The Conference of Radiation Control Program Directors, Inc. (CRCPD) is an organization made up of the radiation control programs in each of the 50 states, the District of Columbia, and Puerto Rico, and of individuals, regardless of employer affiliation, with an interest in radiation protection. The primary purpose and goal of CRCPD is to assist its members in their efforts to protect the public, radiation worker, and patient from unnecessary radiation exposure. CRCPD also provides a forum for centralized communication on radiation protection matters between the states and the federal government, and between the individual states. One method of providing assistance to the states, as well as to other interested parties, is through technical and administrative publications. Most technical publications of CRCPD are written by various committees, task forces or special working groups. Most administrative publications are written by staff of the Office of Executive Director (OED). CRCPD's mission is "to promote consistency in addressing and resolving radiation protection issues, to encourage high standards of quality in radiation protection programs, and to provide leadership in radiation safety and education." This particular publication, Computed Radiography and Digital Radiography State X- Ray Inspection Protocol, contains survey procedures developed by CRCPD’s H-33 Task Force for the Inspection Protocol of Diagnostic X-ray Facilities Using CR/DR Technology. The intention is to provide guidance for state inspectors to test phototimed radiographic X-ray equipment that use CR and DR imaging systems. Measuring skin entrance exposure (ESE) for the AP abdomen, AP lumbar spine and PA chest is emphasized since the ESE in these digital modalities is sometimes higher than for a standard 400-speed film-screen system. Suggestions are given in the document to help a facility lower the ESE without adversely affecting image quality. CRCPD H-33 Task Force for the Inspection Protocol of Diagnostic X-Ray Facilities Using CR/DR Technology, Computed Radiography and Digital Radiography State X- Ray Inspection Protocol, CRCPD Publication # E-10-2, (January 2010) (26 pp). This protocol contains written guidance that state x-ray inspectors could use during the routine inspection of diagnostic x-ray facilities using CR/DR technology. The document addresses the collection of ESE (entrance skin exposure, i.e., patient exposure) measurements for some of the common projections on phototimed equipment, and provides expected values for these projections when CR/DR is used. Ask the technologist to set the SID at the distance commonly used for the exam and to set the techniques for an average-sized male AP view abdomen or lumbar spine. Be sure to center the tube over the image receptor both longitudinally and laterally. For a CR system, you or the technologist may have to insert a CR cassette into the bucky tray in order to allow the system to activate. Record the SID and the technique factors. Check exposure index numbers for proper exposure (see Appendix E attached). Verify the index number obtained with your phantom exposure. The acquisition monitor may display this value or it usually can be obtained from the digital image. Find out what the exposure index (EI) target range is supposed to be (usually provided to the facility by the vendor). What is the facility’s procedure when Exposure Indices fall significantly below the guideline, and also above the guideline? Remember that some manufacturers have an exposure index system set up inversely so that a higher EI means LESS radiation exposure. You will acquire ONE hardcopy image of the phantom with the test tool. For CR surveys inform the technologist that you will require one imaging plate of a size appropriate for routine adult abdomen exams.