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Use of Signal to Noise Ratio for Daily Quality Control of Fluoroscopes Used for Interventional Radiology Procedures

A Goode1*, C Snyder2 , A Snyder3 , G Manninen4 , M DeLorenzo5 , P Collins6 , (1) University of Virginia Health Systems, Charlottesville, VA, (2) Atirix Medical Systems, Minneapolis, MN, (3) Atirix Medical Systems, Minneapolis, MN, (4) Atirix Medical Systems, Minneapolis, MN, (5) University of Virginia Health Systems, Charlottesville, VA, (6) University of Virginia Health System, Charlottesville, VA


(Monday, 7/30/2018) 4:30 PM - 5:30 PM

Room: Exhibit Hall | Forum 1

Purpose: To evaluate a daily image quality control (QC) regimen in a busy academic interventional radiology (IR) department using signal-to-noise (SNR) ratio from fluoroscopic loops.

Methods: Daily QC was performed for a month on six Siemens fluoroscopes (two Artis Zeego, two Axiom Artis and two Artis Q) using a 10�x10�x3� custom-built patient equivalent phantom consisting of polycarbonate, copper and aluminum. The phantom was placed on the table in the same position each day and centered under fluoro, with a source-to-image distance set to 100 cm, and with the table raised to just meet the receptor. The programs in each room were set to the default “Normal� 7.5 pulse per second fluoro. After actuating fluoro several times to allow the filter selection to be reproducible, a fluoro loop was acquired for 5 seconds and stored using the “Store Fluoro� function. Fluoro loops were sent to a QC-Track (Atirix Medical Systems) server for automated processing. A 12 mm region of interest (ROI) was placed in a uniform region in the center of the phantom. SNR was computed in the ROI for each frame of the last 2 seconds of the fluoro loop. The SNR’s for each of the last 15 frames were then averaged to yield a single SNR for the loop.

Results: Using statistical process control logic, QC for all units and times fell within +/- 3 standard deviations of the mean for that unit. The SNR is stable for 3 different vendor models over 6 different IR suites over a month long period.

Conclusion: Automated and observer-independent quality control of units used during fluoroscopically guided interventions was piloted for a busy IR department. Minimal technologist effort and change in workflow were needed to regularly monitor system performance and readiness for the day.


Quality Control


IM- X-ray: Fluoroscopy, digital angiography, and DSA

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