The QA Portal comes loaded with default testing protocols that organize which tests should be performed and how often they should be performed. In the nomenclature of the QA Portal, the tests are called “Procedures” which are grouped into “Lineups” that define when each test should be performed. The Portal also has reporting features that allow you to document your test results and export them for more detailed analysis.
The QA Portal currently has pre-loaded testing protocols for the following four phantoms:
These programs are designed to meet or exceed the QA testing requirements of three main organizations responsible for setting Ultrasound Quality Assurance testing standards in the United States: the ACR1, the AIUM2,3 and the AAPM4. The default protocols all contain phantom-specific test procedures, grouped into three different test lineups. These lineups are named using terminology borrowed from the ACR Ultrasound Accreditation Program.
Which test procedures are included in each lineup was determined after a careful review of the requirements of the ACR, AAPM and AIUM. It should be noted, though, that the default QA Protocol exceeds many of these requirements, and choses to implement them in a way that is not appropriate for your institution. For that reason, all users should review the summary table below and edit the default Procedures and Lineups to match their internal requirements. Note that one test lineup must be designated as the “Baseline” test lineup and sets reference values for determining pass/fail conditions in many tests. The Acceptance Testing lineup is set as the baseline lineup in the default protocols. Users that do not wish to perform acceptance testing (it is optional according to the ACR Ultrasound Accreditation program) will need to set another lineup as the baseline test. See Editing the Default Test Protocols within the Instructions for Use for more information on how to edit protocols.
|Test||QA Portal Protocols||ACR||AAPM||AIUM||IEC TS 62736||Notes|
|Physical & Mechanical Inspection||Routine QC||Annual||Quarterly||Daily+||Monthly||AIUM requires daily cleanliness and safety checks. 40GSE has semi-annual audit of these protocols, while ACR recommends optional semi-annual inspections|
|Ultrasound Scanner Display Performance||Routine QC||Annual||Quarterly||Daily||Monthly||AIUM recommends daily check of controls and the greybar display by the sonographer, while ACR recommends optional inspections during Routine QC.|
|Primary Interpretation Display Performance||Routine QC||––||Quarterly||––||––||ACR recommends optional annual or semi-annual testing. This has been deleted from CIRS protocols, as testing of PACS displays is typically performed by the IT department|
|Image Uniformity and Artifact Survey||Routine QC||Annual||Quarterly||Annual||Monthly (in-air)
|ACR also recommends optional semi-annual testing of image uniformity|
|Geometric Accuracy (Mechanically Scanned Transducers)||Routine QC||––||Quarterly||Annual||Biannual||ACR recommends optional semi-annual distance measurement accuracy tests for 3D transducers with a mechanical sweep (in the sweep direction)|
|Geometric Accuracy||Annual||––||Quarterly||Annual||Biennial||ACR recommends optional annual distance measurement accuracy tests for standard transducers|
|System Sensitivity (Depth of Penetration)||Annual||Annual||Quarterly||Annual||Biennial|
|Contrast Resolution||Annual||––||Annual||Annual||Biennial||ACR recommends optional annual contrast resolution tests. A thorough contrast resolution test is a useful adjunct to the image uniformity artifact surface and also provides useful information about spatial resolution.|
|Spatial Resolution (Axial / Lateral)||Acceptance||––||Annual||––||Biennial||ACR recommends optional annual spatial resolution test|
|Spatial Resolution (Elevational)||Acceptance||––||Annual||––||Biennial||ACR recommends optional annual spatial resolution test|
To get started with the QA portal, you must first create an inventory of the ultrasound scanners and transducers to be tested.5
Note that machines and transducers are tracked separately in the QA Portal, as transducers often move from one scanner to another.
To create your inventory, go to the
Equipment tab on the Portal menu
Many users may wish to edit the default protocols as most appropriate for their institution. To do so, select
Tests on the Portal menu.
Tests page has two separate tabs, defined below:
Lineups – collections of tests conducted at a set frequency
Procedures – tests instructions along with a definition of the data collected as part of the test
To modify the pre-loaded recommendations in the 40GSE QA Test Protocol, edit or delete the each of the Test Lineups associated with the Protocol.
To edit a Lineup, select the icon to the left of the Lineup name. A new screen will open with an Edit menu to the left and a list of Tests to the right.
The following setup information may be changed in the Edit menu:
With the Tests list to the right, users may assign or unassign tests procedures to be performed as part of the Protocol. They may also change the order with which the procedures are performed using the arrow icons to the right of the Procedure.
Test Lineups may be deleted by selecting the icon to the right of the Lineup. Users may choose to do this if, for instance, they will only conduct QA testing annually. In this case, the semi-annual tests could be deleted.
New Lineups and Protocols can be created from the Lineups tab. To do so, use the icon to create a new lineup. The procedure for creating a new lineup is similar to that of editing a lineup, except that field for Protocol Type may be edited when creating a new lineup.
To Create a new Protocol, choose
Other from the list of Protocol Types. A prompt will open asking you to name this protocol. Additional Lineups can be associated to this protocol by creating new Lineups from the Lineups tab. The new protocol will be listed in the Protocol Type field.
Procedures may be created, edited or deleted using the , and icons from the Procedures tab. Basic information about the Procedure is edited in the menu to the left.
Basic information about the Procedure is edited in the menu to the left, which has the following fields:
The section to the right has two tabs for associating Test Values and Lineups to a procedure.
Test Values create the data entry fields associated with each test. New fields are created using the icon, while existing fields are edited using the icon. Note that multiple Test Values can be associated with a single procedure, as appropriate.
Five data types are supported in the Test Values tab:
The Lineups tab is used to associate the Procedure with one or more Lineups. Any procedure associated with a periodic testing lineup (as opposed those only performed during Acceptance Testing) should be associated with two lineups: the baseline lineup (usually Acceptance Testing) and another lineup performed as part of routine QA testing.
Reminder: QA measurements should always be performed at the same system settings to ensure consistency of results. Protocols in the QA Portal includes a test procedure for recording system settings as part of each test lineup; these settings are auto-populated from the baseline test values. Creating a special QA preset is highly recommended so that you can more easily retrieve settings when conducting QA tests. Guidelines for choosing system settings are provided in the instructions document associated with the system settings test procedure.
Once you have completed testing, the Reports page provides convenient summary data for your testing program, and can be accessed by clicking on the
Reports tab on the QA Portal Menu. The available reports include:
Once you have set up your testing program, you will return to the QA Portal Equipment page each time you log onto the portal. The Equipment page lists equipment in the order of which has the soonest test upcoming. To start entering data for one of these tests, click on the test protocol name.
You may also review data from completed tests by selecting the Completed Tests icon .
The designated baseline lineup is always listed prior to upcoming tests. Baseline test data provides the benchmark against which all future tests are conducted, and this test should be repeated any time a machine or transducer is repaired, or any time a new phantom is purchased or repaired, as these changes may affect the outcome of future QA measurements.
To repeat Acceptance Testing, you will first need to deactivate the ultrasound machine or transducer that was sent out for repair. This is done by first clicking on the machine / transducer name in the equipment list to enter the edit screen shown below. From this screen, select “Deactivate” located at the top right of the edit form: