document resume - eric · conjunction with the manual, "photographic quality assurance in...

99
ED 202 667 AUTHOR TITLE INSTITUTION FEPORT NO PUB DATE NOTE AVAILABLE FROM EDRS PRICE DESCRIPTORS ABSTRACT DOCUMENT RESUME SE 034 665 Goldman, Lee W. Radiographic Film Processing Quality Assurance: A Self-Teaching Workbook. Quality Assurance Series. Food and Drug Administration (DHHS) , Rockville, Md. Bureau of Radiological Health.; World Health Organization, Geneva (Switzerland) . HHS-FDA-B1-9146 Jan B1 161p.; Contains occasional marginal legibility. Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402 ($4.00) . MF01/PC07 Plus Postage. Allied Health Occupations Education; Allied Health Personnel; *Film Production; Government Publications; Higher Education; *Instructional Materials; Postsecondary Education; Problem Solving; *Professional Training; *Radiation; Radiation Biology; Science Education; *Workbooks This workbook has been designed for use in conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical problems arising from the existence of variability and fluctuations in the automatic processing of radiographs, which unless corrected, can contribute significantly to increased patient dose, increased incidences of retakes, and poorer image quality. Each problem is presented as an exercise followed by a step-by-step reasoning process, so that the probable cause and appropriate corrective measures can be determined. (CS) *********v************************************************************* Reproductions supplied by EDRS are the best that can,be made from the original document. ****#******************************************************************

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Page 1: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ED 202 667

AUTHORTITLE

INSTITUTION

FEPORT NOPUB DATENOTEAVAILABLE FROM

EDRS PRICEDESCRIPTORS

ABSTRACT

DOCUMENT RESUME

SE 034 665

Goldman, Lee W.Radiographic Film Processing Quality Assurance: ASelf-Teaching Workbook. Quality Assurance Series.Food and Drug Administration (DHHS) , Rockville, Md.Bureau of Radiological Health.; World HealthOrganization, Geneva (Switzerland) .

HHS-FDA-B1-9146Jan B1161p.; Contains occasional marginal legibility.Superintendent of Documents, U.S. Government PrintingOffice, Washington, DC 20402 ($4.00) .

MF01/PC07 Plus Postage.Allied Health Occupations Education; Allied HealthPersonnel; *Film Production; Government Publications;Higher Education; *Instructional Materials;Postsecondary Education; Problem Solving;*Professional Training; *Radiation; RadiationBiology; Science Education; *Workbooks

This workbook has been designed for use inconjunction with the manual, "Photographic Quality Assurance inDiagnostic Radiology, Nuclear Medicine and Radiation Therapy."Presented are several typical problems arising from the existence ofvariability and fluctuations in the automatic processing ofradiographs, which unless corrected, can contribute significantly toincreased patient dose, increased incidences of retakes, and poorerimage quality. Each problem is presented as an exercise followed by astep-by-step reasoning process, so that the probable cause andappropriate corrective measures can be determined. (CS)

*********v*************************************************************Reproductions supplied by EDRS are the best that can,be made

from the original document.****#******************************************************************

Page 2: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

U S DEPARTMENT OF HEALTH.E DUCATION & WELFARENATIONAL INSTITUTE OF

EDUCATION

THIS 60CUMEN7 HAS SEEN REPRO.DUCED EXACTLY AS RECEIVED FROMTHE PERSC.1 OR ORGANIZATION ORIGIN-ATING IT POINTS OF VIEW OR OPINIONSSTATED DO NOT NECESSARILY REPRESENT OFFICIAL NATIONAL INSTITUTE OFEDUCATION POSITION OR POLICY

( (.'

Radiographic Film ProcessingQuality Assurance:

A Self-Teaching Workbook

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health Service

Food and Drug Administration

Page 3: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

BRH PUBLICATIONS

Publications of the Bureau of Radiological Health (BRH) are available as paper copies fromeither the U.S. Government Printing Office (GPO) or the National Technical Information Serviceas indicated by the GPO or PB prefix, respectively, on the ordering number. Publications arealso available in microfiche from NTIS at $3.50 per copy. To receive all BRH reports inmicrofiche, at $0.85 each, you may establish a deposit account with NTIS and request automaticdistribution of "FDA/HFX" reports under the "Selected Research in Microfiche" program.Publications without GPO or PB number are available only from BRH, without charge.

Addresses for ordering are: Superintendent of Documents, U.S. Government Printing Office,Washington, D.C. 20402 ($1.00 minimum order); National Technical Information Service,Springfield, VA 22161 (outside North America, prices are double those listed); and Bureau ofRadiological Health, Technical Information Staff (HFX-28), 5600 Fishers Lane, Rockville, MD20857. All prices are subject to change.

FDA 79-8074 Free-Space Electric Field Mapping of Microwave Diathermy Applicators (PB 291040/AS, $6.00).

FDA 79-8075 Evaluation of Ohmic Instrument Company Model UPM-30 Ultrasound Power Meter(PB 292 405/AS, $5.00).

FDA 79-8077 imaging Ability of Collimators in Nuclear Medicine (PB 290 954/AS, $9.00).FDA 79-8077 Supplement - Imaging Ability of Collimators in Nuclear Medicine - Supplementary

Collimator Data for Rectilinear Scanners (PB 290 955/AS, $10.00).FDA 79.8078 Quantification of Current Practice in Pediatric Roentgenography for Organ Dose

Calculations (GPO 017-015-00158-0, $2.00) (PB 301 120/AS, mf only).FDA 79-8079 Handbook of Selected Organ Doses for Projections Common in Pediatric

Radiology (GPO 017-015-00157-1, $2.50).FDA 79-8080 Measurements of Electromagnetic Fields in the Close Proximity of CB Antennas

(GPO 017-015-00E55-5, $1.40) (P13 292 404/AS, mf only).FDA 79-8081 X-Radiation and Identification Characteristics of CRT's of Foreign Manufacture

(PB 293 459/AS, $8.00).FDA 79-8082 Some Considerations of Hazards in the Use of Lasers for Artistic Displays (GPO

017-015-00156-3, $1.10) (Pb 294 513/AS, mf only).FDA 79-8083 National Conference on Referral Criteria for X-Ray Examinations (GPO 017 -012-

00279-0, $3.75) (Pt3 296 173/AS, mf only).FDA 79-8086 Evaluation of Commercially Available Laser Protective Eyewear (PB 80-103039,

$9.00).FDA 79-8087 X rays, Pregnancy and You...(brochure).FDA 79-8088 X Rays: Get the Picture on Protection (brochure).FDA 79-8088S Sepa no Protegerse de los Kayos Equis (brochure).FDA 79-8090. Source Book of Educational Materials for Radiation Therapy (GPO 017- 015 - 00159-

8, $4.50) (PB 299 415/AS, mf only).FDA 79-8093 Guide for the Preparation of Cathode Ray Tube Reports Pursuant to 1002.10 and

1002.i2.FDA 79-8094 Quality Assurance for Radiographic X-Ray Units and Associated Equipment (PB 80-

101 405, $9.00).FDA 79-8097 Analysis of Retakes: Understanding, Managing, and Using an Analysis of Retakes

Program for Quality Assurance (PB 80-102445, $6.00).FDA 79-8098 Bureau of Radiological Health Index to Selected Acoustic and Related References

(PB 80-120967, $20.00).FDA 80-8024 FDA X-Ray Record Card (card).FDA 80-8027 Directory of Personnel Responsible for Radiological Health Programs (supersedes

FDA 80-8027, September 1979).FDA 80-8034 Report of State and Local Radiological Health Programs, Fiscal Year 1978 (PB 80-

130867, $6.00).FDA 80-8035 Regulations for the Administration and Enforcement of The Radiation Control for

Health and Safety Act of 1968 (July 1980) (GPO 017-015-00173-3, $3.75)(supersedes FDA 79-8035).

FDA 80-8057 Nationwide Evaluation of X-Ray Trends: De tat X-Ray Data (brochure)(supersedes FDA 78-8057).

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HHS Publication FDA 81-8146

quality assurance seridsv

Radiographic Film ProcessingQuality Assurance:

A Self-Teaching Workbook

Lee W. GoldmanDivision of Training and Medical Applications

bureau of radiological health

WHO Collaborating Center forTraining and General Tasks in

Radiation Medicine

January 1981

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES.

Public Health ServiceFood and Drug Administration

Bureau of Radiological HealthRockville, Maryland 20857

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FOREWORD

The Bureau of Radiological Health develops and carries out a national program tocontrol unnecessary .human exposure to potentially hazardous ionizing and nonionizingradiations and to ensure the safe, efficacious use of such radiations. The Bureau publishesthe results of its work in scientific journals and in its own technical reports.These reports provide a mechanism for disseminating results of Bureau and contractorprojects. They are distributed to Federal, State, and local governments; industry; hospitals;the medical profession; educators; researchers; libraries; professional and trade organiza-tions; the press; and others. The reports are sold by the Government Printing Office and/orthe National Technical Information Service.

The Bureau also makes its technical reports available to the World Health Organization.Under a memorandum of agreement between WHO and the Department of Health andHuman Services, three WHO Collaborating Centers have been established within the Bureauof Radiological Health, FDA:

WHO Collaborating Center for Standardization of Protection Against NonionizingRadiations;

WHO Collaborating Center for Training and General Tasks in Radiation Medicine; andWHO Collaborating Center for Nuclear Medicine.

Please report errors or omissions to the Bureau. Your comments and requests forfurther information are also encouraged.

John C. VillfortDirectorBureau of Radiological Health

iii

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PREFACE

Production of radiologic images of acceptable diagnostic quality obtained with minimumradiation exposure to patients is a basic goal of the Bureau of Radiological Health (BRH).The efforts of the Division of Training and Medical Applications to meet this goal arediverse; one very promising approach is the development and dissemination of QualityAssurance (QA) informaton and methodology for medical uses of radiation. A QualityAssurance Recommendation for diagnostic radiology facilities was published in theFEDERAL REGISTER on December 11, 1979. The Division is also developing a series ofquality assurance instruction manuals. These manuals describe in detail the establishmentand operation of specific elements of a quality assurance program. They present proven QAtechniques that can be adapted by individual radiology facilities according to their needsand resources. These manuals are part of the "BRH Quality Assurance Publications" seriesproviding QA inforriralion for many uses of medical radiation including ultrasound, nuclearrifedicine,- and radiation therapy as well as diagnostic radiology. A listing of subjects andspecific titles follows.

This volume, "Radiographic Film Processing Quality Assurance: A Self-TeachingWorkbook," is intended as an educational aid in implementing a quality assurance programfor radiographic film processing. It consists of several typical examples of processingproblems, each in the form of an "exercise." The exercises are presented as they wouldoccur in practice from control charts and maintenance logs, followed by logical solutions.

This and related materials will allow a radiographic film processing QA program to beimplemented with maximum ease and understanding.

We welcome comments on your experience with this manual, as well as suggestions forthe content, style, and direction of future manuals.

William S. Pro rzio , Ph.DirectorDivision of Training and

Medical ApplicationsBureau of Radiological Health

6

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BRH QUALITY ASSURANCE PUBLICATIONS

GENERAL

Gray, J.E. Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine, andRadiation Therapy, Volume 1: The Basic Principles of Daily Photographic QualityAssurance. HEW Publication (FDA) 76-8043 (June 1976).

Gray, J.E. Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine, andRadiation Therapy, Volume 2: Photographic Processing Quality Assurance and theEvaluation of Photographic Materials. HEW Publication (FDA) 77-8018 (March 1977).

U.S. Department of Health, Education, and Welfare. Quality Assurance Catalog and QualityAssurance Catalog Supplement. HEW Publication (FDA) 77-8028 (July 1977), HEWPublication (FDA) 78-8028 (August 1978). Compiled by R.L. Burkhart.

Goldman, L.W. Radiographic Film Processing Quality Assurance: A Self-TeachingWorkbook. HHS Publication (FDA) 76-8146 (January 1981).

DIAGNOSTIC RADIOLOGY

Hendee, W.R. and R.P. Rossi. Quality Assurance for Radiographic X-Ray Units andAssociated Equipment. HEW Publication (FDA) 79-8094 (August 1979).

Hendee, W.R. and R.P. Rossi. Quality Assurance for Fluoroscopic X-Ray Units andAssociated Equipment. HEW Publication (FDA) 80-8095 (October 1979).

Hendee, W.R. and R.P. Rossi. Quality Assurance for Conventional Tomographic X-RayUnits. HEW Publication (FDA) 80-8096 (October i979).

Goldman, L.W. and S. Beech. Analysis of Retakes: Understanding, Managing and Using anAnalysis of Retakes Program for Quality Assurance. HEW Publication (FDA) 79-8097(August 1979).

ULTRASOUND

Lopez, H. and S.W. Smith. Implementation of a Quality Assurance Program for Ultrasound B-scanners. HEW publication (FDA) 80-8100 (October 1979).

NUCLEAR MEDICINE

U.S. Department of Health, Education, and Welfare. Quality Control for ScintillationCameras. HEW Publication (FDA) 76-8046 (June 1976).

U.S. Department of Health, Education, and Welfare. WorkshopManual for Quality Controlof Scintillation Cameras in Nuclear Medicine. HEW Publication (FDA) 76-8039 (May 1976).

Hine, G., P. Paras, and C. Warr. Measurements of the Performance Parameters of GammaCameras, Part 1. HEW Publication (FDA) 78-8049 (December 1977).

Hine, G. et al. Measurements of the Performance Parameters of Gamma Cameras, Part II.HEW Publication (FDA) 79-8049 (June 1979).

Radionuclide Handling and Radiopharmaceutical Quality Control (to be published).

DENTAL RADIOGRAPHY

U.S. Department of Health, Education, and Welfare. Exposure and Processing Guide forDental Radiography. HEW Publication (FDA) 77-8039 (August 1977).

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CONTENTS

Page

Foreword iii

Preface iv

BRH Quality Assurance Publications v

Introduction 1

Background 1

Instructions 3

Afterword 88

References 89

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RADIOGRAPHIC FILM PROCESSING QUALITY ASSURANCE:A SELF-TEACHING WORKBOOK

INTRODUCTION

The existence of variability and fluctuations in the automatic processing of radiographscan contribute significantly to increased patient dose, increased incidences of retakes, andpoorer image quality. A processing Quality Assurance program can eliminate and controlmuch of this variability and be highly cost effective.

Perhaps the most difficult task in the proper maintenance of a QA program is indetermining the probable cause of a processing problem, appropriate corrective action toTake, and when to act. This workbook presents several typical problems requiring correctionwhich will be found in a QA program. Each problem is presented as an exercise followed bya step-by-step reasoning process, so that you can determine the probable cause andappropriate corrective measures. In each case, these determinations are based on routinelyobtained sensitometric data, simple physical measurements, consideration of the processor'srecent "history," and common sense observations on the state of the processor itself. The"answers" arrived at in this way will normally represent the most likely alternative. Thesuggested corrective actions will not necessarily be the only ones acceptable, but are thosewhich the author has found to be useful and workable in practice.

This workbook has been designed for use in conjunction with the manual, "PhotographicQuality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy" (1). Asa prerequisite, you should read it before proceeding. The slide-tape package, "A BasicProgram: Quality Control for the Automatic Film Processor" (2) will provide a basicintroduction to the subject of radiographic film processing quality control.

This workbook by no means attempts to cover all possible problems. It is hoped,however, that as a result of these tutorial exercises you will begin to develop a "feel" forthe type of reasoning and logic needed in weeks of experience and trial-and-error beforegaining confidence in maintaining the QA program. You are therefore strongly urged notto become discouraged before reaching this stage if it seems difficult at first.

BACKGROUND

The concepts and procedures for performing a Quality Assurance program on radio-graphic film processors are discussed in detail in Reference 1. Essentially, the programinvolves routine (i.e., once or twice daily) exposure of a sheet of control x-ray film to asensitometer, after which the film is processed.

Control x-ray film is a batch of the same type film used in the department, but which isset aside to be used only for the QA program. There will be very little difference in filmspeed, contrast or fog among the sheets of film in this batch. A sensitometer is a devicewhich exposes a sheet of film to a controlled, reproducible light source. This light source isgenerally attenuated by a filter to produce a "stepwedge" image showing grey levels rangingfrom base plus fog (B + F) to ma;timum density. When such an exposure is made on a sheetof control film and then processed, any changes in optical density (O.D.) of the step wedge

1

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Image can only be due to changes in processing, since both the film and exposure are tightlycontrolled.

Thus, changes in processing may be characterized by changes in the density of this"stepwedge" image. If the "steps" of this image are plotted vs. optical density (Fig. 1) an "I-1Lac D" or "characteristic" curve results. Most diagnostic information is found within thelinear portion of this curve. To adequately describe this curve, therefore, only the followinginformation is needed:

(a) The "slope" of the straight line portion. For this, a "density difference" index iscalculated. This is the difference in density between two steps: one near the"shoulder" of the curve (2-2.5 O.D.) and one near the "toe" (O.D. 4-6). Thisserves as an index of contrast.

(b) The position or location of the straight line portion. For this, the density of amid-density (MD) step (1.0-1.5 O.D.) is recorded. This number locates the linehorizontally, and is an index of "speed."

(c) The base plug fog (B + F) level of the curve. For this, the density of an unexposedregion of the film is recorded.

On a daily basis, therefore, only these four points (two for density difference, one eachfor mid-density and base plus fog) are measured, using a densitometer, and recorded.Changes in processing are then determined by comparing these numbers to the desiredlevels. In the following, processing is considered acceptable if the DD and MD indices areboth within desired or optimum values.

3.5

3.0

2.5

2.0

1.5

1.0

0.5

0.0LOG RELATIVE EXPOSURE

DE

N

T

Figure 1. Obtaining r.1.! H do D curve from a sensitometric strip.

2

0

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INSTRUCTIONS

The following is a series of imaginary but very representative examples of processingproblems which will normally be found as part of a QA program. Each exercise consists ofone such example and is arranged in the following fashion. The first pair of opposing pagesshows a portion of a processing control chart and a processor maintenance log to be 'used inthe first exercise. Three pieces of sensitometric data are given under each date/timeheading. These are:

(a) Density Difference (DD): This is the difference in optical density of twostandardized steps on the sensitometric strip: one with an optical densitybetween 2.0 and 2.5 and the other with an optical density of about 0.5. Thisnumber serves as an index of contrast.

(b) Medium Density (MD): This is the optical density of a standardized area on thesensitometric strip with an O.D. around 1.0. This number serves as an index ofrelative speed.

(c) Base Plus Fog (B + F): This is the optical density of an unexposed portion of thesensitometric strip.

Two sets of data are plotted each working day: one from a sensitometric strip processedabout 9:00 a.m. and the other processed about 3:00 or 4:00 p.m. Each "gap" in the charts*corresponds to a weekend when no sensitometry was performed.

The last entry on each chart is a set of circled data points which fall outside the controllimits and therefore require corrective action. The portion of the processor maintenancelog facing this chart contains entries of all actions taken on the processor before thedeviation occurred and thus represents the processor's "recent history". All actions arerecorded: those done routinely as well as corrective actions. You should use the log andcontrol chart in conjunction with any other knowledge available to "deduce" the probablecause of the problems and the suggested corrective procedures. Since the developertemperature should be read whenever a sensitometric strip is made, this factor should beassumed, although it is not included in the exercise. In many cases, therefore, you mustpropose two possible courses of action: one assuming improper developer temperature andthe other assuming proper developer temperature. The course of action developed shouldinclude both the steps to be taken in finding the cause and those taken to correct it.The second pair of opposing pages shows the maintenance log after the appropriatecorrective actions have been taken and a detailed evaluation and discussion of the example.In many cases, suggestions or advice will be given in order to prevent or minimize that typeof problem.

These four-page sets make up each succeeding exercise. Think carefully about eachproblem before turning to the answer on the next page. Sometimes there will be noapparent way to correctly interpret the problem from the data given. This is intended,since such situations may often be encountered in practice, and can only be handled throughexperience. Occasionally, you are referred to the "manual" for further information. Thismanual is given in Reference 1.

3

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ACTIONS ON PROCESSOR

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16

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RI RL. MD MF TO TW MR

RI .RL MO MF TO TW MR 61

RI RL MD MFT0' TW MR OT W.I.WV0,....==.m.....m.P.I

or (0 Fvit

. moworsoft 11OT

OT

OT

OT

OT

RI.. Increased Replenishment Rate

RL Lowered Replenishment Rate

MO - Mixed New Developer Replen,

MF - Mixed New Fixer Replen,

TO ... Developer TemperatOe Adjust.

TM Mater Temperature Adjust.

MR Mechanical Repair

'01 - Other (comment)

17

Page 15: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Over-replenishment

CORRECTIVE ACTION: Turn back replenishment rate and run several fully exposed filmsfilms that have been exposed to visible light.)

EXPLANATIONS: Since both the speed and contrast indices are high, the indication is thatthere has been an increase in either developer temperature or chemical activity (strength).Usually, the developer temperature is measured routinely and found tb be normal (in thiscase, .92°). Thus, the source of the problem is probably in the developer chemistry. Thefact that a gradual upward trend is evidenced during the week points to the replenishmentrate being too high as the cause. That is, as each film is processed, a little more newdeveloper is added via replenishment than is used up by the .film's development, thusgradually increasing the strength of the chemicals in the developer tank. Turning down thereplenishment rate will alleviate this problem, although the precise amount of reductiondepends on the individual facility and must be determined by trial and error. Thiscorrective action alone, however, may not bring the processor back to within the controllimits for several days. Thus, in addition, several fully exposed films should be run throughthe processor until the processor is back within the normal limits. These fully exposed filmsreduce developer strength by using much more developer in their processing than is replacedthrough replenishment.

You will observe that in this exercise the replenishment rate had been increased earlierin the week, apparently in response to under-replenishment. In practice, it will be foundthat improper replenishment is a common source of improper development, since variationin patient load, types of exams, film processing practices, and even the amount of chemicalsin the replenisher tanks can affect the amount of replenishment.

7 1

Page 16: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One - See Key),

312 TS pm CL CC CO CF (E) RL MD' MF TO TW

1:14 CL CC CD CF. RI g MD MF TO TW

/5 3:10 CL CC CD CF'.3 MD MF TO 1W

am

pm CL CC CD CF. RI RI MD MF TD TW

am

pm CL CC CD CF ,RI RL MO MF TO TW

am

pm CL CC CO CF RI RL MD MF TO TVamr.011.M.IIam

pm CL CC CD CF RI RL MO MF TO TW. MR Or

Previous

Setting

MR OT. ,CS

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CF

am

pm CL CC CD CF RI RL MD MF ID TW MR DTIMMIMIONNOI=0.

am

pm CL CC CO CF RI RL MO MF ID TV MR OT

pm CL CC CD CF RI RL MD MF TO TW MR OT

am

pm CL CC CD .CF RI RL MD MF TO TW MR OT

am

pm CL CC CD CF RI RL MO MF TO 1 MR OT

am

pm CL' CC CD CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

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pm CL CC CD CF RI RL MD 'ME TO 1W 'MR OT

Im.sloomrwrnpr

4...POPIMlommorirM.1.1, ww

11...010.1011

Cleaned

Total Chemistry Change

Changed Developer

Changed Fixer

RI Increased Replenishment Rate

RL - Lowered Replenishment Rate

MD - Mixed New Developer Replen,

MF - Mixed New Fixer Replen,

TO . Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR . Mechanical Repair

OT - Other, (comment)

2u

Page 17: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 18: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Corment

3,12. 7:1S pm CL CC CD CF (15 RI MO MF TO DI MR OT. .65 4C) ,

111E TIC) 111) CL CC CO CF, RI RL MO MF TO TW MR OT INO

3 S 1:10 CI. CC CO CF RI RL MO MF TO TW MR (0)

ti11.1 1050 pm CL CC CD CF RI RL MO MF TO TW MR (0!)

(() 1230(]) CL CC CO CF RI RI MO MF TO (Ilt)MR OT ?p°

pm CL CC CD CF RI RL MD MF .7D TM MR OT

am

pm CL CC CO CF RI MO MF 0.TO TM. ,MR Ot

am

pm' CL CC CD CF RI RI. MO MF TO TW MR OTam

pm CL CC CD CF RI RL MO 'MF MR OT'

0 am

pm Cl CC CO .CF RI RL MO MF TO TV MR OTam.1.marmwM00.11MIN. 11.111.

1..IMM11110.01M..

pm CI CC CO CF RI RI MO MF TO TW MR 01'INImamNalaga.04 IMmogniwnWIN

pm CL CC CO CF RI RI MD MF TO 7111 MR OTam

pm CL CC CO ,CF RI RI MO MF TO N MR OT

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am

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am

Dm CL' CC CD CF RI RI MD MF TD N 01,am.=1..1111 1011.1111

pm Cl CC CO CF RI RI MD MF TO TM MR 0.1en.a.dagere00 INmaMM0111

am

pm CI CC CD CF RI RI MD MF TO TW MR OT0.1/.101.01N1

Ct, CC CO CF RI RI MO MF TO 114 MR 01

XEI: CL - Cleaned RI Increased Replenishment Rate TO Developer Temperature Adjust,CC - Total Chemistry Change RI Lowered Replenishment. Rate TW Water Temperature Adjust,CD - Changed Developer

MO - Mixed New Developer Replen,MR . Mechanical Repair

CF - Changed Fixer MF Mixed New Fixer Replen, OT - Other (comment)

Page 19: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Oxidation and/or evaporation of the developer chemicals.

CORRECTIVE ACTION: Addition of replenisher directly into developer tank.

EXPLANATION: This type of problem is very common in most facilities (and, in fact, maybe the norm) after lengthy periods of low volume processing such as after a weekend. It isthe result of interaction of the developer chemicals with the atmosphere, causing oxidationand reduced chemical strength. Since the same chemicals have been sitting in the processorfor many hours, the cumulative effect of the oxidation over this period of time can besufficient to noticeably reduce the chemical activity. In most cases, the effect will bemore pronounced in the contrast index than in the speed index. The reason is that there areactually two different "developing" chemicals in all developers. These are usuallyphenidone, which quickly produces the "greys", and hydroquinone, which more slowlyproduces the "blacks" on the final radiograph. The second chemical, hydroquinine, is moresuceptible to chemical oxidation. Since a high density 'black" area on the sensitometricstrip is used to calculate the contrast index, this index is more affected by oxidation thanthe mid-density speed step. Again, this problem will very often be found after a long periodof low volume processing, and it is therefore very important that the processor be checkedbefore running any patient films at these times.

The problem is corrected by simply adding new developer directly to the developer tank.This may be done in three ways: take the cover off the processor and carefully pour somedeveloper replenisher into the developer tank in, for example, 100 ml increments until thecontrol region is reached; or, manually trip the replenisher microswitches for a fewmoments causing replenisher to be dumped into the processor; or run some previouslyprocessed films (such as retakes). The last is often the easiest and merely causesreplenishment with little use of developer.

11

Page 20: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New.

Date Time Actions (Circle One See Key), Setting Setting Comment

3 z IS pm CL CC CD CF (15 RI MD MF TO TW MR OT. ,65

s7V CL CC CD CF. RI (RI) MD MF TO TW MR OT

CL CC CO CF RI RI MD MF TO TV MR

3Ic? 71;60 pm

(0CL CC CO CF' RI RI MD MF TO TW MR

am

3110 1214)(D CL CC CO CF RI RL MD ME TO (MR OT gi:) ° ..ge)

am

Pm CL CC CD CF RI RL MD ME TO TW MR OT

Pm CL CC CD CF RI RL MD MF TO TW. MR OT

am

Pm' CL CC CO CF RI RI. MD MF TO TW MR OT

am

pm CL CC CD CF RI RI: MD 'MF .TD .TW. MR OT'

am

Pm

Pm

alil

Pm

. am

. Pm

am

Pm

am

CL CC CD CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL MD MF TO .TW MR OT

CL CC CO CF RI RI MD ME TO TW MR OT

CL CC CD CF RI RI MO ME TO TW MR CT

CL CC CD CF RI' RL MD MF TD TW MR OT

Pm CL CC CD CF RI RL MD MF TO TW MR OT

am

pm CI CC CO CF RI RI. MD MF TO DI MR OT .

pm CL CC CD CF RI RL MD MF TO TW MR 61

am

pm CL CC CD CF RI RI MD MF TO TW MR OT1.1.m. IMI.M=1.1

KEY: CL Cleaned

CC Total Chemistry Change

CO - Changed Developer

CF Changed Fixer

RI Increased Replenishment Rate

RL Lowered Replenishment. Rate

MO . Mixed New Developer Replen,

MF Mixed New Fixer Replen,

go, 10 Foll 5/FttiF4limS

,OXtaotto-ct84 Loom\ gylm.

TO Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR Mechanical Repair

'OT - Other (comment)

Page 21: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 22: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

30

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One See Key). Setting Setting Comment

jjL1119 CL CC CD CF (E) RL MD MF TO TW MR OT. g; _211)

315 CL CC CO CF. RI ® MD MF TO TW MR OT

am

no 9 CL CC CO CF RI RL MD MF TO TW MR a Pco, (0 F) q

11;bp CL CC CO CF. RI RL MD MF TO TW MR (01)

am

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am

pm CL CC CO CF RI RL. MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MD If 'TO TW MR OT'

am

pm CL CC CO CF RI RL MD ME TO TW MR OT

am

pm CL CC CO CF RI RL MO MF TO MR OT

am

pm CL CC CO CF RI RL. MD MF TD TW MR OT

am

pm CL CC CO .CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

pm CL CC CO CF RI RL MD ME TO TW MR OT

am

pm CL CC CD CF RI RL MO MF TO TW MR OT

am

pm CL CC CD CF RI RL MO MF TD TW MR OT

sionnrm.

CL - Cleaned RI Increased Replenishment Rate

CC Total Chemistry Change RL Lowered Replenishment Rate

CD Changed Developer, MO Mixed New Developer Replen,

CF Changed Fixer MF Mixed New Fixer Replen,

IMMINMEINOMI

TO p Developer Temperature Adjust,

TW r Rater Temperature Adjust,

MR Mechanical Repair

OT Other (Comment)31

Page 23: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Developer temperature too high due to excessive wash water temperature.

CORRECTIVE ACTION: Red lice wash water temperature to proper setting.

EXPLANATION: As usual, the increase in all three monitored indices (contrast, speed, andbase plus fog) points first to excessive developer temperature. In this case, thethermometer reading indicated a developer temperature of 94° instead of the normal 92°for this processor. The normal impulse in these situations is to reduce the developerthermostat setting. It is strongly emphasized, however, that developer temperatureproblems are usually not caused by the thermostat, but by some other source of temperaturefluctuation. The most probable culprit in non-cold water processors is the temperature orpressure of the wash water circulating through the developer heat exchanger. This watershould normally be 4 to 5° cooler than the desired developer temperature. If it is hotterthan this, its heat exchanging capacity is greatly reduced. The resultant insufficient coolingof the recirculating developer allows the higher temperature in this example to occur. (Incold-water systems make sure that the water temperature is at least 4 to 5° lower than thedesired developer temperature.)

Several factors can affect the wash water temperature: alteration of the wash watertemperature setting; a surge or drop in the incoming hot or cold water pressure; or, achange in the temperature of either the hot or cold incoming water lines. In each case, thetemperature of the mixed wash water will be altered.

In this case the wash water temperature setting was increased earlier in the week from80 to 88°, as noted in the processor maintenance log. The cause, apparently was not animproper temperature setting, but a change in the temperature of the incoming water.When this later returned to normal, the wash water was found to be too hot (910), causingthe observed problem.

These conditions may be avoided by the following practices:

(1) Do not alter a mechanical setting unless it is fairly certain that the setting isincorrect and not just the result of temporary environmental conditions.

(2) Pressure and temperature gauges should be installed in both the incoming hot andcold water lines in addition to the single ones usually installed at the mixingvalve; this will allow easy determination of external water-related problems.

(3) If a water problem is suspected, keep an eye on it and correct immediately if theproblem recurs.

NOTE: A routine processor cleaning and chemistry change is entered in the maintenancelog. It is important that all actions taken on the processor be entered in this log, and notjust corrective actions taken in response to a problem. Many future problems may be tracedto these routine procedures.

Page 24: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One See Key). Setting Setting Comment

:312. "IS pm CL CC CD CF RI RL MD MF TO N MR OT. .65 _il:).am

31; 1:10 CL CC CD CF. RI (E.) MD MF TO 114 MR OT ; frID

3/c 114. CL CC CD CF RI RL MD MF TO TW MR 0 pn

319' app CL CC CD CF' RI RL MD MF TO TW MR (0!)

am

3110 1230 CL CC CO CF RI RL MO MF TO ()MR OT /0°

12, 2r.20 CL CC CD CF RI RL MO MF TO !IR OT $ IT° ,

am

3116 00 V. E) CD CF RI RL MO MF TO N. MR Or

aft..

am

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MR Mechanical Repair

'OT - Other (comment)

Page 25: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 26: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Times Actions (Circle One Se

3'z 71.65 Pm CL CC CO CF (g) RL MD

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ME TO TW MR OT. ,65

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MF TD (1DMR OT

ME TO p MROT, 51 °

MF TO 1. MR Of

pm CI CC CO CF RI RL MF TO 1 MR OT111.11VMam.

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CC Total Chemistry Change RL Lowered Replenishment Rate TV Water Temperature Adjust.

CO Changed Developer MD .; Mixed New Developer Replen, MR Mechanical Repair

CF Changed Fixer MF Mixed New Fixer Replen. 'OT Other (comment)

Page 27: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Developer contaminated with fixer.

CORRECTIVE ACTION: Drain and flush developer tank; refill and restart.

EXPLANATION: The sharp drop in both the speed (MD) and contrast (DD) again suggestseither a temperature drop or a problem with the chemistry. This time, the developertemperature is normal. As is often the case, a clue to the problem's source can be obtainedfrom the maintenance log. You can see that the chemistry was changed following a routineprocessor cleaning which had been done the evening before. A problem associated with thischange should be the first item suspected. The sharp drop in the processing in this suggestscontamination of the developer with fixer.* It does not require much fixer to cause thisamount of contamination, and could easily be the result of splash-over of fixer into thedeveloper tank during refilling.

The proper protocol to follow to avoid this problem is to refill the fixer tank first, witha cover over the developer tank. A quick flushing of the developer tank with water willremove any fixer residue. The developer tank may then be refilled without fear ofcontamination.

Actually, it is difficult in this instance to ascertain that fixer contamination is the causeof the problem. It could, for example, have been the result of adding too much startersolution. In either case, the corrective procedure is the same, and should be taken withoutspending excessive time determining the precise cause. If it later becomes evident that thechemistry change was not at fault, other possibilities may be then pursued.

z

*Actually, for several film-chemistry combinations, a significant increase in developeractivity may occur after contamination by small amounts of fixer (2).

19

Page 28: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One See Key). Setting Setting Comment

3/2 3:15 pm Cl CC CO, CF (g) RI MO MF TO TV MR OT. ',65;,

315' 1:14 CL CC CD 0, RI RL MO hiF TO TW MR OT ,t)am

.2.33 CC CO CF: RI RL MD MF TO TW MR

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ani

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am

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am

pm CL CC CO CF RI RI MD MF TO TR MR OT

am

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are

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am

pm CL CC CO CF RI RL MO MF TO TW MR OT

am

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am

pt CL' CC CD CF RI RI MO MF TD TW MR OT

am

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am

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pm CL CC CO CF RI RI MO MF TO Tk MR OT

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in

ClKEY: - Cleaned RI Increased Replenishment RateCC Total Chemistry Change RL Lowered Replenishment RateCD - Changed Developer MD Mixed New Developer Replen.

CF - Changed Fixer MF - Mixed New Fixer Replen.

1=111

11MMOIMownM

TO Developer Temperature Adjust,

TW - Water Temperature Adjust,

MR Mechanical Repair

'OT'. Other (comment)

1041

Page 29: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 30: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Prey ous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

1(12, (pc pm CL CC CO. CF (RI) RL MD MF TO TW MR OT ,(0r .8()al

3 ISe CL CC CD CF RI ® MD MF TO TW MR OT, .B 7()

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aril

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CC CO CF RI

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am

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all

pm CL CC CD CF RI RL MD ME TO TW MR OT

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CC - Total Chemistry Change

CD - Changed Developer

CF - Changed Fixer

RI Increased Replenishment Rate

RL Lowered Replenishment Rate

MD - Mixed New Developer Replen.

ME Mixed New Fixer Replen,

(amS t'`U it) CORR.cct

TO - Developer Temperature Adjust.

TV - Water temperature Adjust.:

MR Mechanical Repair.

OT - Other (comment)

45

Page 31: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Excessive replenishment due to unusually heavy patient load.

CORRECTIVE ACTION: Run several fully exposed films or change chemistry.

EXPLANATION: The purpose of this exercise is twofold: to demonstrate another cause ofimproper replenishment, and to point out the important fact that one cannot isolate theprocessing QA program from other "goings-on" in the department.

In this example both the MD and DD are again on the high side. -The developertemperature checks out okay, and no recent actions have been taken on the processor. Notrend is visible from the sensitometric data. The next logical step is to "ask around", andfind out if anything unusual occurred in the department that could be linked to the problem.In this case, it was determined that there was an unusally heavy workload of chest examsthat day, which resulted in the excessive replenishment. Since the replenishment rate is setfor an "average" workload and distribution of exams, isolated instances of heavy workload orabnormal exam frequency can cause isolated cases of improper replenishment.

The problem may be corrected by either changing chemistry or by running several fullyexposed films. (These should be green films known to be bad, for example, fogged, and notfilm taken from the bin. The latter is costly of film, and it would be easier and cheaper tosimply dump the chemistry and start over).

Two words of caution are in order.

(1) If no apparent cause of the improper processing is found within a reasonableperiod of time (30 minutes or less), then make the necessary correction withouttrying to determine the cause and look further only if it reappears.

(2) Many people like to "assume" a cause of the problem (such as excessivereplenishment rate) and take corrective action accordingly. This will usuallycause more problems than it corrects and is strongly discouraged.

23

Page 32: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date. Time Actions (Circle One - See Key),n,c)312. -1:1 pm CL CC CD CF RI RL MD MF TD

3/6- 3:106 CL CC CD OF. RI (E) MD

3/5 3:10

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pm CL CC

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CD CF RI

CD CF RI

CL CC CD CF RI

CL CC CD CF RI

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CL CC CD CF RI

CL' CC CD CF RI

CL CC CD CF RI

CL CC CD CF RI

CL CC CD CF RI

KEY: CL - Cleaned

CC - Total Chemistry Change

CD - Changed Developer

CF - Changed Fixer

RL

RL

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MD

MD

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TW MR

MF TD TW MR

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Previous New

Setting Setting Comment

01 .65' ,gOT TO .70

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Developer Temperature Adjust.

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Mechanical RepairC5

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Page 33: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 34: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous NewDate Time Actions (Circle One See

Setting Setting Commentam

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am

pm CL CC CD CF RI RI MO ME TO TW MR OT

KEY: CL Cleaned

CC Total Chemistry Change

CO - Changed Developer

CF Changed Fixer

RI Increased Replenishment Rate

RI Lowered Replenishment Rate

MD Mixed New Developer Replen,

ME Mixed New Fixer Replen,

Folot otdrbl

W.PIN

011.111...Mal

TO Developer Temperature Adjust,

TW Water Temperature Adjust,

MR Mechanical Repair

'CT Other (comment)

Page 35: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: New operating levels not made for new box of control film.CORRECTIVE ACTION: Prepare new chart with properly reset operating levels and controllimits.

EXPLANATION: Here again, the processor maintenance log suggests the problem's origin:a new box of control film was opened the previous day without changing the operating levelsand control limits on the chart. Although individual boxes of film will usually be very closein sensitometric prOperties to each other (especially those within the same batch andemulsion number), it is not uncommon to have boxes different in speed by as much as 0.1optical density units in the mid density range. If new operating levels are not made on theprocessor control chart to account for these differences, changes in the processormonitoring indices may be observed although there has been no change in the processingwhatsoever. It is therefore important that such film differences be evaluated whenever anew box of control film is opened.*

This proceduie for determining new operating levels is discussed in the manual. Briefly,however, the last few sheets of film from the "old" control box should be sensitometricallyexposed and processed along with a few strips from the "new" box of control film. The MD,DD, and B + F from the "old" strips should be averaged and compared to the same averagesfrom the "new" strips. The differences between the two MD and DD averages indicate theamount by which the new limits should be changed. For example, if the average MD fromthe "old" box was 1.10 and the average MD from the "new" box was 1.15, the operatinglevels for the new chart must be moved up to 0.05 O.D. on the MD plot.

In this case, it was found that the MD and DD had to be moved up 0.10 units. (The limitshave not been changed in these examples, although in "real life", all future charts wouldhave been shifted upward).

It is a good idea to similarly evaluate samples of all film and not just control film, toscreen out batches of film with excessively large (more than about 0.15 O.D.) differencesin speed or contrast.

27 5

Page 36: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Timeets. Actions (Circle One See Key) Setting Setting Comment

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KEY: CL - Cleaned RI Increased Replenishment Rate TO Developer Temperature Adjust,

CC - Total Chemistry Change '11. - Lowered Replenishment Rate TW Water Temperature Adjust.

CD - Changed Developer MD Mixed New Developer Replen. MR Mechanical Repair,

CF - Changed Fixer MF Mixed New Fixer Replen, OT - Other (comment)

Page 37: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 38: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

Oc

Pm

Pm

am.

Pm

am

Pm

aim

Pm

am

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am

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KEY: CL

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CF

CL CC CO CE (g) RL MD MF TO TW MR OT

CL CC CO CF RI RL MO ME TO TW MR OT

CL CC CO, CF RI RL MO MF TO 1W MR '01

CL CC CO CF RI RL MO MF TD TW MR OT

CL CC CO, CF RI RL MO MF TO TW MR OT

CL CC CD. CF RI RL MD MF TD 1W MR OT

CL CC CO CF RI RL MO ME ID TW MR OT

Cl CC CO CF RI RL, MD ME TD TW MR OT

CL CC CO CF RI RL MD 'MF .TO TW MR OT

CL CC CO CF RI RL MO ME TO TW MR OT

CL CC CO CF RI RL MO MF TO .TW MR OT

CL CC CD CF RI RL MO MF. TO 1W MR OT

CL CC CD CF RI RL MO MF TO TW'MR OT

CL CC CD CF RI RL MO MF TD TW MR OT

CL CC CO CF RI RL MO MF TO 1W MR DT

CL CC CD CF RI RL MO MF TO TW MR OT

CL CC CD CF RI RL MD MF TO TW MR OT

CL CC CD CF RI RL MD M" TO 1W MR OT

Cleaned RI

Total Chemistry Change RI

Changed Developer MO

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Previous New

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MONIM111111111111M

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lowered Replenishment Rate

Mixed New Developer Replen,

Mixed New Fixer Replen,

TO - Developer Temperature AdjUsto

TW - Water Temperature Adjust.

MR Mechanical Repair

OT - Other (comment)

Page 39: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Under-replenishment

CORRECTIVE ACTION: Increase replenishment rate and add some replenisher directly toprocessor to bring it back to within control limits.

EXPLANATION: In this example as in the first, a gradual reduction in development hasoccurred. As before, this is generally the earmark of improper replenispment causing agradual falloff in developer strength. In this case, the inadequate replenishment rate meantthat on the average, each radiograph was using up more developer than was replaced.

The proper corrective action, is to increase the replenishment rate. Also, additionalreplenisher should be added directly to the processor developer tank (in about 100 mlincrements) until the processing is back inside the control limits. This again may be doneeither by manually tripping the microswitches, by using a container to pour it right into thedeveloper tank, or by processing several previously processed films.*

*It should be noted that here and elsewhere the processing of previously developed films issuggested as part of a corrective or routine procedure. There had in the past been opinionsagainst this practice, since residual fixer in the film could cause developer contamination.However, if these films are being adequately washed, little if any fixer should remain, andthe re-processing of a limited number should not be a problem. In fact, their use, as wellas the use of fogged or expired film for processor cleanup, lead films for single-emulsionroll film and correction actions can avoid the wasteful and costly use of "good" film fromthe film bin.

31 60

Page 40: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

6.i

ACTIONS ,ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

CL CC CD CF (g) RL MO MF TD TW MR OT 75 .1k)

3111 ((5 CL CC CO CF RI RI egg) TO TW MR OTam

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Setting Setting Comment

RI RI. MD MF TD TW MR OT

RI RI MD MF TO TW MR OT

RI RL MD MF TO TW 'MR OT

RI RL MD MF TD TW MR OT.

RI RI MO MF TO TW MR OT

RI RI MD MF TO TW MR OT

KEY: CL - Cleaned

CC - Total Chemistry Change

CO - Changed Developer

CF - Changed Fixer

RI It, MO 'MF TO TW MR OT

RI RL MD MF TO TW MR OT

RI RI MO MF TD TV MR OT

RI RL MD MF TO TW MR OT

RI RI MD MF TO TW MR OT

RI RI MO MF TO TW MR OT

RI RL MO MF TO TV MR OT

RI RI MO MF TO TV MR OT

RI RI MD MF TO 11 MR OT

RI RL MD MFTO DI MR OTIMINIMImam4

RI Increased Replenishment Rate

RL - Lowered Replenishment Re

MO - Mixed New Developer Replen,

MF - Mixed New Fixer Replen,

1.1111010111

fIcelsnmkOtgs log

111INI10.mmoNIONNII=1

TO - Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR Mechanical Repair

IT - Other (comment)

Page 41: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 42: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One See Key)

a,

31r. ci cc

33001!) CL CC

am

CL CC

am

Pm

am

Pm011=.1.1

CL CC

CL CC

pm CL CC

am

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am

pm CL CC

pm CL CC

am

pm Ct. CC

am

pm CC

am

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am

pm CL CC

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pm CL CC

dill

pm CL CC

am

pm CL CC

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pm CL CC

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pm CL CC

CO CF (E) RL MO MF TO

CO CF RI RL (g) TD

CO CF RI RL MO MF TO

CD

CD,

CO

CO

CO

CO

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CO

CO

CO

CO

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CO

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CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

CF

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

RI

CL - Cleaned

:C - Total Chemistry Change

CO - Changed Developer

CF - Changed Fixer

RL MD

RL MO

RL MO

RI MO

RL, MD

RI MD

RI MD

RI MD

RL MO

RL MO

RL MO

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MF

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TD

TO

TO

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TO

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TO

TO

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TO

TO

TO

TO

TO

,Previous New

Setting Setting Comment

TW MR OT, .6757,

TW MR OT

TW MR® conciAlz.-tah 101 lizp.

TW MR OT

TW MR OT

TW MR OT

TW MR OT

TN MR OT

TW MR OT

TW MR OT

TW MR OT

IIminmmor

TN. MR OT ..

IMEN*1M~MO M4611

TV MR OT

TW MR OT

TW MR OT

TW MR OT

TW MR OT

TN MR OT

RI - Increased Replenishment Rate

RL Lowered Replenishment Rate

MO . Mixed New Developer Replen,

MF Mixed New Fixer Replen,

1

AMINVIIMilmlftem

Ifts.141m.

TO - Developer Temperature AdjUst,

TW Water Temperature Adjust,

MR - Mechanical Repair

OT - Other (comment) 66

Page 43: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Replenisher too concentrated.

CORRECTIVE ACTION: Dilute replenisher to proper level as indicated by hydrometer.Either dump and restart the developer tank or run several fully exposed films.

EXPLANATION: The maintenance log shows that new developer replenisher was mixed justthe prior afternoon. Thus after first checking for normal developer temperature, explorethe possibility of excessively strong (too 'concentrated) replenisher. Obtain from themanufacturer the specific gravity of the properly mixed replenisher (for that batch number)and compare it to the hydrometer reading taken from the replenisher after correcting thereading for temperature in the tank, (not the tank inside the processor). If the specificgravity is higher than the manufacturer specification, then the replenisher wasinsufficiently diluted when it was mixed.

The proper corrective action is to add additional water to the tank in small (2-4 liters)increments until the proper specific gravity is reached. Since it may take a while for thisaction alone to restore proper processing levels through replenishment, either the developerin the processor itself should be drained and restarted, or several fully exposed films shouldbe processed to lower the chemical strength of the developer.

35

Page 44: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time

Previous New

Actions (Circle One See Key) Setting Setting Comment

3127 !OS'am CL CC CO CF RI RI. MD MF TO N MR OT 75.

10,1 CAT CL CC CD CF RI RI (50 TO TW MR OT

3110 440 le CL CC CD CF RI RL MD MF TO TW MR

am

pm CL CC CO CF RI RL MO MF TO TW MR OTam------pm CL CC CO, CF RI RI MO MF TO TW MR OT

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

pm CL CC CO, CF RI RI MO MF TO TW MR OT

am

pm CL CC CO CF RI RI MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MD 'MF TO TW MR OT

am

pm CL CC CO CF RI RI MD MF TO TW MR OT410.am

pm CL CC CO CF RI RI MO MF TO .TW MR OT

am

pm CL CC CD CF RI RI MD MF TO TW MR OT

am

pm CI CC CD CF RI RI MO MF TD TW MR OT

am

pm CL CC CD CF RI RL MO MF TO TV MR OT1.10. 01.111.11011.

cons

...fte

wmM.. Immu.14..mMWEr.aimmayl..

dm

pm CL CC CO CF RI

am

CL CC CO CF RI

am

pm CL CC CD CF RI

ail

pm CL CC CO CF RI

KEY: CL Cleaned

CC Total Chemistry Change

68 CO Changed Developer

CF Changed Fixer

RL MD ME TO TW MR 01...

RI MD MF TO TW MR OT

RI MD MF TO TW MR OT

RL MO MF TO TW MR OT

ilMoloWIMMIN

0111IMMIMO ..1

RI Increased Replenishment Rate

RI Lowered Replenishment Rate

MO - Mixed New Developer Replen,

MF Mixed New Fixer Replen.

1104401Mos

TO Developer Temperature Adjust,

TW Water Temperature Adjust.

MR - Mechanical Repair

'OT - Other (comment)

Page 45: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 46: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Cate Time Actions (Circle One See Key) Setting Setting Comment

31x1 os.r CL CC CD CF (g) RL MD MF TO TW MR OT 775' 6 iiC).

3111 cpv CL CC CO CF RI RL

3110 00 41)

am

TO TW MR OT

CL CC CO CF RI RL MD MF TO TW MR

CL CC CD CF RI RL MD MF TO TW MR OT...12). ,g5',

TW MR OT

to.WmINVINNaP

pm CL CC CO, CF RI RL MD MF TO

am

pm CL CC CO CF RI RL MD MF TO

am .

pm CL CC 'CO CF RI RL MO MF TO

am

pm CL CC CO CF RI RL MD MF TD

am

pm CL CC CO CF RI RL MO 'MF TD

am

pm CL CC CD CF RI RL MD MF TO

am

pm CL CC CD CF RI RL MD MF TO

am

Pm CL CC CD CF RI RL MD MF TO

TW MR OT

TW MR OT

TW MR OT

TW MR OT

TW MR OT

TW MR OT

TW MR OT

am

pm Cl CC CD CF RI RL MD MF TO TW MR OT

am

pm CL CC CO CF RI RL MD MF TO N MR OT1....100.0.111M0 1.=1

am

pm Cl CC CD CF RI RL MD MF TO TW MR OT

am

pm CL CC CD CF RI RL MD MF TO 11 MR OTPAMIIIMI0110 11am

pm CL CC CO CF RI RL MD MF TO 11 MR OT41=116..MIMmt U11041MMIMMam

pm CL CC, CD CF RI RL MO MF TO TW MR OT

1,011mw.

ftIrdiOImMII

KEY: CL Cleaned RI Increased Replenishment Rate

CC Total Chemistry Change RL Lowered Replenishment Rate

CO Changed Developer ND Mixed New Developer Replen,

CF Changed Fixer MF Mixed New Fixer Replen.

0,....1.=mma

TD - Developer Temperature Adjust.

TW - Water Temperature Adjust,

MR Mechanical Repair

'OT - Other (comment) 73

Page 47: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Under-replenishment.

CORRECTIVE ACTION: Increase replenishment rate and add enough replenisher directly tobring processor back within the control limits.

EXPLANATION: This is perhaps the most common recurrent problem. A gradual fallofftrend can be seen in both the MD and DD, indicating a gradual reduction in development.As before, this is generally the earmark of improper replenishment causing a gradualdecrease in developer strength, although over-diluted replenisher may bring similar results.In this 'Case, an inadequate replenishment rate existed meaning that, on the average, eachradiograph was using up more developer than was replaced via replenishment.

The proper corrective action is to increase the replenishment rate. Also, additionalreplenisher should be directly added to the processor developer tank (in approximately 100ml increments) until the processing is again within control limits. This may be done bymanually tripping the replenisher microswitches, by carefully pouring fresh developerdirectly into the developer tank using a container, or by running a few previously processedfilms.

39

Page 48: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time' Actions (Circle One See Key) ' Setting Setting Comment

2M

CL CC CD CF (g) RL MD MF TO TW MR OT 75. 3C)

CL CC CO CF RI RL MD TO TW MR OT

am

3130 yOOt CL CD CF RI RL MO MF' TO TW MR

am

3

Pm'

am

Pm

pm

PM1......2PM

am

PM

am

Pm

am

Pm

am

Pm

am

Pm

am

Pm

am

Pm

2M

PM

Pm

4.1.1,11.

VM,../

1.1.1.MM*101.

CL CC CD CF (7,9 RL MD MF TO TW MR OT

CL CC CD. CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL MO MF TO TW MR OT

CL CC CD CF RI RL MO 'MF TD TW MR OT

CL CC CO CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL 110 MF TO TW MR OT

CL CC CD CF RI RL MO MF TO TW MR OT

CL CC CO CF RI RL MO MF TO TW MR OT

CL CC CD CF RI RL MD MF TO TW MR OT

CL CC CO CF RI RL MO MF TO TW MR OT

CL CC CO CF RI RL MO MF TO TW MR OT

CL CC CD CF RI RL MD MF TD TW MR OT

CL CC CD CF RI' RL MD MF TO TW MR Ur

KEY: CL - Cleaned

CC Total Chemistry Change

CD Changed Developer

CF - Changed Fixer

RI Increased Replenishment Rate

RL Lowered Replenishment Rate

ND Mixed New Developer Replen,

MF Mixed New Fixer Replen.

=rins

IMP101011

TO Developer Temperature Adjust,

TW Water Temperature Adjust,

MR Mechanical Repair.

'OT - Other (comment)

Page 49: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

CO

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1.-1

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Page 50: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

am

auf

pm CL CC CD CF RI

am

pm CL CC CD CF RI

8111

pm CL CC CO CF RI

am

pm CL CC CD CF RI

am

pm CL CC CD CF RI

8M

PM CL CC CO CF RI

am

pm CL CC CO CF RI

Previous New

Actions (Circle One - See Key) Setting Setting Comment

CL CC CO CF@) RL MD MF TO TW MR OT 775 3C)

CL CC CO CF RI RI (3)(g) TO TW MR OTgiflitlIkk.ktkvA4S (.00

CL CC CD CF RI RL MD MF TO TW MR (0)

CL CC CD IF (E) RI. MD MF TO TW MR

CL CC CD. CF RI RI MD MF TO TW MR

ilowan..

am

pm CL CC CO CF RI

am

pm CL CC CO CF RI

am

Pm CL CC CD CF RI

am

Pm CL CC CD CF RI

am

Pm CL CC CO CF RI

am

pm Cl CC CD CF RI

KEY: CL Cleaned

CC - Total Chemistry Change R

CO - Changed Developer MO

CF - Changed Fixer

at; gtAiltit Qol 1C()RI MD MF TO TW MR OT

RI MD MF TO TW MR OT

RI MO MF TO TW MR OT

RL MD 'MF TO TW MR OT

RI MD MF TO TW MR OT

RI MO MF TO TW MR OT

RI MD MF TO TW MR OT

RL MD MF TO TW MR OT

RL MD MF TO TW MR OT

RI MD MF TU TW MR OT

RI MD MF TO TW MR OT

RL MD MF TO TW MR OT

RI MD MF TO TW MR OT

I Increased Replenishment Rite

I Lowered Replenishment Rate

- Mixed New Developer Replen,

F Mixed New Fixer Replen,

Ii..110.111=1.1prowar...11=1101.

1111.111MWMIMmIPIIMMIIIIIMMIIS1.01111111112.

TO - Developer Temperature AdjUst.

TW - Water Temperature Adjust,

MR - Mechanical Repair

OT - Other (comment) SO

Page 51: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Safe-light fogging.

CORRECTIVE ACTION: Replace safe-light bulb with one of the correct wattage.

EXPLANATION: The observation which suggests the existence of safe-light fogging in thisexample is the elevated MD with little or no change in the DD or B+F. The basis of thiseffect is that the small exposure increases caused by safe-light fogging result in muchlarger increases in optical density in the medium density (straight line region of the H&L)curve) range than in the high (Shoulder) or low (Toe) density ranges. Figure 2 demonstratesthis effect (1). Thus, the safe-light may result in no density increase at the B+F point, andthe small increases in both points used to calculate DD (one around 0.5 O.D. and one around2.5 O.D.) may cancel each other out leaving only the increase observed on the MD. Safe-light fogging may be quickly verified by simply making a second sensitometric strip with allsafe-lights turned off.

In this instance, it was found that the hospital's maintenance crew had inadvertentlyreplaced the 15 watt safe-light bulb with a 100 watt bulb. The problem disappearedfollowing replacement.

3.00

2.50

2.00

1.00

0.50

0.'30

1.5 min.

No Fog

0.16

0 10 26% Increase

0.00 0.50 1.00 1.50

Log Relative Exposure

2.00

Figure 2. Effect of safe-light fogging on the H&D curve.

Note that the increase in density due to safe-light exposure is much greater for themedium density region around 1.0 O.D. where the MD index is taken. The increases aroundboth points at which the contrast index (DD) is calculated are approximately equal and willtherefore normally cancel out leaving the DD relatively unchanged. Observe that there isessen daily no change in the base plus fog, although this area is usually checked for fog.

43 8

Page 52: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

8"

ACTIONS ON PROCESSOR

Previous NewDate Time Actions (Circle One - See Key) Setting Setting Comment

am

Cc CD CF (RI) RI MD MF TO TW MR OT. ,7S'

tOpe Cl CC CD CF RI RI (MF ) TO TW MR. OT

4,1111Ligi2s24.1.4.6).0

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(1 10 Cl CC CD CF RI RI MO MF TO Tli MR OT..

a

2112.115 CI CC CD, CF RI RI MO MF TO TW MR eaui

pm CL CC CD CF RI RI MD ME TO TW MR OTam

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it,

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am

pm ct. CC co CF RI RL MO MF TO N MR OTam

pm CL CC CD CF sii Rt tID ME 10 N MR OTam

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pm, CL CC CD CF RI RI MO MF TO TM MR OT

am

pm CL CC CO CF RI RI MO ME TO TW MR OTMMEWWWwdmm...

pm CL CC CD CF RI 111. MD MF TO TW MR 0TMIMWW.M.W. wwww

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CC

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CF

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- Cleaned

Total Chemistry Change

- Changed Developer

- Changed Fixer

RI Increased Replenishment Rate

RL - Lowered Replenishment Rate

MD Mixed New Developer Replen,

ME Mixed New Fixer Replen,

TO - Developer Temperature Adjust,

TW - Water Temperature Adjust,

MR Mechanical Repair

OT - Other (come it)

83

Page 53: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

AIL

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Page 54: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous Mew

Date Time Actions (Circle One See key) Setting Setting Coment

3Z7 !O CL CC CD CF RI RI MO MF TO If! iiR of .,75

3111 4.111 CL CC CD CF RI RL 0 TO TW MR CT

3 lo CL CC CD CF RI RI MD MF TO rW MR

am

.3.11.210 Cl CC CD CF RI RI MO MF TO N MR

41/ .3 S CL CC CO CF RI RI MD MF TO N MR

ItALE Cl CC CO CF RI RI MO r' T N MR

pm Cl CC CO.

TI

pm CL CC CD

am

pm CL CC CO

am

pm CL CC CD

am

pm CL CC CO

Gill

pm CL CC COamWINININN10...

pm CL, CC CD

am

pm CL CC CO

Ci CC CD

pm CL CC CO

am

pi CL CC CO

al

pm Cl CC CD

CF RI

CF RI

CF RI

CF RI

CF RI

CF RI

CF RI

CF RI

CF RI

Cr RI

CF RI

CF RI

12 Cl , Cleaned.

CC - Total Ci4mistry Change

Changed Developer

Ci Changed Fixer

RI MD MF TO TW MR

RI, MD MF TO TW MR

RL MD 'If .TO TW MR

RI MD MF TO TW MR

RI MD MF TO IV MR

RI MD MF TO N MR

RI MO MF TO TV MR

RI MO MF TO N MR OT .

$110,

RI, MO MF TO TW MR OT

RI MO ME TIP; TV MR OT

RI, MD MF TO TW MR OT

RI. MD ME TO TW MR OT

OT

OT

OT

OT

OT

OT

OT

NalmlaNNIMMII .10

aMMOIMOMMONM

RI Increased Replenishment Rate

RI Lowered Replenishment Rate

MD gixed New Developer Repl en.

g Mixed *it; Fixer Replca,

amangMI.Mal ..OMMOGMan

TO - Developer Temperature Adjust.

TW - Water Temperature Adjust,

MR Mechanical Repair

OT Other (comment)

Page 55: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Developer thermostat set too high.

CORRECTIVE ACTION: Turn back thermostat setting until proper temperature is achieved.

EXPLANATION: It was stated earlier that changes or fluctuations in the developertemperature are not generally the result of an improper thermostat setting. In this case,however, the developer temperature was found to be excessively high (93.50 as opposed tothe proper 92°) and remained high, with no other possible cause being found. (Both the washwater temperature and pressure were normal and therefore not at fault. You must thenassume that the thermostat setting has actually been changed, possibly as a result ofunauthorized tampering.

Rese the thermostat and watch the developer temperature. If there is a recurrence, itmay indicate th onset of thermostat malfunction, and must be checked out by a repairman.

47

Page 56: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time

am

OS' CL

3119 4:01 CL

30 00 CL

am

lo a CL

17 3:1S CL

io q;15 pm CL

Actions (Circle One See Key)

CC CO CF (g) RL MO MF TO

CC CO CF RI RL (30 TO

CC CO CF RI RL MD MF TO

CC CD CFa RL MD MF ID

CC CD CF RI RL 1 MF TO

CC CD CF RI RL MD MF

Previous New

Setting Setting Comment

TW MR OT..jal

DI MR OT

TW MR (OD

TW MR 4T...121. IL

TW MR

TW. MR OT t)

am

pm CL CC CO CF RI RL MO MF TO TW MR OTellommolore Wwmmmam

pm CL CC CO CF RI RL MD MF TO TW MR OT

alil

pm CL CC CD CF R. RL MO 'MF TO TW MR OT

am

pm CL CC CD CF RI RL MD = TO TW rR OT

am

pm CL CC CD CF RI RL MD MF TO TW MR OT

pm CL CC CD CF RI RL MO MF TO TW MR OT

am

pm CL CC CD CF RI RL MD MF ID TW MR OT

pm CL CC CD CF RI RL MO MF TO TV MR OT

dM

pm CL CC CO CF RI RL MD MF TO DI MR OT

am

pm CL CC CD CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MO MF TO 111 MR OT110.....1

pm CL CC CF RI RL MD MF TO TW MR OTdallxMW14.... 11140.1 .41..01.MbNiN

Ortwwwww...do 11.r1

wrop .1.m..11 mml,

KEY: CL - Cleaned RI .

CC - Total Chnistr Change RL -

CD - Changed Developer MD -

CF - Changed Fixer MF

Increased Replenishment Rate

Lowered Replenishment Rate

Mixed New Developer Replen,

Mixed New Fixer Replen,

lomm.1.10mminowlwaw.1001fRapligWVI10101.1simmimmimma.rrd

TO - Developer Temperature Adjust,

TW 'Ater Temperature Adjust,

MR Mechanical Repair

)T - Other (comment;

Page 57: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 58: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

J30 ;OS CL CC CD CF (12) RL MO ME TO TW MR OT ,675-. ,q()

0191 CC CO CF RI RL TO TO TW MR P.4111CLISA11±241.1mSgi......

11130 11006 CL CC CO CE RI RL MO ME TO TW MR

am

4 13 CL CC CO CFa RL MO ME TO. TW MR 01.10

i 17 3 IS CL CC CD. CF RI RL MD MF TO TY MR ;4244) go4tIft 40(1, (/5.4)

11110CL CC CO CF RI RL MO ME TW MR OT 915 tr 12.0

CL CC CO. CF RI RL MD ME TO TW MR OT 1)

am

pm' CL CC CD Cr' RI RL MO ME TO TW MR OT

am

pm CL CC CO CF RI RL MO v TD TW MR .0T

v. am0

pm CL CC CD CF RI RL MO MF TO TW MR OT.

am

pm CL CC CO CF RI RL MD MF TO .TW MR OT

am

pM CL CC CO CF RI RL MO MF. TD TW .MR OT

am

pm CL CC CD CF RI RL MD ME TO TW.MR OT

am

pm Cl CC CD CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MD ME TO DI MR OT

am

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

Pm CL CC CO CF RI RL MD MF TO TW MR OT

am

pm CL CC CD CF RI RL MD MF TD V MR OT

CL - Cleaned

CC - Total Chemistry C

CD - Changed Developer

F - Changed FixerC

RI Increased Replenishment Rate

hange RL Lowered Replenishment Rate

MD Mixed New Developer Replen,

ME New Fixer Replen,

TO - Developer Temperature Adjust,

TW Water Temperature Adjust.

MR Mechanical Repair

OT - Other (comment)

Page 59: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Developer replenisher line pinched..

CORRECTIVE ACTION: Remove obstruction and refill developer tank.

EXPLANATION: There. is not really any way to "diagnme this particular problem from thesensitometric data alone. You will quickly discovc: it, however, by simply removing the lidto look at the processor. The point is that observation's of the processor itself must not beoverlooked in processing a QA problem. In this case, by observing the very low level in thedeveloper tank, you would realize that a blockage might be preventing replenisher fromreaching the processor. Since each film carries a signficant amount of developer out of thedeveloper tank into the fixer, it would not take long to deplete the tank.

The correct procedure is to look for possible ca,..-,es of the apparent blockage. In thiscase, a box of supplies had been accidently placed on top of the replenisher line, preventingreplenishment from reaching the processor. Removing the object eliminates the problem.

Similar problems could also be caused by a clog, somewhere in the line by dirty orclogged filters.

51

Page 60: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Developer replenisher line pinched.

CORRECTIVE ACTION: Remove obstruction and refill developer tank.

EXPLANATION: There.is not really any way to "diagnose" this particular problem from thesensitometric data alone. You will quickly discover it, however, by simply removing the lidto look at the processor. The point is that observations of the processor itself must not beoverlooked in processing a. QA problem. In this case, by observing the very low level in thedeveloper tank, you would realize that a blockage might be preventing replenisher fromreaching the processor. Since each film carries a signficant amount of developer out of thedeveloper tank into the fixer, it would not take long to deplete the tank.

The correct procedure is to look for possible causes of the apparent blockage. In thiscase, a box of supplies had been accidently placed on top of the replenisher line, preventingreplenishment from reaching the processor. Removing the object eliminates the problem.

Similar problems could also be caused by a clog somewhere in the line or by dirty orclogged filters.

9551

Page 61: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

as77

31Z9 !t4jot

3130 po

913

411

410

am

Previous New

Setting Setting

CL CC CD CF RI RI MD ME TO TW MR OT 75- it

CL CC CO CF RI RI Q TO TW MR OT

CL CC CO CF RI RI MD MF TO TW MR (FT) torn

CI. CC CD CF (RI) RI. MO ME TO TW. MR OT.2. .21

CL CC CD. CF RI RI MD ME 70 TW MR (0) g

CL CC CD. CF RI RL MO ME TD TW MR OT ,S° 2141,:m

Cement

10 ilLET CL CC CO. CF RI RI MD MF .TO TW OT

915 0 am Cl CC CD CF RI RI MD MF TO T41 MR OT

MMNIIMdIMMMY.MYMP

pm CL CC CD CF RI RL MO '11F, TD TW MR (IT

am

pm CL CC CD CF RI RI MD MF TO TW MR 01

1111011MMIMMMINI

am

pm CL CC CD CF RI RI MD ME TD .TW MR OT

a M

pm CL CC CD CE RI RI MO MF TO TW, MR OT

am

pm CL CC CD CF RI RI MD MF TD TW MR OT

am

pm CL CC CD CF RI RI MD MF TO TW MR OT

am

Pm CL CC CD CF RI RI MO MF TO TV MR OT

am

Pm CL CC CO CF RI RI MD MF TO TW MR OTam11NIMMENI.I.MIIMN= P..

pm CL CC CD CF RI RI MD ME TO TW MR (jT

1.=101.11.aM

pm CI CC CD CF RI RI MO MF TO TV MR OT

RI Increased Replenishment Rate

e RI Lowered Replenishment Rate

MD Mixed New Developer Replen.

ME Mixed New Fixer Replen,

gEY: CL . Cleaned

CC . Total Chemistry Chang

CO - Changed Developer

CF - Changed Fixer

larrimorimmue

Ir.... SIMMIMIOOmMil

111=.1.1.11110.0

immxma.00

=.=MNIOMMI

AM10=.1

INIT.164eAkAm.0.1=mmwriara.m

VAINAkwomonwar.k.

TO - Developer Temperature AdjUst.

TW - Water Temperature Adjust.

MR - Mechanical Repair

'OT - Other (comment) 9','

Page 62: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 63: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

AXONS ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

CS. CL CC CD3177

Previous New

Setting Setting Comment

CF c) RL MD MF ID TW MR 01..21

4.10 CL CC CD CF RI RL (5E) TO TW MR OT.......... gif3likklai_am

3 1all

CL CC CD CF RI RL MD MF TO TV MR g5iin,h conciht,wa_c) I 51214p

CL CC' CD CF (RI) RL MD MF TD TV MR OT og() sc,

CL CC CD. CF' RI RL MD MF ID TV MR eCL CC CD, CF RI RL MD MFO TV MR OT 91,13; le t)

HIP1 112 CL CC CD, CF RI RL MD MF ID TW MR OT . Dio.)1414 Low-Lots e clki

am

till; 6:oog@C:) CD CF RI RI., MD MF TO TV MR OT . ilttri'lrlf. ((WI IPIC

4 116 ,Ips pm CL CC CD CF RI RL MD MF :T0 TN MR0am

Foltit it Coli) qittetcr

0P pm CL CC CO CF RI RL MD MF TO 11 MR OT

OYINOM ...4.11001...4

am

pm CL CC CO CF RI RL MD MF TO TV MR OT

am

pm CL CC CO CF RI RL MD MI' TD TW MR OT

am

pm CL CC CD CF RI RL MD MF TO TW MR OTIiam

4....WWWW MMIIIMOMMIMP inM,WI.EaMMMNEMMII~a

pm CL CC CD CF RI RL MD MF TD TV MR OTOM~1.1, 1.._1111001 1.01

am

pm CL CC CD CF RI RL MD MF TO TV MR DT

am

pm CL CC CD CF RI RL MD MF TD TV MR OT

am

pm CL CC CO CF RI RL MD MF TO TV MR OTmIlmWMIM.~~em OPIM.1.

am

pm CL CC CD CF RI RL MD MF TO TV MR OT

KEY: CL Cleaned

CC - Total Chemistry C

CD - Changed Developer

CF - Changed Fixer

10d

RI Increased Replenishment Rate

hange RL Lowered Replenishment Rate

MD Mixed New Developer Replen.

MF Mixed New Fixer Replen,,

Malmw1IIINMINNI

MI.INNEMIIMIMINN.41

11.0M

01411.10r441

TD - Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR . Mechanical Repair

OT - Other (comment)

Page 64: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Did not add starter solution following chemistry change.

CORRECTIVE ACTION: Drain developer tank and restart with addition of proper amount ofstarter.

EXPLANATION: It is observed that shortly after a routine cleaning and chemistry changeboth the DD and MD are too high. Look immediately for a cause associated with thischemistry change (after, as usual, first seeing that the developer temperature is normal).Since new replenisher was not mixed, the problem must be limited to the developer in theprocessor. The most probable cause of the excessive chemical strength is failure to addsufficient (or any) starter solution when refilling the processor.* (Insufficient chemicalstrength found after a chemistry change would suggest contamination of the developer withfixer, as in an earlier example.)

It is again difficult to verify this cause unless the individual involved happens toremember. If you cannot, proceed with the draining and -.estarting of the processor withoutverification, being careful to add the proper amount of starter solution. If the assumptionwas correct, the problem should then disappear.

Although the frequency of this type of problem depends on how careful each facility'spersonnel is, it is generally a very good idea to make a sensitometric strip after everychemistry change to ensure that the proper level of processing is restored. In fact, it is agood idea to run a sensitometric strip after any maintenance or corrective activity on theprocessor, to ensure that proper processing is retained or restored.

*Adding starter solution is important to "age" the new developer to a strength found undernormal use. If this is not done, then the strength of this "pure" developer cannot bemaintained as bromide levels increase with use.

55 102

Page 65: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

am

31/7 !os. CL CC CD' CF RI RL MD MF TD N MR 01.2_5° c30

3 Ili ,C0 Cl CC CD CF RI RI (00,TD TW MR OT piflinlskiCktrk LOtO81E1

3 lo '00 CL CC CD CF RI RL MD MF' TO N MR OT cone

CL CC CO CF RI RL MD ME. TO TW MR OT pg0 sg.

411 3:15 Cl CC CO, CF RI RI MD ME TD TW MR e 14/laccgait[tt (Lib IS

cr.15 pm Cl cc CD, CF RI RI MD MF N MR OT 93.S°, ite 11+

D

RbUilht

1.4e

413

0 92 Cl CC CO, CE RI RL MD MF TD TW

am

QC CL CC ICD CF RI RL, MD MF TO TW MR OT

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Page 66: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 67: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

1

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One See Key) Setting Setting Comment

am

OS' CL CC CO CF (g) RL MD MF TO 'Ili MR OT

CL CC CD CF RI RL (3)(!) TO TW MR OT

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KEY: CL - Cleaned

CC - Total Chemistry C

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CF - Changed Fixer

RI Increased Replenishment Rate

hange RL Lowered Replenishment Rate

MO Mixed New Developer Replen,

MF Mixed New Fixer Replen,

TO Developer Temperature Adjust,

TW Water Temperature Adjust,

MR Mechanical Repair

'OT - Other (comment)

Page 68: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Film in film bin fogged.

CORRECTIVE ACTION: Eliminate sources of fogging and replace film.

EXPLANATION: The extremely high base plus fog immediately suggests some form of filmfogging. (Although high developer temperature can cause this amount of fogging, it isnormally accompanied by much greater changes in density difference and medium density.)To determine the source of fogging, the following tests may be performed:

(1) Process several sheets from various parts of the bin (including the contra:. ox)with all safe-lights off.

(2) Perform the test for darkroom fogging described in the manual- 'f itherindicated darkroom fogging, then the problem has been narrowed ..z.s.s.rr Lo thefilm itself.

(3) Run a sheet of film from a new box. If there is still fog on the film, refer to thesection on proper film handling and storage in the manual. If there is no fog,then the problem is only with the film in the bin.

Although the cause could be in the film itself (bad or outdated), look for some externalsource of radiation.* In this example it was found that some radioactive material wastemporarily stored in an adjacent room near the bin.

*The cause of light-fogged film bin is usually indicated by the telltale pattern of low B & Fat the bottom of the boxes and high density at the top, where exposure to the light isgreatest.

The ruined film which is removed from the bin should be kept for use processor clearingfilm or to use as "fully exposed" film in correction actions.

Page 69: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

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MR - Mechanical Repair

'OT - Other (comment)

Page 70: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 71: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

il9 io CL CC CD CF RI (E) MD MF ID TW MR OT

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am

pm CL CC, CD C5 RI RL MD ME TD IN MR OT

am

pm CL CC CO CF RI RL MD MF ID TW MR OT

am

pm CL CC CO CF RI RL MD MF TO TW MR OT

KEY: CL - Cleaned

CC - Total Chemistry C

CO - changed Developer

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MD . Mixed New Developer Replen.

MF Mixed New Fixer Replen.

.....diNogr,..ril014{/aftd~1.11111.00.101

TO - Developer Temperature Adjust,

TN Rater Temperature'Adjust.

MR - Mechanical Repair

'OT - Other (comment)

Page 72: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Replenishment rate too high.

CORRECTIVE ACTION: Lower replenishment rate and run several fully exposed films.

EXPLANATION: As in earlier examples, this problem is indicated by the gradual upwardtrend observed in the Medium Density plot, although the trend in this case is not quite asclear as before and is only seen in the MD region. This does not mean that the apparent over-replenishment has only affected the MD, but that the effect on the DD has probably beenmasked to some extent by random (i.e., inherent) fluctuations.

The proper corrective action, as before, is to readjust downward the replenishment rateand run a few fully exposed films to bring the processor back to within control limits.

63

Page 73: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One See Key)

am

am

pm CL CC CD CF RI RL MD MF ID TW MR OT

am

pm CL CC CD CF RI IL MD MF TO TW MR OT

am

Previous New

Setting Setting Comment

CL CC CD CF RI (!) MD MF ID TW MR OT..11)..

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11

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KEY: CL - Cleaned

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CD - Changed Developer

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RI r Increased Replenishment Rate

RI » Lowered Replenishment Rate

MO . Mixed New Developer Replen.

MF Mixed New Fixer Replen.

TO - Developer Temperature Adjust,

TM .'Water Temperature Adjust,

MR Mechanical Repair

DT - Other (comment)

16

Page 74: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 75: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One - See Key)

am

2 10 CL CC CO CF Ri (E) MD MF TD TW MR 01...,10 7;

27 g :05 pm CL CC CD CF RI RL MD MF TO TN MR

am

pm CL CC CD CF RI IL MD MF ID TW MR OT

am

Previous New

Setting Setting Comment

visow.egl.p.mrm===tmpws

pm CL CC CO CF. RI RL MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MD MF T0 TW MR OT

am

pm CL CC CD CF RI RL MD MF TO TW MR OT

am

pm CL CC CO CF RI RL MD MF TD TN MR OT1.1 101am

pm CL CC CO CF RI RI MD MF TD TW MR OT

am

pm CL CC CO CF RI RL MD 'MF TO TW MR OT

am

pm CL CC CO CF RI RL MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MD MF TD TN MR OT

am

Pm CL CC CD CF RI RL MD MF. TD TW MR OT

am

Pm CL CC CD CF RI RL RD MF TD TV MR OT

am

pm CL CC CO CF RI RL MO RP TD TW MR OT

am

Pm CL CC CO CF RI RL MD MF TO TN MR OT

am

Pm CL CC CO CF RI RL MD MF TO TW MR OT

0....nomeam

Pm CL CC CO CF RI RL MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MO MF TO TN MR OT

KEY. CL - Cleaned

CC - Total Chemistry Change

CD Changed Developer

CF - Changed Fixer

1.....M. ill1

..Miww.wwzmiti

ro.. 41. smImpmwmomm...ammisrm

wri.iso 01111111110M.I

RI Increased Replenishment Rate

RL - Lowered Replenishment Rate

MD - Mixed New Developer Replen,

MF Mixed New Fixer Replen,

TD Developer Temperature Adjust,

111 Rater Temperature Adjust.

MR Mechanical Repair

07 . Other (comment)

Page 76: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Chemical oxidation.

CORRECTION ACTION: Add fresh developer directly to processor developer tank.

EXPLANATION: This is another example of the reduction in developer strength that canoccur over an extended period of low-volume processing as a result of interaction of thechemistry with the atmosphere (oxidation and evaporation). You will again observe that theeffect is more pronounced in the DD plot than in the MD due to the faster oxidation ofhydroqu inone.

The proper corrective action is to add fresh developer directly to the processordeveloper tank by the methods prevously described until acceptable processing levels arerestored.

Three important points must be emphasized, however, for the proper evaluation andcorrection of this common occurrence.

(1) If the processor was shut down (e.g., over the weekend) then sufficient time mustbe allowed for the processor to reach proper operating temperature before asensitometric strip is run. If this is not done, then the sensitometric indicationof low development may be the result of low temperature rather than fromoxidation.

(2) If the period of low-volume processing was unusually long (i.e., after a holidayweekend), the oxidation effect may be much more severe than is shown here. Ifthis is the case, dump the developer and restart the processor rather than try tocorrect it by adding fresh developer.

Most important, oxidation in the developer tank is primarily the result of itselevated temperature (over 900). If the processor must be left running duringlow-volume periods (such as weekends) then a "stand-by" system would be a goodinvestment. These systems maintain the processor in an "on" conditon, butreduce the water flow and hold the developer several degrees below its operatingtemperature. When taken off "stand-by" condition, the developer is quicklybrought up to its operating temperature. These systems usually conserve asignificant amount of water and electricity during low-volume periods, and thereduced temperature greatly reduces chemical oxidation.

(3)

67 123

Page 77: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Cir.cle One - See Key) Setting Setting Comment

b.4 :0 CL CC CO CF RI (E) MD MF TD TW MR OT,

(1?

.3.1./LS:OS pm Cl CC CO CF RI RL MO ME TO TM MR (01)

am

pm CL CC CO CF RI RI MD ME TO TW MR OT

am

pm Cl CC CO CF. RI RI MD MF TO TM MR OT

am

pm Cl CC CD CF RI RL MD ME TO TW MR OTNIMMIIMENIMM. ==

am

pm CL CC CD CF RI RI MD MF TO TW MR OT

pm Cl CC CO CF RI RI MO MF TO TW MR OT

1.11.1=1MO

IMPMIMMMI.1. MMIIMIMMM=

.01.1.111 1.1101mOMM. WW.mmi.M111101MIMMIMMEMMUM

am

MMIOwanaMfmMl.

pm CL CC CO CF RI RI, MO ME TD TM MR OT

am

pm CL CC CO CF RI RI 'MO 'MF TO TW MR OT

am

pm CL CC CD CF RI RI MD MF TO TW MR OT .

am

pm CL CC CO CF RI RI MD MF TO .TW MR OT

am

pm CL CC CO CF RI RI MO MF. TO TV MR OT

am

pm Cl CC CD CF RI RI MO MF TO TW MR OT

am

pm CL CC CD CF RI RI MO MF TO TM MR OT

am

pm CL CC CO CF RI RI MD MF TO TW MR OT

am

pm CI. CC CO CF RI RI MD MF TO TM MR OT

am

pm Cl CC CD CF RI RI, MO MF TD TW MR OT

am

pm CL CC CO CF RI RI MD ME TD TW MR OT.

CL - Cleaned RI

CC - Total Chemistry Change RI

CO - Changed Developer MD

CF - Changed Fixer MF

Increased Replenishment Rate

Lowered Replenishment Rate

Mixed New Developer Replen,

Mixed New Fixer Replen,

MMIN1IM11

TO - Developer Temperature Adjust,

TW . Water Temperature Adjust,

MR . Mechanical Repair

.01 - Other (comment). 125

Page 78: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 79: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

am

Lihti 0.10 lip CL CC CO CF RI E) MO MF TO TW MR OT q .45.6

g:05 pm CL CC CO CF RI RI MO MF TO Tit MR a,am

q [30 q106 CL CC CO CF RI .RL MD MF TO TN MR

am

pM CL CC CD CF' RI RI MO MF TO TW MR OT111.E,pm CL CC CO CF RI RI MO MF TO TW MR OT

am

pm CL CC CD CF RI RI MD MF TO TW MR OT

am

pm CL CC CO CF RI RI MD MF TO TW MR OT

11IMINftwg..WIWN MPIMI

alimmmmMOOMMIMMMMIMMM

pm' CL CC CO CF RI RI MO MF TO TW MR OT

.1d11111m0am

pm CL CC CO. OF RI RL MO 'MF TO TW MR OT

am

pm CL CC CO CF RI RI MD MF TO TW MR OT

am0.0.11M. 1......rmrwroftlinmftum=am

pm Cl CC CO CF RI RI MO MF TO 711 MR OTMomswomm,

am

pm CI CC CD CF RI RI MO MF.,TO TW MR OT

pm CL CC CD CF RI RI MO MF TO TW MR OT

am

pm Cl CC CO C RI RI MD MF TO TW MR OT ONft11 IIMOM.NEMR.P.am

pm CL CC CO CF RI RL MO MF TO TW MR OrM011.M.M.11.01MIPM. almmmem.

am

pm CL CC CD CF RI RL MD MF TD TW MR OT

am

pm CL CC CO CF RI RI MO MF TO TW MR

am

pm CL CC CO CF RI RL MO MF TO DI MR OT10.10~1=1101411 MOPIM0=10

KEY: CL Cleaned

CC Total Chemistry Change

CO Changed Developer

CF - Changed Fixer

RI Increased Replenishment Rate

RL Lowered Replenishment. Rate

MO Mixed New Developer Replen.

MF Mixed New Fixer Replen.

TD Developer Temperature Adjust,

TW Water Temperature Adjust.

MR . Mechanical Repair

'OT,- Other (comment)

Page 80: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Cause unknown.

CORRECTIVE ACTION: Add fresh developer until processor is back to within the controllimits.

EXPLANATION: Although it may appear that this exercise was to "trick" the reader, themoral of this example is important: if the cause of a problem cannot be found within areasonable period of time (20-30 minutes), stop looking and just correct the problem.Although it is certainly desirable to "solve" all sub-optimum processing problems, it must bekept in mind that the processor is an important link in a normally busy clinical environment.Thus, the processor should not be tied up for too long a time in searching out the source ofthe problem. The problem should be remedied by the appropriate corrective action (in thiscase the addition of fresh developer to increase developer strength) and the processingobserved for a possible recurrence. if it does not recur, then the problem's source was of noconsequence. If there is a recurrence, then that is the proper time to spend more effort inlocating the cause.

71 130

Page 81: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

13i

ACTIONS ON PROCESSOR

Date Time Actions

am

1.1 CL CC CD

,i1 ;/7 ;Ai CL CC co

11130 Lime CL cc co

am

51q S.3o CL CC Co

pm CL CC CO CF RI RL MD ME TD TW MR OTWINem,~,. .11Mm

am

pm CL CC CO CF RI RL MO ME TD TW MR OT

Previous New

(Circle One - See Key) Setting Setting Comment

CF RI (11) MO ME TD TW MR OT

CF RI RL MD ME TO TN MR

CF RI IL MO ME 'TD TV MR as 12/1h .giAcCIftptgOW6

CE' RI RI® (E) TO TW MR

,20

II...=11.10

11rwrm,

am

pm CL CC CO CF RI RL MD ME TO TW MR 01

am

CL CC CD CF RI RL MD ME TO 111 MR OT...am

pm CL CC CO CF RI RL MD TO TW MR 01

am.

pm CL CC CO CF RI RL MD MF TD TW MR OT

=111..01 =ww.P.IIMMEM=MM,.....ImmOdINNIM

DIMENION.M 1...111P..10

1dm

pm CL CC CD CF RI RL MO MF TO .TW MR OT

am

pm CL CC CO CF RI RL MO MF. TD TW MR OT

am

pm CL CC CO CF RI RL MO ME TO 1W MR OT

am

pm CL CC CD CF RI RL MO MF TO TW MR OT

am

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

pm CL CC CD Cr RI RL MD ME TO TW MR OT

am

pm CL CC CO CF RI RL MD MP TO DI MR OT am.1...1

IMONINIMMIONEN

pm CL CC CD CF RI RL MO Mr TO TW MR OT

KEYS CL - Cleaned

CC Total Chemistry C

CO - Changed Developer

CF - Changed Fixer

RI Increased Replenishment Rate

hange RL Lowered Replenishment Rate

MD Mixed New Developer Replen,

ME . Mixed New Fixer Replen.

TO Developer Temperature Adjust,

TW . Water Temperature Adjust.

MR . Mechanical Repair

'VT Other (comment)

132

Page 82: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 83: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting Comment

am

11119 10 CL CC CD CF RI (E) MO MF TO Di MR OT, ,211.

Litz7 1;:ospm CI. CC CD CF RI RI MO MF TO TW MR

130 4106 a

am

CL CC CD CF RI RI MO MF TD TW MR

am

514 S30 qrp CL CC CD Cr RI RI® (E) TO TW MR OT, Loo

51; ,LIQE CL CC CD CF RI RI MD MF TO TW MR

am

pm CL CC CO CF RI RI MD MF TO Di MR OT

am

Pm CL CC CD CF RI RI MO MF TO TW MR OT

aim

°Nation -14 0014

Pm' CL CC CD CF RI RI MO MF TO TW MR OT

am

pm CL CC CD CF RI RI MO *MF TO TV MR OT

am

pm CL CC CO CF RI RI MD MF TO TV MR OT11111111

pm CL CC CD CF RI RI MO MF TO TV MR OT

am

pm CL CC CO CF RI RI MO MF TO TW MR OT

am

pm CL CC CO CF RI RI MD MF TO TW MR OT,I=RM~...01111.1= 01

am

ENWMEMIMmal

IM.momms

pm CL CC CO CF RI RI MO MF TO TW MR OT

am

CL CC CO CF RI RI MD MF TO TW MR OT

am

OIMENIM.mftlimg MmEl

Pm CI CC CO CF RI RI MD MF TO TV MR OT

am

pm CI. CC CO CF RI RI MD MF TO TV MR (11.

mMMommi0

am

WWWW1M.8

Pm CI CC CD CF RI RI, MO MF TO TW MR OT001.1~..M040 M.FONNWMPO 11~~1...IPOO.11.0.1.11011

KEY: CL Cleaned

CC . Total Chemistry C

CO Changed Developer

CF Changed Fixer

RI Increased Replenishment Rate

huge RI Lowered Replenishment Rate

MD Mixed New Developer Replen.

MF Mixed New Fixer Replen.

'TO Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR Mechanical Repair

OT - Other (comment)

13(J

Page 84: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Replenishment too concentrated.

CORRECTIVE ACTION: Dilute replenisher with water until proper specific gravity isreached.

EXPLANATION: This it another example of a problem encountered in an earlier exercise.The sensitometric indication of high MD arid OD was found shortly after a new batch ofdeveloper replenisher was, mixed. Thus, after first determining that the developertemperature was normal, the next thought should be in the direction of the replenisher tank.A specific gravity test quickly indicates insufficient dilution.

As before, additional water should then be slowly mixed in until the correct specificgravity is obtained. An important point to remember when mixing new developer replen-isher is that it is easy to add more water to get the right specific gravity, but it isimpossible to take out. Therefore, somewhat less water should be added when doing thedilution than is called for, followed by a specific gravity measurement. Then, more watercan be slowly mixed in if required until the right dilution is reached as indicated by thespecific gravity. This "ounce of prevention" can eliminate several incidences of improperprocessing which would require throwing out an entire tank of developer.

137

Page 85: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

?revious New

Date Time Actions (Circle One See Key) Setting Setting Comment

lay lo CI CC

9(27 t(D,

OS CL CC

130 CL CC CD CF RI

am

51q S:30 CI CC CD CF RI.

1;30 pm CL CC CD CF RI

am

pm CL CC CD CF RI

CO CF RIO MO MF TO TW MR 01

CD CF RI RI. MD MF 'TD TW MR011aLtILVA jobilakt.

or,....raPNO

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..=1N.0111...m.

pm CL CC CO CF RI

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am

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am

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am

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am

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am

pm CI

am

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pm CL

RI MO MF TO TW MR

RL ®Q TO TW MR OT

RI. MD MF TO TW MR (!)

RI MD MF TO TW MR OT

RI. MD MF TO TV MR OT

RI. MD MF TO TW MR OT

RI: MD liF TO TW MR OT

CC CO CF RI RI MD MF TO TW MR OT

CC CO CF RI

CC CD CF RI

CC CD CF RI

CC CO CF RI RI MD MF TD TW MR OT

CC 'CO CF RI RI MD MF TO TW MR OT

CC CD CF RI RI MD MF TO TW MR OT

CC CD CF RI RI MO MF TO TW MR OT

CC CO CF RI RI MO MF TO TW MR OT

uK

10010 OwswINMEIM.,.1

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RL MO ME. TD 141 MR OT

RI MO ME TO TW MR OT

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KEY: CL - Cleaned

CC Total Chemistry Change

CD.- Changed Developer

CF Changed Fixer

RI Increased Replenishment Rate

RL lowered Replenishment Rate

MO Mixed New Developer Replen,

MF Mixed New Fixer Replen,

IMMII11

....InIMM...11TO Developer Temperature Adjust,

TW Water Temperature Adjust.

MR Mechanical Repair

OT Other (comment)

13J

Page 86: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 87: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One - See Key) Setting Setting. Comment

am

th 61 10 all CL CC CD CF RI O MO MF TD .114 MR OT. I CIe4127 g:t5pm Cl CC CD CF RI RL MO MF TD TW MR a

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RI Increased Replenishment Rate

RL Lowered Replenishment Rate

MD Mixed New Developer Replen,

MF Mixed New Fixer Replen,

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TO - Developer Temperature Adjust,

TW - Water Temperature Adjust,

MR Mechanical Repair

OT - Other (comment)

Page 88: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: First sensitometric strip not from control box.

CORRECTIVE ACTION: None.

EXPLANATION: The lesson of this exercise is that it is important to verify a processorchange before searching out a processor-related case. This verification consists of nothingmore than making a second sensitometric strip to see if the change is still evident. In thiscase, the second strip was normal. It was then realized that the first strip was erroneouslymade on a sheet of film not taken from the control box.* The observed change was due todifferences in the film and not related to the processor at all.

Other similar "anomalous" sensitometric exposures may be due to momentary electric"surges" through the sensItometer during exposure, as an example. A single additionalsensitometric strip will uncover most such situations, and save searching out a nonexistantprocessing problem.

*There is a fair amount of legitimate feeling that control film should not be kept in the filmbin, this example being one such reason. If it is not kept in the bin, small amounts of itshduld be kept in a light-tight film carrying case, the rest kept refrigerated until needed.There is, however, at least one reason for keeping it in the bin: it be subject to thesame conditions as the regular film, and resulting environmental problems will be evi-denced in the control strips which may otherwise go unnoticed for a length of time. If keptin the film bin, the control film must be readily distinguished from the rest either bykeeping it in its box with the top replaced, or by keeping it in its bag with flap folded over.

79

Page 89: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One See Key) Setting Setting Comment

am

1111 110 iA CL CC CD CF RI (R) MD MF TD TW MR OT.2.1.. ,7g

1:05p CL CC CO CF RI RL MD MF TO TW MR (0!)

am

130 Too Cl CC CD CF RI .RL MO MF, TO TW MR

am

slq S:30 o CL CC CD

Sic 1:30 pm, CL CC CD

511 3:C4i pm CL CC CD

am

pm CL CC CDWIMINWPW =MIME.

am

pm Cl CC CD

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am

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am

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001

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am

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am

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am

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RI MD MF TO DI MR OT

RL 'MD 'MF TO TW MR OT

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hange RL Lower'ed Replenishment Rate TW - Water Temperature Adjust.

MO Mixed New Developer Replen, MR Mechanical Repair

MF Mixed New Fixer Replen. 'OT - Other (comment)

141]

Page 90: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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Page 91: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Previous New

Date Time Actions (Circle One Sc. Key) Setting Setting Comment

am

11,1L. :10 0 CL CC CD CF RI8 MD MF TO TW MR OT

(1?

4117 g :OS pm CL CC CO CF RI RL MD MF TO TW MR (0)

am

Tob CL CC CD V RI RL MD MF TO TW MR

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am

pm CL CC CO CF RI RL MD MF TO TW MR OT

am

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am

pm CL CC CO CF RI RL MD MF TO TW MR OT

KEY: CL . Cleaned

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CF . Changed Fixer

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RL . Lowered Replenishment Rate

MD . Mixed New Developer Replen.

MF Mixed New Fixer Replen,

MMIMMII.M.miummonmplinummoon.ftm.1

TO Developer Temperature Adjust,

TW - Water Temperature Adjust.

MR Mechanical Repair

OT Other (comment)

Page 92: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ANSWER: Replenisher microswitches stuck.

CORRECTIVE ACTION: Repair microwswitches and run several fully exposed films.

EXPLANATION: In this case., the cause of a processing problem could have been detectedby observing the physical condition of the processor itself. An observant individual mayhave noticed that the developed replenisher tank was emptying unusually fast, and that theflow meters showed a continuous stream of replenishment.

The problem was traced to the replenisher microswitches which remained on per-manently as a result of mechanical failure. Following mechanical repair, the processor wasrestarted and the problem solved. Remember, it is very important to remain alert to thephysical condition of the processor. It is, after all, a machine, and machines can malfunc-tion and break down.

Also, as with most machines, much may be observed about the processor's condition bylistening to it. Many minor problems can produce noises different from usual. In thisexample, since you can hear the replenishment pumps on many processors, you. may havenoticed that the pumps were running continuously, or, at least, that they were not going onand off. Thus, listen!

83

i 51

Page 93: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

ACTIONS ON PROCESSOR

Date Time Actions (Circle One See Key)

ilb.4 40; Cl CC CD

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TO Developer Temperature Adjust,

TM - Mater Temperature Adjust,

MR Mechanical Repair

OT - Other (comment)

153

Page 94: DOCUMENT RESUME - ERIC · conjunction with the manual, "Photographic Quality Assurance in Diagnostic Radiology, Nuclear Medicine and Radiation Therapy." Presented are several typical

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ACTIONS ON PROCESSOR

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CL CC CO CF RI RL MO MF TO TW MR OT

CL CC CD CF RI RL MO MF TO TW MR OT

CL CC CO CF RI RL MD MF TO TW MR OT

pm CL CC CD CF RI RL MD MF TO TW MR OT

KEY: CL - Cleaned

CC - Total Chemistry Change

CD - Changed Developer

CF - Changed Fixer

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RL Lowered Replenishment Rate TW -

MD Mixed New Developer Replen, MR -

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ANSWER:' Overreplenishment caused by single emulsion roll film tripping microswitches.

CORRECTIVE ACTION: Run several fully exposed films.

EXPLANATION: The problem indicated in this exercise is one which may be severe infacilities that routinely process strip film (105 mm, cine, etc.) through the regulardepartment processor. If the roll film is processed in such a way as to trip the replenishermicroswitches, then replenishment will be pumped into the processor during the entirelength of the strip film, without using up nearly that amount of developer. Possible

corrective actions:

1. If the processor has microswitches located only at either end of the feed tray,then process the strip film only down the center; then either manually addreplenisher as needed (i.e., as indicated by a sensitometric strip) or use apreviously processed film as a leader*.

2. If the processor has microswitches controlled by a single bar along the entirelength of the feed tray, either replace or readjust the switches so that roll filmdoes not trip them, or turn replenishment rate down very low prior to processingthe strip film; afterwards return rate to normal and correct as before. If thisprocedure is not followed, improper replenishment may result after every stripfilm processed.

TISiricTirie single emulsion roll film is generally of much lower average density (being singleemulsion) than sheet film, the previously processed leader will usually provide sufficientreplenishment, but not if large amounts of roll film are run at once. In this case, it wouldprobably be worthwhile to invest in a roll film processor rather than continue to processroll film under possibly less than ideal conditions.

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AFTERWORD

As a result of the previous exercises, a few patterns of emphasis may have becomeevident to the reader. These points are, in fact, very important and are summarized hereone last time as a final word: .

(I) Many processing problems are the result of human error in actions taken on theprocessor. These can often be avoided by following a few simple rules:whenever chemistry is changed or remixed, test it (either sensitometrically forchemistry inside the processor or by specific gravity for replenisher) do notmake thermostat adjustments unless it is fairly certain that the thermostat isimproperly set; finally, be sure to enter all actions taken on the processor in themaintenance log so problems related to those actions may be quickly correctedwhen they do occur.

(2) Two of the more common processing problems are caused by improper replenish-ment and improper wash water temperature. The first will usually have to belived with as unavoidable if there is a large daily variation in workload and examdistribution. The second can usually be eliminated to some extent throughinvestment in high quality mixing valves and pressure regulators.

(3) Remember not .to spend a lot of time tracking down the source of every pro-cessing problem. If you cannot be find it in about a half hour or less, thenproceed to counteract it without looking further. If a problem reappears, thenspend more time in searching out its origin.

(4) With experience, most problems can be quickly and easily solved with little morethan diligent monitoring and common sense.

A word of warning (and consolation) is given to "small" facilities with automaticprocessors which process 50 sheets of 14" x 17" film (or the equivalent) per day. These "lowvolume" processors are, for the most part, extremely difficult to stabilize or maintain.Success may be achieved, however, through the use of standby systems and a techniqueknown as "flood replenishment," a method in which developer replenisher containing startersolution is introduced into the processor at timed intervals, regardless of the number offilms being processed (3).

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REFERENCES

1. Gray, J. E.: Photographic Quality Assurance in Diagnostic Radiology, NuclearMedicine, and Radiation Therapy Vol.'s I and II. DHEW Publications (FDA) 76-8043(1976) and (FDA) 77-8018 (1977).

2. "Radiation Protection During Medical X-Ray Examinations, Part 6. A Basic Program:Quality Control for the Automatic Film Processor," (slide-tape package available fromNational Archive and Record Service, GSA, Washngton, D.C. 20409), DHEW Publication(FDA) 78-8061, April 1978.

3. Frank, D.E., J.E. Gray, D.A. Wilken: Flood Replenishment: A new method of processorcontrol, Mayo Clinic, 1979.

BIBLIOGRAPHY

Goldman, L.W., J.J., Vucich, S. Beech, W.L. Murphy. Automatic Processor QualityAssurance: Impact on a Radiology Dept., Radiology, 125:591-595 (1977).

Stears, J.G., J.E. Gray, and N.T. Winkler. Evaluation of PH monitoring as a method ofprocessor control, Radio! Technol 50, No. 6:657-663 (1979).

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U.S. GOVERNMENT PRINTING OFFICE: 1981-0-341-177/14

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FDA 80-8070

FDA 80-8092

FDA 80-8095

FDA 80-8096

FDA 80-8100

FDA 80-8101FDA 80-8102FDA 80-8103

FDA 80-8104

FDA 80-8105FDA 80-8106

FDA 30 -8107

FDA 80-8108

FDA 80-8109FDA 80-8110

FDA 80-8116

FDA 80-8117FDA 80-8118FDA 80-8119

FDA 80-8120FDA 80-8121FDA 80-8122

FDA 80-8123

FDA 80-8124

FDA 80-8125

FDA 80-8126

FDA 80-8127

FDA 80-8128

FDA 80-8129

FDA 80-8130FDA 80-8131FDA 80-8135

Bureau of Radiological Health Publications Subject Index (supersedes FDA 80-8070, October 1979) (PB 80-201221, $5.00).Biological Bases for and Other Aspects of a Performance Standard for. LaserProducts (PB 80-128648, $6.00).Quality Assurance for Fluoroscopic X-Ray Units and Associated Equipment (PB 80-129778, $8.00).Quality Assurance for Conventional Tomographic X-Ray Units (PB 80-128838,$7.00).Implementation of a Quality Assurance Program for Ultrasound B-Scanners (PB 80-138340, $6.00).Ionization Chamber Smoke Detector Meeting (PB 80-128705, $7.00).Inexpensive Microwave Survey Instruments: An Evaluation (PB 80-114028, $5.00).Analysis of Some Laser Light Show Effects for Classification Purposes (PB 80-131576, $5.00).The :tcicction of Patients for X-Ray Examinations (GPO 017-012-00285-4, $3.50).(PB 80-157431, mf only).X Rays: So You Want To Be In Pictures? (Bookmark).An Evaluation of Microwave Emissions from Sensormatic Electronic SecuritySystems (PB 80-155385, $5.00).Quantitative Analysis of the Reduction in Organ Dose in. Diagnostic Radiology byMeans of Entrance Exposure Guidelines (GPO 017-015-00164-4, $1.75) (PB 80-174956, mf only).Positive Beam Limitation Effectiveness Evaluation (GPO 017-015-00163-6, $2.00)(PB 80-166937, mf only).Proceedings of a Workshop on Thermal Physiology (PB 80-187867, $8.00).Quality Assurance Programs for Diagnostic Radiology Facilities (GPO 017 -015-00166 -1, $2.50) (PB 80-183338, mf only).Chest X-Ray Screening Practices: An Annotated Bibliography (GPO 017 -015-00167-9, $3.50) (PB 80-183890, mf only).X Radiation and the Human Fetus - A Bibliography (PB 80-157712, $15.00).A Word of Caution on Tanning Booths (brochure).Measurements of Emission Levels During Microwave and Shortwave DiathermyTreatments (GPO 017-015-00168-7, $1.75) (PB 80-194772, mf only).Microwave Oven Radiation (brochure) (supersedes FDA 79-8058).Laser Light Shows Safety - Who's Responsible? (brochure).Microwave Hazard Instruments: An Evaluation of the Narda 8100, Holaday HI-1500, and Simpson 380M (PB 80-227820, $6.00).Guide for the Filing of Annual Reports for X-Ray Components and Systems (PB 80-204597, $5.00).Optimization of Chest Radiography - Proceedings of a Symposium Held inMadison, Wisconsin, April 30-May 1. 1979 (GPO 017-015700176-8, $7.50) (PB 80-208317, mf only).Research Into the Biological Effects of Ionizing Radiation in The Bureau ofRadiological Health (GPO 017-015-00172-5, $4.00) (PB 80-217268, mf only).Symposium on Biological Effects, Imaging Techniques, and Dosimetry of IonizingRadiations (July 1980) (GPO 017-015-00175-0, $8.00).Guide for the Filing of Annual Reports (21 CFR Subchapter J, Section 1002.11)(PB 80-810099, $6.00).The Selection of Patients for X-ray Examinations: The Pelvimetry Examination(GPO 017-015-00174-1, $2.00).Possible Genetic Damage from Diagnostic X Irradiation: A Review (PB 81-101743,$6.00).Nationwide Survey of Cobalt-60 Teletherapy: Final Report (PB 81-101784, $8.00).Vignettes of Early Radiation Workers: A Videotape Series (flyer).Hazards from Broken Mercury Vapor and Metal Halide Lamps (Notice of Alert)(pamphlet).

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