Although quality assurance programmes have been recommended for many years, there is limited evidence of their efficacy. This study aimed to assess whether an automated image quality analysis method could demonstrate changes in scanner performance in a quality assurance programme. Test object images were analysed, measuring lateral resolution, low contrast penetration, slice thickness, anechoic target visibility and grey-scale target contrast and visibility. Known and suspected scanner faults were investigated and routine results were reviewed. At least one variable changed in response to each known or suspected scanner fault. Resolution and grey-scale target visibility changed due to image shadowing. Slice thickness, lateral resolution and grey-scale target contrast were affected where users reported deterioration in image quality. A single probe fell out of tolerance on routine testing, due to an unrecorded change to the default preset by the supplier's representative. Interpretation of individual results is not always intuitive, observed changes depending on the shape of the grey-scale transfer curve and on target and background echo levels. Our results have provided evidence for the efficacy of this method of performance testing. Further experience is required to evaluate this method for prospective detection of faults and further work is required to determine optimum scanner settings and test object properties to maximise fault detection and to reduce the dependence of results on confounding factors.
Ultrasound scanner preset programmes are factory set or tailored to user requirements. Scanners may, therefore, have different settings for the same application, even on similar equipment in a single department. The aims of this study were: (1) to attempt to match the performance of two scanners, where one was preferred and (2) to assess differences between six scanners used for breast ultrasound within our organisation. The Nottingham Ultrasound Quality Assurance software was used to compare imaging performance. Images of a Gammex RMI 404GS test object were collected from six scanners, using default presets, factory presets and settings matched to a preferred scanner. Resolution, low contrast performance and high contrast performance were measured. The performance of two scanners was successfully matched, where one had been preferred. Default presets varied across the six scanners, three different presets being used. The most used preset differed in settings across the scanners, most notably in the use of different frequency modes. The factory preset was more consistent across the scanners, the main variation being in dynamic range (55-70 dB). Image comparisons showed significant differences, which were reduced or eliminated by adjustment of settings to match a reference scanner. It is possible to match scanner performance using the Nottingham Ultrasound Quality Assurance software as a verification tool. Ultrasound users should be aware that scanners may not behave in a similar fashion, even with apparently equivalent presets. It should be possible to harmonise presets by consensus amongst users.
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