Evaluation of the Quality Control Program for Diagnostic Radiography and Fluoroscopy Devices in Syria during 2005-2013

Introduction: Extensive use of diagnostic radiology is the largest contributor to total population radiation doses. Thus, appropriate equipment and safe practice are necessary for good-quality images with optimal doses. This study aimed to perform quality control (QC) audit for radiography and fluoroscopy devices owned by private sector in Syria (2005-2013) to verify compliance of performance of X-ray machines with the regulatory requirements stipulated by the national regulatory body. Materials and Methods: In this study, QC audit included 487 X-ray diagnostic machines, (363 radiography and 124 fluoroscopy devices), installed in 306 medical diagnostic radiology centers in 14 provinces in Syria. We employed an X-ray beam analyzer device (NERO model 8000, Victoreen, USA), which was tested and calibrated at the National Secondary Standard Dosimetry Laboratory traceable to the IAEA Network of Secondary Standard Dosimetry Laboratories. Standard QC tool kits were used to evaluate tube and generator of the X-ray machines, which constituted potential (kVp), timer accuracy, radiation output consistency, tube filtration, small and large focal spot sizes, X-ray beam collimation and alignment, as well as high- and low-resolution and entrance surface dose in fluoroscopy. Results: According to our results, most of the assessed operating parameters were in compliance with the standards stipulated by the National Regulatory Authority. In cases of noncompliance for the assessed parameters, maximum value (28.77%) pertained to accuracy of kVp calibration for radiography units, while the lowest value (2.42%) belonged to entrance surface dose in fluoroscopy systems. Conclusion: Effective QC program in diagnostic radiology leads to obtaining information regarding quality of radiology devices used for medical diagnosis and minimizing the doses received by patients and medical personnel. The findings of this QC program, as the main part of QA program, illustrated that most of the considered diagnostic X-ray devices had acceptable performance and few of them need to be recalibrated for some parameters.