Quality assurance, written protocols and dose evaluation

In accordance with Article 101 of the Law of 28 May 2019 on radiation protection, the establishment implements appropriate quality assurance programmes for its medical radiology equipment and assessments of doses received by patients.

Quality control

Quality control is defined in Article 102 of the Law on radiation protection and encompasses:

• acceptance tests and regular performance checks (‘level B’) conducted by an expert in medical physics*
• frequent in-house checks (‘level A’) aimed primarily at checking the constancy of certain parameters, e.g. using ‘quality control phantom samples’ produced by a user of medical X-ray equipment

The content of these tests and checks is defined in:

• Annex XI of the Grand Ducal Regulation of 1 August 2019 on radiation protection for equipment used for external radiotherapy and brachytherapy
• Annex XIII of the Grand Ducal Regulation on conventional dental radiology equipment
• Annex XII of the Grand Ducal Regulation on other equipment used in the context of exposure for medical reasons, and
• where applicable, in the annexes to authorisations

* The level B quality control of dental X-ray equipment in class III may be carried out by a radiation protection officer who is authorised to advise establishments.

Written protocols

In accordance with Articles 89 and 90 of the Law, the establishment operating medical X-ray installations is required to set out in writing procedures describing:

• the process for justifying the radiological examination request and patient information
• the steps or processes involved in the practical implementation of exposure for medical purposes through to data processing and archiving, for each type of exposure and broken down by equipment and patient category

These written procedures must be available at every inspection.

 Dose assessment

In accordance with Article 97 of the Law, the establishment must assess the average dose delivered to patients for different types of radiodiagnostic or interventional radiology procedures at least once a year for each radiological installation and send the results to the Health Directorate (Radiation Protection Division). The class I or class II establishment delegates the implementation of this evaluation to the expert in medical physics.

If the assessment results reveal that the diagnostic reference levels for a practice have been exceeded, the establishment must consult with the medical physics expert without undue delay in order to optimise the doses.