North Macedonia has selected the DOSE and MAMMO solutions of Qaelum NV to monitor the radiation dose and quality control in digital mammography.
In the last 10 to15 years, there was a sharp increase in the number of CT scanners installed in the Republic of North Macedonia. In 2000 there were less than ten CT scanners, while in 2019, according to the latest official data, there is a total of 29 operational CT scanners, with a wide range of technical and software performances. 19 of them are installed in state hospitals and 10 of them are in private health institutions.
This has led to a significant increase in the number and the type of CT examinations performed, as well as an increase in the number of patients with multiple studies and follow-up examinations. The same story applies to mammography systems, and nowadays there is a total of 14 digital mammography systems (with several more are in the process of procurement) in state hospitals and 5 in private units.
Following new national legislation, radiology units have to meet quality criteria in order to be allowed to clinically practice. In addition, there are requirements that local and national DRLs have to be established and patient dose assessment has to be performed periodically.
However, it turns out that these requirements cannot be fulfilled without employing a medical physicist in radiology departments across the country, something that is typical for most of the Southeast European countries, and the surrounding area.
Implementation of procedures for Quality Control testing on an annual basis, done by external technical services, neither guarantees nor contributes to the improvement of radiation protection of patients and the application of the ALARA principle.
The way to overcome this situation is by establishing QC procedures and radiation dose data collection on a daily basis, and so the idea of establishing a National Dose Registry and QA Center was born.
Initially, the project included only one hospital, but later on we recognized the importance of the project and the real benefit for patients and decided to broaden it to all state hospitals, by including of all CT scanners and digital mammography units.
The CT modality was chosen because it delivers high patient doses to the patient, while mammography was chosen to ensure reliability and high performance within national screening program.
Mrs. Vesna Gershan, Associate Professor at Faculty of Natural Sciences and Mathematics, Department of Physics, Ss Cyril and Methodius University in Skopje and a member of the National Committee for mammography screening program responsible for QA and national coordinator of this project said:
It was found that QAELUM was the only company that offers both solutions. A requirement for patient dose tracking in CT and mammography, and online image quality assessment to monitor performance tracking, meant there was no dilemma as to which system should be chosen – Qaelum! [...]We believe that Practical implantation of these two QAELUM solutions will bring North Macedonia to a new level of radiation protection of patients, ensuring quality in mammography screening."
KEY POINTS:
- Dose monitoring software allows the implementation of stringent radiation protection standards and optimization of patient dose.
- An online quality control solution can overcome the problem of not having Medical Physicists in local radiology departments, particularly in developing countries.
- QC procedures carried out on a daily basis is the only way to guarantee quality and reliability.