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:
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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.
– 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
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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
Annual System Perform ance Evaluation Report
Ultrasound/Breast Ultrasound Equipm ent Evaluation Sum m ary
• Summary page
Site:
Facility UAP #:
Report Date:
Facility BUAP #:
Survey Date:
System Manufacturer:
Model:
System SN:
System ID:
Building/Room #:
Medical Physicist (or designee):
Signature:
Equipm ent Evaluation Tests
Test
Pass/Fail
1. Physical and Mechanical Inspection
2. Image Unif ormity and Artif act Survey
3. Geometric Accuracy
4. System Sensitivity
5. Scanner Electronic Image Display Perf ormance
6. Primary Interpretation Display Perf ormance*
7. Contrast Resolution (Optional)
8. Spatial Resolution (Optional)
* If located at the facility where ultrasound is performed
Medical Physicist's (or designee's) Recom m endations for Quality Im provem ent:
You
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must send ACR the entire, most recent Annual System Performance Evaluation report. It must include:
Equipment Evaluation Summary form, signed by the medical physicist (or designee)
Evaluation of Site’s Routine QC Program form, AND
All data pages from the report (not just the summary forms)
Com m ents
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?