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The two basic principles of radiological protection of the patient as recommended by International Commission of Radiological Protection (ICRP) are justification of the practice and optimization of protection, including the consideration of reference levels. These principles sets currently internationally accepted requirements for radiation safety. In the area of optimization of protection in diagnostic radiology and particularly in mammography there is considerable scope for both improve of image quality and dose reductions.
There is a need to evaluate the situation of optimization of protection in mammography to identify the points where action is needed and then document improvement after corrective actions are put in place.
Quality assurance applied to the radio diagnostic practice is intrinsically related to medical ethics. It’s primary goal to solve the clinical problem; to produce images with enough information and to optimize radiation exposure with lower cost. Quality Assurance (QA) programme was implemented for mammograms mobile units.
The main objective of the programme is producing high quality images which can show the breast anatomy and the disease signs. The following QC tests were performed as the first set (baseline data collection):
reproducibility and accuracy of kVp;
alignment of X ray field/image receptor and tube output;
HVL determination and
The results obtained showed that quality control tests methods used,as
well as the criteria for scoring the results, were in full agreement with those
specified in the European Protocol for the Quality Control of the
CHAPTER 4 CONCLUSION AND RECOMANDATIONS
Physical and Technical Aspects of Mammography Screening.
The HVL test should be performed annually. The HVL should be evaluated for each filter and for at least one kV that is typical of clinical operating techniques. We recommend initial test (commissioning test), if the
HVL is compliant with the manufacturer’s specification, the measured value should be adopted as the reference value and changes from that value tracked. This will insure that the image quality will allow the doctor to diagnose the disease and will make sure that the patient dose is as low as reasonably achievable (ALARA). Based on the results and the conclusion of this research, the following recommendations are addressed to relevant stakeholders to achieve optimization of patient radiation protection in mammography practices.
1- Quality Assurance should be established to reduce the chances of misdiagnosis while maintaining safe levels of radiation exposure to mammography patients.
2- A key factor to promote success QA program is teamwork and the collaboration of all key staff (e.g. radiographers, radiologists, medical physicists and healthcare managers).
3- Contrast and image noise is recommended to evaluate because they have been commonly used to assess image quality with spatial resolution.
4- Training and continuous feedback mechanisms are essential to improve the testing procedures and strengthen the outcomes of the program.
5- Automatic exposure (and other controls, e.g. automatic kVp, Target-Filter selection, etc.) controls should be verified as part of routine acceptance testing and checked on a routine basis.
6- When a recommended protocol cannot be implemented in full, a selection of tests may be adequate. selection criteria should take into consideration resources and expertise available and the relevance of the tests to local practices.