SECTIONTITLEHERE

RadiationProtectionDosimetry(year),Vol.0,No.0,pp.00
DOI:10.1093/rpd/nc0000

ACCEPTANCE TESTING AND ROUTINE QUALITY CONTROL IN

GENERAL RADIOGRAPHY: MOBILE UNIT AND FILM/SCREEN
FIXEDSYSTEMS
L.Gray1,A.Dowling1,A.Gallagher1,D.Gorman1,U. OConnor1,M.Devine1,A.Larkin1,C.Walsh1,J.F.
Malone1
1
St.JamessHospital/TheHaughtonInstitute,Dublin,Ireland
Receivedmonthdateyear,amendedmonthdateyear,acceptedmonthdateyear
ThisstudypresentsthefindingsfromacceptancetestingandroutineQualityControl(QC)ofgeneralradiographicXray
equipment in Ireland during 2006 and early 2007, including mobile Xray units and film/screen fixed systems.
Acceptancetestingandroutine QCofdiagnostic XrayimagingequipmentisarequirementofEuropeanandIrish
legislation.Althoughfilm/screentechnologyiscurrentlybeingreplacedbycomputedanddigitalradiography,systems
utilisingfilm/screencombinationsstillrepresentasignificantportionofsystemsinuseinIreland.Testingwascarriedout
ononehundredgeneralradiographicXraysystemswithinIreland.73%ofthesystemstestedfailedtomeettherequired
QCguidelines,wherebyoneormorefaultswereidentified.Themajorityofthesefailureswereminorones,requiring
attention by the suppliers at the next routine service. Significant faults were only identified in seven systems. The
equipmentsupplierswererequestedtoinvestigatetheseissuesassoonaspossible,andtakethenecessarycorrective
action.AreviewoftheQCresultshighlightstheneedtoperformcomprehensiveacceptanceandroutinetestingofthese
systems.

DetailedinhouseQCprotocolshavebeendeveloped
for the acceptance and routine testing of general
radiographicXraysystems.Theseprotocolsarebased
on recommendations and guidelines published by
International[3]andEuropeanbodies[47].
Thefollowingparameterscommontobothmobile
andfixedsystemswereassessed:

INTRODUCTION
Optimisation of patient dose andimagequality is of
primaryconcerninthefieldofdiagnosticimaging.Itis
recognised that comprehensive Quality Assurance
(QA) programs are a vital component of the
optimisationprocess.
AcceptancetestingandroutineQualityControl(QC)
testing of diagnostic imaging equipment is a
requirementofEuropean[1]andIrish[2]legislation.
Althoughfilm/screentechnologyiscurrentlybeing
replacedbycomputedanddigitalradiography,systems
utilising film/screen combinations still represent a
significant portion of general radiographic Xray
systemsinuseinIreland.
The Medical Physics and Bioengineering (MPBE)
Department, St. Jamess Hospital, Ireland, is
responsiblefortheannualtestingofapproximately100
general radiographic Xray systems in thirtyfour
hospitals within Ireland. This includes thirtynine
film/screen fixed general radiographic Xray systems
andsixtyonemobilegeneralradiographicXrayunits,
suppliedbytenmanufacturers.Theaverageageofthis
equipmentisapproximatelyeightyears.
This work presents the findings from acceptance
testing and routine QC performed during 2006 and
early2007.

AcceptanceandRoutineQATesting

TubeandGeneratorPerformance
RadiationOutput
HalfValueLayer
BeamAlignment
FocalSpotSize,
DoseAreaProduct(DAP)MeterAccuracy
MechanicalSafety
EquipmentCondition

AcceptanceTestingOnly

ElectricalSafety
TubeLeakageRadiation

For fixed film/screen general radiographic Xray

equipment, the Automatic Exposure Control (AEC)
systemwasalsoassessed.Testsincludedanassessment
of the mean film optical density, repeatability, and
consistencywithvaryingchambers,tubevoltageand
waterphantomthickness.
Testingwasperformedusingacalibratedionisation
chambers (6cc and 180cc), calibrated kVp/exposure

MATERIALANDMETHODS
*Correspondingauthor:lgray@stjames.ie

1
Theauthor(year).PublishedbyOxfordUniversityPress;allrightsreserved

SAMPLEETAL

time meter, patientequivalent water phantoms,

calibrated electrical safety test equipment, beam
alignment and focal spot test tools, and aluminium
filters.
RESULTSANDDISCUSSION
Acceptancetestingwasperformedonthirteensystems.
Faultswereidentifiedwithsevenofthesesystems.
RoutineQCtestingwasperformedoneightyseven
systems.Oneormorefaultswereidentifiedwith76%
ofthesesystems.
Themajorityoffaultsidentifiedatacceptanceand
routinetestingwereminor.Typicalfaultsidentifiedare
showninFigure1.

Figure2.IssuesidentifiedwithDAPMeters

80% of film/screen fixed systems incorporated an

AEC system. Eight systems did not incorporate an
AEC system, and so were not on par with modern
equipment.Thesesystemsareovertenyearsoldand
due for replacement in the future. AEC faults were
identifiedinallbutonesystem,andincluded:

No. of Syste ms

Faults ide ntifie d during Te sting

30
25
20
15
10

5
0
Automatic

Beam

Exposure Alignment
Control

DoseAre
Product
Meter

Exposure Half Value

Timer

Layer

Tube

Light Beam

Voltage

Diaphragm

Te st Faile d

MeanOpticalDensity
ConsistencywithChambers
ConsistencywithTubeVoltage
ConsistencywithWaterPhantomThickness

The maximum selectable focal spot charge, or

current, that could be selected was found to be
800mAs,whichexceedsthetoleranceof600mAs,as
recommendedbyRP91[4].Thismayresultinadditional
unnecessary exposure of the patient in the event of
AECfailure.

Figure 1. Typical Faults identified during Acceptance and

RoutineTesting

Xrayfieldtolightbeamalignmentfailuresarea
particular problem for mobile Xray equipment, as
constantmotionofunitsmaydislodgetheXraytube
orcollimatorhousing.
Tube output varied significantly, typically in the
rangeof28.467.4Gy/mAs.InthecaseofmobileX
raysystems, thishasimplicationsforpatientdoseand
image quality, particularly within hospitals that have
manymobileXraysystemsattheirdisposal.Agiven
mAssettingmayproduceanimageofoptimalquality
on one unit, while the same setting will produce an
imageofinferiorqualityonanother.NotallmobileX
rayunitsincorporateanAECsystemandforthosethat
do,itmaynotalwaysbeused.Inthisstudy,noneofthe
mobilestestedincorporatedandAECsystem.Thereis
apotentialtounderoroverexposethepatient.This
mayleadtorepeatexaminations.
Thetubeoutputforaparticularsystemincreasedby
24%from2005to2006,highlightingtheimportanceof
datatrendingfromyeartoyear.
45%ofsystemsincorporated aDAPmeter forthe
purpose of monitoring patient dose. The majority of
DAP meters were found to be working within
tolerance, howeversome typicalissues identifiedare
depictedinFigure2.

CONCLUSION
73%ofthe systemstestedfailedtomeettherequired
standards,wherebyoneormorefaultswereidentified.
The majority of these failures were minor ones,
requiringattentionbythesuppliersatthenextroutine
service.Significantfaultsthatcouldpotentiallyimpact
uponpatient doseand safetywere onlyidentified in
seven systems. The equipment suppliers were
requested to investigate these issues as soon as
possible,andtakethenecessarycorrectiveaction.
Althoughgeneralmobileunitsandfilm/screenfixed
systemsarenotconsideredhighdosemodalities,useof
these systems comprises a significant portion of a
diagnostic imaging workload. A review of the QC
resultshighlightstheneedtoperformcomprehensive
acceptanceandroutinetestingofthesesystems.

SHORTTITLE

ACKNOWLEDGEMENT
Thisworkwasconductedpartiallywithintheframeof
theEuropeanCommission6thFrameworkProgramme
SENTINELContractNoFP6012909.
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