Keith J. Strauss MS, Presenter: Research Consultant, Koninklijke Philips NV Speakers Bureau, Koninklijke Philips NV

1) Understand need for and advantages of quantitative (as opposed to qualitative) analysis of image quality. 2) Identify and understand new tools becoming available for evaluating fluoroscopic equipment performance. 3) Identify appropriate configuration of acquisition parameters as a function of patient size. 4) Be able to configure the radiation dose to the detector to ensure diagnostic image quality at properly managed patient dose.

Abstract Steps that are required to turn physics support of fluoroscopy from a compliance focused to operationally focused program will be discussed. New metrics and analytics to better quantify high contrast resolution, low contrast resolution, temporal resolution, and 3D imaging will be examined. Changes in testing protocols necessary to address new hardware technologies, new acquisition methods, state-of-the-art image processing and analysis will be reviewed. A recently developed “physics testing mode” that the vendors will provide in the near future will be described. Proper management of patient dose metrics will be reviewed. The presentation concludes with clinical implementation of these new strategies. Proper training and communication is critical. Proper configuration of acquisition parameters (focal spot size, voltage and added filter, tube current, pulse width, pulse rate, scatter removal) as a function of patient size from the smallest neonate to the largest bariatric patient is key to providing diagnostic image quality at properly managed radiation doses. In addition, one must ensure that the detector dose as a function of filter type and thickness, pulse rate, field of view, and complexity of the examination is properly configured.

Strauss, K, Fluoroscopy 2.0 .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13010882.html