Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-20T12:31:05.017Z Has data issue: false hasContentIssue false

Chapter 30 - Quality assurance and radiographic skeletal survey standards

from Section V - Technical considerations and dosimetry

Published online by Cambridge University Press:  05 September 2015

By
Patricia L. Kleinman
Edited by
Paul K. Kleinman
Patricia L. Kleinman
Affiliation:
Department of Radiology, Boston Children’s Hospital, and Harvard Medical School, Boston, Massachusetts, USA
Paul K. Kleinman
Affiliation:
Children's Hospital Boston
Get access

Summary

Quality assurance

Quality assurance (QA) and quality control (QC) are fundamental to the establishment and ongoing analysis of imaging strategies. All parameters of the imaging chain must meet specific criteria and be critically evaluated on a continuous basis. A solid QA/QC program can be implemented to ensure consistent, high-quality diagnostic imaging in cases of suspected child abuse (1–7).

Radiographic QA sets standards for the production of optimal quality images obtained at the lowest radiation dose to the patient. Radiographic QC, a component of QA, is the overall system of activities whose purpose is to ensure integrity of the imaging equipment and provide consistent quality images. QA also includes examination screening for appropriateness, equipment calibration, preventive maintenance, in-service education of radiologic technologists, acceptance testing of new radiographic equipment/digital imaging chain components, and evaluation of new imaging products.

The implementation of QA in the healthcare environment has been an important step in reinforcing and improving standards of care. A well-designed QA program should regulate the production, quality, and maintenance of consistent imaging. Radiology departments should seek to prospectively build QA and QC into their imaging services rather than retrospectively attempt to correct failures. As greater control is obtained over imaging practices and as observations and trends are noted, new areas for improved quality may be illuminated (1, 3, 4, 8, 9).

Type
Chapter
Information
Diagnostic Imaging of Child Abuse , pp. 708 - 715
Publisher: Cambridge University Press
Print publication year: 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, H, Arora, S. Total Quality in Radiology. A Guide to Implementation. Delray Beach, FL: St. Lucie Press; 1994.Google Scholar
Gray, JE, Winkler, NT, Stears, J, Frank, ED. Quality Control in Diagnostic Imaging. Rockville, MA: Aspen Publishers; 1983.Google Scholar
McKinney, WEJ. Radiographic Processing and Quality Control. Philadelphia, PA: J. B. Lippincott; 1988.Google Scholar
National Council on Radiation Protection and Measurements. Report No. 99: Quality Assurance For Diagnostic Imaging Equipment. Recommendations of the National Council on Radiation Protection and Measurements, issued December 30, 1988. Washington, DC: US Government; 1988.Google Scholar
Papp, J. Quality Management in the Imaging Sciences, 4th edn. St. Louis, MO: Mosby; 2011.Google Scholar
American College of Radiology. ACR–SPR Practice Guideline for Skeletal Surveys in Children. Revised 2014 (Resolution 39). Reston, VA: American College of Radiology; 2014, pp. 1–6. Available from .Google Scholar
American College of Radiology. ACR–AAPM–SIIM Practice Guideline for Digital Radiography Revised 2012 (Resolution 37). Reston, VA: American College of Radiology; 2012, pp. 1–16.Google Scholar
Herrmann, TL, Fauber, TL, Gill, J, Hoffman, C, Orth, DK, Peterson, PA, et al. Best practices in digital radiography. Radiol Technol. 2012;84(1):83–9.Google ScholarPubMed
John, SD, Moore, QT, Herrmann, T, Don, S, Powers, K, Smith, SN, et al. The image gently pediatric digital radiography safety checklist: tools for improving pediatric radiography. J Am Coll Radiol. 2013;10(10):781–8.CrossRefGoogle ScholarPubMed
Meyer, JS, Gunderman, R, Coley, BD, Bulas, D, Garber, M, Karmazyn, B, et al. ACR Appropriateness Criteria® on suspected physical abuse – child. J Am Coll Radiol. 2011;8(2):87–94.CrossRefGoogle ScholarPubMed
American Academy of Pediatrics Section on Radiology. Diagnostic imaging of child abuse. Pediatrics. 2009;123(5):1430–5.CrossRefGoogle Scholar
Belanger, P, Kleinman, P. Establishing a protocol for detecting child abuse. Adv Admin Radiol Radiati Oncol. 1994;4(5):36–8.Google Scholar
Kleinman, PK. Diagnostic Imaging of Child Abuse, 2nd edn. St. Louis, MO: Mosby–Year Book; 1998.Google Scholar
Kleinman, PK, Blackbourne, BD, Marks, SC, Karellas, A, Belanger, PL. Radiologic contributions to the investigation and prosecution of cases of fatal infant abuse. N Engl J Med. 1989;320(8):507–11.CrossRefGoogle ScholarPubMed
Kleinman, PK, Marks, SC, Richmond, JM, Blackbourne, BD. Inflicted skeletal injury: a postmortem radiologic–histopathologic study in 31 infants. AJR. 1995;165(3):647–50.CrossRefGoogle ScholarPubMed
Caffey, J. Multiple fractures in the long bones of infants suffering from chronic subdural hematoma. AJR. 1946;56(2):163–73.Google Scholar
Kleinman, PL, Kleinman, PK, Savageau, JA. Suspected infant abuse: radiographic skeletal survey practices in pediatric health care facilities. Radiology. 2004;233(2):477–85.CrossRefGoogle ScholarPubMed
Karmazyn, B, Duhn, RD, Jennings, SG, Wanner, MR, Tahir, B, Hibbard, R, et al. Long bone fracture detection in suspected child abuse: contribution of lateral views. Pediatr Radiol. 2012;42:463–9.CrossRefGoogle ScholarPubMed
Kleinman, PL, Zurakowski, D, Strauss, KJ, Cleveland, RH, Perez-Rosello, JM, Nichols, DP, et al. Detection of simulated inflicted metaphyseal fractures in a fetal pig model: image optimization and dose reduction with computed radiography. Radiology. 2008;247(2):381–90.CrossRefGoogle Scholar
Kleinman, PK, O’Connor, B, Nimkin, K, Rayder, SM, Spevak, MR, Belanger, PT, et al. Diagnostic performance of modern radiographic imaging systems in the detection of inflicted skeletal injury in infancy. AJR. 1997;168(Suppl.):127.Google Scholar
Curry, TS, Dowdey, JE, Murry, RC. Christensen’s Physics of Diagnostic Radiology, 4th edn. Philadelphia, PA: Lippincott, Williams & Wilkins; 1990.Google Scholar
Bushberg, JT, Seibert, JA, Leidholdt, EM, Boone, JM. The Essential Physics of Medical Imaging, 3rd edn. New York, NY: Lippincott, Williams & Wilkins; 2011.Google Scholar
Bomer, J, Wiersma-Deijl, L, Holscher, HC. Electronic collimation and radiation protection in paediatric digital radiography: revival of the silver lining. Insights Imaging. 2013;4(5):723–7.CrossRefGoogle ScholarPubMed
Sherer, MAS, Visconti, PJ, Ritenour, ER. Radiation Protection in Medical Radiography, 6th edn. St. Louis, MO: Mosby–Elsevier; 2010.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×