RIO® Grande Physics Goal:
Is to assist our clients in establishing performance standards consistent with the American College of Radiology (ACR) and the American Association of Physicist in Medicine (AAPM) for Radiographic and Fluoroscopic equipment to ensure high-quality diagnostic images are obtained and are consistent with the clinical use of the CT equipment.
Encourage our clients to achieve ACR accreditation for this unique and important imaging modality.A. Annual performance checks of your Fluoro system are performed on each unit to include, but not be limited to, the following:
- Integrity of unit assembly
- Collimation and radiation beam alignment
- Fluoroscopic system resolution
- Automatic exposure control system performance
- Image artifacts
- Fluoroscopic phantom image quality
- KVp accuracy and reproducibility
- Linearity of exposure vs. mA
- Exposure reproducibility
- Timer accuracy
- Beam quality assessment (half-value layer)
- Fluoroscopic exposure rates
- Image receptor entrance exposure
- Fluoroscopic alignment test
- Equipment radiation safety functions
- Patient dose monitoring system calibration, if present
- Video and digital monitor performance
- Digital image receptor performance.
B. Monitoring of Technologist’s Quality Control Program. The following aspects of a technologist’s quality control program shall be reviewed as deemed applicable:
- Appropriateness of technique factors
- Dark-room and screen cleanliness
- Processor quality control
- Film-screen speed matching
- Viewboxes and viewing conditions
- Phantom images
- Visual equipment checklists
- Repeat analysis
- Analysis of fixer retention
- Darkroom fog
- Screen-film contact
- Laser film printer quality control
- Personnel radiation monitoring.
C. Radiation Dose and Patient Safety
Patient radiation dose shall be evaluated for radiographic and fluoroscopic equipment at least annually. Tables of patient radiation exposure for representative examinations shall be prepared and supplied to the facility. These tables shall be prepared using measured radiation output data and imaging techniques provided by the facility. These results shall be compared with appropriate guidelines or recommendations when they are available.
Equipment must provide fluoroscopic image quality and recording (film, video, or digital) capability that is
adequate for the procedures performed. Fluoroscopic equipment requirements for specific radiologic
examinations are found in the guidelines or standards for those examinations. Equipment incapable of operating at tube voltages of at least 100 kVp must not be used for examinations other than for distal extremities. Equipment performance monitoring should be in accordance with the ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic and Fluoroscopic Equipment. New fluoroscopic systems used for vascular imaging procedures and systems capable of radiation exposure
rates greater than 10 roentgens per minute at a distance of 30 cm from the image intensifier should be provided with automated means of determining and displaying dose or dose-area-product to the physician guiding the fluoroscopic procedure.
D. Establishment of a daily, weekly, monthly, and quarterly Quality Control Program (QCP) for each fluoro unit. The frequency and performance of QCP testing based on the ACR and AAPM recommendations.
The medical physicist regularly performs radiation measurements, dosimetric calculations, and equipment performance evaluations of fluoroscopic equipment of the types being used in sufficient numbers to maintain competence in the performance of these activities. The medical physicist must be familiar with the principles of imaging physics, radiation dosimetry, and radiation.
Policies and procedures related to quality, patient education, infection control, and safety should be developed and implemented in accordance with the ACR Policy on Quality Control and Improvement, Safety, Infection Control, and Patient Education Concerns appearing elsewhere in the ACR Practice Guidelines and Technical Standards book.
