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Advisory DI21/07: Standard 3.2: Optimised Radiation Technique Charts - evidence requirements

To clarify the required evidence for Standard 3.2, Optimised Radiation Technique Charts.

Advisory details

Item Details
Advisory number DI21/07
Version number 1.0
Trim number D21-45373
Publication date 7 December 2021
Replaces Advisory Statement A19/01 version 2.0 published May 2020
Compliance with this advisory Mandatory for Diagnostic Imaging Accreditation Scheme (DIAS) accrediting agencies and diagnostic imaging practices.
Information in this advisory applies to
  • All DIAS accrediting agencies
  • Diagnostic imaging practices
Key relationship 2016 DIAS Standard 1.5: Equipment Servicing Standard
Attachment Nil
Notes

Additional resources:

Responsible officer Margaret Banks
Director, National Standards
Phone: 1800 304 056
Email: AdviceCentre@safetyandquality.gov.au
To be reviewed December 2023

Purpose

To clarify the required evidence for Standard 3.2, Optimised Radiation Technique Charts.

Issue

The purpose of Standard 3.2 is to ensure that diagnostic imaging practices adopt a consistent approach to imaging procedures that:

  • Delivers images of diagnostic quality
  • Adheres to the principle of keeping radiation doses As Low as Reasonably Achievable (ALARA).

There has been confusion about the evidence required to demonstrate compliance with Standard 3.2 Optimised Radiation Technique Charts for:

  • Various ionising radiation equipment
  • Ionising radiation equipment with programmed and embedded settings.
  • Ionising radiation equipment with manual settings

The evidence an imaging practice provides is dependent on the ionising radiation equipment used for imaging procedures.

Requirements

Diagnostic imaging practices must provide, as a minimum, the following evidence for:

Angiography, computed tomography (CT)[1], fluoroscopy, mammography, orthopantomography (OPG) and X-ray equipment

For each piece of equipment, provide evidence that demonstrates:

  • An annual review of ionising radiation settings
  • The review outcomes
  • The actions following the review
  • Which qualified person[2] authorised the conduct of the review
  • Who is responsible for the outcomes and progressing the actions.

Mammography, OPG and X-ray equipment with manual settings

For each piece of equipment with manual settings, also provide a technique chart that

  • Is consistent with the ALARA principle
  • Contains a table of recommended settings (mA, time, kVp) that is referred to when selecting exposure factors for different procedures

Angiography and Fluoroscopy Equipment

For each piece of equipment, also provide a log demonstrating:

  • The procedure’s name
  • The procedure screening times or system-generated radiation dose metrics for each procedure
  • An annual review of the log
  • The review outcomes
  • The actions to optimise equipment settings
  • Which qualified person[2] authorised the conduct of the review
  • Who is responsible for the outcomes and progressing the actions.

A log of procedure screening times is only acceptable for equipment that does not generate dose metrics.

The information provided in this advisory is summarised below in the section Required evidence for Standard 3.2 – Optimised Radiation Technique Chart.

Required evidence for Standard 3.2 - Optimised Radiation Technique Chart

Evidence Angiography Computed tomography Fluoroscopy Mammography
A review of settings authorised by a qualified person for each piece of equipment Required Required Required Required
A log of screening times or dose metrics authorised by a qualified person. Required N/A Required N/A
A technique chart consistent with ALARA for each piece of equipment with manual settings N/A N/A N/A Required where settings are manual
Evidence Nuclear medicine OPG X-ray
A review of settings authorised by a qualified person for each piece of equipment Required for CT in conjunction with PET and SPECT Required Required
A log of screening times or dose metrics authorised by a qualified person. N/A N/A N/A
A technique chart consistent with ALARA for each piece of equipment with manual settings N/A Required where settings are manual Required where settings are manual

ALARA = As Low as Reasonably Achievable, CT – Computed Tomography, DRL = diagnostic reference levels, N/A – not applicable, OPG = orthopantomography, PET - Positron Emission Tomography, SPECT - single photon emission computed tomography

For more information

For guidance on the evidence for Standard 3.2, see the User Guide for Diagnostic Imaging Practices Applying for Accreditation.

Relevant appendices in the user guide includes Appendix 2: Example safety and quality manual and Appendix 11: Fluoroscopy screening log.

Australian national DRLS are located on the ARPANSA website.

For guidance on diagnostic reference levels see Advisory DI21/03: Requirements for comparison with national diagnostic reference levels.

 


  • [1] This includes CT in conjunction with PET and SPECT.
  • [2] A qualified person can be a radiologist, medical physicist, or senior radiographer and other personnel who have direct authority and responsibility for the imaging performed and can authorise the doses delivered to patients at the practice. It is not an equipment service provider.
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