To Ryszard P. Kowski, MUSC is the medical imaging quality assurance center of the world. He was here Dec. 7 through 9.

It’s the place any radiological imaging engineer charged with developing a national system to ensure high quality X-rays, MRIs (magnetic resonance images) and other imaging technologies should look to for information, advice and guidance.

That’s Kowski’s job. He’s Poland’s man to develop quality standards for mammography equipment and quality assurance processes within Polish health care institutions.

As Poland emerged from a government-controlled and financed health care system, quality standards, cost reduction and equipment upgrades add to the list of burning issues which need to be addressed with Poland joining the European Community.

More than a year ago a delegation of social activists and physicians devoted to the cause of fighting breast cancer in Poland visited MUSC to gather information on ways to lower the rates of breast cancer morbidity and mortality among that country’s women. One of the issues raised at that visit was the lack of quality standards for mammography equipment and quality assurance processes within Polish health care institutions.

Stan Trojanowski, a Polish native and at that time manager of MUSC’s Department of Biomedical Engineering, led the initiative to provide assistance. Biomedical Engineering, among others, is responsible for service of mammography and other radiologic equipment. Trojanowski sought the help of MUSC’s Donald Frey, Ph.D., the Radiology Department’s director of diagnostic physics and nationally recognized specialist in mammographic equipment testing.

Meanwhile in Poland, through Maria Grochulska, who spearheads the Polish Coalition to Combat Breast Cancer, Trojanowski and Frey made contact with Kowski, a physicist-engineer who heads the Department of Medical Physics at Copernicus Hospital, a large hospital in the city of Lodz. He assumed the task of introducing quality assurance programs for all radiologic technologies, not only mammography. Kowski is also a consultant to the Polish Ministry of Health on Medical and Radiological Devices and also heads a section of clinical engineers in the Polish Radiological Society.

The benefits of quality assurance in radiology is not yet fully appreciated by the health care decision makers in Poland, Kowski explained. For that reason, his task is both legal and political. The Polish Coalition to Combat Breast Cancer started the political ball rolling, but the need for quality assurance exists for all the radiologic technologies. The legislation mandating quality assurance has yet to be passed, testing standards and procedures need to be introduced, an infrastructure of specialized physics testing laboratories need to be established, and 6,000 radiology technicians need to be trained on daily quality assurance at the grassroots hospital level.

Last June, Frey and Trojanowski were invited speakers to the 35th Congress of the Polish Radiological Society in Katowice to present the existing quality assurance techniques and processes in the United States. They made three presentations. Frey, in a plenary session, spoke to Polish radiologists about the role of the physician in the radiology quality assurance program and the benefits of such a program. Trojanowski provided two workshops for engineers and technologists sharing the quality assurance procedures and techniques in radiography and fluoroscopy.

As an invited guest of the departments of Radiology and Biomedical Engineering, Kowski’s visit is a continuation of the MUSC-Poland cooperation in exploring radiological quality assurance.

“We want to collaborate with all the best places,” Kowski said, explaining that he was gathering information from hospitals in Western Europe. “He has an advantage,” Frey said, referring to Kowski. “He doesn’t have to start out at ground zero. He can benefit from the best the United States and Europe have to offer and select the most efficient system for them.”

Kowski and Frey also discovered common ground outside radiology and biomedical engineering: they both spend their spare time working with Boy Scout troops in their respective countries.