{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:03:36Z","timestamp":1791306216969,"version":"4.3.1"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,8,17]],"date-time":"2018-08-17T00:00:00Z","timestamp":1534464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2018,9]]},"abstract":"Abstract<\/jats:title>Purpose<\/jats:title>The study illustrates how a renewed approach to medical physics, Medical Physics 3.0 (MP<\/jats:styled-content>3.0), can identify performance decrement of digital radiography (DR<\/jats:styled-content>) systems when conventional Medical Physics 1.0 (MP<\/jats:styled-content>1.0) methods fail.<\/jats:p><\/jats:sec>Methods<\/jats:title>MP<\/jats:styled-content>1.0 tests included traditional annual tests plus the manufacturer's automated Quality Assurance Procedures (QAP<\/jats:styled-content>) of a DR<\/jats:styled-content> system before and after a radiologist's image quality (IQ<\/jats:styled-content>) complaint repeated after service intervention. Further analysis was conducted using nontraditional MP<\/jats:styled-content>3.0 tests including longitudinal review of QAP<\/jats:styled-content> results from a 15\u2010yr database, exposure\u2010dependent signal\u2010to\u2010noise (SNR<\/jats:styled-content>2<\/jats:sup>), clinical IQ<\/jats:styled-content>, and correlation with the institutional service database. Clinical images were analyzed in terms of IQ<\/jats:styled-content> metrics by the Duke University Clinical Imaging Physics Group using previously validated software.<\/jats:p><\/jats:sec>Results<\/jats:title>Traditional metrics did not indicate discrepant system performance at any time. QAP<\/jats:styled-content> reported a decrease in contrast\u2010to\u2010noise ratio (CNR<\/jats:styled-content>) after detector replacement, but remained above the manufacturer's action limit. Clinical images showed increased lung noise (Ln), mediastinum noise (Mn), and subdiaphragm\u2010lung contrast (SL<\/jats:styled-content>c), and decreased lung gray level (Lgl) following detector replacement. After detector recalibration, QAP CNR<\/jats:styled-content> improved, but did not return to previous levels. Lgl and SL<\/jats:styled-content>c no longer significantly differed from before detector recalibration; however, Ln and Mn remained significantly different. Exposure\u2010dependent SNR<\/jats:styled-content>2<\/jats:sup> documented the detector operating within acceptable limits 9 yr previously but subsequently becoming miscalibrated sometime before four prior annual tests. Service records revealed catastrophic failure of the computer containing the original detector calibration from 11 yr prior. It is likely that the incorrect calibration backup file was uploaded at that time.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>MP<\/jats:styled-content>1.0 tests failed to detect substandard system performance, but MP<\/jats:styled-content>3.0 methods determined the root cause of the problem. MP<\/jats:styled-content>3.0 exploits the wealth of data with more sensitive performance indicators. Data analytics are powerful tools whose proper application could facilitate early intervention in degraded system performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.12425","type":"journal-article","created":{"date-parts":[[2018,8,17]],"date-time":"2018-08-17T08:13:45Z","timestamp":1534493625000},"page":"694-707","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Medical physics 3.0 versus 1.0: A case study in digital radiography quality control"],"prefix":"10.1002","volume":"19","author":[{"given":"Diana E.","family":"Carver","sequence":"first","affiliation":[{"name":"Department of Imaging Physics University of Texas M. D. Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Willis","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas M. D. Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Stauduhar","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas M. D. Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas K.","family":"Nishino","sequence":"additional","affiliation":[{"name":"Department of Imaging Physics University of Texas M. D. Anderson Cancer Center Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jered R.","family":"Wells","sequence":"additional","affiliation":[{"name":"Clinical Imaging Physics Group Duke University Medical Center Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan","family":"Samei","sequence":"additional","affiliation":[{"name":"Clinical Imaging Physics Group Duke University Medical Center Durham NC USA"},{"name":"Carl E. Ravin Advanced Imaging Laboratories Duke University Medical Center Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,17]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"National Council on Radiation Protection and Measurements.Quality Assurance for Diagnostic Imaging Equipment: Recommendations of the National Council on Radiation Protection and Measurements. NCRP Report No. 99;1988."},{"key":"e_1_2_9_3_1","unstructured":"ShepardS LinP BooneJ et al.Quality Control in Diagnostic Radiology. AAPM Report No. 74;2002."},{"key":"e_1_2_9_4_1","volume-title":"ACR\u2010AAPM\u2010SIIM Practice Parameter for Digital Radiography","author":"American College of Radiology (ACR)","year":"2014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4932623"},{"key":"e_1_2_9_6_1","unstructured":"US Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health Inspection Support Branch Division of Mammography Quality and Radiation Programs Office of Health and Industry Programs.The Mammography Quality Standards Act Final Regulations. Subpart B Sec. 900.12(e) Washington DC;1999."},{"key":"e_1_2_9_7_1","unstructured":"American College of Radiology (ACR).Mammography Quality Control Manual: Medical Physicist's Section.Mammography Quality Control Manual;1999:225\u2010330."},{"key":"e_1_2_9_8_1","unstructured":"The Joint Commission.Diagnostic Imaging Requirements.https:\/\/www.jointcommission.org\/diagnostic_imaging_standards\/. 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