2018 acr dm qc manualamos3.aapm.org/abstracts/pdf/144-42045-475604-142944...alternative standards...
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2018 ACR DM QC Manual
Dustin A. Gress, MS, DABR, DABSNMSenior Advisor for Medical Physics
American College of Radiology
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Outline Why switch? Overview of phantom & select tests Transitioning & some key details Resources
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Alternative standards 2016: FDA approved ACR DM QC Manual as
alternative standard…
2018: FDA approved supplemental DBT material to be integrated into ACR DM QC Manual
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For ACR Members in Physics
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https://www.acr.org/Clinical-Resources/Medical-Physics-Resources
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Standardization It’s good.
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Standardization Expect cleaner MQSA inspections Standardization reduces errors No more chasing down mfr manual versions Current and future revisions will always be
available Current and future forms will always be free
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Standardizing: Tests themselves Test frequencies Performance criteria Clinical relevance Operator-friendliness
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Paradigm emphasis 1. Radiologist leadership and oversight 2. MD-RT-MP teamwork 3. Medical physicist ownership
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QA Committee (QAC) “Should” LIP, RT, MP, mgr, sup. RT, QC RT, other
radiology (e.g. nurse, desk attendant, etc.)
Ideally owns Facility QC Review…
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Radiologist feedback
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Demonstrate value Re-establish relationships Be the go-to resource Direct lines of communication
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Improved efficiency Fewer QC tests than mfr Less total time spent on QC tests Excel and pdf forms available for free 2D and DBT both included, streamlined
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Phantom
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Purchasing phantom Must be from approved manufacturer Google “acr digital mammography qc manual
resources” https://www.acraccreditation.org/resources/digital-
mammography-qc-manual-resources Mfr list at bottom of page
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Pass Criteria: 2 Fibers, 3 Specks, 2 MassesEquivalent to SFM Phantom: 4 Fibers, 3 Specks, 3 Masses
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Unit MP tests (annual) Phantom – IQ & artifacts DBT Z-resolution Spatial resolution DBT volume coverage AEC Collimation (DBT only) AGD (HVL & output)
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*This test may require evaluation downstream from AW if AW can’t provide ROI capabilities
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MEE only HVL kVp 2D collimation
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Major Component Service, Upgrade, Replacement & Repair
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*This test may require evaluation downstream from AW if AW can’t provide ROI capabilities
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Typo AEC Performance Criteria
2D
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Why else? QC program structured for modern facilities Multiple units… multiple RWS… multiple facilities
New, better phantom More efficient artifact detection Team approach w/QA Committee Radiologist feedback incorporated
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RWS
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RWS
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Tech RWS QC
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Applicability Adoption is a choice Each unit is a choice Manufacturers now also have a choice
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Applicability
CEM
Units with CEM can use the ACR manual for 2D and DBT applications, but must use manufacturer QC for CEM applications
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Transitioning Full MEE not required Annual survey required “transition survey”
MEE QC test data (HVL, kVp, 2D collimation) must be available for baseline and troubleshooting purposes
Display devices
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Ideas for transitioning Read the manual Read the manual again Have a meeting with lead tech, mgr, & LIP to plan Schedule time to train technologist(s) Be the expert – consider this an opportunity
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Do I need to call my inspector?
No.
But documentation of transition dates for all devices is essential
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Do I need to call ACR? No. Unless of course you have questions
ACR is accepting (re)submissions using new DM QC Manual
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What’s happening now? Outreach (hi!) CRCPD FDA → inspectors MITA / mfr
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Resources ACR Digital Mammography QC Manual
Resources Accreditation web page 1-800-227-6440 [email protected]
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DM QC Manual Resources Up-to-date FAQs Phantom scoring key (good for teaching!) Excel forms for QC tests (tech and med phys!) Webinars by Eric (tech and med phys!) Approved phantom vendors
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Acknowledgements Eric Berns, PhD Chair, ACR Subcommittee on Breast Imaging X-ray
Physics Chair, ACR Subcommittee on QA in Mammography
Priscilla F. Butler, MS, FAAPM, FACR
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