Efficient quality assurance programs in radiology and nuclear medicine in Ostergotland, Sweden

Owners of imaging modalities using ionising radiation should have a documented quality assurance (QA) program, as well as methods to justify new radiological procedures to ensure safe operation and adequate clinical image quality. This includes having a system for correcting divergences, written imaging protocols, assessment of patient and staff absorbed doses and a documented education and training program. In this work, how some aspects on QA have been implemented in the County of Ostergötland in Sweden, and efforts to standardise and automate the process as an integrated part of the radiology and nuclear medicine QA programs were reviewed. Some key performance parameters have been identified by a Swedish task group of medical physicists to give guidance on selecting relevant QA methods. These include low-contrast resolution, image homogeneity, automatic exposure control, calibration of air kerma-area product metres and patient-dose data registration in the radiological information system, as well as the quality of reading stations and of the transfer of images to the picture archive and communication system. IT-driven methods to automatically assess patient doses and other data on all examinations are being developed and evaluated as well as routines to assess clinical image quality by use of European quality criteria. By assessing both patient absorbed doses and clinical image quality on a routine basis, the medical physicists in our region aim to be able to spend more time on imaging optimisation and less time on periodic testing of the technical performance of the equipment, particularly on aspects that show very few divergences. The role of the Medical Physics Expert is rapidly developing towards a person doing advanced data-analysis and giving scientific support rather than one performing mainly routine periodic measurements. It is concluded that both the European Council directive and the rapid development towards more complex diagnostic imaging systems and procedures support this changing role of the medical physics professional.