Quality assessment of conventional X-ray diagnostic equipment by measuring X-ray exposure and tube output parameters in Great Khorasan Province, Iran

Document Type : Original Paper


1 Medical Physics Research Center, Mashhad University of Medical Sciences, Mashahd, Iran.

2 Department of Radiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.


Introduction: Regular implementation of quality control (QC) program in diagnostic X-ray facilities may affect both image quality and patient radiation dose due to the changes in exposure parameters. Therefore, this study aimed to investigate the status of randomly selected conventional radiographic X-ray devices installed in radiology centers of Great Khorasan Province, Iran, to produce the data needed to formulate QC policies, which are essential to ensure the accuracy of the diagnosis while minimizing the radiation dose.
Material and Methods: This cross-sectional study was performed using a calibrated Piranha multi-purpose detector to measure QC parameters in order to unify X‐ray imaging practices using international guidelines. The QC parameters included voltage accuracy, voltage reproducibility, exposure time accuracy, exposure time reproducibility, tube output linearity with time andmilliampere (mA), and tube output reproducibility. Data analysis procedures were performed based on the type of an X-ray generator, which has not been reported in previous studies.
Results: The results showed that the implementation of high-frequency X-ray generators were more advantageous compared to alternative current generators, due to their efficient, better accuracy, linearity, and reproducibility.
Conclusion: The survey revealed that the QC program was not conducted at regular intervals in some of the investigated radiology centers, mostly because of inadequate enforcement by national regulatory authorities for implementation of QC program.


Main Subjects

  1. References


    1. Pernicka F, McLean ID. Dosimetry in diagnostic radiology: an international code of practice. International Atomic Energy Agency. 2007.
    2. Sungita YY, Mdoe SS, Msaki P. Diagnostic X‐ray facilities as per quality control performances in Tanzania. Journal of Applied Clinical Medical Physics. 2006 Sep 1;7(4):66-73.
    3.   World Health Organisation. Global Initiative on Radiation Safety Health Care Settings. Technical Meeting Report. Geneva. 2008;21-6.
    4. Bosnjak J, Ciraj-Bjelac O, Strbac B. Implementation of quality assurance in diagnostic radiology in Bosnia and Herzegovina (Republic of Srpska). Radiation protection dosimetry. 2008 Feb 18; 129(1-3):249-52.
    5. Gray L, Dowling A, Gallagher A, Gorman D, O'connor U, Devine M, et al. Acceptance testing and routine quality control in general radiography: mobile units and film/screen fixed systems. Radiation protection dosimetry. 2008 Mar 1; 129(1-3):276-8.
    6. Van den Berg L, Aarts JC, Beentjes LB, Van Dalen A, Elsakkers P, Julius HW, et al. Guidelines for quality control of equipment used in diagnostic radiology in the Netherlands. Radiation protection dosimetry. 1998 Nov 1; 80(1-3):95-7.
    7. Korir GK, Wambani JS, Ochieng BO. Optimisation of patient protection and image quality in diagnostic radiology. East African medical journal. 2010; 87(3):127-33.
    8.   Ngoye WM, Motto JA, Muhogora WE. Quality Control Measures in Tanzania: Is it Done? Journal of Medical Imaging and Radiation Sciences. 2015 Sep 1; 46(3): S23-30.
    9. World Health Organization. World Health Statistics. Switzerland.2006.
    10. Asadinezhad M, Toossi MT. Doses to patients in some routine diagnostic X-ray examinations in Iran: proposed the first Iranian diagnostic reference levels. Radiation protection dosimetry. 2008 Dec 1;132(4):409-14.  DOI: 10.1093/rpd/ncn308.
    11. Asadinezhad M, Bahreyni Toossi MT, Ebrahiminia A, Giahi M. Quality Control Assessment of Conventional Radiology Devices in Iran. Iranian Journal of Medical Physics. 2017 Mar 1;14(1):1-7.
    12. Jomehzadeh Z, Jomehzadeh A, Tavakoli MB. Quality Control Assessment of Radiology Devices in Kerman Province, Iran. Iranian Journal of Medical Physics. 2016 Mar 1;13(1):25-35.
    13. Khoshbin Khoshnazar A, Hejazi P, Mokhtarian M, Nooshi S. Quality control of radiography equipments in Golestan Province of Iran. Iranian Journal of Medical Physics. 2013; 10(1):37-44.
    14. Brindhaban A, Al Khalifah K, Al Wathiqi G, Al Ostath H. Effect of x-ray tube potential on image quality and patient dose for lumbar spine computed radiography examinations. Australasian Physics & Engineering Sciences in Medicine. 2005 Dec 1; 28(4):216.
    15. The American Association of Physicists in Medicine (AAPM). Quality Control in Diagnostic Radiology. Report No.74. 2002.
    16. International Commission on Radiological Protection. ICRP 103. The 2007 Recommendations of the International Commission on Radiological Protection. Ann. ICRP. 2007; 37(2-4)
    17. Wagner LK, Fontenla DP, Kimme‐Smith C, Rothenberg LN, Shepard J, Boone JM. Recommendations on performance characteristics of diagnostic exposure meters: Report of AAPM Diagnostic X-Ray Imaging Task Group No. 6. Medical physics. 1992 Jan 1; 19(1):231-41.
    18. Papp J. Quality Management in the Imaging Sciences-E-Book. Elsevier Health Sciences; 2014 Sep 30.
    19.   McClelland IR. X-ray equipment maintenance and repairs workbook for radiographers and radiological technologists. World Health Organization. 2004; 215.
    20. Barthez PY, Manwaring N, Mitelmann PM, Benoit E. Comparison of single-phase and high-frequency generators for x-ray units. Veterinary Radiology & Ultrasound. 2002 Mar 1; 43(2):118-22.
    21. Brahme A. Comprehensive biomedical physics. Sweden: Newnes. 2014 Jul 25; 170-1.



Volume 16, Issue 1 - Serial Number 1
January and February 2019
Pages 34-40
  • Receive Date: 07 August 2018
  • Revise Date: 04 October 2018
  • Accept Date: 25 October 2018
  • First Publish Date: 01 January 2019