背景:乳房X线照相术是技术要求最高的射线照相过程之一,和乳房X线照相术质量保证举措是实施公共卫生筛查服务的优先事项。在优化图像质量(IQ),放射技师发挥了重要作用。在1998年至2009年之间,意大利北部大型人群筛查服务的乳房X线照相术指导委员会对成像设施进行了几次审核检查。2009年,筛查服务的目标年龄范围得到了扩展。乳房X线照片的体积预计将急剧增加,但放射线照相师的劳动力没有实质性增加。
方法:鉴于对乳房X线摄影智商的潜在影响,被动审核方法被放弃,转而采用主动的以放射技师为导向的智商审查计划。其技术基础包括由每名一级放射技师和更有经验的本地参考放射技师定期重复进行数字乳房X线照片随机抽样审查,通过智商分类,接下来是培训工作和监控工作。
结果:乳房X线照片体积从2008年的140,822增加到2014年的319,394(127%),然后稳定下来。2012年,智商差的乳房X光检查的比例从0.6%上升到19.3%,同时乳房X线照片的大幅减少被解释为具有中等和完美的智商。相反,在2016年和2018年的第一轮都出现了普遍的改善.
结论:在新的挑战性场景中,该方案被证明是有效的。成功的智商审查计划是鼓励放射技师以积极和自信的态度参与的计划。
BACKGROUND: Mammography is one of the most technically demanding radiographic processes, and mammography quality assurance initiatives are priorities in the implementation of public health screening services. In the optimisation of image quality (IQ), radiographers play a major role. Between 1998 and 2009, the steering committee for mammography of a large population-based screening service in northern Italy undertook several audit checks of the imaging facilities. In 2009, the target age range of the screening service was extended. The mammogram volume was projected to increase steeply but with no substantial increase in the radiographer workforce.
METHODS: In view of the potential impact on mammographic IQ, the passive audit approach was abandoned in favour of an active radiographer-oriented IQ
review programme. Its technical basis consists of regularly repeated rounds of
review of random samples of digital mammograms performed by each first-level radiographer and by more experienced local reference radiographers, with IQ classification, followed by a training effort and a monitoring work.
RESULTS: The mammogram volume grew from 140,822 in 2008 to 319,394 in 2014 (+127%) and then stabilised. In 2012, the proportion of mammograms with a poor IQ rose from 0.6% to 19.3%, paralleled by a substantial decrease of mammograms interpreted to have a moderate and perfect IQ. Conversely, a generalised improvement occurred in both rounds of 2016 and in the first round of 2018.
CONCLUSIONS: In the new challenging scenario, the programme proved to be effective. A successful IQ
review initiative is one that encourages radiographers to participate with a positive and confident attitude.