIGITAL MAMMOGRAPHY (DM
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Chart 4 LASER PRINTER SENSITOMETRY
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Chart 6 — WEEKLY DISPLAY MONITOR
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Chart 7(b) WEEKLY QC TEST OBJECT:
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Chart 9 — SAFETY AND FUNCTION CHE
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Chart 11 — LASER PRINTER ARTEFACT
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Chart 13(a) — RECORD OF DIGITAL M
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Chart 14 — CR PLATE SENSITIVITY M
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Annex IIITHE MAMMOGRAPHY EXTRACTThe
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GLOSSARYair kerma. The energy depos
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image quality. The overall merit of
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CONTRIBUTORS TO DRAFTING AND REVIEW
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