The Quality Assurance (QA) Cycle of X-ray
Equipment used in Diagnostic Radiology:
X-ray equipment undergoes a quality assurance cycle of specification,
installation, critical examination, acceptance, commissioning, routine
performance testing, maintenance and finally disposal that are the subject of
regulations and guidance. The cycle is shown below. RPC, acting as your
RPA, is able to assist you in most of the requirements of the equipment QA cycle.
Further explanation is provided below.
Specification of the X-ray Equipment:
The RPA should be consulted when drawing up a specification for new
equipment. In particular the restriction of patient exposure should be
considered when purchasing radiological equipment. RPC has the combined
experience to assist in this decision. Additionally, during the specification
process, RPC will assess the suitability of the QA programme for new
equipment, taking account of any special requirements recommended by the
Critical Examination, Acceptance and
The Radiology Manager must ensure that new equipment is not used clinically
until a critical examination (by the installer) and commissioning tests have
been completed. This includes new installations, when equipment is re-installed
in another room and for replacement equipment such as X-ray tubes and
The purpose of the critical examination is to
demonstrate to the purchaser that the designed safety features and warning
devices operate correctly, that there is sufficient protection for persons from
exposure to ionising radiation and that the equipment is safe to use in normal
circumstances. In all situations, it is the responsibility of the
installer to ensure that the critical examination is performed to specification.
Any new installation must be subjected to a Critical Examination by the
installer who should provide written evidence that this has been undertaken and
with satisfactory results. An RPA has to be consulted about the examination and
the results. The RPA may be the installer's or the purchaser's RPA; this should
be agreed at the time of placing the order.
Newly installed X-ray equipment shall be
commissioned to check that the equipment is ready for clinical use and when
equipment is re-installed in another room. Commissioning ensures that the
equipment is fit for clinical use and will enable baseline values, for future
routine performance testing, to be
established. Commissioning is undertaken by the purchaser's RPA in conjunction with the supplier's X-ray
Acceptance is undertaken by a representative of the
purchaser, usually the RPA, in conjunction with the supplier. Its purpose is to
verify that the engineer has supplied all the equipment specified and that the
requirements of the contract have been met. The results of the commissioning
tests and the purchase contract are needed to determine whether the equipment
should be accepted.
Routine Performance Testing:
Regular radiation safety and performance surveys of diagnostic x-ray equipment
are vital to ensure the optimum level of protection for both staff and patients
while maintaining the highest image quality and so a suitable Quality Assurance
programme is legally required (regulation 32 of the (IRR) Ionising Radiations
Regulations). This programme is usually regular in house tests, backed up
by an annual radiation safety survey carried out by your RPA. RPC has a
lot of experience in carrying out such surveys. The safety surveys may however,
be required more frequently, for more complex and higher dose imaging equipment.
The survey includes all parts of the imaging chain and ensures that the
performance of your equipment is optimised.
Maintenance, Modification and Disposal:
Regular maintenance is also required by the IRR and this is usually arranged by
having a contract with the equipment supplier, or other suitable body..
The RPA should be informed of any modifications, such as change of the imaging
intensifier, as the further checks on the equipment's fitness of purpose may
need to be checked. The RPA may also be contacted for advice on the
correct disposal route for X-ray generating equipment.
For further information call RPC on 020 8725