CRCPD Publication E-12-2

CT Inspection Checklist

for State Regulators

Developed by the CRCPD’s

H-32 Committee on Computed Tomography

July 2012

This is an example inspection checklist that has been developed based on generic criteria. It should be reviewed and evaluated against your specific state regulations and modified accordingly before using. There are questions that are more database type questions and some that are more enforcement in nature. Note: This must be modified to meet your specific state regulations. This checklist is intended to be used for each unit.

Facility/Registrant: ______
State ID number: ______/ Date: ______
Location (room number): ______/ Manufacturer: ______
Model and serial number: ______/ Manufacturer date: ______
Maximum number of images per rotation capable on unit: ______
Name of CT operator during inspection: ______
Number of CT operators: ______/ All CT operators credentialed: Y____ N ____
Number of CT operators with ARRT CT certification and currently registered: ______
Is your facility accredited? Y ____ N ____
Which accrediting organization(s)(check all that apply): / ACR_____ IAC_____ JointCommission_____
List the medical physicist(s): ______
Are they Qualified Medical Physicists (QMP)? / Y ____ N ____
If not, what are their qualifications: ______
State registered or licensed? Y ____ N ____ / License or Registration #: ______

Machine and Room Parameters:

  1. Emergency stop button identified (kill switch)?Y ____ N ____
  2. Availability of means for X-ray termination(temporary stop)?Y ____ N ____
  3. Ability to maintain constant audible & visual patient contact?Y ____ N ____
  4. Control of all CT suite entrances (visual or auto locks)?Y ____ N ____
  5. CT room appropriately labeled with caution signage?Y ____ N ____

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Dose Management Program

  1. mA modulation capability available?Y ____ N ____
  2. Dose Management Committee established?Y ____ N ____
  3. Protocols established and available to review for each unit?Y ____ N ____
  4. Protocols review:

Monthly ____ Quarterly____ Annually ____ or Other Frequency _____

  1. Indication of CT dose (CTDIvol or DLP)
  2. Is it indicated at operator’s console?Y____ N ____
  3. Is it provided to interpreting physicians on each study?Y____ N ____
  4. Is it included in the patient’s permanent medical record?Y____ N____
  5. Does the technologist monitor dose values for each patient study?Y____ N ____
  6. Does the site have established thresholds for dose evaluation?Y____ N ____
  7. Specific protocols for pediatrics Y ____ N ____
  • Do these differ from adult protocols? Y ____ N ____
  1. Specific dose reduction protocols Y ____ N ____
  2. mA modulation?Y ____ N ____
  3. Iterative reconstruction technology?Y ____ N ____
  4. Are protocols password protected, if available?Y____ N ____
  5. Are individuals identified who are allowed to modify protocols?Y ____ N ____
  6. Are modified protocols validated prior to clinical use?Y____ N ____
  7. Technologist’s QC Checks:
  • Written policy including frequency of QC check?Y ____ N ____
  • Images stored for future review?Y ____ N ____
  • Storage method used______
  • Corrective action initiated prior to patient imaging?Y ____ N ____

Machine Calibration and Maintenance:

  1. Performance evaluation by Qualified Medical Physicist:

Quarterly_____ Semi-annually_____ or Annually_____

  • Dates of the two most recent tests:

______

  • Calibrated dosimetric equipment (calibrated <2 yrs)?Y ____ N ____
  1. Calibration or preventative maintenance by service provider:

Monthly_____ Quarterly_____ or Annually_____

  • Calibration report with numerical values?Y ____ N ____
  • Are records available?Y ____ N ____

Qualified Medical Physicist Requirements/Reports:

  1. Spot check by Qualified Medical Physicist after major servicing?

(e.g., tube, detector or beam filters)Y ____ N ____

  1. Records available for review?Y ____ N ____
  2. Is there a shielding review for current scanner?Y ____ N ____
  3. Are there in-room scatter measurements for the current scanner?Y ____ N ____

Suggested standards to be included on the Qualified Medical Physicistsevaluation – relevant items to be determined by the QMP:

  • CT conditions of operation (image thickness, # of images per rotation, gantry angle, etc.) are indicated prior to the initiation of the scan
  • CT conditions of operation visible before scan initiation
  • Initiation of each scan or series is required by operator
  • A signal is visible to the operator indicating when X-ray exposure has been terminated
  • Operator is able to terminate scans of greater than 0.5 seconds at any time
  • Manual reset required after termination of 0.5 seconds or greater
  • Means provided for visible determination (light indicators) of the tomographic plane
  • Visible indication of X-ray production at the gantry
  • All emergency buttons and/or switches are clearly labeled
  • Qualified Medical Physicistevaluation includes acceptable limits for QC checks performed

Suggested Quality Control (QC) checks that should be contained on the Qualified Medical Physicist evaluation

Mechanical Accuracy – establish parameters based on manufacturer recommendations andstate regulations.

  • Gantry angle
  • CT laser alignment
  • CT table index

Image Quality Test

  • CT number accuracy
  • Image noise
  • Image uniformity
  • Artifacts

Image Quality Test Continued

  • Spatial resolution (Image sharpness)
  • Low contrast performance
  • Image thickness

Dosimetry

  • Radiation beam width
  • Adult head,adult body
  • Pediatric head, if applicable
  • Pediatric body, if applicable
  • Accuracy of CTDIvol

CT Acquisition Workstation Monitor QC

  • Test pattern
  • Luminance testing

Developed by

CRCPD H-32 Committee on Computed Tomography

Lisa Bruedigan, Chairperson

Candance Brown (MN), Member

Asish Banerjee (NH), Member

Roy Huhn (PA), Member

Thomas Payne, ACR Resource

Thomas Ruckdeschel, AAPM Resource

Jan Martensen, ACCR Resource

Doug Pfeiffer (CO), Medical Physicist Contributor

Published by

Conference of Radiation Control Program Directors, Inc.

1030 Burlington Lane, Suite 4B

Frankfort, KY 40601

The information contained in this document is for guidance. The implementation and use of the information and recommendations contained in this document are at the discretion of the user. The implications from the use of this document are solely the responsibility of the user.

The mention of commercial products, their sources, or their use in connection with material reported herein is not to be construed as either an actual or implied endorsement of such products by the CRCPD or any federal agency.

This document has been developed by a working group of the Conference of Radiation Control Program Directors, Inc. (CRCPD) and accepted by the Board of Directors for publication. The contents contained herein, however, may not necessarily represent the views of the entire membership of the CRCPD or any federal agency supporting the work contained in this document.

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