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Present status of technical quality control of diagnostic radiology equipment

From the required three-level system of QC, based on EU-requirement and international experience, the first level, i.e. acceptance testing to be performed by NRIRR has run since May 2002. During 9 years, more than 300 tests were performed, although there is a lot of new equipment even now, for which testing is not ordered, and radiation health authority does not require it effectively.
Tests of the third level, i.e. constancy tests to be performed daily-weekly-monthly by the licensees themselves run in mammography screening stations which are all equipped with sensitometer, densitometer and test phantom. In other healthcare institutions, constancy tests are performed practically only where the service – within the framework of warranty or a lump-sum payment service contract – performs also QC tests, together with the maintenance in its own interests, moreover, in some hospitals where a devoted engineer performs them, with support of the chief physician. In case of conventional (film) radiography an important part of it is (would be) systematic checking of conditions of film processing and viewing. In digital radiography, it is replaced by checking of image displaying. In Hungarian radiology, there are extremely large deficiencies in this field. Starting constancy testing would demand no major investment but a small amount of work only. Recommendations for it, endorsed by Hungarian Board of Radiology, can be downloaded from website of NRIRR.
A major unsolved problem, however, is the middle (second) level of QC. It is the status testing, to be performed in Hungary yearly and after major servicing, by independent accredited testing organizations. Unfortunately, these tests till now – except from the rare cases of “voluntary law implementation” – are not performed at all. Considering the EU obligation and that the requiring ministerial decree has been valid since 2001, it is not only surprising but also unacceptable.
An important reason for this, that many interested people confuse it with the so-called “periodic safety check”, required originally by Decree No. 47/1999., nowadays by its replacing Decree No. 4/2009 (III.17.) of the Minister of Health. This check is not the QC but mainly electric and mechanic safety check, and from text of the decree it is also unambiguous that it does not replace any other required test.
To summarize, it can be pointed out that technical QC of diagnostic radiology equipment, and within it above all the status testing, to be performed by accredited laboratories, suffers deficiencies because there is nobody really in charge of it, and system, operating, regulating and supervising diagnostic radiology in Hungary, practically does not deal with it. Radiology departments, troubled with many other, mainly administrative quality related obligations, can not realize that equipment QC is also their own real interest, although it may require some extra effort at the beginning.

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