Concept and Strategy for a National Quality Assurance Program in Medical Imaging

In diagnostic imaging the ALARA (“As Low as Reasonable Achievable”) principle requires the accurate configuration, proper use and faultless operation of medical imaging devices. It can not be tolerated that wrong diagnostics or repeated exposures are performed due to insufficient image quality or faulty imaging modalities. Therefore it is very important to implement an adequate quality assurance programme.
Image Quality on radiation equipment is defined by law in Luxembourg. This includes two level of tests: Level A tests, which are performed by the hospitals, are frequent periodic tests that are easy to perform. Level B tests, which are performed by a group of medical physics experts at the Entente des Hôpitaux Luxembourgeois (EHL), are more complex and test advanced parameters of the different equipments. Both types of tests are controlled under supervision of the Ministry of Health, department Radioprotection.
During the last 4 years, the Centre de Recherche Public Henri Tudor, the EHL and the Ministry of Health work on a multidisciplinary project to standardize the test procedures, to support the evaluation and to support proper documentation of the tests for Level A.
In this collaborative project the software package Optimage (A. Jahnen, et al: Optimage: Central organised Image quality control including statistics and reporting, Radiation Protection Dosimetry Advance Access published online on February 5, 2008) was developed. This multi-platform software package supports the automatic evaluation of phantom images used for CT, MRI, Nuclear medicine, digital radiography and digital mammography. During the automatic evaluation the software segments the supported phantom images into different feature areas. This enables the calculation of the different image quality parameters like noise, high and low contrast, spatial resolution, distortion, etc. depending on the modality. These calculation results are documented in a central database and compared to deposited reference and tolerance values. Yearly or even monthly reports are supported to enable a easy reporting to the Ministry.
During the implementation of the project we have been able to show that proposed concept feasible. The automated reading and the documentation save time and improve the service. The developed procedures are used in five Luxembourgish hospitals for several types of modalities. Due to small differences of the phantoms from different vendors and several unique characteristics of different modalities the implementation of a 100% error free automatic reading was a difficult task. As this project involves several institutions with people of different domains, the communication proved to be one of the main tasks. It is important in a multidisciplinary project to address the needs of every group involved during the different phases of the project.

A. Jahnen¹, C. Moll¹, A. Schreiner², J. Hermen¹, Martine Grelot³, Christina Bokou³, Olga Kaphammel³, Alex Meyer³, Carlo Back²

CRP Henri Tudor¹


Ministry of Health Luxembourg, Radioprotection²

ntente des Hopitaux Luxembourgeois, Medical Physics³

quality assurance, medical imaging, automatic phantom reading


Concept and Strategy for a National Quality Assurance Program in Medical Imaging
A. Jahnen[1], C. Moll[1], A. Schreiner[2], J. Hermen[1], M. Grelot[3], C. Bokou[3], O. Kaphammel[3], A. Meyer[3], C. Back[2]
[1]CRP Henri Tudor, CR SANTEC, Luxembourg; [2]Ministry of Health Luxembourg, Radioprotection, Luxembourg; [3]Entente des Hopitaux Luxembourgeois, Medical Physics, Luxembourg

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