Description With digital techniques exist the potential to improve the practice of radiology but also the risk to overuse radiation. The main advantages
of digital imaging: wide dynamic range, post-processing, multiple viewing options, electronic transfer and archiving possibilities are
clear but overexposures can occur without an adverse impact on image quality. In conventional radiography, excessive exposure produces
a "black" film. In digital systems, good images are obtained for a large range of doses. With digital fluoroscopy systems it is very
easy to obtain (and delete) images. There may be a tendency to obtain more images than necessary. In digital radiology, higher patient
dose usually means improved image quality and thus a tendency to use higher patient doses than necessary could occur. Different medical
imaging tasks require different levels of image quality and doses which have no additional benefit for the clinical purpose shall be
avoided. Image quality can be compromised by inappropriate levels of data compression and/or post-processing techniques and all these
new challenges should be part of the optimization process and included in the clinical and technical protocols. Local diagnostic reference
levels should be reevaluated for digital imaging and patient dose parameters should be displayed at the operator console. Frequent patient
dose audits should occur when digital techniques are introduced. Training in managing image quality and patient dose in digital radiology
is necessary. Digital radiology will involve new regulations and invoke new challenges for practitioners. As digital-radiology images
are easier to obtain and to transmit the justification criteria should be reinforced. Commissioning of digital systems should involve
clinical specialists, medical physicists and radiographers to ensure that imaging capability and radiation dose management are integrated.
Quality control requires new procedures and protocols (visualization, transmission and archiving of the images).
Educational slides
have been developed by the ICRP to accompany this report, and are available free of charge from the society's website - http://www.icrp.org/educational_area.asp
Contents
1. INTRODUCTION
1. Purpose of this document 1.2. Introduction 1.3. History 1.4. What is digital radiology? 1.5. Differences
between intrinsic digital modalities and digital radiology 1.6. Digitised conventional films 1.7. Plain radiography 1.8. Digital fluoroscopy
1.9. Comparison of digital and non-digital techniques 1.10. Image quality and exposure levels in digital radiology 1.11. Further aspects
of digital radiology
2. PATIENT DOSE AND IMAGE QUALITY IN DIGITAL RADIOLOGY
2.1. Relationship between image quality (or
diagnostic information) and patient dose in digital radiology 2.2. What image quality (or diagnostic information) is needed for a medical
imaging task? 2.3. Actions that affect patient dose 2.4. Practical advice for managing patient dose and image quality 2.5. Training needs
for radiologists and radiographers
3. REGULATORY ASPECTS AND QUALITY MANAGEMENT
3.1. Radiation protection principles 3.2.
Quality control and image management 3.3. Electrical safety inspection 3.4. Diagnostic reference levels 3.5. Auditing dose levels in
digital imaging 3.6. Deterministic injuries 3.7. The DICOM standard
4. ICRP RECOMMENDATIONS FOR DIGITAL RADIOLOGY
APPENDIX
A. THE FUNDAMENTALS AND ADVANTAGES OF
DIGITAL SYSTEMS
A.1. Introduction A.2. Basic terminology A.3. Imaging chain of digital
x-ray systems A.4. Image processing A.5. Image quality and imaging performance A.6. Integrated dosimetry tools
APPENDIX B. PATIENT
DOSIMETRY: QUANTITIES AND UNITS
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