diff --git a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
index 49a95a23e..e4360ebd4 100644
--- a/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
+++ b/IRaCIS.Core.Application/Service/Reading/Dto/ReadingImageTaskViewModel.cs
@@ -464,6 +464,9 @@ namespace IRaCIS.Core.Application.Service.Reading.Dto
     {
         public Guid VisitTaskId { get; set; }
 
+
+        public bool UpdateMark { get; set; } = false;
+
         public List<ChangeDicomReadingQuestionAnswerDto> Answers { get; set; }
 
 
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
index 6989cbb3c..78cfdeb32 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
@@ -1474,6 +1474,7 @@ namespace IRaCIS.Application.Services
         [TypeFilter(typeof(TrialResourceFilter), Arguments = new object[] { "AfterStopCannNotOpt" })]
         public async Task<IResponseOutput> SaveImageQuality(ChangeDicomReadingQuestionAnswerInDto inDto)
         {
+            inDto.UpdateMark = true;
             return await ChangeDicomReadingQuestionAnswer(inDto);
         }
 
@@ -1549,24 +1550,28 @@ namespace IRaCIS.Application.Services
             }).ToList();
             await _readingTaskQuestionAnswerRepository.AddRangeAsync(needAddAnswer);
 
-
-            var questionMarkList = await _readingTaskQuestionMarkRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId).Select(x => new
+            if (inDto.UpdateMark)
             {
-                x.QuestionId,
-                x.FirstAddTaskId,
+                var questionMarkList = await _readingTaskQuestionMarkRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId).Select(x => new
+                {
+                    x.QuestionId,
+                    x.FirstAddTaskId,
 
-            }).ToListAsync();
-            await _readingTaskQuestionMarkRepository.BatchDeleteNoTrackingAsync(x => x.VisitTaskId == inDto.VisitTaskId);
-            var datetime = DateTime.Now;
+                }).ToListAsync();
+                await _readingTaskQuestionMarkRepository.BatchDeleteNoTrackingAsync(x => x.VisitTaskId == inDto.VisitTaskId);
+                var datetime = DateTime.Now;
 
-            var markList = _mapper.Map<List<QuestionMarkInfo>, List<ReadingTaskQuestionMark>>(inDto.QuestionMarkInfoList);
-            markList.ForEach(x => {
-                x.Id = NewId.NextGuid();
-                x.VisitTaskId = inDto.VisitTaskId;
-                x.CreateTime = datetime;
-                x.FirstAddTaskId = questionMarkList.Where(y => y.QuestionId == x.QuestionId).Select(x => x.FirstAddTaskId).FirstOrDefault() ?? inDto.VisitTaskId;
-            });
-            await _readingTaskQuestionMarkRepository.AddRangeAsync(markList);
+                var markList = _mapper.Map<List<QuestionMarkInfo>, List<ReadingTaskQuestionMark>>(inDto.QuestionMarkInfoList);
+                markList.ForEach(x => {
+                    x.Id = NewId.NextGuid();
+                    x.VisitTaskId = inDto.VisitTaskId;
+                    x.CreateTime = datetime;
+                    x.FirstAddTaskId = questionMarkList.Where(y => y.QuestionId == x.QuestionId).Select(x => x.FirstAddTaskId).FirstOrDefault() ?? inDto.VisitTaskId;
+                });
+                await _readingTaskQuestionMarkRepository.AddRangeAsync(markList);
+            }
+
+            
             await _readingTaskQuestionAnswerRepository.SaveChangesAsync();
             return ResponseOutput.Ok(true);
         }