Cel The main objectives of the proposal are all concerned with the development of optimisation strategies in diagnostic radiology for the 21st Century, including mechanisms for their routine implementation throughout Europe. This will be achieved by means of a computer supported collaborative research programme which will fully research and develop a predictive framework for radiological practice which links the outcome of an examination, in terms of patient dose and image quality, to the optimum selected radiographic technique. Existing radiation protection strategies for diagnostic radiology employ human controls to a significant extent, whereby education and training underpins the selection of radiographic factors. This approach has consistently had minimal effect on the overall range and magnitude of doses delivered to patients during x-ray examinations. The proposed project will, therefore, develop operational tools, based upon the rational implementation of information technology, for use in x-ray departments which will actively support standardised operational programmes aimed at firmly placing optimised protection of the patient at the very point of radiation delivery and thus reducing doses delivered to patients. These objectives will be implemented through extensive further development of the Quality Criteria for both the chest and lumbar spine examinations which can then be used as a model for similar developments in all other radiological examinations involving existing and future technical developments. This work builds upon past work of the Commission's Radiation Protection Research Programme. Development of the Ouality Criteria will be pursued in; a) the techniques for assessing image quality from clinical images, b) understanding more fully the role of the observer, c) implementation of clinically relevant objective physical measures, d) improved and more relevant data management systems, e) development of feedback mechanisms for optimisation of the selection of radiographic technique. The proposed project is based upon three fundamental foundations involving the clinical, physical/technical and theoretical modelling aspects of the problem. An expert group of European radiologists will be established to help develop the framework for the quantitative assessment of the quality of clinical radiographs. They will also participate in annual trials of the Ouality Criteria for chest and lumbar spine examinations. A library of standard and modified images will be established for evaluation by this group. The images will be modified by means of image processing techniques established to reproduce changes in the main radiographic technique factors. Investigations into the visual detection of artificially simulated pathology will also be employed utilising ROC analysis. Detailed analysis of the range and variation of radiographic technique factors employed routinely will be undertaken for the chest and lumbar spine examinations. All relevant factors will be assessed including detailed performance of the image receptor. A large scale patient dose measurement programme will be established and multi-parameter and sensitivity analyses used to develop a predictive framework for relating the patient dose and image quality to the radiographic technique. Objective physical measurements of image quality will also be developed which can be related to clinical measures. The practical aspects of the project will be firmly underpinned by forefront theoretical and modelling activities. A three dimensional voxel phantom will be employed in detailed dosimetric and image formation studies. Monte Carlo techniques will be applied to model the radiographic process and optimisation studies performed in order to investigate the potential for lowering the patient dose for a given level of image quality. Image processing mechanisms will be established as well as comprehensive data management systems for detailed analysis of the Quality Criteria trials. Irrespective of the socio-medical and political decisions for performing particular x-ray examinations it is envisaged that the optimisation methodologies developed by this proposal could reduce the collective effective patient dose from diagnostic radiology throughout Europe by at least 20% or 40,000 man Sv with a detriment cost-saving equivalent to approximately 0.5 billion ECU or 5% of the radiological budget. Program(-y) EAEC-NFS 2 - Specific research and training programme in the field of nuclear safety and safeguards, 1994-1998 Temat(-y) 040304 - Optimisation strategies for radiation protection of the patient in diagnostic radiology Zaproszenie do składania wniosków Data not available System finansowania CSC - Cost-sharing contracts Koordynator INTEGRATED RADIOLOGICAL SERVICES LTD. 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