2004 aapm annual meeting diagnostic ultrasound …2004 aapm annual meeting 1 diagnostic ultrasound...

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2004 AAPM Annual Meetin 1 Diagnostic Ultrasound Physics Diagnostic Ultrasound Physics and QC Workshop and QC Workshop Randell Kruger, Ph.D., Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI Marshfield Clinic, Marshfield, WI Zhengfeng Zhengfeng Lu, Ph.D., Lu, Ph.D., Columbia Presbyterian Medical Center, New York, NY Columbia Presbyterian Medical Center, New York, NY Heather Miller, Engineer Heather Miller, Engineer CIRS Inc., Norfolk, VA CIRS Inc., Norfolk, VA

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Page 1: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

1

Dia

gnos

tic U

ltras

ound

Phy

sics

D

iagn

ostic

Ultr

asou

nd P

hysi

cs

and

QC

Wor

ksho

pan

d Q

C W

orks

hop

Ran

dell

Kru

ger,

Ph.

D.,

Ran

dell

Kru

ger,

Ph.

D.,

Mar

shfie

ld C

linic

, Mar

shfie

ld, W

IM

arsh

field

Clin

ic, M

arsh

field

, WI

Zhe

ngfe

ng

Zhe

ngfe

ng L

u, P

h.D

.,L

u, P

h.D

.,C

olum

bia

Pres

byte

rian

Med

ical

Cen

ter,

New

Yor

k, N

YC

olum

bia

Pres

byte

rian

Med

ical

Cen

ter,

New

Yor

k, N

Y

Hea

ther

Mill

er, E

ngin

eer

Hea

ther

Mill

er, E

ngin

eer

CIR

S In

c., N

orfo

lk, V

AC

IRS

Inc.

, Nor

folk

, VA

Page 2: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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ting

2

Wor

ksho

p O

utlin

eW

orks

hop

Out

line

•• Int

rodu

ctio

nIn

trodu

ctio

n•• O

verv

iew

of u

ltras

ound

pha

ntom

sO

verv

iew

of u

ltras

ound

pha

ntom

s•• Q

A/Q

C in

trodu

ctio

n an

d ba

ckgr

ound

QA

/QC

intro

duct

ion

and

back

grou

nd!

QA

/QC

requ

irem

ents

!U

ltras

ound

acc

redi

tatio

n!

Res

ourc

es•• Q

C T

est /

phy

sics

dem

onst

ratio

nsQ

C T

est /

phy

sics

dem

onst

ratio

ns!

Eigh

t tes

ts re

view

ed!

Rev

iew

test

pro

cedu

res

!R

evie

w p

hysi

cs p

rinci

ples

Page 3: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

3

Dia

gnos

tic U

ltras

ound

Phy

sics

and

D

iagn

ostic

Ultr

asou

nd P

hysi

cs a

nd

QC

Wor

ksho

p : A

n O

verv

iew

of

QC

Wor

ksho

p : A

n O

verv

iew

of

Ultr

asou

nd P

hant

oms

Ultr

asou

nd P

hant

oms

Page 4: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

4

Wha

t is a

n ul

tras

ound

pha

ntom

?W

hat i

s an

ultr

asou

nd p

hant

om?

Any

stru

ctur

e th

at

Any

stru

ctur

e th

at

cont

ains

one

or m

ore

cont

ains

one

or m

ore

mat

eria

ls th

at si

mul

ate

a m

ater

ials

that

sim

ulat

e a

body

of t

issu

e in

its

body

of t

issu

e in

its

inte

ract

ion

with

in

tera

ctio

n w

ith

ultra

soun

d an

d is

use

d to

ul

traso

und

and

is u

sed

to

mim

ic u

ltras

onic

m

imic

ultr

ason

ic

inte

ract

ions

in th

e hu

man

in

tera

ctio

ns in

the

hum

an

body

.bo

dy.

Page 5: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

5

Tis

sue

Mim

icki

ng M

ater

ials

Tis

sue

Mim

icki

ng M

ater

ials

••A

gar

Aga

r••

Zerd

ine

Zerd

ineT

MTM

••U

reth

anes

Ure

than

es••

Oth

erO

ther ep

oxie

sep

oxie

sliq

uids

liqui

dsna

tura

l mat

eria

lsna

tura

l mat

eria

ls

Page 6: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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ting

6

Aco

ustic

Pro

pert

ies

Aco

ustic

Pro

pert

ies

•• Spe

ed o

f Sou

ndSp

eed

of S

ound

•• Atte

nuat

ion

Coe

ffic

ient

Atte

nuat

ion

Coe

ffic

ient

•• Bac

ksca

tter C

oeff

icie

nt/R

elat

ive

Bac

ksca

tter C

oeff

icie

nt/R

elat

ive

Con

trast

Con

trast

Page 7: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

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ting

7

Aco

ustic

Pro

pert

ies

Aco

ustic

Pro

pert

ies

•• Spe

ed o

f Sou

nd

Spee

d of

Sou

nd

1540

m/s

1540

m/s

•• Atte

nuat

ion

Coe

ffic

ient

Atte

nuat

ion

Coe

ffic

ient

•• Bac

ksca

tter C

oeff

icie

nt/R

elat

ive

Bac

ksca

tter C

oeff

icie

nt/R

elat

ive

Con

trast

Con

trast

Page 8: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

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l Mee

ting

8

Aco

ustic

Pro

pert

ies

Aco

ustic

Pro

pert

ies

•• Spe

ed o

f Sou

nd

Spee

d of

Sou

nd

1540

m/s

1540

m/s

•• Atte

nuat

ion

Atte

nuat

ion

0.5

dB/c

m/M

Hz

or 0

.7 d

B/c

m/M

Hz

0.5

dB/c

m/M

Hz

or 0

.7 d

B/c

m/M

Hz

•• Bac

ksca

tter C

oeff

icie

ntB

acks

catte

r Coe

ffic

ient

Page 9: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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Page 10: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

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10

Wir

esW

ires

Page 11: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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Var

ious

Mas

ses

Var

ious

Mas

ses

Page 12: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

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ting

12

App

licat

ions

App

licat

ions

•• Tra

inin

gTr

aini

ng•• D

emon

stra

tion

Dem

onst

ratio

n•• Q

ualit

y A

ssur

ance

Qua

lity

Ass

uran

ce•• R

esea

rch

& D

evel

opm

ent

Res

earc

h &

Dev

elop

men

t

Page 13: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

13

Tra

inin

g Ph

anto

ms

Tra

inin

g Ph

anto

ms

•• Bio

psy

Bio

psy

•• Cry

osur

gery

Cry

osur

gery

•• Bra

chyt

hera

pyB

rach

ythe

rapy

•• HIF

UH

IFU

•• IV

US

IVU

S•• 3

D3D

Page 14: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

14

Dem

onst

ratio

nsD

emon

stra

tions

!3D

Sys

tem

s•

Mai

nly

feta

l ultr

asou

nd!

Bra

chyt

hera

py S

yste

ms

•D

emon

stra

te n

eedl

e an

d se

ed v

isua

lizat

ion

!O

ther

Sal

es d

emon

stra

tions

Page 15: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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Bra

chyt

hera

pyB

rach

ythe

rapy

Page 16: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

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ting

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QA

/QC

QA

/QC

••Eq

uipm

ent S

elec

tion

Equi

pmen

t Sel

ectio

n••

Acc

epta

nce

Test

ing

Acc

epta

nce

Test

ing

••C

onsi

sten

cy c

heck

sC

onsi

sten

cy c

heck

s••

Acc

redi

tatio

n Pr

ogra

ms

Acc

redi

tatio

n Pr

ogra

ms

!A

CR

!A

IUM

!IC

AV

L

Page 17: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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17

Page 18: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

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ting

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R&

D U

ses

R&

D U

ses

•• Pro

duct

Dev

elop

men

tPr

oduc

t Dev

elop

men

t•• F

DA

App

rova

l Pro

cess

FDA

App

rova

l Pro

cess

•• Bas

ic S

cien

tific

Res

earc

hB

asic

Sci

entif

ic R

esea

rch

Page 19: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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ting

19

Man

ufac

ture

rsM

anuf

actu

rers

•• ATS

Lab

s, B

ridge

port,

CT

ATS

Lab

s, B

ridge

port,

CT

!w

ww

.ats

labs

.com

•• CIR

S, N

orfo

lk V

AC

IRS,

Nor

folk

VA

!w

ww

.cirs

inc.

com

•• Gam

mex

RM

I, M

adis

on W

IG

amm

ex R

MI,

Mad

ison

WI

!w

ww

.gam

mex

.com

Page 20: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

20

Dia

gnos

tic U

ltras

ound

Phy

sics

and

D

iagn

ostic

Ultr

asou

nd P

hysi

cs a

nd

QC

Wor

ksho

p :

QC

Tes

ts a

nd

QC

Wor

ksho

p :

QC

Tes

ts a

nd

Phys

ics R

evie

wed

Phys

ics R

evie

wed

Page 21: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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Wor

ksho

p O

utlin

eW

orks

hop

Out

line

•• QA

/QC

Intro

duct

ion

and

Bac

kgro

und

QA

/QC

Intro

duct

ion

and

Bac

kgro

und

!Q

A/Q

C R

equi

rem

ents

!U

ltras

ound

Acc

redi

tatio

n!

Res

ourc

es•• Q

C T

est /

Phy

sics

Dem

onst

ratio

nsQ

C T

est /

Phy

sics

Dem

onst

ratio

ns!

Dep

th o

f Vis

ualiz

atio

n (F

requ

ency

and

Fra

me

Rat

e)!

Axi

al a

nd L

ater

al R

esol

utio

n (D

epth

and

Fre

quen

cy)

!D

ista

nce

Acc

urac

y!

Dea

d Zo

ne a

nd Im

age

Uni

form

ity!

Ane

choi

c O

bjec

t Per

cept

ion

!D

oppl

er:

Gat

e A

ngle

, Gat

e Si

ze, a

nd G

ate

Posi

tion

!Lo

w C

ontra

st O

bjec

t Det

ecta

bilit

y

Page 22: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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QA

/QC

Req

uire

men

tsQ

A/Q

C R

equi

rem

ents

•• Lev

els o

f ultr

asou

nd Q

C te

stin

gLe

vels

of u

ltras

ound

QC

test

ing

!Le

vel 1

, Fre

quen

t tes

ting

•O

pera

tor�

s QC

test

s!

Leve

l 2, S

emi-a

nnua

l (or

ann

ual)

test

ing

•Ph

ysic

ist�s

QC

test

s!

Leve

l 3, A

ccep

tanc

e te

stin

g •

Bas

elin

e va

lues

est

ablis

hed

Page 23: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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QA

/QC

Req

uire

men

tsQ

A/Q

C R

equi

rem

ents

•• Am

eric

an A

ssoc

iatio

n of

Phy

sici

sts i

n M

edic

ine

Am

eric

an A

ssoc

iatio

n of

Phy

sici

sts i

n M

edic

ine

!U

ltras

ound

Tas

k G

roup

No.

1, �

Rea

l-tim

e B

-mod

e ul

traso

und

qual

ity c

ontro

l tes

t pro

cedu

res�

•A

utho

rs/e

dito

rs: M

M G

oods

itt e

t al.

•M

edic

al P

hysi

cs, 2

5(8)

:138

5-40

6, 1

998

Aug

ust

!A

APM

Ultr

asou

nd C

omm

ittee

•A

nnua

l con

tinui

ng e

duca

tion

cour

ses

•A

nnua

l wor

ksho

ps (h

ands

-on

and

dem

onst

ratio

ns)

!R

emot

ely

Dire

cted

Con

tinui

ng E

duca

tion

(RD

CE)

Page 24: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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QA

/QC

Req

uire

men

tsQ

A/Q

C R

equi

rem

ents

•• Am

eric

an In

stitu

te o

f Ultr

asou

nd in

Med

icin

eA

mer

ican

Inst

itute

of U

ltras

ound

in M

edic

ine

!�Q

ualit

y A

ssur

ance

Man

ual f

or G

ray

Scal

e U

ltras

ound

Sc

anne

rs (S

tage

2)�

•A

utho

rs/e

dito

rs: E

. Mad

sen

•AIU

M, L

aure

l, M

D, 1

995

!�P

erfo

rman

ce C

riter

ia a

nd M

easu

rem

ents

for D

oppl

er

Ultr

asou

nd D

evic

es: T

echn

ical

Dis

cuss

ion�

•2nd

Editi

on•A

IUM

, Lau

rel,

MD

, 200

2

Page 25: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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QA

/QC

Req

uire

men

tsQ

A/Q

C R

equi

rem

ents

•• The

Inst

itute

of P

hysi

cal S

cien

ces i

n M

edic

ine

The

Inst

itute

of P

hysi

cal S

cien

ces i

n M

edic

ine

!R

epor

t 70,

�Te

stin

g of

Dop

pler

Ultr

asou

nd

Equi

pmen

t�•

Aut

hors

/edi

tors

: PR

Hos

kins

, SB

She

rriff

and

JA E

vans

•Y

ork:

ISPM

, 199

4!

Rep

ort 7

1, �

Rou

tine

Qua

lity

Ass

uran

ce o

f U

ltras

ound

Imag

ing

Syst

ems�

•A

utho

rs/e

dito

rs:

R P

rice

•Y

ork:

ISPM

, 199

5

Page 26: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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Ultr

asou

nd A

ccre

dita

tion

Ultr

asou

nd A

ccre

dita

tion

•• AC

R A

ccre

dita

tion

(A

CR

Acc

redi

tatio

n ( w

ww

.acr

.org

ww

w.a

cr.o

rg))

!B

reas

t Ultr

asou

nd A

ccre

dita

tion

Prog

ram

!G

ener

al U

ltras

ound

Acc

redi

tatio

n Pr

ogra

m•

Obs

tetri

cal

•G

ynec

olog

ical

•G

ener

al•

Vas

cula

r•

Com

bina

tion

of th

e ab

ove

••A

IUM

Acc

redi

tatio

n (

AIU

M A

ccre

dita

tion

( ww

w.a

ium

.org

ww

w.a

ium

.org

))!

Bre

ast,

Obs

tetri

cal,

Gyn

ecol

ogic

al, A

bdom

inal

/Gen

eral

Page 27: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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ting

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Ultr

asou

nd A

ccre

dita

tion

Ultr

asou

nd A

ccre

dita

tion

••A

CR

QA

/QC

pro

gram

spec

ifics

AC

R Q

A/Q

C p

rogr

am sp

ecifi

cs!

Dire

cted

by

med

ical

phy

sici

st o

r sup

ervi

sing

phy

sici

an!

Test

ing

mus

t be

done

at l

east

sem

i-ann

ually

•R

epea

t tes

ts a

nd m

onito

r cha

nges

ove

r tim

e•

Impl

emen

t cor

rect

ive

actio

ns w

hen

nece

ssar

y•

Res

ults

mus

t be

docu

men

ted

and

mai

ntai

ned

on si

te

••A

CR

gen

eral

US

accr

edita

tion

sem

iA

CR

gen

eral

US

accr

edita

tion

sem

i -- ann

ual t

ests

annu

al te

sts

!Sy

stem

sens

itivi

ty a

nd/o

r pen

etra

tion

capa

bilit

y !

Imag

e un

iform

ity

!Ph

otog

raph

y an

d ot

her h

ard

copy

reco

rdin

g !

Low

con

trast

obj

ect d

etec

tabi

lity

(opt

iona

l)!

Ass

uran

ce o

f ele

ctric

al a

nd m

echa

nica

l saf

ety

!V

ertic

al a

nd h

oriz

onta

l dis

tanc

e ac

cura

cy

Page 28: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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nnua

l Mee

ting

28

Ultr

asou

nd A

ccre

dita

tion

Ultr

asou

nd A

ccre

dita

tion

•• AC

R S

emi

AC

R S

emi -- A

nnua

l Bre

ast Q

C T

ests

Ann

ual B

reas

t QC

Tes

ts!

Max

imum

dep

th o

f vis

ualiz

atio

n!

Dis

tanc

e ac

cura

cy (v

ertic

al a

nd h

oriz

onta

l)!

Uni

form

ity!

Elec

trica

l-mec

hani

cal c

lean

lines

s con

ditio

n!

Ane

choi

c vo

id p

erce

ptio

n!

Rin

g do

wn

!La

tera

l res

olut

ion

!Q

ualit

y C

ontro

l Che

cklis

t

Page 29: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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PM A

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l Mee

ting

29

Res

ourc

esR

esou

rces

••A

ccre

dita

tion

and

QA

/QC

gui

danc

eA

ccre

dita

tion

and

QA

/QC

gui

danc

e!

Am

eric

an C

olle

ge o

f Rad

iolo

gy ®

(AC

R)

!In

ters

ocie

tal C

omm

issi

on fo

r the

Acc

redi

tatio

n of

Ec

hoca

rdio

grap

hy L

abor

ator

ies ®

(IC

AEL

) and

V

ascu

lar L

abor

ator

ies ®

(IC

AV

L)

•• �La

bora

tory

� de

mon

stra

tions

usi

ng p

hysi

cs te

st

�Lab

orat

ory�

dem

onst

ratio

ns u

sing

phy

sics

test

eq

uipm

ent a

nd ro

utin

e cl

inic

al e

quip

men

teq

uipm

ent a

nd ro

utin

e cl

inic

al e

quip

men

t!

Qua

lity

assu

ranc

e ph

anto

m(s

)!

Clin

ical

equ

ipm

ent a

nd so

nogr

aphe

rs

Page 30: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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nnua

l Mee

ting

30

Res

ourc

esR

esou

rces

••Ed

ucat

iona

l and

Res

earc

h O

rgan

izat

ions

Educ

atio

nal a

nd R

esea

rch

Org

aniz

atio

ns!

Am

eric

an In

stitu

te o

f Ultr

asou

nd M

edic

ine

®(A

IUM

)!

Am

eric

an R

egis

try o

f Dia

gnos

tic M

edic

al

Sono

grap

hers

® (A

RD

MS)

!

Am

eric

an R

egis

try o

f Rad

iolo

gic

Tech

nolo

gist

s ®

!C

omm

issi

on o

n A

ccre

dita

tion

of A

llied

Hea

lth

Educ

atio

n Pr

ogra

ms �

Car

diov

ascu

lar (

CA

AH

EP-

DM

S) a

nd D

iagn

ostic

(CA

AH

EP-D

MS)

!Jo

int R

evie

w C

omm

ittee

on

Educ

atio

n in

Dia

gnos

tic

Med

ical

Son

ogra

phy

(JR

CD

MS)

Page 31: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

31

Res

ourc

esR

esou

rces

••C

linic

al U

ltras

ound

Phy

sics

: C

linic

al U

ltras

ound

Phy

sics

: A

Wor

kboo

k fo

r Phy

sici

sts,

A W

orkb

ook

for P

hysi

cist

s, R

esid

ents

, and

Stu

dent

sR

esid

ents

, and

Stu

dent

s!

Aut

hors

(AA

PM U

S C

omm

ittee

):•

Jam

es M

. Kof

ler,

Jr.,

Ph.D

•R

ande

ll L.

Kru

ger,

Ph.D

•Ev

an B

oote

, Ph.

D•

Zhen

gfen

g Lu

, Ph.

D•

J. B

rain

Fow

lkes

, Ph.

D•

Mar

k R

. Hol

land

, Ph.

D!

Publ

ishe

d fo

r the

AA

PM b

y M

edic

al

Phys

ics P

ublis

hing

(200

1)

Page 32: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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l Mee

ting

32

Res

ourc

esR

esou

rces

••M

any

text

s are

ava

ilabl

eM

any

text

s are

ava

ilabl

e!

Ref

er to

wor

kboo

k fo

r a

list o

f pos

sibl

e re

fere

nces

••B

asic

topi

cs in

clud

eB

asic

topi

cs in

clud

e!

Phys

ics r

evie

w!

Inte

ract

ion

with

mat

ter

!In

stru

men

tatio

n!

Imag

e st

orag

e an

d di

spla

y!

Dop

pler

ultr

asou

nd!

QC

, saf

ety,

and

bio

effe

cts

Page 33: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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l Mee

ting

33

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Max

imum

Dep

th o

f Vis

ualiz

atio

n Q

C te

stM

axim

um D

epth

of V

isua

lizat

ion

QC

test

!Th

e m

axim

um d

epth

of v

isua

lizat

ion

is d

eter

min

ed

by c

ompa

ring

the

grad

ually

wea

keni

ng e

cho

text

ure

to e

lect

roni

c no

ises

nea

r the

bot

tom

of t

he im

age

!U

se th

e sa

me

setti

ngs a

nd m

onito

r cha

nges

!Ph

ysic

s dem

onst

ratio

n �f

ram

e ra

te a

nd fr

eque

ncy

•Fr

ame

rate

is in

vers

ely

prop

ortio

nal t

o th

e m

axim

um d

epth

�Fr

ame

rate

dec

reas

es a

s im

agin

g de

pth

incr

ease

s•

Dep

th o

f pen

etra

tion

decr

ease

s as f

requ

ency

incr

ease

s�

Hig

her f

requ

ency

bea

m is

atte

nuat

ed m

ore

rapi

dly

than

one

tra

nsm

itted

at a

low

er fr

eque

ncy

Page 34: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

34

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 35: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

35

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Axi

al a

nd la

tera

l res

olut

ion

QC

test

ing

Axi

al a

nd la

tera

l res

olut

ion

QC

test

ing

!Sp

atia

l res

olut

ion

may

be

eval

uate

d by

eith

er o

f the

fo

llow

ing

way

s:•

Cou

nt th

e nu

mbe

r of t

he p

ins d

istin

guis

hed

with

out o

verla

p in

late

ral a

nd a

xial

dire

ctio

n;�

Min

imum

targ

et sp

acin

g is

doc

umen

ted

•M

easu

re th

e si

ze o

f the

pin

in la

tera

l and

axi

al d

irect

ion

!Ph

ysic

s dem

onst

ratio

n: im

agin

g de

pth

and

freq

uenc

y•

Com

pare

dep

th a

nd fr

eque

ncy

to m

easu

red

late

ral r

esol

utio

n•

Dem

onst

rate

bet

ter a

xial

reso

lutio

n at

a h

ighe

r fre

quen

cy

Page 36: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

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ting

36

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Page 37: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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PM A

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l Mee

ting

37

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Page 38: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

38

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 39: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

39

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Dis

tanc

e ac

cura

cy Q

C te

stin

gD

ista

nce

accu

racy

QC

test

ing

!Sc

an th

e ph

anto

m w

ith a

ver

tical

col

umn

and

a ho

rizon

tal r

ow o

f ref

lect

ors

!Th

e di

gita

l cal

iper

read

out o

n sc

reen

is c

heck

ed

agai

nst t

he k

now

n di

stan

ce b

etw

een

refle

ctor

s•

Ver

tical

: 1.5

% o

f the

act

ual d

ista

nce

or 2

mm

, whi

chev

er

is g

reat

er•

Hor

izon

tal:

3% o

f the

act

ual d

ista

nce

or 3

mm

, whi

chev

er

is g

reat

er

Page 40: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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PM A

nnua

l Mee

ting

40

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 41: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

41

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Dea

d zo

ne (r

ing

Dea

d zo

ne (r

ing --

dow

n) Q

C te

stin

gdo

wn)

QC

test

ing

!A

gro

up o

f ref

lect

ors c

onsi

stin

g of

fibe

rs a

re

plac

ed a

t diff

eren

t sep

arat

ions

from

the

top

of th

e ph

anto

m (~

1-8

mm

)!

As t

he tr

ansd

ucer

scan

s acr

oss t

he to

p, th

e di

stan

ce

from

the

trans

duce

r to

the

first

refle

ctor

com

plet

ely

imag

ed is

the

dead

zon

e di

stan

ce (r

ing

dow

n)!

Rec

ord

and

mon

itor p

erfo

rman

ce

Page 42: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

42

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 43: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

43

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Im

age

unifo

rmity

QC

test

ing

Imag

e un

iform

ity Q

C te

stin

g!

Adj

ust t

he T

GC

con

trols

and

oth

er se

nsiti

vity

con

trols

to

obt

ain

an im

age

as u

nifo

rm a

s pos

sibl

e!

Insp

ect t

he im

age

for:

•V

ertic

al o

r rad

ial o

rient

ed st

reak

s•

Dro

pout

s•

Red

uctio

n of

brig

htne

ss n

ear e

dges

of t

he sc

an•

Brig

htne

ss tr

ansi

tions

bet

wee

n fo

cal z

ones

!R

ecor

d an

d m

onito

r per

form

ance

Page 44: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

44

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 45: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

PM A

nnua

l Mee

ting

45

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Ane

choi

c ob

ject

per

cept

ion

eval

uatio

nA

nech

oic

obje

ct p

erce

ptio

n ev

alua

tion

!Th

is te

st e

valu

ated

the

syst

em�s

abi

lity

to d

etec

t and

ac

cura

tely

dis

play

roun

d, n

egat

ive

cont

rast

obj

ects

(c

yst)

of v

ario

us si

zes

!U

se c

alip

ers t

o m

easu

re h

eigh

t and

wid

th o

f obj

ect

!Pe

rfor

man

ce c

riter

ia a

nd c

orre

ctiv

e ac

tion

limits

•M

ajor

dis

torti

on: h

eigh

t and

wid

th d

iffer

by

>20%

•A

con

sist

ent m

easu

rabl

e ch

ange

from

the

base

line

Page 46: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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PM A

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l Mee

ting

46

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 47: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

AA

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ting

47

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Low

con

trast

obj

ect d

etec

tabi

lity

eval

uatio

nLo

w c

ontra

st o

bjec

t det

ecta

bilit

y ev

alua

tion

!Sc

ans o

f a lo

w c

ontra

st re

solu

tion

phan

tom

can

reve

al

the

low

con

trast

obj

ect d

etec

tabi

lity

•M

onito

r and

trac

k pe

rfor

man

ce•

Des

crib

e no

ise

and

cont

rast

!A

n op

tiona

l tes

t on

the

AC

R se

mi-a

nnua

l QC

test

list

fo

r gen

eral

ultr

asou

nd a

ccre

dita

tion

Page 48: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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l Mee

ting

48

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

Live

Dem

onst

ratio

n of

QC

Tes

t or P

hysi

cs C

once

pt

Page 49: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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l Mee

ting

49

Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Dop

pler

dem

onst

ratio

ns; g

ate

Dop

pler

dem

onst

ratio

ns; g

ate --

size

and

si

ze a

nd ��

posi

tion

posi

tion

!G

ate

size

det

erm

ines

the

size

of t

he sa

mpl

e vo

lum

e•

Blo

od fl

ow is

non

-uni

form

acr

oss t

he v

esse

l cro

ss-s

ectio

n•

Smal

l gat

e si

ze: r

ange

of v

eloc

ities

is sm

all,

spec

tra is

nar

row

•La

rge

gate

size

(enc

ompa

sses

ent

ire v

esse

l), sp

ectra

is w

ider

Page 50: 2004 AAPM Annual Meeting Diagnostic Ultrasound …2004 AAPM Annual Meeting 1 Diagnostic Ultrasound Physics and QC Workshop Randell Kruger, Ph.D., Marshfield Clinic, Marshfield, WI

2004

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Phys

ics/

QC

Dem

onst

ratio

nsPh

ysic

s/Q

C D

emon

stra

tions

•• Dop

pler

dem

onst

ratio

ns; g

ate

Dop

pler

dem

onst

ratio

ns; g

ate --

size

and

si

ze a

nd -- p

ositi

onpo

sitio

n!

Sim

ilar t

o ga

te si

ze, p

ositi

on a

lso

influ

ence

s dat

a •

Blo

od fl

ow is

non

-uni

form

acr

oss t

he v

esse

l cro

ss-s

ectio

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Phys

ics/

QC

Dem

onst

ratio

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Que

stio

ns?

Que

stio

ns?

Than

k Y

ou!

Than

k Y

ou!