MR QA Flashcards

1
Q

Health Technology Management

A
  • Procurement of appropriate equipment, technology, and maintenance agreements
  • Acceptance testing and clinical user acceptance of what was agreed to be purchased
  • Routine QC testing; annual performance testing
  • Review of QC, service logs, repairs, and maintenance agreements
  • Appropriate transport or disposal of equipment
  • In the best interests of the patients and staff, independent of vendors and manufacturers
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2
Q

AHPRA - Responsibilities of Medical
Radiation Practitioners

A
  • Equipment issues will usually be encountered first by radiographers or radiation therapist
  • Day-to-day quality control and maintenance of imaging systems
  • Following vendor specific instructions of operation and use of equipment
  • Identifying and arranging equipment repairs when there is an equipment fault
  • Clinical decision making whether equipment is still appropriate for use on patients or stop until equipment issue is resolved
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3
Q

Safety and Quality Management

A
  • Equipment issues can be minor or major
  • Medical physicists, biomedical engineers, and imaging technicians support clinics in resolving equipment issues with vendors or to make improvements
  • Established pathway to escalate and notify TGA
  • Investigate equipment faults or failures, patient and staff safety, and other clinical sites
  • Continuous improvement of quality and safety
  • Keep documented evidence
  • Equipment history: acceptance, reports, servicing, repairs, testing
  • Requires multi-disciplinary teamwork and multi-site collaboration
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4
Q

MRI General System Checks

A
  • Table docking and movement, RF coil integrity and connections, temperature, and laser operations
  • Transmitter (central frequency) and gain calibration
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5
Q

MRI Bore Lasers and Table Position Accuracy + test method

A
  • MRI bore lasers are set to drive a certain table position to isocentre
  • The rest of the QA tests and phantom scans depend on the accuracy of the MRI bore lasers and table position

Distance Accuracy Test Method:
* Place an object with a known distance on the table
* Drive the table a known distance with the MRI bore laser on and compare object dimensions with the change in displayed table position

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6
Q

MRI Bore Lasers and Isocentre

A
  • Use the MRI bore laser to setup a phantom and drive the center of the phantom to isocentre
  • Compare the displayed z position in the image localiser
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7
Q

Slice Position Accuracy

A
  • Localiser is a low-resolution image used to set the scan region for a given protocol
  • The scan region is set by selecting the central slice position
  • The system adjusts the selected slice position relative to isocentre and table position
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8
Q

what is geometric Accuracy

A

Geometric accuracy is a measure of the difference in spatial localisation between an object and the corresponding MR image of the object.

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9
Q

Geometric Accuracy Test

A
  • Typical phantoms have either a uniform grid or hole pattern
  • Scan phantom of known geometry and dimensions spanning the volume of the FOV
  • Scanning protocol: SE without distortion correction will test spatial linearity and gradient calibration of system
  • Percent geometric distortion is calculated between the actual dimensions of the phantom and the measured dimensions in the final MR image
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10
Q

Geometric Accuracy Test equation + tolerance criteria

A

geometric distortion (%GD) = 100 x (actual phantom dimensions - measured phantom dimensions on image / measured phantom dimensions on image)

tolerance criteria with phantom
- less than 2% for treatment planning
- less than or equal to 2mm

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11
Q

Slice Thickness Accuracy + test method and tolerance

A
  • Depends on RF excitation bandwidth and the gradient field amplitude
  • Affects spatial resolution, SNR, and minimal slice gaps

Test Method:
* Phantom with crossed-ramps (NEMA; ACR)
* Tolerance criteria for 5 mm slices or more: ≤ 10% (NEMA); -/+ 1 mm

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12
Q

High Contrast Spatial Resolution Accuracy + test method

A
  • Distinguish between two nearby objects with minimal noise
  • Mainly depends on acquisition matrix size (pixel size)
  • Other factors include image processing, and display resolution

Test Method:
* Phantom with high contrast objects of varying size or MTF method
* Tolerance criteria: distinguish between objects that are at least one pixel width in size, and separated by one pixel width

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13
Q

Percent Signal Ghosting - artefact

A
  • Appears as low-intensity signals from the object superimposed at a different location
  • Occurs in the phase encoding direction
  • Due to hardware, pulse sequence or coil design
  • Can also be caused by motion
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14
Q

Percent Signal Ghosting test Method + tolerance

A

Test Method
* Ghosting is easier to detect in low-level signal areas (ie. background)
* Homogeneous phantom or insert
* Depends on pulse sequence

Tolerance Criteria
* PSG compares the ratio of the background signal, ghosting signal, and mean phantom signal
* PSG should be ≤ 1%

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15
Q

Magnetic Field Homogeneity Test

A
  • Measures the variation in magnetic field over a diameter spherical volume (DSV)
  • Depends on MRI hardware, coil design, ferromagnetic structures close to the magnet
  • Optimised by magnet shimming

Test Method
* Spherical phantom, homogeneous solution
* Changing bandwidth, or uniformity maps

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16
Q

Magnetic Field Homogeneity Test - bandwidth difference + tolerance criteria

A
  • Acquire slice using 2 different bandwidths
  • Compare change in diameter or distance
  • Evaluate for each orientation

Tolerance Criteria
* Depends on: the dimensions and features of the phantom used; scan protocol

17
Q

What information is needed from the MRI images?

A
  • Anatomical regions of interest
  • Biomarkers for pathology
  • Required patient positioning
  • Scan setup and coil configuration
18
Q

How will the MRI information be used?

A
  • MRI-only vs CT/ MRI co-registration
  • Different requirements and tolerance levels for different applications
  • MR images supplementary to CT can use CT images as a standard comparison
19
Q

What are the major sources of error or uncertainty in the imaging/treatment chain?

A
  • Patient positioning
  • Geometric distortion
  • RF coil performance
  • Laser alignment
20
Q

What sources of error or uncertainty can be reduced, and which ones can’t be changed?

A
  • Treatment position
  • RF coils and coil holder size
  • Field of View
21
Q

RF Coil Test (PIU,PSG, SNR) + test method and tolerance criteria

A

RF Coil Checks
* Vendor specific coil tests for routine maintenance
* Coil and protocol specific tests (application based)

Test Method
* Vendor instructions, depends on MRI coil design and subsystem
* Clinical testing depends on clinical setup

Tolerance Criteria
* Vendor specific or benchmark performance for site or system model
* Depends on protocol and procedure

22
Q

RF Coil - SNR

A
  • SNR affects contrast resolution and signal localisation
  • Lower SNR could result from RF coil failure or external sources of RF noise
  • Hard flat-top couch and coil holders reduces body deformation, but also reduces SNR due to coils being further away from the body
23
Q

Accuracy of External Lasers and MRI Bore Lasers test + tolerance

A
  • Patient is set-up on MRI table based on external laser position
  • Vendor specific phantoms, or a phantom with known dimensions
  • Patient is positioned at MRI isocentre based on lasers and relative table position

Laser Accuracy Tolerance
* Defined by laser tolerance used for treatment setup < 2 mm

24
Q

Geometric Distortion for RT Planning

A
  • Geometric distortion increases further away from isocentre
  • Degree of distortion can depend on scan protocol
  • Can affect target delineation depending on application
  • Vendors provide correction algorithms to minimise system related distortion based on their coil design
  • Scan should cover FOV, or at least extend beyond ROI
  • Images should be acquired in RT setup and coil configuration with distortion algorithms on
  • Phantom with grid lines makes it easier to visibly inspect differences in spatial localisation
  • Phantom with hole pattern makes it easier to quantify and analyse degree of distortion and correct if needed
25
Q

Geometric Distortion for RT Planning Test Method

A
  • Comparison with CT images
  • CT and MRI compatible phantom for distortion analysis/ correction
  • Compare CT and MRI images of patient with image analysis software
26
Q

Artefacts

A
  • Patient related distortion: spatial and signal localisation
  • Can affect delineation of organs of interest for accurate treatment planning
  • Intrinsic: Magnetic susceptibility, chemical shift, tissue boundaries (mm)
  • Extrinsic: Metallic or conductive implants (cm)
  • Patient-motion: breathing, movement
  • Scans are repeated with optimised scan protocols if necessary to minimise artefacts
27
Q

purpose of MR QA

A
  • ensures safe and effective use of medical imaging technology
  • provides a clear pathway to resolve equipment issues
  • prevent avoidable equipment failures and risks to patients and staff