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Quality Assurance Program For Medical Diagnostic X-Ray Machines


Since 2001, New Jersey medical x-ray facilities have been continuously implementing a quality assurance (QA) program as required by New Jersey radiation protection regulations with the goal of reducing patient radiation exposure while increasing x-ray image quality.

To measure the effectiveness of this program, the Bureau of X-Ray Compliance monitors Entrance Skin Exposure (ESE) and radiographic image quality (IQ) for three commonly performed radiographic exams: AP lumbar spine, PA chest and AP foot.

The Bureau is pleased to report that these efforts have resulted in reduced radiation exposure to patients while simultaneously improving radiographic image quality.

Quality Assurance Downloads



Patient radiation exposure measured as “Entrance Skin Exposure” (ESE) and reported in milliroentgens (mR).
Image quality scores are measured and reported on a scale of zero to one hundred. Image quality scores are determined by the inspector’s evaluation of an x-ray taken of an image quality tool and processed using the facility’s processing equipment. The total image quality score is compiled by the inspector evaluating six areas of image quality including background density, high contrast resolution, low contrast resolution, density uniformity and noise/artifacts. Image quality scores of 0-29 are reported as poor; 30-49 as fair; 50-69 as good and 70 or greater as excellent image quality. Machines that measured high or extremely high radiation have steadily dropped from 42% prior to QA to just 4% in year-sixteen. Each discipline has demonstrated similar reductions in radiation exposure.
Machines that measured high or extremely high patient radiation exposure decreased from 42% prior to quality assurance implementation to just 4% in year-sixteen of the quality assurance program. Image quality scores in year 16 of our QA program increased 20%, 29% and 50% in chest, foot and lumbar spine radiographic procedures as compared to year 1. Average radiation exposure decreased in year 16 by 63%, 65% and 46% respectively as compared to year 1.

Comparison of quality assurance achievements broken down by the specific medical study follows below. If you have questions or would like more information regarding our medical quality assurance program, please visit the following website links or call our office at (609) 984-5634.

To view the data for type of study, please click one of the following:

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Last Updated: June 8, 2018