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Pilot Study Comparing Patient ESE. Manual vs. AEC Technique Factors. Decision Made at Start of QA Program. Test all equipment in manual mode AEC equipment mostly found in hospitals and large radiology suites

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pilot study comparing patient ese

Pilot StudyComparing Patient ESE

Manual vs. AEC

Technique Factors

decision made at start of qa program
Decision Made at Start of QA Program
  • Test all equipment in manual mode
    • AEC equipment mostly found in hospitals and large radiology suites
    • Facilities equipped with AEC equipment required to have manual technique charts for times when AEC not functioning
    • NJ test phantom could not be used to simulate patient anatomy in AEC mode
    • Design of Victoreen 4000 meter prevents measuring exposure parameters in AEC mode

Bureau of Radiological Health

affect on ese numbers
Affect on ESE Numbers?
  • Physicists have raised concerns that our tests do not reflect “reality” at sites using AEC exposures
  • Bureau agreed that the time was right to re-evaluate its testing protocols for AEC radiographic machines and established a pilot study

Bureau of Radiological Health

goals of study
Goals of Study
  • Measure ESE utilizing both manual and AEC exposure techniques
  • Determine if there is correlation or variance in the measured ESEs

Bureau of Radiological Health

estimate of aec population
Estimate of AEC Population

Bureau of Radiological Health

pilot study testing protocol
Pilot Study Testing Protocol
  • Verify that facility has manual technique charts available for AEC units tested
  • Ensure that radiographic machines chosen for study have functioning AEC and are stable by testing kVp, mAs and timer linearity and accuracy
  • Evaluate ESE for AP Lumbosacral Spine exposures at 40” SID

Bureau of Radiological Health

testing setup
Testing Setup
  • Utilized CDRH NEXT Phantom simulating 21 centimeter patient
  • Utilized a calibrated Radcal MDH 1015-X with 10X5-6 Ion Chamber. Chamber setup 9” above the phantom to eliminate scatter affects
  • Measured mAs, ms, mR and ESE exposures using facility provided manual techniques

Bureau of Radiological Health

testing setup1
Testing Setup
  • Repeated measurements using AEC technique factors and center sensor
  • Four exposures were taken in each mode and average values were calculated
  • Calculated ESE measurements in both modes and compared differences

Bureau of Radiological Health

photo of testing setup
Photo of Testing Setup

Bureau of Radiological Health

composition of study
Composition of Study
  • 17 machines tested at four facilities
  • 2 machines discarded from study due to malfunctioning AEC
  • 5 machines used CR image receptors
  • 10 machines used film systems

Bureau of Radiological Health

raw data
Raw Data

Bureau of Radiological Health

summary of results
Summary Of Results

Bureau of Radiological Health

summary data
Summary Data

Bureau of Radiological Health

summary of results1
Summary Of Results

Bureau of Radiological Health

reasons for variance
Reasons for Variance?
  • Manual Technique Charts Not Always Accurate
    • 5 machines not capable of being set at recommended technique factors
    • 3 machines varied by 5 kVp or more between manual and AEC technique settings
  • CDRH phantom not a perfect match for manual technique evaluation
    • 21 cm patient vs. 23-24 cm Techniques

Bureau of Radiological Health

reasons for variance1
Reasons for Variance?
  • AEC more efficient than manual techniques
    • For Same kVp settings, mAs was 2 to 8 times less than manual counterpart

Bureau of Radiological Health

where do we go from here
Where Do We Go From Here?
  • Joint BRH/Physicist effort to improve the accuracy of manual technique charts?
  • Joint BRH/Physicist effort to develop an AEC test protocol including valid test phantom(s)?

Bureau of Radiological Health

brh preliminary tests on alternative phantom materials
BRH Preliminary Tests on Alternative Phantom Materials
  • CDRH Phantom not ideal and not practical
  • Suggestion from physicists and other state programs that copper or aluminum could simulate lumbar spine phantom
  • BRH conducted abbreviated tests using two different thicknesses of copper: 2.4 mm and 2.0 mm

Bureau of Radiological Health

ese difference lucite vs copper
ESE Difference Lucite vs Copper

Bureau of Radiological Health

summary of results2
Summary Of Results

Bureau of Radiological Health

physicist input
Physicist Input
  • Suggestions?
  • Phantom Materials?
  • Volunteers to Develop AEC Protocol?

Bureau of Radiological Health

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