• Principio di giustificazione
• Principio di ottimizzazione
• Appropriatezza diagnostica
• CTDI
• DLP
• ICRP
• Dose efficace
• BEIR

The following work aims at monitoring and analyzing the quantity and quality of ionizing radiation used in medical imaging, especially when taking care of paediatric patients. This experimental research is part of a project in collaboration between the Operating Unit of Radiodiagnostic 3 of the University of Pisa and a Belgian company, Qaelum Inc., a spin-off company of the University Hospitals of Leuven.
For this purpose the software Total Quality Monitoring (TQM), supplied in Italy by Fujifilm, was used to collect metadata information of every study in our sample, including but not restricted to dose data. It allows to control the doses of diagnostic modalities (RX, CT, MN/CT, and so on) used in the various Operating Units of the Hospital of the University of Pisa and to analyze the children who need this kind of diagnostic exams.
The representative sample chosen for this research concerns children under 15 years of age (9283 studies), who were subject to methodologies of conventional radiography, computed tomography and nuclear medicine methodologies in the period from 21/03/2008 to 25/06/2013. In regard to this sample, it was possible to view and/or analyze the provided dose and to collect more general data of the diagnostic devices in our sample, including exposure settings, processing parameters, responsible person and the devices vendor name and model.
Thanks to the collaboration with the hospital staff and the computer experts, this large amount of information was collected and then analyzed. The interfaces, diagrams and charts provided by TQM are available quicker and are more complete than the information given by the RIS/PACS. It was possible to analyze, in DAP or DLP, the daily and average quantity of dose of some of the selected diagnostic devices, and the cumulated dose of radiations of many paediatric patients.
In regard to this sample, it was possible to have a clear view of the diagnostic history of each considered paediatric population, calculating even the cumulative dosimetric figures of the exams carried out with different devices and in different Operating Units, but it was impossible to get a complete analysis of the following parameters: definition of the model and trademark of the used devices and of the Operating Unit where that device is situated. This depends on the way the software TQM reads specific DICOM Headers. The classification of patients who have more than one ID in RIS/PACS is going to be fixed in TQM.
The positive aspect of the use of the software TQM is the possibility, for the hospital staff, to know the amount of dose given by each device and, at the same time, the amount of dose administered to each paediatric patient in the course of their life. This is reflected in the possibility to create patient specific dose passports. In this way it could be useful to compare the dose received by every independent study with available DRLs (Diagnostic Reference Levels) and to utilize this information when defining best practices in medical imaging.