14 H. Sekkat et al.: Radioprotection 2025, 60( 1), 9 – 19
3.4.2 Maintaining quality in radiology
In radiology, as in many fields requiring quality monitoring, " quality " is a common term, often claimed by most departments. But how to confirm that a diagnostic radiology department truly provides high-quality services? Without specific criteria, quality remains a vague concept. To genuinely assess quality, we must use concrete evaluation and quantification methods, involving objective measurements and peer reviews.
3.4.2.1 Record-keeping
While the record-keeping process may be time-consuming, its significance in the form of a quality manual remains crucial within any quality management system. This documentation serves as an internal reference for employees, outlining quality objectives and departmental policies while also delineating the necessary procedures for achieving these objectives. Externally, it communicates the implementation of the quality management system to partners and serves as evidence of compliance with quality benchmarks. Effective organization and teamwork are essential for maintaining and updating this documented manual, ensuring its accessibility to all stakeholders involved. It should strike a balance between comprehensiveness and conciseness while maintaining clarity and consistency to facilitate implementation. Radiology is living a digital age, the traditional hardcopy quality manual may no longer be essential, as it can be integrated into the facility’ s IT system providing easy access for all staff. An illustrative example of this documentation structure and content is presented in Appendix 3( Dance et al., 2014).
3.4.2.2 Dosimetry
While radiation dose is essential for imaging, it carries potential risks, necessitating careful management to minimize exposure while maintaining diagnostic quality. Appendix 4 presents at table that illustrate the key purposes of dosimetry in diagnostic radiology based on IAEA report’ s findings( IAEA, 2007):
Within the framework of quality assurance, dosimetry assumes an important role as it can be linked to different components and, to some extent, utilized as a performance indicator to evaluate the quality of radiological services. For example, dosimetry as part of equipment performance testing ensures proper and consistent X-ray source calibration, essential for maintaining diagnostic accuracy. Furthermore, dosimetry in standard radiological practices helps derive typical doses, enabling comparisons with established DRLs and driving quality optimization efforts.
However, given the wide spectrum of techniques and modalities in diagnostic radiology, relevant dosimetry can become complex. Competent professionals in dosimetry, such as medical physicists, are essential for its accurate implementation. It is the responsibility of registrants and licensees to ensure that patient dosimetry is conducted and documented by or under the supervision of a medical physicist, using calibrated dosimeters, and adhering to internationally or nationally accepted protocols.
3.4.2.3 Performance Indicators( PIs) in diagnostic radiology
In diagnostic radiology, to achieve continuous improvement with measurable results, clear essential Performance Indicators( PIs) are essential( Delis et al., 2017). The team collaborates to identify relevant PIs aligned with department practices and challenges. As quality matures, PIs evolve accordingly. Medical physicists play a key role in developing and monitoring technical PIs due to their expertise in measurement. For practical examples of departmental PIs Appendix 5 presents some of the indicators that offer a practical means of assessing and enhancing the performance and quality of a diagnostic radiology department.
4 Discussion
An international agreement of the optimization strategy enhancement in diagnostic radiology, as a fundamental task of radiological teams, has already been established in literature through organizations like IAEA, ICRP, and others. This shows the huge importance of patient radiation protection.
Collaborative initiatives present commitment to safety, while the IAEA’ s International Action Plan emphasizes education and support. Challenges in dose optimization are multifaceted, requiring more than technical changes due to evolving technology and diverse protocols. Collaborative projects, like HERCA and COCIR, aim to reduce exposure( Tsapaki et al., 2018; HERCA, 2020).
Medical physicists play a fundamental role, following equipment performance, protocols, and staff practices. New tools like RDSR, PDMS, and AI offer promise for optimization. Amidst technological evolution, the pursuit of dose optimization remains a complex, yet collaborative, journey Parakh et al., 2016; Kortesniemi et al., 2018).
In radiology and diagnostic imaging, the optimization process takes center stage amidst a wave of technologies and studies. The emergence of artificial intelligence( AI) and machine learning( ML) algorithms holds immense potential, enhancing image interpretation, workflow efficiency, and clinical decision support, all of which can be finely tuned through optimization( Chartrand et al., 2017).
Additionally, a developing field is the use of sophisticated imaging methods to investigate the influence of the human microbiome on health and disease. As this emerging field improves, optimization strategies will be vital in utilizing its capabilities. By visualizing and comprehending the complex interactions between the human body and its microbiota, radiologists can optimize diagnostic and therapeutic approaches for a diverse range of conditions, demonstrating the indispensable nature of optimization in shaping the future of radiology( Gollub et al., 2017).
5 Conclusion
While medical imaging has significantly advanced clinical practices, the potential errors in X-ray machines necessitate thorough monitoring through quality assurance programs. To uphold safety and effectiveness, the use of X-ray machines