Maintaining diagnostic imaging equipment is of great importance in today’s health care environment. Imaging has many diagnostic benefits. Maintaining these valuable pieces of equipment improves patient outcomes as well as patient satisfaction. It also helps with the bottom line as imaging devices generate a good deal of revenue for health care facilities.
Test equipment for HTM professionals tasked with maintaining and repairing diagnostic imaging equipment, of all modalities, are vital. The test equipment helps with troubleshooting to isolate the problem so that it can be repaired quickly and correctly. TechNation sought the scoop on this test equipment from Advanced Ultrasound Electronics (AUE) Director of Service and International Operations Jim Carr, Radcal Corporation President and CEO Curt Harkless and Acertara Acoustic Laboratories President and CEO G. Wayne Moore.
Q: What are the most important things to look for when purchasing test equipment for diagnostic imaging equipment?
Carr: It is important to use test equipment that reliably provides objective and repeatable results. An objective test that can be easily repeated provides meaningful and actionable results.
Harkless: Since your test equipment represents a major investment that is critical to your business for many years to come, one should look for a partner who is proven, stable, reliable and established. Consider the lifecycle of the relationship including service, repair and calibration that are critical to operating and maintaining test equipment over the long run. As diagnostic imaging continues to grow and evolve, the requirements of your test equipment may grow and will likely evolve as well. One should select test equipment from a line that is modular, interchangeable and extensible to meet changing needs.
Moore: Although it may seem self-evident, make sure that the device being purchased is capable of providing the answers you need to both diagnose a medical imaging device problem and ascertain if that device is functioning at its optimal level.
Q: What basic testing capabilities do HTM professionals need in their test equipment?
Carr: An electrical safety analyzer and a DMM are basic and essential tools. Electrical leakage testing to assure the safety of patients and users is required by state and federal regulations for almost all imaging systems. For X-ray systems, a dosimeter is required test equipment and an oscilloscope may be needed. For X-ray and MRI, phantoms are needed for calibration and testing, and might be provided and kept with the system. For ultrasound, a general QA phantom (TMP) or some way to test transducer and system performance is needed for maintenance and troubleshooting.
Harkless: In X-ray imaging, the name of the game is getting good imagery with minimal dose which is why ensuring that the system is operating correctly is so important. In assessing the behavior of the system, the following are standard measurement quantities: dose, dose rate, kV, mA, filtration, pulse number, and pulse duration. The ability to view and analyze waveforms of these quantities provides a much deeper understanding of the operation of the X-ray system, especially for the new dynamic mode switching systems. For HTM professionals working as part of a team, one might consider interoperability of sensor components enabling sharing of equipment amongst multiple users.
Moore: When I founded Sonora Medical Systems more than 20 years ago, HTMs told me over and over that they needed to get to the answers about the performance and safety of a medical imaging device under test as quickly, as quantitatively, and as easily as reasonably possible. We invented the FirstCall probe tester with that criteria in mind.
Q: What are the newest features biomeds should look for when buying imaging test equipment?
Carr: Some of us are OK with the older tools that are often simpler to use and less expensive, and can be used on a wider variety of systems. For those that are doing the same types of tests on a frequent basis, there can be some great advantages in the automation and wireless networking available on newer test equipment. Programmable electrical safety analyzers and dosimeters also can improve objectivity and repeatability of testing. Some can store drawings and documents on them, and interfaces to CMMS systems can improve productivity of PMs.
Harkless: With the advent of low-cost computer tablets, measurement systems providing two-line text displays are being displaced by those that integrate large, easy-to-read displays. These displays run sophisticated applications that automatically record and display all measurement details including time and date stamp, detailed measurement data, waveforms, and serial numbers of equipment used. In fact, use of iPads in hospitals has become almost ubiquitous and X-ray QA instruments are now available that offer the convenience and familiarity of an iPad or iPhone interface. As with everything else today, “there’s an app for that.” Since these displays are essentially tablet computers, all of the connectivity features such as Internet communication, emailing of reports, and remote printing of results are now accessible to the user.
Moore: With our probe testing devices, such as Aureon and Atlas, we focused on developing technology that both matches and unravels the intricacies of complex OEM transducers now on the market, and those that will be coming on the market over the next several years. These include 2D matrix arrays, cMUT, as well as wireless probes.
Q: Why is it important to have testing equipment with a waveform display?
Carr: An oscilloscope is required for service and maintenance on many imaging systems. That includes many MRI systems and almost all systems with an X-ray tube. An o-scope is very useful to anyone troubleshooting AC input issues, intermittent power supply problems and noise caused by RF and electromagnetic interference.
Harkless: The ability to view the waveform provides a depth of understanding with regard to the operating state of the imaging system unmatched by point measurements. New innovations provide ever improving imaging capabilities with reduced effective radiation dose. These improvements come with added complexity that requires waveform display and analysis to effectively assess. Waveform analysis can seem daunting, but with the right equipment and software this analysis can be achieved with ease (and without the need for special equipment or scopes as in the past).
Moore: It is a matter of preference on conveying test data and results; some HTMs prefer waveforms, others prefer graphical displays, with some devices both modes are available.
Q: How can HTM professionals make sure their testing equipment will keep up with new features and technologies on future diagnostic imaging devices?
Carr: The ability to upgrade and add options to test equipment can be important features that save money in the long run. For example, purchasing an X-ray dosimeter with a modular design that allows the addition of detectors for mammography and CT and options for different types of systems means you can service a new type of system without having to purchase an entirely new dosimeter. Some test equipment has add-on options to help with other aspects of service and maintenance. For example, Fluke has a light detector option for their RaySafe Xi dosimeter that can be used for CRT and LCD luminance measurements.
Harkless: The X-ray field is experiencing a period of rapid development, especially in the area of mammography where tomography and novel filtration are improving imaging capabilities. Considering instruments that are software upgradeable so that new imaging modes can be rapidly accommodated would be advisable. Look for an instrument partner with a history of responding to emerging technologies with timely solutions.
Moore: Talk with the manufacturer of the test device, ask them what the design philosophy behind the device was, and how the hooks for adding new technology to accommodate testing of newer imaging devices was built into the system architecture of the test device. This is a great conversation to have as it can double as a peek behind the curtain of new technologies coming down the line.
Q: What else do you think TechNation readers need to know about purchasing test equipment?
Carr: It is important to identify the present and future needs for test equipment prior to comparing test equipment to purchase. Having test equipment with a lot of bells and whistles may mean you are paying too much, and it may actually take longer to do the job. The cost and availability of calibration and repair are also important criteria. Check with your calibration supplier for that, and ask if they have any opinions regarding the equipment you are considering. Try to check with existing users, especially if the equipment is relatively new.
Harkless: Time is money when performing quality assurance on high usage systems. It is worth thinking through the QA process in its entirety including setup, measurement, analysis, reporting, and archiving of the results. Look for systems that provide hands-off automatic ranging, direct data readout, and avoid the need for applying manual corrections. Systems that provide the ability to generate forms tailored for a user’s individual needs that are completed automatically in the course of a measurement can dramatically reduce the timeline and effort associated with the measurement process. Forms in standard applications such as Excel facilitate archiving and subsequent retrieval in the future.
Moore: Talk with the device manufacturer before you buy and, if appropriate, test the device, schedule a demo in the hospital and do some actual testing. See if it meets your specific needs and the requirements that may be unique in your setting.
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