Optimization is a fundamental process in medical imaging asa tool of continuous quality improvementand as requirement by international safety guidelines .
Evaluation of practices that will eventually lead to their optimization can be motivated by:
Need for continuous quality improvement of practices
Contribution to Diagnostic Reference Levels
Methodologies for the evaluation and optimization processes have been published in the past, including extensiveguidelines for paediatric patients [HHS-24]. To evaluate the applicability of these approaches in a wide range of clinical settings the International Atomic...
Description of activity and work performed
The methodology used for optimization was, in principle, a straightforward process, following a relevant analogueof the PDCA (plan-do-check-act) process, in seven discrete steps, as summarized in Figure 1.
A total of 1445 anonymized patient data were collected, relatively well distributed between examination types studied (radiography: thorax and abdomen, fluoroscopy: MCU, CT: chest and head) and age groups (0-1y, 1y-5y, 5y-10y, 10y-16y), as shown in Figure 2.
Results demonstrated thatin order to effectively carry out the comparison stage, as a pre-requisite to identifying and implementing optimization...
Conclusion and recommendations
Optimization is a complicated exercise requiring skills and competences from various professionals. Even the main step of data collection presents challenges that all stakeholders should know, especially when recording and archiving of data are not based on an electronic and calibrated system, as is commonly the case in conventional radiography and fluoroscopy.
The experience from this multicentre optimization exercise lead to the development of ten practical tips for the implementation of the optimization process, as highlighted in Figure 4.
H. Delis, G. L. Poli, International Atomic Energy Agency, Vienna, Austria
P. Homolka, Medical University of Vienna, Vienna, Austria
P. R. Costa, University of Sao Paulo, São Paulo, Brazil
C.-L. Chapple, Newcastle upon Tyne Hospitals NHS Trust, Newcastle, United Kingdom
E. Attalla, National Cancer Institute, Cairo, Egypt
T. A. Sackey, Ghana Atomic Energy Commission, Accra, Ghana
L. E. Lubis, University of Indonesia, Jakarta, Indonesia
International Atomic Energy Agency. Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards,General Safety Requirements.IAEA Safety Standards Series No. GSR Part 3, Vienna, 2014.
International Atomic Energy Agency. Dosimetry in Diagnostic Radiology for Paediatric Patients, IAEA Human Health Series No. 24, Vienna 2014.