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Medical physics 3.0 versus 1.0: A case study in digital radiography quality control.

Publication ,  Journal Article
Carver, DE; Willis, CE; Stauduhar, PJ; Nishino, TK; Wells, JR; Samei, E
Published in: J Appl Clin Med Phys
September 2018

PURPOSE: The study illustrates how a renewed approach to medical physics, Medical Physics 3.0 (MP3.0), can identify performance decrement of digital radiography (DR) systems when conventional Medical Physics 1.0 (MP1.0) methods fail. METHODS: MP1.0 tests included traditional annual tests plus the manufacturer's automated Quality Assurance Procedures (QAP) of a DR system before and after a radiologist's image quality (IQ) complaint repeated after service intervention. Further analysis was conducted using nontraditional MP3.0 tests including longitudinal review of QAP results from a 15-yr database, exposure-dependent signal-to-noise (SNR2 ), clinical IQ, and correlation with the institutional service database. Clinical images were analyzed in terms of IQ metrics by the Duke University Clinical Imaging Physics Group using previously validated software. RESULTS: Traditional metrics did not indicate discrepant system performance at any time. QAP reported a decrease in contrast-to-noise ratio (CNR) after detector replacement, but remained above the manufacturer's action limit. Clinical images showed increased lung noise (Ln), mediastinum noise (Mn), and subdiaphragm-lung contrast (SLc), and decreased lung gray level (Lgl) following detector replacement. After detector recalibration, QAP CNR improved, but did not return to previous levels. Lgl and SLc no longer significantly differed from before detector recalibration; however, Ln and Mn remained significantly different. Exposure-dependent SNR2 documented the detector operating within acceptable limits 9 yr previously but subsequently becoming miscalibrated sometime before four prior annual tests. Service records revealed catastrophic failure of the computer containing the original detector calibration from 11 yr prior. It is likely that the incorrect calibration backup file was uploaded at that time. CONCLUSIONS: MP1.0 tests failed to detect substandard system performance, but MP3.0 methods determined the root cause of the problem. MP3.0 exploits the wealth of data with more sensitive performance indicators. Data analytics are powerful tools whose proper application could facilitate early intervention in degraded system performance.

Duke Scholars

Published In

J Appl Clin Med Phys

DOI

EISSN

1526-9914

Publication Date

September 2018

Volume

19

Issue

5

Start / End Page

694 / 707

Location

United States

Related Subject Headings

  • Software
  • Radiographic Image Enhancement
  • Quality Control
  • Nuclear Medicine & Medical Imaging
  • Health Physics
  • Calibration
  • 5105 Medical and biological physics
  • 3208 Medical physiology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Carver, D. E., Willis, C. E., Stauduhar, P. J., Nishino, T. K., Wells, J. R., & Samei, E. (2018). Medical physics 3.0 versus 1.0: A case study in digital radiography quality control. J Appl Clin Med Phys, 19(5), 694–707. https://doi.org/10.1002/acm2.12425
Carver, Diana E., Charles E. Willis, Paul J. Stauduhar, Thomas K. Nishino, Jered R. Wells, and Ehsan Samei. “Medical physics 3.0 versus 1.0: A case study in digital radiography quality control.J Appl Clin Med Phys 19, no. 5 (September 2018): 694–707. https://doi.org/10.1002/acm2.12425.
Carver DE, Willis CE, Stauduhar PJ, Nishino TK, Wells JR, Samei E. Medical physics 3.0 versus 1.0: A case study in digital radiography quality control. J Appl Clin Med Phys. 2018 Sep;19(5):694–707.
Carver, Diana E., et al. “Medical physics 3.0 versus 1.0: A case study in digital radiography quality control.J Appl Clin Med Phys, vol. 19, no. 5, Sept. 2018, pp. 694–707. Pubmed, doi:10.1002/acm2.12425.
Carver DE, Willis CE, Stauduhar PJ, Nishino TK, Wells JR, Samei E. Medical physics 3.0 versus 1.0: A case study in digital radiography quality control. J Appl Clin Med Phys. 2018 Sep;19(5):694–707.

Published In

J Appl Clin Med Phys

DOI

EISSN

1526-9914

Publication Date

September 2018

Volume

19

Issue

5

Start / End Page

694 / 707

Location

United States

Related Subject Headings

  • Software
  • Radiographic Image Enhancement
  • Quality Control
  • Nuclear Medicine & Medical Imaging
  • Health Physics
  • Calibration
  • 5105 Medical and biological physics
  • 3208 Medical physiology
  • 1116 Medical Physiology
  • 1103 Clinical Sciences