Ferenc Nagy1, Aron K Krizsan2, Kornél Kukuts2, Melinda Szolikova3, Zsolt Hascsi2, Sandor Barna2, Antonietta Acs2, Peter Szabo2, Lajos Tron4, Laszlo Balkay4, Magnus Dahlbom5, Mihaly Zentai3, Attila Forgacs2, Ildiko Garai2. 1. ScanoMed Nuclear Medicine Centers, Nagyerdei krt. 98, Debrecen, H-4032, Hungary. nagy.ferenc@scanomed.hu. 2. ScanoMed Nuclear Medicine Centers, Nagyerdei krt. 98, Debrecen, H-4032, Hungary. 3. Mediso Ltd., Budapest, Hungary. 4. Medical Imaging Clinic-Nuclear Medicine, Clinical Center, University of Debrecen, Debrecen, Hungary. 5. Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, USA.
Abstract
BACKGROUND: Regular and precise inspection of the realization of the local nuclear medicine standard operation procedures (SOPs) is very complex and time-consuming, especially when large amount of patient data is obtained from a wide scale of different scan procedures on a daily basis. DICOM metadata comprise a complete set of data related to the patient and the imaging procedure, and consequently all information necessary to evaluate the compliance with the actual SOP. METHODS: Q-Bot, an automatic DICOM metadata monitoring tool which is capable to verify SOP conformities, was tested for 11 months at two nuclear medicine departments. Relevant parameters, such as patient ID, patient mass and height, injected activity, and uptake time, were investigated in the case of adult 18F-FDG whole-body PET/CT and 99mTc-MDP gamma camera bone scans on a daily basis. Q-Bot automatically inspected the actual SOP compliance of these relevant DICOM parameters. Q-Bot graphical user interface (GUI) provided a summary of the outliers in a table format to be investigated by a dedicated technologist. In addition, information related to the error handling was also collected for retrospective analysis of long-term tendencies. RESULTS: In total, 6702 PET/CT and 2502 gamma camera scans were inspected, from which 8581 were confirmed as valid patient study without errors. Discrepancies related to the lack of a parameter, not appropriate format, or improper scan procedures were found in 623 cases, and 156 out of these were corrected before the medical reading and reporting. SOP non-conformities explored with Q-Bot were found to be non-correctable in 467 cases. Systematic errors to our practice turned out to be the manual radiopharmaceutical injection, the allowance to use both SI and non-SI units, and the clear definition of decimal point symbol to use. CONCLUSION: The daily evaluation of Q-Bot results provided early detection of errors and consequently ensured the minimization of error propagation. Integration of a QM software that inspects protocol compliance at a nuclear medicine department provides significant support to detect non-conformities for technologists, and much higher confidence in image quality for physicians.
BACKGROUND: Regular and precise inspection of the realization of the local nuclear medicine standard operation procedures (SOPs) is very complex and time-consuming, especially when large amount of patient data is obtained from a wide scale of different scan procedures on a daily basis. DICOM metadata comprise a complete set of data related to the patient and the imaging procedure, and consequently all information necessary to evaluate the compliance with the actual SOP. METHODS: Q-Bot, an automatic DICOM metadata monitoring tool which is capable to verify SOP conformities, was tested for 11 months at two nuclear medicine departments. Relevant parameters, such as patient ID, patient mass and height, injected activity, and uptake time, were investigated in the case of adult 18F-FDG whole-body PET/CT and 99mTc-MDP gamma camera bone scans on a daily basis. Q-Bot automatically inspected the actual SOP compliance of these relevant DICOM parameters. Q-Bot graphical user interface (GUI) provided a summary of the outliers in a table format to be investigated by a dedicated technologist. In addition, information related to the error handling was also collected for retrospective analysis of long-term tendencies. RESULTS: In total, 6702 PET/CT and 2502 gamma camera scans were inspected, from which 8581 were confirmed as valid patient study without errors. Discrepancies related to the lack of a parameter, not appropriate format, or improper scan procedures were found in 623 cases, and 156 out of these were corrected before the medical reading and reporting. SOP non-conformities explored with Q-Bot were found to be non-correctable in 467 cases. Systematic errors to our practice turned out to be the manual radiopharmaceutical injection, the allowance to use both SI and non-SI units, and the clear definition of decimal point symbol to use. CONCLUSION: The daily evaluation of Q-Bot results provided early detection of errors and consequently ensured the minimization of error propagation. Integration of a QM software that inspects protocol compliance at a nuclear medicine department provides significant support to detect non-conformities for technologists, and much higher confidence in image quality for physicians.
Authors: Amna J Al-Jabri; Khalid Alzimami; K Alsafi; Abdulaziz S Alaamer; M A Al-Rajhi; I I Suliman Journal: Radiat Prot Dosimetry Date: 2019-06-01 Impact factor: 0.972
Authors: Andres Kaalep; Coreline N Burggraaff; Simone Pieplenbosch; Eline E Verwer; Terez Sera; Josee Zijlstra; Otto S Hoekstra; Daniela E Oprea-Lager; Ronald Boellaard Journal: EJNMMI Phys Date: 2019-12-26