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Flashcards

Imaging Performance and Lab Accreditation

Autumn Kilbarger Cardiovascular Sonography Inglês 61 flashcards

Flashcards do conjunto (61)

  1. 1QC is also known asQuality Assurance (QA)
  2. 2• Routine, periodic evaluation of the sonography equipment and transducer to produce the best image quality possible • Making sure that everything and everyone in the department is functioning at the highest level possible to produce the best quality of work • Ultimately the responsibility of the sonographerQuality Control
  3. 3• Testing image performance of all US units and transducers • Check expiration dates • Schedule preventative maintenance • Minimum of twice a year per accreditation • Must document any PM or service • Compliance in record keeping/reportsQC/QA
  4. 4• Clean US machine filters regularly • Cross reference radiology, surgery and other reports with US findings • Do statistical analysis comparing exams with Gold standards • Cleaning transvaginal and TEE probes properly and within the guidelinesQC/QA
  5. 5Testing US Performance *includes :2D and Doppler instruments
  6. 62 groups of testing devices:• Devices that test the imaging performance
    • Devices that measure the acoustic output
  7. 7• Considers the entire operation of the instrument *how the US unit and transducers are performing, anatomic imaging and flow performance • Important for evaluating the instrument as a diagnostic toolDevices that test the imaging performance
  8. 8• Pressure, power and intensity • Considers only the beam former and transducer working together as the “instrument” • Important when considering bioeffects and safetyDevices that test the acoustic output
  9. 9Imaging Performance Determined by measuring primarily the following parameters:• Detail resolution
    • Contrast resolution
    • Penetration and dynamic range
    • TGC operation
    • Accuracy of depth and distance measurement
  10. 10Two different devices are used for testing image performance:• Tissue equivalent phantoms (TE Phantom)
    • Test objects
  11. 11• Use these today to evaluate • Made of graphite gel or urethane rubber • Typically contain anechoic areas and nylon fibers • May also contain cones or cylinders that appear hyper/hypoechoic • Have built in tissue characteristicsTE Phantom
  12. 12TE Phantom • Have built in tissue characteristics:• scattering
    • attenuation
    • prop speed-1540 m/s
    • echogenicity
  13. 13• Do not simulate tissue • Usually water filled to conduct sound • 3 typesTest Objects
  14. 14Test Objects 3 types:*Beam Profile Slice Thickness test object
    *Particle Image ResolutionTest Object (PIRTO)
    *AIUM 100mm Test Object
  15. 15• Shows beam width within and perpendicular to the scan plane *section thickness • Used to evaluate elevational resolutionBeam Profile Slice Thickness Test Object
  16. 16a type of test object that • Shows detail resolutionParticle Image Resolution Test Object (PIRTO)
  17. 17• First imaging performance device made • .75 mm diameter stainless steel rods • Fluid filled • Propagation speed of 1.54 mm/µs at room temperature • Does not evaluate tissue/grayscale • Evaluates accuracy of the systemAIUM 100 mm Test Object
  18. 18what type of fluid is involved with AIUM 100 mm Test Objectalcohol, water and algae inhibitor
  19. 19Performance Measurements:• Sensitivity (Minimum and Normal)
    • Axial resolution
    • Lateral resolution
    • Depth calibration (Range Accuracy)
    • Dead zone
  20. 20• Smallest amount of gain required to visualize a pin located deep into the test objectMinimum Sensitivity
  21. 21• Setting the gain to visualize ALL the pinsNormal Sensitivity
  22. 22• Spacing between the rods varies at 5,4,3,2,1 mm from top to bottom • If 5 of 6 rods are imaged , axial resolution is 2mm • The smallest separation between rods= ________Axial Resolution
  23. 23AR is evaluated when pins are _____ to the beamparallel
  24. 24AR you scan rod group ______ from side ____B from A
  25. 25• Spacing between the rods varies at 25, 20, 15, 10, 5, 3 mmLateral Resolution
  26. 26• If the last two rods are distinguished, lateral resolution is _____3mm
  27. 27LR is evaluated when pins are _____ to the sound beamperpendicular
  28. 28LR scan rod group _____ from side _______C from E
  29. 29• Checks the ability to accurately measure distances • Rods are equally spaced 20 mm apart • Placing calipers at the first and last rod, the distance should be 10 cmDepth Calibration (Range Accuracy)
  30. 30A difference of +/- _____ indicates defective depth calibration2 mm
  31. 31To evaluate ______ the distances of the reflections on the display are compared to the actual distances on the test objectdepth
    calibration
  32. 32depth calibration vertically scan rod group ___ from side _____E from A
  33. 33depth calibration horizontally (perpendicular to beam) scan rod group _____ from side ______D from A
  34. 34• This test is used to determine near field resolution • Refers to the portion of the beam closest to the transducer face in which imaging cannot be performed • Rods are located 2, 4, 6, 8, 10 mm from the surface of the test object • The depth of the rod that can be imaged closest to the surface indicatesDead Zone
  35. 35Dead Zone scan rod group ____ from side _____A from A
  36. 36• Sensitivity (Minimum and Normal) • Axial resolution • Lateral resolution • Depth calibration (Range Accuracy) • Dead zone can all be tested with what:Test Object or TE Phantom
  37. 37______ can also evaluate compensation, penetration, dynamic range and dynamic focusingTE Phantoms
  38. 38Testing Doppler Performance Useful for testing:• Penetration of the Doppler beam
    • Accuracy of the SV location
    • Accuracy of flow speeds
    • Ability to discriminate between flow direction
  39. 39Types commonly used to test Doppler performance:• Doppler Flow phantom
    • String test object (Vibrating String)
    • Moving belt phantoms
  40. 40• Checks accuracy of flow speeds on spectral analysisString Test Object
  41. 41• Tissue characteristics and flow mimicking liquid • Contains a pump that forces fluid through “vessels” • Tests the accuracy of PW, CW and color flowFlow Phantom
  42. 42• Normally performed by engineers or physicists, not sonographers • The device used is a hydrophone, also called a microprobe • A hydrophone is usedTesting Acoustic Output
  43. 43when Testing Acoustic Output A hydrophone is used in forms of*a small transducer element mounted on the end of a large
    hollow needle
    *a large piezoelectric membrane made of polyvinylidene
    fluoride (PVDF)
  44. 44• The hydrophone is attached to an ______ for displayoscilloscope
  45. 45• The hydrophone is attached to an oscilloscope for display • From the display, calculations for period, PRP and pulse duration can be made • From these calculations, frequency, PRF and duty factor can be determinedTesting Acoustic Output
  46. 46• Pressure, amplitude, wavelength, SPL and intensity can also be calculated • Intensity outputs are measured as SPTA intensity (mW/cm2 ) important to evaluate output/intensities to make sure safe • Lowest output intensity is real-time (2D) and highest is CW spectral Doppler *M mode, color Doppler and PW Doppler are in betweenTesting Acoustic Output
  47. 47• Method of self evaluation for improving and strengthening ultrasound practice • Participation in accreditation is voluntary • Accreditation is a peer review processLab Accreditation
  48. 48Why is lab accreditation important?• Sets a minimum standard
    • Recognizable standard
    • Improves patient care quality
    • Voluntary involvement may deter federal regulation
  49. 49Who offers accreditation?• American College of Radiology (ACR)
    • Intersocietal Accreditation Commission (IAC)
    • American Institute of Ultrasound in Medicine (AIUM)
  50. 50what areas are under American College of Radiology (ACR):• Obstetrics
    • Gynecology
    • General (abdomen)
    • Vascular
    • Breast (diagnostic and interventional)
  51. 51Sonographer Criteria ACR• RDMS or eligible
    • Must be RDMS by renewal for accreditation
    • At least 1 RVT if applying for vascular accreditation
  52. 52IAC-Vascular areas include:• Extracranial Cerebrovascular
    • Intracranial Cerebrovascular
    • Peripheral Venous
    • Peripheral Arterial
    • Visceral Vascular
  53. 53Sonographer Criteria IAC-Vascular• RDMS or eligible
    • Must be RDMS by renewal for accreditation
    • Technical directors must be RVT
  54. 54IAC-Echocardiography focused areas:• Adult Echo
    • Adult TEE
    • Adult Stress
    • Pediatric Echo
    • Pediatric TEE
    • Fetal Echo
  55. 55Sonographer Criteria IAC-Echo• RDMS or eligible
    • Must be RDMS by renewal for accreditation
  56. 56IAC has what to areas of focusvascular and echo
  57. 57AIUM areas of focus:• Obstetrical
    • Gynecological
    • Abdominal/General
    • Breast
    • Dedicated Thyroid/Parathyroid
    • Dedicated Musculoskeletal
    • Fetal Echo
    • Urologic
  58. 58Sonographer Criteria AIUM• RDMS or eligible
    • Must be RDMS by next accreditation renewal
    • Should be credentialed in all areas requesting accreditation
  59. 59these are required for what? • requirements for Medical Director, Technical Director and Technical Staff • Protocol requirements • Volume requirements • Correlation and peer/physician review requirementsAccreditation
  60. 60Making sure that everything and everyone in the department is functioning at the highest level possible to produce the best quality workQuality Control-Accreditation
  61. 61• Testing image performance on all US units and transducers • Testing processor operation • Check expiration dates • Schedule preventative maintenance with manufacturers • Clean US machine filters regularly • Cross reference with radiology, surgery…. • Do statistical analysis comparing exams with gold standards •requires regular, periodic documentationQuality Control-Accreditation

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Cardiovascular Sonography (Sonographic Physics and Instrumentation 2) FlashCards sobre Imaging Performance and Lab Accreditation, criado por Autumn Kilbarger em 24-02-2020.
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