Objectives

1. Identification of examinations and practice in existing/new member states
2. Collation and standardisation of protocols and results for patient and staff dosimetry
3. Consensus on image quality/dose and standardisation of high dose radiology

Description of work

1. Collation of a series of equipment performance tests on new digital systems
2. Collation of information from a series of dosimetry studies3. Consensus on the use of the DICOM header for information on patient dosimetry and quality control

Deliverables

1. Techniques, practices and optimisation in interventional radiology in existing and new member states: review and collation of data.
2. Patient and staff dosimetry and their standardization in interventional radiology: review and collation of data.
   

Workpakage description

Interventional systems all work under various degrees of automatic control. Thus the system may deteriorate without the user being aware. Automated methods for regular dose characterisation of interventional systems will be developed by drawing upon the results of existing work.

It is necessary to assess the image quality and dose performance of interventional systems using new technology. Methods for acceptance, status and constancy testing of these systems will be developed by consensus being informed by the analysis of these surveys. Centres with these new systems will compare results obtained from adapted survey protocols. Simple, informative test procedures are required. Quantitative and qualitative image quality indices will be used to assess the system performance as well as the influence of post processing routines. This will contribute to workpackage 1. Activity in this area will inform international standardisation initiatives.

Collation of the results of patient dose surveys of interventional radiology performed in a wide range of settings will be performed. Baseline transnational data will be obtained. This will be used to assess the impact of optimisation strategies developed in this project, new technologies and new techniques on patient dose levels in interventional radiology. Patient dose data will be used to contribute to the future establishment of reference dose levels. Staff dose surveys will also be performed.

One of the main problems with interventional radiology is the difficulty of assessing its contribution to the collective dose of the population. There is insufficient experience in performing national interventional radiology dose surveys. As a consequence the contribution of interventional radiology to population dose may be underestimated. It is proposed to develop a methodology to undertake a national survey and to assess how to deduce the accuracy of the sampling techniques used.

There is a lack of knowledge of radiation protection training issues amongst medical, clinical and technical staff. This inevitably results in patient doses being higher than necessary. Training requirements will be assessed via accessible training material and training courses.

Whilst the DICOM header can be analysed to obtain patient dose data information, the header contains other useful information to compare clinical protocols and to assess if clinical image quality criteria have been met.
Interventional procedures involve high doses and risks for both patients and staff. Optimisation of patient dose may also reduce staff doses, but not necessarily so, studies are needed to analyse the influence of operating techniques and generator parameters. This will be undertaken on the basis of available documents. Optimisation guidelines will be produced by consensus. He input of optimisation initiatives on staff doses will be assessed via an analysis of personnel monitoring results.