AAPM Task Group Report 272: Comprehensive acceptance testing and evaluation of fluoroscopy imaging systems

Abstract

Modern fluoroscopes used for image guidance have become quite complex. Adding to this complexity are the many regulatory and accreditation requirements that must be fulfilled during acceptance testing of a new unit. Further, some of these acceptance tests have pass/fail criteria, whereas others do not, making acceptance testing a subjective and time‐consuming task. The AAPM Task Group 272 Report spells out the details of tests that are required and gives visibility to some of the tests that while not yet required are recommended as good practice. The organization of the report begins with the most complicated fluoroscopes used in interventional radiology or cardiology and continues with general fluoroscopy and mobile C‐arms. Finally, the appendices of the report provide useful information, an example report form and topics that needed their own section due to the level of detail.

Understanding entrance‐air‐kerma as a quality‐control metric for dual‐energy x‐ray absorptiometry

“…For general x‐ray and fluoroscopy applications, the typical regulations at the federal and state levels in the United States require that vendor‐reported radiation output (EAK, DAP, or kerma‐area‐product, KAP) be within ±35% of what is measured 21 . There is currently not a similar requirement for DXA in the United States; however, our results show that many of the reported EAK values in this study would not fit within such requirements.…”

Performance evaluation of two interventional fluoroscope suites for cardiovascular imaging

“…Although somewhat simplistic, the methods used in the current study are of low cost, easily reproducible, and provide a relatively comprehensive overall evaluation of the systems. In addition, these methods of SNR, CNR, and motion assessment align with recommendations put forth in the report of AAPM Task Group 272 on acceptance testing and evaluation of fluoroscopy imaging systems 19 …”

“…In addition, these methods of SNR, CNR, and motion assessment align with recommendations put forth in the report of AAPM Task Group 272 on acceptance testing and evaluation of fluoroscopy imaging systems. 19 …”

“…Patient entrance surface dose for a patient with skin located at the PERP was estimated using backscatter factors and air-tissue conversion factors as documented by Benmakhlouf et al 8 For SNR evaluation, flat field images of three simulated patient thicknesses (6, 9, and 12 in. PMMA) were acquired in fluoro mode at fields of view (FOVs) of 25 (27), 20 (19), and 16 (15) cm for the Artis Q (Azurion) system. The last 15 frames (2 s) of a 5-10-s exposure were saved in DICOM format.…”

AAPM Medical Physics Practice Guideline 12.a: Fluoroscopy dose management

“…Accreditation and regulatory requirements may require additional tests and establish minimum standards and frequencies for such evaluations 34 . AAPM Task Group reports, Medical Physics Practice Guidelines (MPPG), and American College of Radiology (ACR) Practice Parameters may provide guidance on test methods, expected values, and the role of the QMP and other personnel in performing these evaluations 35–39 . It is also important to establish performance baselines during acceptance testing, compare these baselines to manufacturer specifications, where applicable, and to compare future measurement values to established baselines.…”