Art Of Imaging Critique/ Quality Managent Flashcards by Lizeth Rodriguez

What are the three steps in an effective image critique?

Classification of the image
Determination of the cause of the problem
Recommendation of the corrective action

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What is the first step when looking at an image? The radiographer needs to determine if the image is

Acceptable or unacceptable

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When determining the cause of the problem, there are three categories to classify an issue. What are those three major categories?

1.Technical problem
2. Procedural factor problem
3. Equipment malfunction problem

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Factors that influence the cause of the problem:
Technical Factors

IR exposure
Exposure Indicator
Contrast
Detail
Distortion

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Factors that influence the cause of the problem:
Procedural Factors

Patient Preparation
Patient Position

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Factors that influence the cause of the problem:
Equipment Malfunction

Processing
Radiographic tube/table
Fluoroscopic tube/table

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Quality assurance includes each of the following…

Equipment maintenance
Radiology reports accuracy
Scheduling

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The larges hospital accreditation agency is the…

The Joint Commission

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The Joint Commission approval is linked to ____ reimbursements.

Federal
State
Insurance company

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Input for the purchase of new radiographic equipment should include the…

Radiologists
Radiographers
Administrators

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Installation and acceptance testing of equipment is the responsibility of the:

Radiology equipment vendor

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Routine quality management procedures should be preformed by the:

Qualified radiographer

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What quality control should be done on a regular, ongoing basis?

Image repeat analysis

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Each of the following monitoring tests should be done on a semiannual basis:

Focal spot size estimation
Collimator accuracy
Kilovoltage Accuracy

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Test tools for focal spot size estimation include each of the following

Pinhole camera
Star test pattern
Line pair resolution

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Focal spots measuring 0.3 mm or less should be measured with a

Start test pattern

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Focal spots measuring 0.3 mm or more should be measured with a

Pinhole camera

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Which type of equipment is used to measure half-value layers?

DUKE chest phantom

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When testing collimator accuracy, an SID error of ____ is allowed.

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The centering mark should be within ____ of the light field central ray.

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Distance indicators are checked with a

Tape measure

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A generator must be recalibrated when the kVp drifts beyond ____ kVp of the labeled setting.

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The accuracy of single-phase generator time settings can be measured with a

Computerize dosimeter

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A thorough reject analysis program would include data collection on images produced

By each technologist
In each radiographic room
By service engineers

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Exposure time settings should be maintained within ____ of the labeled setting.

+ or - 5 percent

The source-to-skin distance limit for a stationary fluoroscopic unit is ____ inches.

Tomographic system uniformity and completeness of motion are tested with a

lead mask with a pinhole.

Tomographic systems should be tested for each of the following

Completeness of motion Section depth indicator accuracy Section thickness accuracy

Most AECs utilize a ____ ion chamber combination.

Three

Computerized storage and transmission systems for digitized images of all types are called

PACS

The accuracy of mA stations on a radiographic generator:

1. Should be measured after the timer and kVp accuracy have been confirmed 2. tend to drift as the tube ages 3. Are measured using mR/ mAs calculations across all mA stations

You have just taken a CR radiograph of a patient’s knee and the S# is 225. Unfortunately, the image has some degree of motion distortion and needs to be repeated using the same exposure settings. In repeating the image, the new image shows no motion but the S# is now 400. No changes were made to collimation, patient position, exposure techniques, etc. Based upon this new S# value,

Exposure reproducibility is suspect

A qualified x-ray service engineer should be used to evaluate and correct the following radiographic/fluoroscopic imaging features:

automatic brightness control fluoroscopic contrast image display monitor brightness/contrast AEC reproducibility

Digital detectors with a higher DQE will

produce better images of small objects with low subject contrast

A common device to measure display monitor quality and characteristics is a/an

luminance meter

An effective method to assess department image quality is to perform a repeat image analysis. This procedure will demonstrate which of the following department traits?

percent of repeat images per room percent of repeat images per radiographer

True or false: The art of image critique is the application of scientific knowledge to the analysis of an image.

True

Image critique is particularly challenging with current technology due to the problems centering around

the sophistication of the digital technologies used.

Generally speaking, the process of image analysis should start with

a review of the entire image

With film-screen radiography, the largest percentage of image quality problems center around

automatic processing.

As medical imaging continues to adopt digital imaging technologies, one of the greatest challenges for technologists regarding image analysis will be

clearly identifying the problem as a photographic vs. geometric problem with detail. identifying possible causes that may be electronic in nature. determining if postprocessing algorithms are accurate.

All of the following are related EXCEPT: exposure timer error. technical factor problem. equipment malfunction problem. procedural factor problem.

exposure timer error.

All of the following would be classified as technical factor problems EXCEPT

the presence of residual barium in the patient’s colon scheduled for an IVU exam.

Images that are grossly underexposed

will possess poor visibility of detail

Problems with radiographic/fluoroscopic equipment image quality can be kept to a minimum by

a quality control program

Static marks on a film radiographic image represents

a visibility of detail problem.

The presence of the Moire effect on an image indicates a problem with

a CR cassette and grid.

A photographic problem with visibility of detail would be likely due to

inadequate kVp

If the electronic timer of a high-frequency generator is suspect,

a qualified service engineer should be called.

A film-screen image that demonstrates too little contrast would represent

a technical factor problem.

An image is presented to the department quality control coordinator by a disgruntled radiologist that shows an asymmetrically narrowed ankle mortis on an AP projection. His dissatisfaction would be most likely classified as a

procedural factor patient positioning problem

Geometric problems dealing with distortion could be due to

x-ray tube alignment

Technical factor problems can include both

photographic and geometric problems.

An optimal diagnostic quality radiograph

is always within acceptable limits.

The three alignment factors include the

x-ray tube, part, and receptor.

True or False: Equipment malfunction involves radiographic/fluoroscopic equipment only.

false

You have just completed an AP projection of the knee using a DR detector. On review of the image, the image demonstrates a series of several, thin white lines across the bottom third of the image. One of your colleagues immediately states that the image problem is due to grid cut-off and tells you to repeat it without the use of the grid. Your response should be to

analyze the image further to look for nongrid technical issues.

An effective and reliable assessment of DR image quality, from an exposure intensity standpoint, is to

look at the Exposure Index(EI) number and reference the EI target numbers.

As you are performing a KUB on a 375 lb. male patient using AEC, the exposure terminates within 1–2 milliseconds. The DR image displayed following exposure demonstrates objectionable quantum noise. The likely cause can be classified as a(n)

equipment malfunction problem procedural problem technical problem

The presence of two opaque metallic objects in the region of C1–C2 on a lateral cervical spine projection is an example of

a procedural issue

A radiologist who complains about an inability to assess heart size on a PA chest radiograph because of patient rotation, is likely upset about

a procedural problem.

possible ethical ALARA violation

an S# of 50

AEC hits back-up mAs setting

barium still remaining in small bowel

possible explanation of image quality cues

hypothesis

equipment malfunction problem

presence of grid lines on image

poor visibility of bony trabeculae

small focal spot not selected

residual feces in bowel

improper patient preparation

image receptor alignment problem

image cut-off along the long dimension of a cassette

Art Of Imaging Critique/ Quality Managent Flashcards

(69 cards)