Quality Control for CR and DR Systems: Interpretation of State Regulations

The Colorado regulations spell out three distinct types of areas of quality control (QC) for computed and digital radiography systems (CR and DR, respectively). The specific regulations can be found in sections 6.3.3.2 (3), 6.3.5.7, and 6.3.5.8 in the 6 CCR 1007-1 Part 06. Here’s a summary of the regulations that are relevant for most of our clients.

Technique Selection.
The first set of regulations details how each x-ray imaging system must have a “documented protocol for technique selection for each type of examination” (6 CCR 1007-1 Part 06, section 6.3.3.2 (3)). This regulation is generally satisfied by the software for each CR or DR system that has different body parts that the user selects which in turn brings up the recommended technique settings. Many practices also post a paper copy of recommended technique settings for different situations.

Computer Monitors.
The second area of quality control encompasses the monitors on which the digital images are viewed for interpretation. Quality control for your monitor must include annual calibration for visualization of low contrast patches and spatial resolution targets, and measurements of ambient light levels and luminance from a sufficient number of driving levels. The state regulations defer to the manufacturer’s specifications or a registered medical physicist or a nationally recognized body like the AAPM (American Association of Physicists in Medicine).

Cassettes and Readers.
The third aspect of the Colorado regulations involve the cassettes and cassette readers. Again, the regulations defer to the manufacturer’s specifications and/or a registered medical physicist and/or a nationally recognized organization like the AAPM. In fact, section 6.3.5.8mentions AAPM report 93 by name. While you can manage periodic cleaning and erasing the cassettes yourself, you will probably need an expert to use a QC phantom to evaluate things like contrast/noise, exposure indicator accuracy, and laser jitter. Even if you have your own QC phantom, the regulations then go on to say that the entire QC program must be “reviewed annually by a registered medical physicist.”

One of the many benefits of working with Atom Physics is that we have registered medical physicists on staff, including owner Adam Evearitt, who can tailor your QC program to fit the needs of your practice, as allowed by state regulations.