Development of a free open-source tool for semi-automated quality control of diagnostic planar X-ray images : focus on ease of integration into a QATrack+ workflow

Abstract

Problem Statement: Reproducibility of routine Quality Control (QC) testing of medical radiological installations is fundamental to ensure a quality service in terms of diagnostic accuracy, radiation protection and patient radiation safety, as well as being essential prerequisites for clinical protocol optimization (Caruana et al., 2018; European Commission et al., 2014; European Council, 2013; Van Asten et al., 2023). Current QC methods—predominantly spreadsheet-based—are limited by fragmented data and formulas, leading to inadequate data control and increased risk of error (Shay and Gersh, 2017). A popular, free tool to facilitate QC automation is QATrack+, however it does not include features specific to the QC of diagnostic planar X-ray images (Studinski et al., 2013). Other tools that provide full or semi-automated QC of these images, such as ImageJ plugins COQ and DRIQ, are not readily integratable into the QATrack+ system. Aim: This work aims to develop a free, open-source tool for QC of diagnostic planar X-ray imaging systems that supports automated operation and can be packaged as part of the QATrack+ software tool. Method: A custom QC software library was developed in Python and integrated with QATrack+. Validation of the integration of the tool was carried out and three validated QC tests were implemented: Signal Transfer Property, image uniformity, and pixel dropout detection (IPEM, 2010). QC test results were compared with the established tools DRIQ and COQ (Donini et al., 2014; Loveland, 2015). The tool was written in a modular fashion to facilitate the addition of further QC tests. Results: The developed free, open-source Python-based QC tool was successfully installed as part of the QATrack+ tool. The QC results from the in-house tool agreed well with other established tools and retrospective QC data. Conclusion: This work presents a validated, open-source solution for semi-automated QC of planar diagnostic X-ray systems. Its integration with QATrack+ supports standardized, efficient workflows and offers a practical, scalable tool for the medical physics community. Designed for extensibility, the tool supports the addition of further tests and, through its open-source nature, enables the use of modern version control for full auditability—addressing key limitations of spreadsheet-based systems.