Bone_Scan_Image_Quality

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					                                                                                     Facility Name
                                                                              Quality Improvement Study
                                                                              Bone Scan Image Quality

                 The goal of this technical quality improvement study is to measure the percentage of bone scans with technical artifacts or poor quality that could effect the accuracy of
 Purpose:        the study.
 Threshold:         10%
 Date of Study:
 Data Collection Period

 Rationale:
 Bone scintigraphy is a diagnostic study used to evaluate the distribution of active bone formation in the body. There are numerous potential artifacts and sources of error associated with
 bone scanning that must be avoided to ensure accurate interpretation and diagnosis. Some of these sources of error include: Urine contamination, injection artifacts, patient motion,
 increased collimator to patient distance, imaging too soon after injection before the radiopharmaceutical has been optimally cleared from the soft tissues, prior administration of a higher
 energy radionuclide, limited imaging views, renal failure, etc. Clinical images must be evaluated for these and other artifacts. Any identified artifacts must be further investigated and
 documented.

 References:
 Society of Nuclear Medicine Procedure Guideline for Bone Scintigraphy, version 3.0 approved June 20, 2003. www.snm.org

 Instructions:
 1) Enter overall threshold or goal in spreadsheet and individual thresholds for each quality parameter.
 2) Randomly display all images for 30 patients from the data collection date range.
 3) Evaluate each image display for the parameters listed below. For example, determine is there is poor, fair, good or excellent radiopharmaceutical uptake.
 3) Enter data into the spreadsheet.
 4) Determine if threshold for overall quality and each individual parameter has been met
 5) Conduct Quality Improvement meeting to discuss results and make plans for improvement
 6) Record minutes from meeting in form below




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                                                                                  Data Collection


                                 Increased                                              Artifact:     Artifact:    Artifact:                 Artifact:
                    Bone                                     Image       Additional                                              Artifact:                 Artifact:     Overall
                               Background Resolution                                      Dose          Full        Urine                    Patient
                   Uptake                                    Label         Views                                                  Metal                     Other        Quality
                               (Soft Tissue)                                           Infiltration   Bladder     Contamin.                  Motion
                                               Poor, Fair,   Images        Additional
                                  None
                    Poor,                         Good,       labeled   views acquired                None,
                             (Insignificant),                                            None, Mild,              None, Mild,   None, Mild, None, Mild,   None, Mild,   Poor, Fair,
                     Fair,                      Excellent correctly and as needed:                     Mild,
     Measure                      Mild,                                                  Moderate,                Moderate,     Moderate, Moderate,       Moderate,       Good,
                    Good,                     (e.g. Camera- include     Yes/No (lateral              Moderate,
                               Moderate,                                                  Severe                   Severe        Severe      Severe        Severe       Excellent
                   Excellent                    to-Patient  laterality? skulls, oblique,              Severe
                                 Severe
                                                Distance)    Yes/No           etc)
                     % of      % of patients % of patients % of patients % of patients     % of         % of   % of patients    % of        % of      % of patients     % of
                   patients    with moderate with poor or incorrectly    with needed patients with patients with moderate patients with patients with     with      patients with
                   with poor   or severe soft     fair       labeled      views not    moderate or      with     or severe   moderate or moderate or moderate or poor or fair
    Predicted
                    or fair        tissue     resolution                  acquired     severe dose moderate        urine       severe      severe     severe other     quality
    Threshold
                     bone      accumulation                                             infiltration or severe contamination    metal      patient      artifact
                    uptake                                                                            bladder                  artifact    motion
                         10%             10%           10%          10%            10%           10%       10%           10%         10%        10%            10%          10%

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                            Study/Patient Comments
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                                                                            Results
                   Bone       Increased   Resolution   Image     Additional    Artifact:     Artifact:    Artifact:   Artifact:   Artifact:   Artifact:   Overall
                  Uptake    Background                 Label       Views         Dose          Full        Urine       Metal      Patient      Other      Quality
                            (Soft Tissue)                                     Infiltration   Bladder     Contamin                 Motion
  % Low Quality   #DIV/0!       #DIV/0!    #DIV/0!     #DIV/0!    #DIV/0!       #DIV/0!      #DIV/0!      #DIV/0!     #DIV/0!     #DIV/0!     #DIV/0!     #DIV/0!


                                                         Quality Improvement Meeting Minutes

 Staff Meeting Date:

 Staff in Attendance




 Discussion




 Plan for Improvement




 Re-evaluation Date:

 Reported by:




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