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Ultrasound Physiscs > QA > Flashcards

QA Flashcards

1
Q

4 Requirements for QA Program

A
  1. Assessment
  2. Repairs
  3. Prevention
  4. xRecord Keeping
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2
Q

5 goals for QA

A
  1. Proper equipment operation.
  2. Detect gradual changes.
  3. Minimize downtime.
  4. Reduce non-diagnostic exams.
  5. Reduce repeat scans.
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3
Q

LAB ACCREDITATION

3 major agencies for QA

A
  • ACR: American College of Radiology
  • AIUM: American Institute of Ultrasound in Medicine
  • IAC: Intersocietal Accreditation Commission *the biggest agency
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4
Q

LAB ACCREDITATION

IAC

  1. What are 2 reasons given for why a lab might consider seeking accreditation from the agency?
  2. What type of accreditation are available through the agency?
  3. How will lab be notified whether or not they become accredited?
  4. What are the requirements lab must go through to attain accreditation with these agencies?
A

Intersocietal Accreditation Commission

1

  • nationally recognized accreditation organization
  • shows that the lab has the appropriate utilization, standardization and quality of diagnostic imaging and intervention-based procedures
  • very extensive; high level of expectation

2

  • vascular
  • echocardiography
  • nuclear/PET
  • MRI
  • CT/Dental CT
  • carotid stenting
  • vein center
  • cardiac electrophysiology
  • cardiovascular catherization

3

  • After submission, the application is locked and becomes your final application submission
  • Upon submission of the application and case studies the IAC will begin the internal review process. The internal review, peer review and board review are conducted prior to a decision being rendered.
  • The application review process takes approximately 8 to 10 weeks* to complete. The accreditation decision will be provided to the facility via a notification letter that may be downloaded from the Online Accreditation account
  • lasts 3 years

4

https://intersocietal.org/wp-content/uploads/2021/11/Echocardiography-Accreditation-Checklist.pdf

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5
Q

LAB ACCREDITATION:

ACR

  1. What are 2 reasons given for why a lab might consider seeking accreditation from the agency?
  2. What type of accreditation are available through the agency?
  3. How will lab be notified whether or not they become accredited?
  4. What are the requirements lab must go through to attain accreditation with these agencies?
A

American College of Radiology

1

  • demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible
  • ACR is the ”voice of radiology” in matters of legislation and regulation.

2

  • breast MRI
  • breast US
  • CT
  • mammography
  • MRI
  • nuclear medicine & PET
  • radiation oncology practice
  • stereotactic breast biopsy
  • ultrasound

3

At the completion of the accreditation review process, the ACR will issue a separate, confidential final report for each modality through the online system. A notification will be sent to the modality-specific supervising physician and administrator at the practice site when the report is available to their modality’s online user.

4 *done by the physicians

  • Submit application with facility name, address, supervising physician, administrator, CMS information, survey agreement cosigners, technologist contact person, unit details, list of personnel
  • Submit payment.
  • Submit testing package
  • Submit images for each modality
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6
Q

LAB ACCREDITATION:

AIUM

  1. What are 2 reasons given for why a lab might consider seeking accreditation from the agency?
  2. What type of accreditation are available through the agency?
  3. How will lab be notified whether or not they become accredited?
  4. What are the requirements lab must go through to attain accreditation with these agencies?
A

Practices accredited by the American Institute of Ultrasound in Medicine (AIUM) have demonstrated competency in every aspect of their operation, including:

  • Personnel Education, Training, and Experience
  • Document Storage and Record Keeping
  • Policies and Procedures Safeguarding Patients, Ultrasound Personnel, and Equipment
  • Instrumentation
  • Quality Assurance
  • Case Studies

1

  • Exhibit your commitment to clinical excellence.
  • Display your commitment to the highest quality patient care.
  • Provide credibility to peers and patients.
  • Demonstrate that your practice meets the quality assurance requirements of a growing number of insurance companies.
  • Meet the requirements of a growing number of insurers.

2

AIUM ultrasound practice accreditation is a voluntary peer review process that allows practices to demonstrate that they meet or exceed nationally recognized standards in the performance and interpretation of diagnostic ultrasound examinations. The accreditation process encourages providers of diagnostic ultrasound services to assess their strengths and weaknesses and initiate changes to improve their practices.

3

The Ultrasound Practice Accreditation Council will decide whether to grant accreditation based on your application and your response to the findings letter.

Practices that are awarded accreditation will be notified via email and will receive a certificate.

4

https://www.aium.org/accreditation/appChecklist.pdf?__sw_csrfToken=99aa5854

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7
Q

Q & A STATISTICS

There are a series of statistical measures used to determine the “quality” of a test. To validate a test, the test is compared against another test referred to as the __________.

A

“Gold Standard”

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8
Q

The Golden Rule

A

For the purposes of the statistical indices, the assumption is that the gold standard is perfect.

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9
Q

______ implies that the test correctly predicts that there is disease (the test predicts disease when the gold standard predicts disease).

A

True Positive (TP)

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10
Q

_____ implies that the test correctly predicts that there is no disease (the test predicts no disease when the gold standard predicts no disease).

A

True Negative (TN)

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11
Q

______ implies that the test incorrectly predicts there is disease (the test predicts disease when the gold standard does not).

A

False Positive (FP):

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12
Q

______ implies that the test incorrectly predicts that there is no disease (the test predicts no disease when the gold standard predicts disease).

A

False Negative (FN)

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13
Q

sensitivity equation & its definition

A

The ability of a test to detect disease

(How many times the test correctly said there was disease divided by the total number of times there was disease.)

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14
Q

specificity equation & its definition

A

The ability of a test to detect the absence of disease

(How many times the test correctly said there was no disease divided by the total number of times there was no disease.)

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15
Q

Accuracy equation & its definition

A

The percentage of times the test is correct.

(The number of times the test was correct divided by the total number of tests.)

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16
Q

POSITIVE PREDICTIVE VALUE equation & its definition

A

The percentage of times the test was correct when it predicted the presence of disease.

(How many times the test correctly predicted the presence of disease divided by the total number of times the test predicted that there was disease.)

17
Q

NEGATIVE PREDICTIVE VALUE equation & its definition

A

The percentage of times the test was correct when it predicted the absence of disease.

(How many times the test correctly predicted the absence of disease divided by the total number of times the test predicted that there was no disease.)

18
Q

THE “PERFECT” TEST definition

A

The sensitivity, specificity, accuracy, positive predictive value, and the negative predictive value would all be 100%.

18
Q

THE “PERFECT” TEST definition

A

The sensitivity, specificity, accuracy, positive predictive value, and the negative predictive value would all be 100%.

19
Q

In reality, the statistical measures are only as meaningful as the gold standard is accurate. In essence:

  • There is no guarantee that the gold standard is always correct
  • A “good” match to a good standard means a good test
  • A “good” match to a bad standard means a bad test
  • A “bad” match to a good standard means a bad test
  • A “bad” match to a bad standard doesn’t tell you much
A

It’s an assumption

20
Q

Purpose of QA:

A

To detect problems with the machine that might adversely affect the image

21
Q

The region close to the transducer where reflections may not appear is called

A

dead zone

22
Q

________ probes have smaller dead zones

A

Higher frequency

23
Q

_______eliminate dead zones for very superficial reflectors (ex.: subcutaneous cysts)

Can also use a water bath to image superficial structures

A

Stand-off pads

24
Q

135

What testing device is used to measure acoustic output (intensity) level?

  1. Tissue phantom
  2. AIUM test phantom
  3. Doppler flow phantom
  4. Hydrophone
A

4

The hydrophone is used to measure intensity. Know that a hydrophone is also called a microprobe

25
Q

136

Avoiding a local temperature increase exceeding _____ should ensure that are no thermally induced biological effects

a. 2°C
b. 4°C
c. 10°C
d. 95°F

A

a

A local temperature increase of <2°C appears to be safe, according to AIUM guidelines

26
Q

137

Which of the following will increase the acoustic exposure to the patient?

  1. Increased receiver amplification
  2. Increase time gain compensation
  3. Pulse repetition frequency
  4. Increased output gain
A

4

Increasing the output gain is increasing the power. This will increase exposure

27
Q

138

What does the mechanical index indicate on an ultrasound system?

  1. Minutes of exposure time
  2. The likelihood of cavitation during an US exam
  3. The maximum temperature increase in tissue
  4. The minimum temperature increase in tissue
A

2

The MI, or mechanical index, measures the risk for cavitation

28
Q

139

If you wish to practice the ALARA principle, which of the following techniques should you employ?

  1. Always use the lowest receiver gain that allows for tissue visualization
  2. Use the lowest transmit power that allows adequate tissue visualization
  3. Use the highest exposure time
  4. Use more spectral Doppler
A

2

Use the lowest power, minimize exposure time, and decrease use of Doppler

29
Q

140

Which operator control adjusts the intensity of the transmitted pulse?

  1. Receiver gain
  2. Depth of scanning
  3. Power
  4. Time gain compensation (TGC)
A

3

The power control is the only one listed that affects the intensity, or amount of energy entering the patient

30
Q

141

At what point do the amplitudes get assigned gray scale numbers so they can be placed into memory?

  1. Pre-processing of the signal
  2. Post-processing of the signal
  3. In the computer memory
  4. In the receiver
A

1

A. Pre-processing is the assigning of a shade of gray to be placed into memory. Post-processing pulls the numbers out of memory (that represent reflector location and amplitude) and assigns a shade of gray for the display

31
Q

145

When you adjust the output power control, you affect the following system component:

  1. Pulser
  2. Memory
  3. Converter
  4. Receiver
A

1

Power is controlled by the pulser

32
Q

151

Which of the following is a true statement about bioeffects?

  1. Ultrasound is incapable of producing bioeffects
  2. Ultrasound has the potential to produce bioeffects under some conditions
  3. Ultrasound does not produce a temperature increase as it travels through soft-tissue
  4. The lowest temperature increase occurs at a soft-tissue: bone interface
A

2

Ultrasound does have the potential to produce bioeffects to some degree and at certain power levels

33
Q

160

A slice-thickness phantom measures which plane of the transducer?

  1. The scanning plane
  2. The elevation plane
  3. The azimuthal plane
  4. The temporal plane
A

2

The slice-thickness plane is the same as the elevation plane

34
Q

162

This test object (to the right) has pins along the top of the phantom. These test for

  1. Axial resolution
  2. Lateral resolution
  3. Dead zone
  4. Horizontal calibration
A

3

The pins along the top allow for measurement of the dead zone of the transducer

35
Q

165

If I wanted to evaluate the contrast resolution of a transducer or US system, I would buy a:

  1. Doppler phantom
  2. AIUM 100mm phantom
  3. Tissue equivalent phantom
  4. Beam profile phantom
A

3.

The tissue equivalent phantom has taken cysts/masses in it and useful for evaluating contrast resolution

Ultrasound Physiscs (18 decks)

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