Implementation of the 2012 ACR CT QC Manual in a Community Hospital Setting

42 Pages·2013·4.47 MB·English

Implementation of the 2012 ACR
CT QC Manual in a Community
Hospital Setting
BRUCE E. HASSELQUIST, PH.D., DABR, DABSNM
ASPIRUS WAUSAU HOSPITAL
Conflict of Interest Disclaimer
Employee of Aspirus Wausau Hospital

ACR Activities

Reviewer for CT accreditation program (physics)

Reviewer for NM accreditation program (physics)

Member Medical Physics Guidelines Committee

No conflicts to disclose

Objectives
Review the major elements of the 2012 ACR QC

manual
Compare the manual to current ACR accreditation

program and phantom testing requirements and to
the current technical standard
Highlight some interesting details of the new

physicist testing recommendations
2012 ACR CT Quality Control Manual
Table of Contents

Radiologist’s Section

Definitions of QA and QC

Responsibilities

Radiologic Technologist’s Section

Daily QC

Weekly QC

Monthly QC

Medical Physicist’s Section

Annual QC

http://www.acr.org/~/media/ACR%20No%20Index/Documents/Random/2012CTQCManual2.pdf
To be accredited by the ACR
“Effective 12/01/2013, all facilities applying for
accreditation must maintain a documented QC program
and must comply with the minimum frequencies of
testing outlined in the 2012 ACR Computed Tomography
Quality Control Manual.”
Page 4: 2012 ACR CT QC Manual
What’s Mandatory?
Should’s (177 instances!) Must’s (35 instances!)
Acceptance testing before 1st Maintain documented QC program
 
patient scanned
Comply with minimum testing

Equipment evaluation dated frequencies

within 1 year at renewal
QMP oversees QC program

Evaluation after major repairs,
 QMP monitors performance at

incl x-ray tube and detector
installation and annually
assembly replacement
Annual equipment evaluation

Refer to state and local
 submitted initially and at renewal
regulations if more restrictive
Evaluation dated within 14 months

Greater frequently for QC tests
 at renewal
when being introduced or results
Evaluation performed by a QMP

inconsistent.
Annual QMP review of tech QC

Records accessible from CT

records (qtly preferred)
scanner location
Quality Assurance
is a comprehensive concept to ensure that:
1. Every imaging procedure is necessary and appropriate to the clinical
problem at hand;
2. The combination of acquisition parameters used for each exam is
appropriate to address the clinical question;
3. The images generated contain information critical to the solution of
that problem;
4. The recorded information is correctly interpreted and made available in
a timely fashion to the patient’s physician; and
5. The examination results in the lowest possible risk to the patient and is
consistent with Objective 2 (above).
Quality Control
is a series of distinct technical procedures
Four steps are involved:
1. Acceptance testing to detect defects in equipment that is newly installed
2. Establishment of baseline equipment performance
3. Detection and diagnosis of changes in equipment performance before
they become apparent in images
4. Verification that the causes of deterioration in equipment performance
have been corrected
(Supervising) Radiologist
 “Radiologists must assume the primary responsibility for
the quality of CT and for the implementation of an
effective QA program at their site.”
 Convene a CT QA or Protocol Review Committee
Oversees QA program

Sets goals and directions

Determines policies

Assesses effectiveness of QA activities

 Assist with development of CT QA Manual
 Participate in “Interpretive Quality Assurance”
aka peer review

Quality Assurance Committee
• Design and review all new or modified CT protocol settings to ensure
that both image quality and radiation dose are appropriate
• Develop internal radiation dose thresholds during any new CT protocol
design.
• Implement steps to ensure patient safety and to reduce future risk if an
estimated dose value is above the applicable threshold for any routine
clinical exam
• Review, at least annually, all protocols to ensure no unintended
changes have been applied that may degrade image quality or
unreasonably increase dose
• Establish a policy stating that the CT dose estimate interface option is
not to be disabled and that the dose information is displayed during the
exam prescription phase