Medical physics 3.0 versus 1.0: A case study in digital radiography quality control
Abstract
Abstract Purpose The study illustrates how a renewed approach to medical physics, Medical Physics 3.0 (MP3.0), can identify performance decrement of digital radiography (DR) systems when conventional Medical Physics 1.0 (MP1.0) methods fail. Methods MP1.0 tests included traditional annual tests plus the manufacturer's automated Quality Assurance Procedures (QAP) of a DR system before and after a radiologist's image quality (IQ) complaint repeated after service intervention. Further analysis was conducted using nontraditional MP3.0 tests including longitudinal review of QAP results from a 15‐yr database, exposure‐dependent signal‐to‐noise (SNR 2), clinical IQ, and correlation with the institutional service database. Clinical images were analyzed in terms of IQ metrics by the Duke University Clinical Imaging Physics Group using previously validated software. Results Traditional metrics did not indicate discrepant system performance at any time. QAP reported a decrease in contrast‐to‐noise ratio (CNR) after detector replacement, but remained above the manufacturer's action limit. Clinical images showed increased lung noise (Ln), mediastinum noise (Mn), and subdiaphragm‐lung contrast (SLc), and decreased lung gray level (Lgl) following detector replacement. After detector recalibration, QAP CNR improved, but did not return to previous levels. Lgl and SLc no longer significantly differed from before detector recalibration; however, Ln and Mn remained significantly different.…
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