Digital intraoral radiographic quality assurance and control in private practice

Self-Instruction Exercise No. 355
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Exercise No. 355
Subject Code: 165
Digital Radiology

The 15 questions for this exercise are based on the article, “Digital intraoral radiographic quality assurance and control in private practice,” on pages 22-29. This exercise was developed by Steven E. Holbrook, DMD, MAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • identify components of a quality control (QC) and quality assurance (QA) program for digital radiography,
  • understand what is necessary to improve the diagnostic quality of digital radiographs, and
  • recognize how an effective QC/QA program can reduce patients’ radiation exposures.

Answers for this exercise must be received by August 31, 2015.
  1. Guidelines for the QA of a digital sensor must consider all of the following except one. Which is the exception?

    A. dynamic range
    B. spatial resolution
    C. absorption efficiency
    D. contrast depth resolution

  2. Computer monitor calibration was evaluated using a test pattern developed by the _________________.

    A. American Dental Association (ADA)
    B. Society of Motion Picture and Television Engineers
    C. American Academy of Oral and Maxillofacial Radiology
    D. Bureau of Radiological Health

  3. The test phantom used to evaluate image quality in this study was the ____________________.

    A. Dental Image Quality Test Tool
    B. Dexis Dental Quality Test Phantom
    C. Sirona Dental Quality Assurance Phantom
    D. Digital Dental Quality Assurance Phantom

  4. The use of operatory monitors for diagnosis and treatment planning was compromised by which of the following?

    A. improper lighting
    B. spatial distortion
    C. contrast variation
    D. inadequate resolution

  5. X-ray measurements of each generator included all of the following except one. Which is the exception?

    A. accuracy of the kilovolt peak (kVp)
    B. grayscale of the step wedge
    C. half-value layer
    D. reproducibility of repeated exposures

  6. What was the dose reduction percent achieved following image quality testing at the first Schick office?

    A. 15
    B. 25
    C. 35
    D. 45

  7. At present, the ADA has guidelines that include QA and QC of digital radiography. This study sought to present available techniques for a QA program that includes image optimization.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  8. According to the National Council on Radiation Protection and Measurements, the maximum recommended exposure for bitewing radiographs is ______ mR.

    A. 367
    B. 293
    C. 207
    D. 183

  9. Compared to the Schick CDR sensor, the newer Schick Elite sensor demonstrated _______ image quality and _______ entrance skin exposure (ESE).

    A. poorer; higher
    B. better; higher
    C. poorer; lower
    D. better; lower

  10. The purpose of the step wedge is to find a setting that

    A. achieves optimal exposure in a finite period of time.
    B. allows for visualization of the entire range of patient (tissue) thickness.
    C. provides the desired contrast/detail resolution at a specific kVp.
    D. demonstrates the ideal collimation to maximize ESE.

  11. The QCs instituted resulted in a significant reduction in exposure for all types of sensors. The mean optimized exposure was less than the diagnostic reference level recommended by the NCRP.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  12. Five of the X-ray units evaluated

    A. had a kVp >10%.
    B. had a half-value layer that did not comply with Texas regulations.
    C. were found to be marginally within compliance boundaries.
    D. were approved by state inspectors 1 year previously.

  13. What percentage of X-ray units operated in excess of recommended ranges according to the Dental Exposure Normalization Technique?

    A. 20
    B. 30
    C. 40
    D. 50

  14. The third parameter measured with the phantom was the visual identification of the total number of

    A. varying diameter wells.
    B. visible steps in the step wedge.
    C. visible line pairs per millimeter.
    D. distinct peaks on the grey scale.

  15. Examination of the quality of the X-ray images made it possible to accomplish all of the following except one. Which is the exception?

    A. evaluate X-ray machine performance
    B. optimize digital X-ray images
    C. routinely reduce ESE
    D. efficiently train dental auxiliaries

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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