Ask the Radiography Expert: Answers to the Most Frequently Asked Questions

Welcome to Ask the Radiography Expert.   This presentation was written by: Nancy Haynes, RT (R)(CT) Siemens Healthcare Advanced Clinical Education Specialist     Aristos MX Multix M Luminos TF Ysio Luminos dRF All information in this presentation is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine.  Any healthcare practitioner reading this information is reminded that they must use their learning, training, and expertise in dealing with their individual patients.  This material does not substitute for that duty and is not intended by Siemens Medical Solutions USA, Inc. to be used for any purpose in that regard. The length of time required to complete this course will vary depending on, but not limited to, expertise of subject matter, reading speed, interruptions, and Internet connection speed.  The accrediting agency is responsible for determining the number of CE credits awarded for this course. This activity may be available in multiple formats such as web-based training and an actual live event.  The ARRT does not allow CE activities such as Internet courses, live events, home study programs, or directed readings to be repeated for CE credit in the same of any subsequent biennium. Any of the protocol(s) presented herein are for informational purposes and are not meant to substitute for any clinical judgment in how best to use any medical devices.  It is the clinician that makes all diagnostic determinations based upon education, learning, and experience. This presentation content was prepared by the speaker and not Siemens. By navigating to the next page, you are confirming that you have read and understood this disclaimer.   This discussion will focus on the most frequently asked questions for Siemens’ best-selling products: Aristos MX Multix M Luminos TF and mFD Ysio® Luminos dRF The top questions for each product, based on calls to the Uptime Service Center and Clinical Education site visits, will be reviewed and answered to help Radiologist Technologists to better understand and utilize their Siemens product.   I. Most frequently asked questions:   A. Calibrations and Self-Tests 1. Reasons for performing detector self-tests and calibrations 2. Performing a calibration and self-test B. Markers and Annotations 1. Positioning tips for lead marker placement 2. Placing and removing electronic markers and annotations C. Cropping and Collimation 1. Why cropping errors occur 2. Tips to prevent cropping errors D. Reject Analysis 1. Systems with reject analysis 2. Information collected during reject analysis E. Accession Number 1. Acquiring images with the correct accession number 2. Ways to help make sure images are acquired on the correct accession number Calibration of Digital Detectors   Question: How do you calibrate the detector?   Aristos Wi-D Mfd Ysio X-radiation Scintillator Control Switch To the electronics Pixel Light sensor Structure of a solid-state detector (schematic) (X rays) Scintillator (Visible light) Cesium Iodide Or Gadolinium Oxysulfide Photodiode (a-Silicon) TFT Array (Digital image) Photo diode Gate Line TFT Bias Line Data Line Pixel structure of an indirect converting amorphous silicon active matrix sensor array showing photodiode, TFT, as well as gate, bias and data lines   Digital Detector System Pixels/detector Calibration Schedule Aristos 9M 15 months Mfd 5.9M 12 months Wi-D 7M 12 months Ysio wall 9M 12 months Column Defect Line Defect Comet Defect Spots Phantom Images Ghost (head) visible in the Thorax Luminos TF/mFD Multix M   The system should be ON for at least 30 minutes before performing a calibration. Select SYSTEM > CALIBRATION Place the detector on the floor. Align the tube over the detector at approx. 79 inches and collimate so there is light on the entire surface of the detector. Do not place any object on the detector! Any object will be calibrated into the detector and will show up on all images. Select Start Follow the directions in the upper left corner. If Calibration is not successful: Perform a shutdown and try again before calling service. Select FINISH. Self-Test 1 is a calibration check. Unless a calibration has been performed, Test 1 will fail. Self-Tests 2, 3, and 4 are for internal image transfer tests for the detector and detector power supply. Self-Test 5 is for analyzing how much electrical interference is experienced by the detector. Patient Mode > Settings > User Settings > double click Flat Detector Options > Detector Calibration The listed criteria need to be met prior to initiation of calibration sequence. Once all criteria are met, select OK. Each detector requires 20 uninterrupted minutes to calibrate. System will instruct user to make exposures, as indicated below. Failure to make acquisitions in time allowed or release of acquisition button during procedure requires a restart from the beginning. Ysio Calibration Switch Learn about the Ysio Calibration Switch. Element HTMLWhen complete, select the X in the upper-right corner to close the window and continue. Sound File Audio ScriptJust a quick note for Ysio system users regarding the calibration switch. This switch will be moved to the ON position during a calibration of the system and should be turned OFF upon completion of the calibration. Failure to return the switch to the OFF position, or accidental movement of the switch to the ON position will result in a message on the system as indicated on the slide. No acquisitions can be made while this message is on the system. The “Calibration switch on” message can be cleared by simply flipping the switch on the back of the generator ON/OFF console.   Electronic Markers   Question: How do I add and remove electronic markers and annotations?   R L Detector QC   Question: Why are some of my images collimated incorrectly?   Aristos MX Ysio Luminos dRF Luminos Mfd Note: Without ACSS Collimation field light may be larger than the detector size Manual collimation will most likely be required prior to image acquisition Manual cropping will most likely be required in post processing Detector QC   Question: How does Reject Analysis work?   Ysio and Luminos dRF Software version VB10 and higher   Multix M Software version 6.4 and higher   Aristos MX Software version VB21A and higher Select up to 10 images to delete One image per study must remain in the folder Select a Reject Reason and Operator Both fields are required *Reject reasons/operators list can be customized in the User Configuration   The following data of each rejected image are logged: Date and time of rejection Date and time of acquisition Patient name and ID Reject reason and user rejecting the image Accession number; Requested Procedure ID; Study name; OGP kV; mAs; ms; Exposure technique of OGP; Cu-Filtration Diamond View identifier Comment line   Question: Why does the system mix up my Accession numbers?   Kaiser Permanente Nancy Haynes 05-12-2011 10:24 am Make sure the Accession Number displayed is the correct one. Make sure the Accession Number displayed is the correct one. The Exam/Study Manager Appears after Selecting a Patient Always Replace a Triangle You are requested to do an examination on a patient that was not in the original order Accession number cannot be assigned   Accession number cannot be assigned Aristos MX Ysio and Luminos dRF Accession number cannot be assigned   You are requested to do an examination on a patient that was not in the original order Make sure you Add the Organ Program to the correct study. Operator Manual AXIOM Aristos FD Imaging System (RADIS) VB20   ©Siemens Healthcare Intranet: https://intranet.healthcare.siemens.com/cms/sales/en/International/Business_Units/Angio_Fluoro_Radiographic_Sys/Products-Systems/Radiography/Digital_Radiography_Systems/AXIOMAristosMX/Pages/Default.aspx : 2009. accessed 3/18/2009. Operator Manual MD Imaging System Version VA40A and higher ©Siemens Healthcare Intranet: https://intranet.healthcare.siemens.com/cms/sales/en/International/Business_Units/Angio_Fluoro_Radiographic_Sys/Products-Systems/Radiography/Digital_Radiography_Systems/AXIOMMultixM/Pages/Default.aspx: 2009. accessed 3/18/2009. Operator Manual FLUOROSPOT Compact Digital Imaging System for AXIOM Luminos TF ©Siemens Healthcare Intranet: https://intranet.healthcare.siemens.com/cms/sales/en/International/Business_Units/Angio_Fluoro_Radiographic_Sys/CrossProductInformation/Customer_Documents/OperatorManuals/Fluoroscopy/Pages/Default.aspx: 2009. accessed 3/18/2009. Excel (Part of the Microsoft Office Professional Edition) [computer program]. Microsoft; 2003. Image of x-ray patient info recorder.