Medical imaging practice changed dramatically with the introduction of digital imaging. Although digital imaging has many advantages, it also has made it easier to delete images that are not of diagnostic quality. Mistakes in imaging—from improper patient positioning, patient movement during the examination, and selecting improper equipment—could go undetected when images are deleted. Such an approach would preclude a reject analysis from which valuable lessons could be learned. In the analog days of radiography, saving the rejected films and then analyzing them was common practice among radiographers. In principle, reject analysis can be carried out easier and with better tools (ie, software) in the digital era, provided that rejected images are stored for analysis. Reject analysis and the subsequent lessons learned could reduce the number of repeat images, thus reducing imaging costs and decreasing patient exposure to radiation. The purpose of this study, which was conducted by order of the Dutch Healthcare Inspectorate, was to investigate whether hospitals in the Netherlands store and analyze failed imaging and, if so, to identify the tools used to analyze those images.
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Abstract—A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children’s hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children’s hospitals but also between the respective general and children’s hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.
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Abstract—A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients
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