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DOI: 10.1055/a-2597-0689
Position Paper

Requirements for Physico-Technical Quality Assurance in the Framework of Early Detection of Lung Cancer

Article in several languages: English | deutsch

Authors

  • Rainer Eßeling

    1   Clinic for Radiology, University Hospital Münster, Münster, Germany (Ringgold ID: RIN39069)

  • Mathis Konrad 

    2   Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany

  • Hannah Prokesch

    3   Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
    2   Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany

  • Bernhard Renger

    4   Institute for Diagnostic and Interventional Radiology, TUM University Hospital, Rechts der Isar, Technical University of Munich, Munich, Germany (Ringgold ID: RIN9184)

  • Constantin Schareck

    5   Institute for Radiology and Nuclear Medicine, University Hospital Schleswig Holstein, Lübeck, Germany (Ringgold ID: RIN54186)

  • Georg Stamm

    6   Institute for Clinical and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany (Ringgold ID: RIN27177)
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Abstract

Summary

According to the text of the Lung Cancer Screening Ordinance on the permissibility of using low-dose computed tomography to screen smokers (LuKrFrühErkV, §7 Quality Assurance, [1]), the “radiation protection officer must establish and operate a comprehensive quality assurance system. This must take account of organizational, medical, and technical aspects, in particular [...] 2. the diagnostic image quality of the computed tomography scan, 3. the physical-technical parameters for the acquisition of the computed tomography scan [...]”.
The German Radiological Society (DRG) considers itself responsible for making recommendations regarding the implementation of such a quality assurance system, in order to provide users with legal certainty and ensure patient safety.
The DRG’s Physics and Technology Working Group has thus identified the main issues regarding quality assurance for technology, outlined the related challenges, and proposed potential areas for future investigation and resolution (see sections I–V).
Existing quality assurance measures for technology must be checked for their suitability with regard to a low-dose screening program and adapted, if necessary.
Complex additional constancy tests and the use of special (anthropomorphic) phantoms are not currently considered necessary. The tasks of manufacturers and medical physicists were refined further, and it was recommended that reference centers should be established as soon as possible.

Key Points

  • Constancy testing methods for CT are largely sufficient for lung cancer screening.

  • Daily air calibration is recommended to ensure consistent image quality.

  • Anthropomorphic phantoms are not currently required for quality assurance.

  • Manufacturers must provide protocols that meet LuKrFrühErkV requirements.

Citation Format

Eßeling R, Konrad M, Prokesch H et al. Requirements for Physico-Technical Quality Assurance in the Framework of Early Detection of Lung Cancer. Rofo 2026; DOI 10.1055/a-2597-0689

Keywords

CT - QA/QC - screening - quality assurance - lung cancer screening - constancy test


Publication History

Received: 29 April 2025

Accepted after revision: 18 November 2025

Article published online:
17 December 2025

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