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Optimisation of image quality and reduction of patient exposure in medical diagnostic radiology

Objective


The overall observations emerging from the work carried out during the reporting period are:

- the scientific work concerning the design of an Expert System prototype for Quality Control in mammography successfully attained the objectives of the program. The benefits of such a novel approach were highlighted and compared to the current practices. Although the amount of knowledge encoded in the prototype is not sufficient to cover the whole range of real situations, a strong progress has been made in the automatic interpretation of equipment malfunctions and in the optimisation of technical parameters to be used to comply with the ALARA principle in patient radiation protection.
- the laboratories involved in theoretical aspects of computing codes and mathematical simulation made significant progresses in extending their computer program to include the effects of patient inhomogeneities. Within this context, an important methodological work was carried out in order to select the most available and flexible approach to be used. The adopted solution was writing a voxel phantom computer program which enable advantage to be taken of any developments in models without major rewriting of already existing programs. This objective was completely achieved through a good cooperation of the involved laboratories.
- different studies were performed to investigate the quantitative and qualitative assessment of clinical image quality of radiology by applying the image criteria approach as suggested in the CEC Criteria Document. Results obtained were used to updating the knowledge in this field and to improve the existing CEC working document.
- an assessment of image quality from mammographic phantom images was made in view of complementing clinical image evaluation (use of a computer algorithm to locate phantom features of varying contrast and size on digitized mammographic films).
THIS COORDINATED PROJECT HAS THE GENERAL OBJECTIVE "OPTIMISATION OF THE RADIATION PROTECTION" AND AIMS AT IMPLEMENTING ALL RELEVANT INITIATIVES WHICH CAN REDUCE RADIATION RISK AND IMPROVE IMAGE QUALITY IN DIAGNOSTIC RADIOLOGY. ALL LABORATORIES INVOLVED IN THIS PROJECT HAVE CONSIDERABLE PAST EXPERIENCE IN THIS FIELD AND HAVE SIGNIFICANTLY CONTRIBUTED TO THE DEVELOPMENT AND THE IMPLEMENTATION OF PATIENT DOSE REDUCTION STRATEGIES WHICH UNDERPIN THE EURATOM DIRECTIVE 84/466 LAYING DOWN BASIC MEASURES FOR RADIATION PROTECTION OF PERSONS UNDERGOING MEDICAL EXAMINATION OF TREATMENT THE PROJECT IS CONCERNED WITH TWO BASIC AREAS OF RADIATION PROTECTION IN MEDICINE :1) THE PRACTICAL IMPLEMENTATION OF QUALITY ASSURANCE (QA) IN DIAGNOSTIC RADIOLOGY ; 2) DEVELOPMENT OF AN EXPERT SYSTEM FOR QA. THIS PROJECT IS A DEVELOPMENT OF THE PREVIOUS COORDINATED CONTRACT BI7-00019 1) THE PRACTICAL IMPLEMENTATION OF QA IN DIAGNOSTIC RADIOLOGY IN THE PRACTICAL IMPLEMENTATION OF QA PROGRAMMES IN DIAGNOSTIC RADIOLOGY IT IS IMPORTANT TO OBTAIN THE REQUIRED IMAGE QUALITY AT THE LEAST POSSIBLE DOSE. IT IS ESSENTIAL THEREFORE THAT THE CORRECT CHOICE OF EQUIPMENT AND OPERATING PARAMETERS IS MADE. IN ADDITION THE CONCERTED CHOICE OF PARA METERS TO BE MONITORED AND THE EXISTENCE OF QUALITY CONTROL (QC) PROTOCOLS ARE FUNDAMENTAL TO THE QUALITY SYSTEM. THE OBJECTIVE OF THIS PART OF THE PROJECT IS THEREFORE TO IDENTIFY THE PARAMETERS WHICH CONTROL IMAGE QUALITY AND PATIENT DOSE AND TO DEVELOP METHODS FOR THEIR OPTIMISATION AND MONITORING. THIS WILL BE ACHIEVED BY THE USE OF COMPUTER MODELLING AND EXPERIMENTS, AND BY ASSESSMENT OF DATA GATHERED FROM EXISTING QC PROTOCOLS 2) EXPERT SYSTEM
DIFFUSION OF SCARCE EXPERTISE CONCERNING THE MANAGEMENT AND INTERPRETATION OF QC PRACTICES. THE KEY FOR SOLVING THIS PROBLEM IS THE DESIGN OF A COM PURERISED TOOL CAPABLE OF SIMILATING SUCH AN EXPERTISE WHICH CAN BE DERIVED FROM ARTIFICIAL INTELLIGENCE APPLICATION. SUCH A TOOL (EXPERT SYSTEM)IS IN DEVELOPMENT AS A PART OF THE PREVIOUS CEC RADIATION PROTECTION PROGRAMME CONCERNING MAMMOGRAPHY. THE WORK PROGRAMME OF THIS PART OF THE PROJECT WILL DEAL WITH :
-IMPROVEMENT OF THE THEORETICAL KNOWLEDGE BASE ;
- VALIDATION OF THE EXPERT SYSTEM FOR MAMMOGRAPHY.

Funding Scheme

CSC - Cost-sharing contracts

Coordinator

Centre d'Evaluation et d'Assurance de la Qualité des Applications Technologiques dans le Domaine de la Santé
Address
49-51 Rue Fessart
75019 Paris
France

Participants (5)

INTEGRATED RADIOLOGICAL SERVICES LTD.
United Kingdom
Address
Brunswick Business Park, Century Building Unit 188, Tower Street
L3 4BJ Liverpool
LINKOEPING UNIVERSITY
Sweden
Address
Universitets
581 85 Linkoeping
ROYAL MARSDEN NHS TRUST
United Kingdom
Address
Fulham Road
SW3 6JJ London
Regione Friuli Venezia-Giulia
Italy
Address
Via Colugna 50
33100 Udine
UNIVERSIDAD COMPLUTENSE DE MADRID
Spain
Address
Ciudad Universitaria S/n
28040 Madrid