Overview of Safety Code 35

Transcription

1 Common Quality Control Procedures for All s Quality Control Procedures Film All s Daily Quality Control Tests Equipment Warm-up (D1) According to manufacturers instructions Can include auto calibration(d1) Meters Operation (D2) Meter, visible and audible indicators should function Equipment Conditions (D3) Visual inspection for loose or broken components, ease of movements Darkroom Cleanliness (D5) (M DAP) Film Processor Function (D6) Overall Visual Assessment of Electronic Display Devices (D7) (M DAP) Display SMPTE or QC pattern for general image quality of all Radiologists workstations Quality Control Procedures All s Weekly Quality Control Tests View box condition (W2) Visual inspection for cleanliness, colour, illumination Print pattern such as SMPTE or PQC Laser Film Printer Operation (W3) Check for 0/5% and 95/100% patch visibility OD of 10% to 90% patches No artifacts or geometrical distortion Monthly Quality Control Tests Darkroom Temperature and Humidity (M2) Temp: C; Humidity 40-60% Darkroom Light Conditions (M3) Visual check for light tightness Film Processor Operation (M4) Temp ±0.5 C; Developer and fixer correct (M DAP) Electronic Display Device Performance (M6) Display pattern such as SMPTE or QC on all image display stations Laser Film Printer Operation (M7) As W3 plus measurement of optical density of the 10% to 90% grey scale

2 Quality Control Procedures All s Quarterly Quality Control Tests Interlocks (Q2) These are not usually used on diagnostic doors Annual Quality Control Tests Safelight Test (Y1) Expose film for 2 min View boxes (Y26) Check luminance, uniformity, homogeneity, ambient light Electronic Display Device All clinical workstations must be calibrated for Performance (Y27) luminance, distortion, resolution and noise Integrity of Protective Equipment Lead aprons, glasses, integral shields (Y28) General Preventive Maintenance As per manufacturer (Y29) Acceptance testing Baseline value determination Device use period Next constancy testing Data evaluation PASS Within the established criteria FAIL Remedy 2

3 Radiographic QC Tests Quality Control Procedures Film CR DR Comments Weekly Quality Control Tests Visual Inspection of Cleanliness of Imaging W1 W1 W1 Inspect screens/cr plates/dr housing s View boxes Condition W2 W2 W2 Cleanliness, luminance Laser Film Printer Operation W3 W3 Print pattern such as SMPTE Monthly Quality Control Tests Cassette, Screen, and Imaging Plate Cleaning M1 M1 Clean screens/cr plates/dr housing Darkroom Temperature and Humidity Conditions (DAP) M2 Temp: C; Humidity 40-60% Darkroom Light Conditions M3 Check for light tightness Film Processor Operation M4 Temp ±0.5 C; Developer and fixer correct Retake Analysis M5 M5 For film, collect discards; for CR use M5 Electronic Display Device Performance M6 M6 M6 Laser Film Printer Operation M7 M7 M7 manufacturers software; DR? Display pattern such as SMPTE on all image display stations Print pattern such as SMPTE Check for 0/5% and 95/100% patch visibility OD of 10% to 90% patches. No artifacts or geometrical distortion Annual QC Tests (1) Safelight Test Y1 Film/Screen Contact Y2 Accuracy of Loading Factors Y3 Y3 Y3 mas Linearity Radiation Output Reproducibility Y4 Y4 Y4 Reproducibility Radiation Output Linearity Y5 Y5 Y5 Output with mas X-ray Beam Filtration Y6 Y6 Y6 HVL Automatic Exposure Control Y7 Y7 Y7 Check AEC for all kvps and thicknesses X-ray Field and Light Field Alignment Y8 Y8 Y8 X-ray Beam Collimation Y9 Y9 Y9 Image Quality Grid Performance Exposure Index Noise, Uniformity and Image Artifacts Congruency of x-ray beam and light field edges Congruency of x-ray beam and light field centers Y10 Y10 Y10 Check uniformity and movement of grid Y12 Y12 Exposure Index versus Dose 1 to 50 mgy For above range of dose measure noise in Y14 Y14 center and each quadrant Check for artifacts 3

4 Quality Control Procedures Film CR DR Comments Spatial Resolution Y15 Y15 Y15 Line-pair or Leeds phantom Contrast Detectability Y16 Y16 Y16 Leeds phantom Digital Detector Residual Take image at 50 mgy then zero; Y17 Y17 Images check for artifacts Measure dose at surface of standard Phantom Dose Measurements Y18 Y18 Y18 phantom e.g. 20 cm PMMA DAP Meter Calibrate Radioscopic QC Tests Quality Control Procedures DF Radioscopic Weekly Quality Control Tests Visual Inspection of Cleanliness of Imaging s W1 W1 Laser Film Printer Operation W3 W3 Digital Subtraction Angiography Performance Use phantom to check consistency (W7) Quarterly Quality Control Tests Protective devices (Q6) Lead skirts, lead glass, etc Table angulation and motion (Q3) Compression devices (Q4) Timer (Q5) Annual Quality Control Tests Safelight Test Y1 Y1 Film/Screen Contact Y2 Y2 Accuracy of Loading Factors Y3 mas Linearity Radiation Output Reproducibility Y4 Reproducibility Radiation Output Linearity Y5 Output with mas X-ray Beam Filtration Y6 HVL X-ray Field and Light Field Alignment Y8 Congruency of x-ray beam and light field edges X-ray Beam Collimation Y9 Congruency of x-ray beam and light field centers Phantom Dose Measurements Y18 Measure dose at surface of standard phantom e.g. 20 cm PMMA Typical Image Intensifier Air Kerma Rate Y19 e.g. 20 cm PMMA, Al or Cu Maximum Image Intensifier Air Kerma Rate Y20 With detector blocked by lead Automatic Intensity Control Y21 Tracking of detector dose with phantom thickness 4

5 Quality Control Procedures DF Radioscopic Annual Quality Control Tests Image Quality Grid Performance Y10 Check uniformity and movement of grid Exposure Index Noise, Uniformity and Image Artifacts Spatial Resolution Contrast Detectability Digital Detector Residual Images Quality Control Procedures Weekly QC Tests CT Number Accuracy CT Noise CT Uniformity Monthly QC Tests Electronic Display Devices Performance CT Tomographic Section Thickness Y12 Exposure Index versus Dose 1 to 50 mgy For above range of dose measure noise in center Y14 and each quadrant Check for artifacts Y15 Line-pair or Leeds phantom Y16 Leeds phantom Take image at 50 mgy then zero; Y17 check for artifacts Computed Tomography QC Tests CT s Check CT number water 0 ±4 HU (W4) Image noise in center of water phantom ±10% from baseline value (W5) Check CT number in center and 4 quadrants ±10% from baseline value (W6) All device used to display digital images use pattern SMPTE Slice thickness should be ±0.5 mm from baseline value (M8) Check CT number water 0 ±4 HU and air 1000 ±10 HU Calibration of CT Number (M9) CT Number Linearity Check CT number over CT range to (M10) Quarterly QC Tests Interlocks (Q2) Error? Interlocks are seldom used on CT scanner doors CT Patient Support Check table movement corresponds to digital display ±1 mm Movement (Q8) CT Spatial Resolution Measure MTF or line pair phantom (Q9) CT Low Contrast Detectability Q10 Semi-annual QC Tests CT Laser Light Accuracy Check laser light vs. X-ray beam with phantom(sy1) CT Accuracy of Automatic Positioning of Tomographic Check localization scan corresponds to digital display ±2 Plane (using the scanned mm (SY2) projection radiograph) CT Accuracy of Gantry Tilt SY3 CT Patient Dose Check CTDI ±20% from baseline values (SY4) 5

6 Quality Control Procedures Annual QC Tests CT Number Dependence on Phantom Position CT Radiation Dose Profile CT Radiation Dose Scout Localisation Image General Preventive Maintenance CT s Check CT number water 0 ±5 HU for possible patient positions in the gantry(y23) Y24 Radiation Dose for Localization Image within 20% of baseline value (Y25) Biomed PMs must be performed (Y29) Tests for Acceptance Testing Acceptance Testing Filmbased CR DR Radioscopic CT 1.0 Identification 1.1 Initial Inspection and Inventory X X X X X 1.2 Inspection of Documentation X X X X X 2.0 Visual and Functional Texts 2.1 Mechanical Properties X X X X X 2.2 Safety s X X X X X 3.0 Performance Evaluation (X-ray Generator) 3.1 X-ray Tube Voltage X X X X X 3.2 Current Time Product X X X 3.3 Loading Time X X X 3.4 Radioscopic Timer and Chronometer X 3.5 Beam Limitation and Indication X X X X X 3.6 X-ray Beam Filtration X X X X 3.7 Automatic Exposure Control X X X 3.8 Automatic Intensity Control X X 3.9 Radiation Output X X X X X 3.10 Maximum Air Kerma Rate X 3.11 Phantom (Entrance) Dose (Rate) X X X X X 4.0 Performance Evaluation (Image Receptor) 4.1 Exposure Index X X 4.2 Dynamic Range X X X 4.3 Spatial Resolution X X X X X 4.4 Contrast Detectability X X X X X 4.5 Uniformity X X X 4.6 Artifacts X X X X X 4.7 Digital Detector Residual Image X X 4.8 Noise X X X 6

7 Tests for Acceptance Testing Filmbased CR DR Radioscopic CT 4.9 Modulation Transfer Function X X 4.10 Mean CT Numbers (calibration and linearity) X 4.11 Tomographic Section Thickness X 4.12 Axial Patient Positioning Accuracy X 4.13 Positioning of Patient Support X Radiographic Exam Projection Diagnostic Reference Levels DRL Gy.cm 2 Generalized Conversion Coefficients DAP to Effective Dose msv per Gy.cm2 Skull PA Lat AP C Spine PA 0.2 Lat 0.03 Shoulder AP 0.04 Chest PA Lat AP 0.2 T Spine Lat AP L Spine Lat AP LSJ Lat Kidneys PA 0.1 AP 0.2 Abdomen PA AP R hip AP 0.15 L hip AP 0.2 Pelvis AP

8 Complete Exam Fluoroscopy DRL Gy.cm 2 DAP to E Time minutes Barium Swallow Barium Meal Ba follow thru Barium enema Femoral angio Hysterosalpingiography 3 1 IVP MCU Nephrostography Retro Pyelogram Sialography T tube cholangiogram Sinography Small bowel enema Venography leg Coronary angiography Fistulography Complete Exams Fluoroscopy DRL Gy.cm 2 DAP to E Time minutes Biliary Drainage Facet joint injection Hickman line Nephrostomy Esophageal stent Esophageal dilation Pacemaker PTCA single stent