Optimisation in paediatric radiology. Are there specific problems for quality assurance in paediatric radiology

Radiological facilities must be adapted to the needs of infants and children, and examination technique must be modified. Quality assurance starts with the questions: ''Is this radiological examination really necessary. Will it influence the diagnosis as well as the selection of therapy and patient management. How much effective dose to the patient is justifiable. Does the expected benefit for the patient outweigh possible risks and unavoidable burdens''. Considerations concerning the effective quality are much more important in paediatric radiology. Otherwise, technical quality control and assurance must be adapted to the specific techniques of paediatric radiology. Many adjustments (exposure time, automatic exposure control, tube voltage, fluoroscopic dose rate, film-screen performance etc.) must be made near the lower technical limit. The range of tolerable variations is small. Devices unknown in general radiology must be tested. Methods and phantoms for quality control, therefore, must take into account these specific conditions of paediatric radiology. (author)