Radiation protection evaluations following the installations of two cardiovascular digital x-ray fluoroscopy systems

Acceptance testing and commission are essential elements of the quality assurance program for imaging equipment. We present the results of a performance evaluation of Flat Panel-Based Cardiovascular Fluoroscopy X-ray Systems as a part of acceptance testing and commissioning. Measurements were obtained using a calibrated dose rate meter, patient equivalent phantoms, and Leeds image quality test tools. The results were compared with the manufacturer and European acceptability criteria. The entrance surface air kerma (ESAK) rate ranged from 8.0 to 12.0 mGy min⁻¹ in the continuous mode and from 0.01 to 0.04 mGy fr⁻¹ in the pulsed mode of operation. Detector-input air kerma rates ranged from 0.29 to 0.39 mGy min⁻¹ in continuous mode and from 0.02 to 0.07 µGy fr⁻¹ in pulsed mode. Fluoroscopy device half-value layer (HVL) ranged from 2.5 to 3.0 mm Al, and the low resolution ranged from 0.9 to 1.3%. The spatial resolution limit was double that of the image intensifier (2.4 to 3.6) lp/mm. Flat-panel fluoroscopy demonstrated superior image quality and dose performance as compared to conventional image intensifier-based fluoroscopy. The quality assurance measurements presented are essential in the rapid evaluation of the imaging system for acceptance testing and commissioning.