Multi-Institutional Survey of 4-Year Ultrasound Quality Control Findings

Zaiyang Long; Megan Russ; Sandra Larson; Mark R Holland; Zheng-Feng Lu; Cameron Kofler; Wei Zhou; Jian-Feng Chen; Zhimin Li; James Zagzebski; Jennifer Stickel; Andreea Dohatcu

doi:10.1002/jum.16763

Multi-Institutional Survey of 4-Year Ultrasound Quality Control Findings

J Ultrasound Med. 2025 Jul 3. doi: 10.1002/jum.16763. Online ahead of print.

Authors

Zaiyang Long¹, Megan Russ², Sandra Larson³, Mark R Holland⁴, Zheng-Feng Lu⁵, Cameron Kofler⁵, Wei Zhou⁶, Jian-Feng Chen⁷, Zhimin Li⁸, James Zagzebski⁹, Jennifer Stickel¹⁰, Andreea Dohatcu¹¹

Affiliations

¹ Department of Radiology, Mayo Clinic, Rochester, MN, USA.
² Clinical Imaging Physics Group, Department of Radiology, Duke University Health System, Durham, NC, USA.
³ Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
⁴ Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
⁵ Department of Radiology, University of Chicago, Chicago, IL, USA.
⁶ Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
⁷ Department of Radiology, Loyola University Medical Center, Maywood, IL, USA.
⁸ Department of Radiology, Northwestern University, Chicago, IL, USA.
⁹ Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA.
¹⁰ Diagnostic and Nuclear Medicine section, Colorado Associates in Medical Physics, Colorado Springs, CO, USA.
¹¹ Radiation Safety, MD Anderson Cancer Center, Houston, TX, USA.

PMID: 40607767
DOI: 10.1002/jum.16763

Abstract

Objectives: Periodic quality control (QC) testing of ultrasound (US) imaging systems is essential to ensure and maintain image quality and safety. The study aims to analyze QC findings from medical physics annual surveys of modern clinical US systems in a multi-institutional survey.

Methods: QC results from annual surveys between 2018 and 2021 were retrospectively collected from 12 medical physicists from 11 institutions or consulting companies (hereafter referred to as sites). QC tests were classified as scanner- and transducer-related tests, where scanner-related tests also included evaluation of diagnostic workstation display monitors and routine QC programs if applicable. Test methodology and pass/fail criteria were established by each site. QC findings were defined as results requiring follow-up action by service engineers, vendors, or other personnel. The percentage of annual findings was calculated for each site and averaged across the years of data contributed. Furthermore, findings across all sites were aggregated for an overall analysis.

Results: QC data from a total of 1069 scanner tests and 4542 transducer tests were collected. The average annual percentage of scanner-related findings varied from 0 to 40.8% among all sites (first quartile 8.7%, median 18.2%, and third quartile 34.1%), while that of transducer-related findings ranged between 0.5% and 19.9% (first quartile 3.9%, median 7.2%, and third quartile 14.5%). For scanner-related tests, the top 3 categories of findings were associated with physical and mechanical integrity (171 findings, 74.7%), quantitative testing of the scanner display monitor (40 findings, 17.5%), and scanner port creating artifacts (10 findings, 4.4%). The top 3 findings for transducers related to uniformity and artifact (227 findings, 79.9%), physical and mechanical integrity (44 findings, 15.5%), and sensitivity in fundamental mode (9 findings, 3.2%).

Conclusions: Medical physics annual surveys revealed considerable actionable findings of modern US systems, which inform the status of current US QC practices in the United States and may guide future standardization and recommendation of QC tests.

Keywords: diagnostic medical physics; quality assurance; quality control; transducer; ultrasound.