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Sheet: Sheet1

Unnamed: 0 | FORM B: MEDICAL PHYSICIST'S MAMMOGRAPHY QC TEST SUMMARY | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | FORM B: MEDICAL PHYSICIST'S MAMMOGRAPHY QC TEST SUMMARY.1 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35 | Unnamed: 36 | Unnamed: 37 | Unnamed: 38 | Unnamed: 39
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | (continued)
 | Site |  |  |  |  |  |  |  |  |  |  |  | Report Date |  |  | 2009-08-26 00:00:00 |  |  |  |  | Evaluation of Site'd Technologist QC Program
 |  |  |  |  |  |  |  |  |  |  |  |  | Survey Date
 | X-Ray Unit Manufacturer |  |  |  |  |  | GE |  |  |  |  |  | Model |  |  |  |  |  |  |  | 1. | Darkroom cleanliness (weekly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | Date of Installation |  |  |  |  |  |  |  |  |  |  |  | Room ID |  |  |  |  |  |  |  | 2 | Processor QC - performed, records maintained, action taken when needed (daily) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | Medical Physicist |  |  |  |  |  | [NAME] |  |  |  |  |  | Signature |  |  |  |  |  |  |  | 3. | Screen Cleaning (weekly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 4. | Phantom imaging - performed, records maintained, action taken when needed (weekly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | Medical Physicist’s QC Tests |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Site baseline optical density
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Pass / Fail |  | 5. | Darkroom fog (semi-annually) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | 1. | Mammographic Unit Assembly Evaluation |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 6. | Film-screen contact test (semi-annually) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | 2. | Collimation Assessment |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 7. | Compression pressure monitored (semi-annually) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  | Deviation between X-ray field and light field on any margin is less than 1% of SID |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 8. | Repeat analysis - performed, records maintained, action taken when needed (quarterly or every 250 patients) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  | X-ray field extends to edge of image receptor but does not extend beyond any side of image receptor by more than 2% of SID on all margins
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 9. | [NAME] and viewing conditions (weekly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  | Chest wall edge of compression paddle does not extend beyond image receptor by more than 1% of SID |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 10. | Analysis of fixer retention (quarterly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 11. | Visual [NAME] (monthly) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | 3. | Evaluation of System Resolution |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 12. | X-ray system constancy check |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  | Measured performance within acceptable limits for large focal spot |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 13. | Stereotatic accuracy confirmation (where applicable)
 |  |  | Measured performance within acceptable limits for small focal spot |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 14. | AEC calibration test |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 | 4. | Automatic Exposure Control (AEC) System Performance |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 15. | Infection control |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | P
 |  |  | Exposure reproducibility is within acceptable limits
 |  |  | AEC compensation for kVp and breast thickness contact mode is adequate |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Medical Physicist's Comments & Recommendations for Quality Improvement:
 |  |  | AEC compensation for kVp and breast thickness mag mode is adequate
 |  |  | AEC density control function is adequate |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | 1.  The spot compression paddle is a marginal FAIL as the chest wall edge of the paddle is just visible in the image.  This should be adjusted at the next service.  2.  Some minor dust/pick-off is evident on most images.  Attention to cleanliness of the screens is crucial.  3.  The film OD is approximately 1.6 in contact mode which is at the lower end of the acceptable range (1.6 to 2.0). QC tests should be monitored closely to ensure this does not fall any lower.  4. The viewboxes are quite variable in their brightness and some are not matched well for colour.  It is recommended that the large viewbox immediately inside dooor on right hand side be used for mammography reporting as it is significantly brighter and more uniform than the other one (see detailed report).
 |  |  | Back-up timer & security cut-out are functional
 | 5. | Uniformity of Screen Speed
 |  |  | Optical density does not vary from the mean OD by more than ± 0.15
 | 6. | Artefact Evaluation
 |  |  | Artefacts were not apparent or not significant
 | 7. | Phantom Image Quality Evaluation
 |  |  | 4 largest fibres, 3 largest speck groups and 3 largest masses are visible
 |  |  | Phantom image quality scores: |  |  |  |  |  |  |  |  |  |  | Fibres
 |  |  |  |  |  |  |  |  |  |  |  |  |  | Specks
 |  |  |  |  |  |  |  |  |  |  |  |  |  | Masses
 | 8. | kVp Accuracy and Reproducibility
 |  |  | Measured average kVp within ± 5% of nominal kVp
 |  |  | kVp coefficient of variation £ 0.2
 | 9. | Beam Quality (Half-Value Layer [HVL]) Assessment)
 |  |  | HVL is within acceptable lower and upper limits at all kVp values tested
 | 10. | Breast Entrance Exposure, Mean Glandular Dose (MGD) & Radiation Output Rate
 |  |  | MGD for average breast is below 3 mGy
 |  |  | MGD to a 4.2cm thick breast on your unit is |  |  |  |  |  |  |  |  |  |  |  |  |  | mGy
 |  |  | Radiation output rate is acceptable
 |  |  | Radiation output rate (broad focus) is ³ 7.0 mGy/s |  |  |  |  |  |  |  |  |  |  |  |  |  | mGy/s
 |  |  | Radiation output rate (fine focus) should be ³ 1.5 mGy/s |  |  |  |  |  |  |  |  |  |  |  |  |  | mGy/s
 | 11. | [NAME] and Room Illuminance
 |  |  | Mammographic viewbox is capable of a luminance of ³ 3000 nit
 |  |  | Room illuminance (viewbox surface as seen by observer) £ 50 lux
 | If either the phantom image quality or the MGD fails corrective action must be taken before any further clinical exams are undertaken.