engleski

Quality Assurance of DEXA systems, necessity or overkill?

Introduction Dual Energy X-ray Absorption (DEXA) scanning is currently the gold standard method for measuring bone mineral density (BMD). It is an effective parameter in assessing fracture risk, confirming a diagnosis of osteoporosis and monitoring the outcome of treatment. By 2050, the worldwide incidence of hip fracture is projected to increase by 310% and 240% in men and women (Gulberg 1997), respectively. Consequently, there is a possibility of introducing population screening programs in EU member states. The number of DEXA scans is rapidly increasing over the last two decades in both public and private medical institutions. Also, the technology of DEXA systems has led to higher exposure levels, shorter scan times, increased workload and increased shielding requirements. For example, patient dose from fan-beam is comparable to dental X-ray and approaching to dose of chest X-ray. Thus, a regular quality control including radiation protection and performance testing is required. Materials and methods Testing of DEXA scanners is obligatory by law in Croatia since 2009. However, the situation in practice is somewhat different. At University Hospital Rijeka DEXA machines are included in Quality Assurance program. Therefore, the protocol for independent evaluation of technical performance is developed in accordance to international recommendations. The tendency for horizontal exchange of knowledge has motivated us to investigate the situation regarding DEXA practice on a national level. A survey was conducted among DEXA users. A questionnaire was distributed to all of them in order to obtain the basic information about their workload, quality control testing and personnel education. Results Results show the lack of quality control testing among Croatian DEXA users and also the lack of personnel education. Some further data investigation revealed actually even the lack of94 understanding the terms of quality assurance/quality control. Quality control protocol and the results of this survey will be presented. Discussion Our intention is to emphasize the importance of incorporating DEXA machines and procedures in quality assurance programme. Nowadays, with the more frequent use of fan-beam and conebeam scanners, the doses from bone densitometry are comparable to the ones from dental and chest PA X-ray examinations. Therefore, more attention must be given to this topic. References 1. Larkin A, Sheahan N, O'Connor U, Gray L, Dowling A, Vano E, et al. QA/Acceptance Testing of DEXA X-ray Systems used in Bone Mineral Densitometry. Radiat Prot Dosimetry. 2008 ; 129 (1-3): 279-83 2. Slavchev A, Avramova–Cholakova S, Vassileva J. National Protocol for Quality Assurance in DXA-Bone Densitometry. Pol J Med Phys Eng. 2008 ; 14 (4): 207-215 3. Accreditation Guidelines for Bone Densitometry. Australian and New Zealand Bone and Mineral Society ; June 2004

DEXA, quality control

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