Experiences with the European guidelines on quality criteria for radiographic images in Tanzania

Objective assessment of the quality of radiographic images is practically a difficult task and protocols that address this problem are few. In 1996, the European union published nearly objective image quality criteria to unify the practices in Europe. However, experience with these criteria in countries of lower health care levels is little documented. As a case study in Tanzania, we present the general performance of European guidelines in some Tanzanian hospitals to a total of 200 radiographs obtained from some common x-ray examinations. The results show that more than 70% of chest (PA), lumbar spine (AP), and pelvis AP radiographs passed the quality criteria, while the performance of lumbar spine LAT x-ray examinations was about 50% and therefore less satisfactory. The corresponding mean entrance dose to the patient for specified x-ray techniques was of range 0.08-0.56 mGy, 3.1-7.7 mGy, 2.53-5.4 mGy, and 4.0-16.78 mGy for chest PA, lumbar spine AP, pelvis AP, and lumbar spine LAT x-ray examinations, respectively. Although a good number of observers were not well familiar to the guidelines, the quality criteria have been found useful and their adoption in the country recommended. The need to provide relevant education and training to staff in the radiology departments is of utmost importance.