In each issue of this Newsletter, I'll continue Penny's tradition of presenting frequently asked questions (FAQs) or other information of particular importance for medical physicists. You may also check out the ACR's accreditation web site portal for more FAQs, accreditation application information, and QC forms.

The ACR recently transitioned to requiring electronic uploads for accreditation. The following FAQs address this recent, important change. Please contact us at accreditation@acr.org if you have questions.

Q. The ACR now requires electronic upload of all accreditation images and documents. What is the benefit of electronic image submission via TRIAD?
A. TRIAD overcomes the challenges of manual image submission with easy-to-use tools that reduce cost and streamline the image submission process. Benefits of TRIAD for electronic image submission include:

• Faster turnaround time from image submission to final results
• Reduced costs associated with burning and shipping CDs
• Elimination of delays in shipping images
• Mitigation of risk of losing image data
• Ensured compliance with HIPAA regulations throughout the submission, review, and reporting processes
• Submission and storage of images on an encrypted secure server

Q. What options are available for electronic submission of images?
A. Facilities seeking ACR Accreditation will choose between two options to upload clinical and phantom images electronically, as follows:

1. The new and improved TRIAD web-based image submission:
   • Offers user-friendly functionality
   • Provides full-size image display with a fully functional DICOM viewer, allowing you to view images before submission
   • Provides the ability to upload individual files or entire folders (depending on your browser)
   • Does not require any software to be installed on your computer
   • Is compatible with Windows PC or Mac
2. The TRIAD Windows PC Client image submission:
   • Requires software installation on your Windows PC
   • Allows direct connection between TRIAD and PACS systems for image data retrieval
   • Provides the ability to upload individual files or entire folders
   • Enables connection with ClearCanvas Workstation for viewing full images before submission
   • Requires user to have administrative privileges on local computer

Q. Where can I find instructions for electronic image submission and how can I get assistance if needed?
A. ACR Accreditation Image Upload Instructions are found on the modality-specific webpages on the accreditation microsite. For additional assistance on electronic image submission, facilities may contact the ACR Accreditation team for guidance. The knowledgeable staff will assist with submission questions and concerns.

Q. How do I prepare images for electronic submission?
A. Review the modality-specific accreditation testing instructions as well as the ACR Accreditation Image Upload Instructions for specific requirements on image submission. In general, the following rules apply to preparing for electronic image submission:

• DICOM images are required or preferred for accreditation submission (some modalities may allow images to be uploaded as jpeg, gif, tiff or bmp files).
• Do not anonymize images for accreditation.
• Physician reports should not be included in the image upload.
• Only postprocessed images should be uploaded.
• Upload only the required images for accreditation review.
• Once the images are uploaded, view all of the images within the testing package to ensure all required images have been uploaded and are viewable.
• Do not upload lossy compressed images.
• Images can be exported from PACS or the unit and saved to your computer, a CD, DVD, or thumb drive.

Q. Our facility is unable to submit images electronically. How should we proceed?
A. If images can be burned to a CD, DVD, or thumb drive, or saved locally to a computer, the images can be uploaded into TRIAD. After the accreditation testing package is sent to the facility, refer to the ACR Instructions for Image Upload Instructions for guidance. After this, if your facility realizes that there is a technical limitation that prohibits you from uploading images electronically, please contact the ACR staff for assistance.