Tests to be performed during acceptance and status testing

Test procedures, to be performed according to acceptance test standards, valid between 2002 and 2010, for radiographic and fluoroscopic, mammography, panoramic dental and CT equipment are listed concisely hereinafter. Acceptance testing includes also measurement of leakage radiation and – where applicable – attenuation of table top.

I. Inspection and functional checks

 
(Based on requirements of IEC=EN=MSZ EN 61223-3 series)
1) Report of acceptance or previous status test exists (yes – no); recommendations given in its remarks are performed (yes – no) (if applicable)
2) User’s manual in Hungarian available onsite (yes – no)
3) Constancy tests are running and documented (yes – no)
4) Location of the focal spot on the X-ray tube assembly is marked (yes – no)
5) Nominal focal spot value(s) of the X-ray tube(s) and permanent filtration of the X-ray source assembly (assemblies), according to labels or manufacturer’s specification
6) Visibility of light field indication is appropriate (yes – no)
7) Operation of controls is appropriate (yes – no)
8) In case of mammography equipment only: compression device is smooth, without cracks or sharp edges (yes – no)

II. Measurements

 
A) Radiographic equipment
1) Measurements of x-ray parameters (X-ray tube voltage, irradiation time, dose) with non-invasive X-ray parameter measuring instrument. Includes: measurement of radiation output, accuracy of X-ray tube voltage and irradiation time, linearity of dose with irradiation time and/or X-ray tube current, reproducibility (MSZ EN 61223-3-1 5.2. and 5.6.)
2) Measurement of half value layer (HVL), determination of filtration with Al filter series and dose measurement (MSZ EN 61223-3-1 5.3.). Note: There are measuring instruments (e.g. RTI Barracuda) which assess HVL and filtration from one shot, without use of filter series.
3) Dimensions of the X-ray beam, its centering, coincidence with the light beam and the image reception area – taking a radiogram about a test object (MSZ EN 61223-3-1 5.5.1., 5.5.2. and 5.5.3.). In case of possibility of appropriate darkening coincidence of the X-ray beam and the light beam may be tested also by a special phosphorescent screen, without exposing the staff. In case of digital equipment evaluation of the radiogram is performed on the monitor.
4) Constancy of AEC (automatic exposure control) density (in case of digital equipment: dose) – three radiograms with different (10, 15 and 20 cm) PMMA phantom thicknesses (MSZ EN 61223-3-1 5.8.2.1.)
5) Reproducibility of AEC dose with phantom and dosimeter (MSZ EN 61223-3-1 5.8.2.2.)
6) Operating AEC backup timer with lead covering (MSZ EN 61223-3-1 5.8.2.3.)

B) Tomography units
In addition to tests described in A):
7) Test with tomographic test object, according to its manual – Multiple exposures on one film, it includes: depth of tomographic layer, line pair resolution, centering and uniformity of running (MSZ EN 61223-3-1 7.)

C) Fluoroscopic equipment
1) X-ray tube voltage in AERC (automatic exposure rate control) mode with 25 mm Al phantom; if there is no AERC: at 70 kV setting (MSZ EN 61223-3-1 6.2.)
2) Measurement of half value layer (HVL), determination of filtration with Al filter series and dose measurement (MSZ EN 61223-3-1 6.3.). Note: There are measuring instruments (e.g. RTI Barracuda) which assess HVL and filtration from one shot, without use of filter series.
3) Checking operation of AERC (automatic exposure rate control) mode: registration of displayed values of X-ray tube voltage and current at 10, 15 and 20 cm PMMA phantom thicknesses, in all magnification modes (MSZ EN 61223-3-1 6.5.)
4) Coincidence of the X-ray beam and the image reception area – testing beam limitation with fluoroscopic screen (MSZ EN 61223-3-1 6.6.). In case of no possibility for appropriate darkening this test is omitted.
5) Patient input dose rate with a phantom (MSZ EN 61223-3-1 6.9.)
6) Image intensifier (or DR detector) input dose rate with a phantom (MSZ EN 61223-3-1 6.8.)
7) Line pair resolution with and without phantom (MSZ EN 61223-3-1 6.12.)
8) Contrast resolution with and without phantom (MSZ EN 61223-3-1 6.13.)
9) At digital units: dose per frame (MSZ EN 61223-3-3 5.5.)
10) At DSA (digital subtraction angiography) units: radiogram with a DSA test object, it includes dynamic range, DSA contrast sensitivity, artefacts, compensation for attenuation non-linearity (MSZ EN 61223-3-3 5.6., 5.7., 5.9., 5.10.)

D) Panoramic dental X-ray equipment
In addition to test A) 1), 2) and 3):
4) Line pair resolution (MSZ EN 61223-3-4 6.8.)
5) Low contrast resolution (MSZ EN 61223-3-4 6.9.)
6) Homogeneity of the image (MSZ EN 61223-3-4 6.11.)
7) Test for beam limiting and alignment – with an intraoral film (MSZ EN 61223-3-4 6.5.)
8) At cephalometric equipment: test for beam limiting and alignment – with a homogeneous radiogram (MSZ EN 61223-3-4 7.5)

E) Mammography equipment
1) Measurements of x-ray parameters (X-ray tube voltage, irradiation time, dose) with non-invasive X-ray parameter measuring instrument. Includes: measurement of radiation output, accuracy of X-ray tube voltage and irradiation time, linearity of dose with X-ray tube current time product, reproducibility (MSZ EN 61223-3-2 5.2. és 5.6.)
2) Measurement of half value layer (HVL), determination of filtration with Al filter series and dose measurement (MSZ EN 61223-3-2 5.3.)
3) Dimensions of the X-ray beam, its centering, coincidence with the light beam and the image reception area – taking a radiogram about a test object (MSZ EN 61223-3-2 5.5.) In case of possibility of appropriate darkening coincidence of the X-ray beam and the light beam may be tested also by a special phosphorescent screen, without exposing the staff. In case of digital equipment evaluation of the radiogram is performed on the monitor.
4) Smallest X-ray tube current time product in AEC (automatic exposure control) mode (MSZ EN 61223-3-2 5.7.1.)
5) Constancy of AEC density (in case of digital equipment: dose) – three radiograms with different (20, 40 and 60 mm) PMMA phantom thicknesses (MSZ EN 61223-3-2 5.7.2b.)
6) Reproducibility of AEC dose with phantom and dosimeter (MSZ EN 61223-3-1 5.8.2.2.)
7) Operating AEC backup timer with lead covering (MSZ EN 61223-3-2 5.7.3.)
8) Measuring of compression force with dynamometer (MSZ EN 61223-3-2 5.9.)

F) Computed tomography (CT)
1) CTDI (computed tomography dose index) measurements with CT ionization chamber and CT dose phantoms (MSZ EN 61223-3-5 5.4)
2) Accuracy of table positioning (MSZ EN 61223-3-5 5.1)
3) Accuracy of patient positioning (MSZ EN 61223-3-5 5.2)
4) Tomographic slice thickness (MSZ EN 61223-3-5 5.3)
5) Noise, CT number, uniformity (evaluation of a homogeneous exposure) (MSZ EN 61223-3-5 5.5)
6) Spatial resolution (MSZ EN 61223-3-5 5.6)

It is important to note that with the technical development this set of measurements is not enough anymore. It is possible and practical, to complete it with some optional tests. Analogue (film) technology is replaced by digital radiology very quickly, in the last years there was no new analogue X-ray equipment installed (except dental ones). In case of digital equipment, testing image displaying is more important than that of X-ray generators. It will be explained in details later on.