The implementation of an X-ray Quality Assurance (QA) program is a legal requirement in Europe as stipulated in the EU Council Directive 97/43/EURATOM (MED). A review of the literature has identified that European countries are performing some level of QA testing of their dental X-ray equipment, although the type and level to which testing is performed can differ. The European SENTINEL co-ordination action proposed to collate a survey of equipment data for both conventional and digital dental X-ray installations among the SENTINEL partners. The European QA results confirm that systems can be operated below tolerance, and in some cases significantly so, while still in clinical use. This can occur despite servicing of equipment. The results have emphasised the fact that there is a requirement for the medical physics/engineering professions to become more closely involved in the management of dental radiology equipment. This also includes their involvement in the development and delivery of appropriate training courses for dentists and suppliers of dental radiology equipment.

This study presents the findings from acceptance testing and routine quality control (QC) of general radiographic X-ray equipment in Ireland during 2006 and early 2007, including mobile X-ray units and film/screen fixed systems. Acceptance testing and routine QC of the diagnostic X-ray imaging equipment are requirements of European and Irish legislation. One hundred general radiographic X-ray systems were tested within Ireland, 73% of them failed to meet the required QC guidelines, whereby one or more faults were identified. The majority of these failures were minor ones, requiring attention by the suppliers at the next routine service. Significant faults were only identified in seven systems. The suppliers were requested to investigate these issues as soon as possible and take the necessary corrective action. A review of the QC results highlights the need to perform comprehensive acceptance and routine testing of the systems.

Current guidelines quote tolerances for automatic exposure control (AEC) device performance for X-ray systems as 'Baseline ± X %'. However, in the situation where a baseline figure has not yet been achieved, as in the case of commissioning assessments, this tolerance is not relevant. The purpose of this work is to provide mean doses for direct digital radiography (DDR) X-ray system, operating in AEC, against which comparisons can be made. Dose measurements have been recorded under AEC operation on 29 DDR detectors from three different manufacturers. Two different testing protocols were examined: (1) water equivalent phantoms in front of the DDR detector and (2) aluminium block at the tube head. The average patient exit dose, using the aluminium block was 4.6 μGy with the antiscatter grid in place and 4.0 μGy with the grid removed. Using the water phantoms, the average dose was measured at 17.1 μGy with the antiscatter grid in place and 5.4 μGy with grid removed. Based on these results, it is clear that different testing configurations significantly impact on the measured dose.

This study presents the results of acceptance testing on 18 interventional fluoroscopy systems in Ireland. Acceptance testing and routine quality assurance (QA) of X-ray systems are the requirements of the EU Medical Exposures Directive (MED) and these requirements were subsequently implemented into Irish legislation. The MED states that special consideration should be given to the QA and dose assessment of high dose procedures such as interventional fluoroscopy. Owing to the advances in fluoroscopy technology, it has been found that comprehensive testing of interventional systems proves challenging in a busy hospital environment. A number of recurrent problems have been identified and are presented.

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