ACR Ultrasound PM / Standards

ACR Accreditation This accreditation program involves the following: Acquisition of clinical ultrasound images. Personnel qualifications must be met for both physicians and technologists. The submission of physician reports related to the ultrasound images. Quality Control Program must be in place for each ultrasound system in the facility.

ACR Accreditation Changes New for 2014 Different forms New tests / verifications New mandatory frequency of testing

Sensitivity/Penetration Testing To perform system sensitivity/penetration test, the following parameters should be selected: • Maximum transmit power. • Proper gain and TGC (time gain control) to produce an image in the far field. • Transmit focus set as deep as possible. The maximum depth of visualization represents system’s penetration capability.

Sensitivity/Penetration Testing Measure to the noise floor

Image Uniformity Testing To perform image uniformity test, adjust TGC / DGC and gain settings to obtain an image as uniform as possible. Note on the QC/Preventative maintenance form any of the following: Dropouts Vertical or radial streaks Reduction in brightness near edges of the scan Brightness transitions between focal zones

Image Uniformity Testing Image artifact in near field of probe Probe array? Probe cable? Probe pins/connector? Connector board? Front end board?

NEW: Geometric Accuracy Commonly involves use of the scanner calipers to measure known distances between test targets. Measurement is required only in the mechanically scanned directions The caliper readout of the distance between these two targets agrees to within 1.5 % or 1.5 mm, whichever is greater both axially (vertically) and laterally (horizontally)

Geometric Accuracy

NEW: Scanner Electronic Image Display Performance Display characteristics that are evaluated may include gray scale response and luminance calibration, presence of pixel defects, and overall image quality Completed Not Completed

NEW: Primary Interpretation Display Performance Display characteristics that are evaluated may include gray scale response and luminance calibration, presence of pixel defects, and overall image quality Completed Not Completed N/A (Only required if located at the facility where ultrasound is performed.)

LCD Visual Inspection Brightness. Color clarity. Dead pixels. Details of the image should not be difficult to see or dull. Color clarity. Colors should be brilliant and dissimilar. Dead pixels. Dead pixels are acceptable around the outer perimeter of the screen out of the viewing area. General inspection. Monitor should not have abnormalities in display area. Utilize grayscale bar to ensure all shades of gray are displayed. Whites should be white but not blooming.

Assurance of Electrical/Mechanical Safety Make sure all cords and cables are intact Make sure all transducers are intact without cracks or delaminating Verify all transducers are being cleaned after each use Make sure the image monitors are clean Verify air filters are clean Make sure the wheel locks are in working condition Make sure the wheels are fastened securely to the US unit and they rotate easily Make sure all accessories (VCR, cameras, etc.) are fastened securely to the US unit

New Forms for ACR Compliance Summary page

New Forms for ACR Compliance ACR worksheet page 1

New Forms for ACR Compliance ACR worksheet page 2

Frequency Annual Surveys are complete tests performed once a year by the medical physicist or designee to assess the performance of the equipment. Although the Annual Surveys include all of the same tests conducted during routine QC testing, it is intended to be more extensive. In addition, Annual Surveys include an evaluation of the facility’s routine QC program, if applicable. Routine QC testing is less extensive and is recommended to be performed semiannually by the facility’s sonographer (or a service engineer).

What is the benefit of a Conquest PM?

Customer Interview during a PM Start your PM by talking to the customer and end it with talking to the customer. Make sure you address all of your customer’s concerns before you leave the site. If you have to come back to finish the job, communicate that to the customer.

System Configurations Print/capture DICOM settings Print/capture licensed options/encrypted strings Print/capture system S/N, SW revision, HW revision, system type, supported applications and PCB configuration. Back up user presets and peripheral settings.

Mechanical / Visual Inspection Perform visual inspection on the ultrasound system paying close attention to its user interface, trackball, lights, probes, casters, break assembly and peripherals. Inspect system’s display and peripherals and make sure they are securely attached to the ultrasound unit. Inspect and clean all air filters

Electrical / Safety Inspection

Transducer Leakage

Completing the PM Document the outcomes of the PM. If the PM is not completed because of system/probe concerns, document your recommendations to resolve these issues on the PM report. Fill out a complete PM service report with customer name, system type, and system serial number. Discuss with the customer any items that need further attention Attach a PM verification label to the system Get a customer signature

Questions?