| Clinical Images | Phantom Images |
Nuclear Medicine | Failure to label for laterality and orientationFailure to follow the accreditation instructionsIncomplete submission of examsSubmitting CT, MRI, or fused imagesFailure to follow written procedureFailure to send quality imagesData form does not accurately reflect information for images submitted
| Incomplete datasetFailure to submit composite of rodsCenter of rotationHigh-count floodPhantom mixing and positioningNot applying required attenuation correction (if available in the processing software)Data form does not accurately reflect information for images submitted
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PET | Failure to label for laterality and orientationFailure to follow the accreditation instructionsSubmitting CT, MRI, or fused imagesFailure to follow written procedureFailure to send quality imagesData form does not accurately reflect information for images submitted
| Incomplete datasetFailure to include rodsFailure to remove spheresPhantom mixing and positioningSUV measurements outside of the ACR acceptable range Not submitting 1cm thick DICOM slicesData form does not accurately reflect information for images submitted
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CT | Scanning through orbits/lens on brain CTNot submitting required series (i.e. contrast enhanced)Not reviewing and following the CT Testing Instructions before choosing exams for submissionSelecting examinations your site does not usually performSupervising physician not reviewing images before they are sent to the ACR
| Techniques listed in Phantom Site Scanning Data Form do not match techniques used to scan the ACR or dosimetry phantomsParameters given to physicist are not parameters used for clinical examsNot checking images for correct protocolNot submitting dose imagesIncorrect size chosen for pediatric abdomen phantom in data form
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MRI | Not reviewing testing instructions before choosing exams for submission Not reviewing and following instructions located on the first page of each module in the Testing Instructions Not submitting required sequencesNot submitting ADC mapPoor SNRIncomplete anatomical coverage Supervising physician not reviewing images before they are sent to the ACR
| Not following instructions provided in guidance documentsPhysicist not reviewing images/data before sending to the ACR
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Mammography | PositioningCompressionAnonymizing imagesFailure to read instructions
| Phantom images do not meet criteria for fibers, specks and massesFailure to read instructionsNot choosing best tomosynthesis slice for DBT unitsChoosing wrong size phantom in testing package
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Breast MR | Low SNRArtifactsParameters for pre- and post-contrast T1 images do not match
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Breast Ultrasound | Correlating mammogram was not performed within 60 days prior to sonogramCC and MLO images not submittedSonogram discordant with mammogramDistance from nipple to abnormality not measured on imagesImproper technical settingsImproper scanning techniquePoor image quality
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Stereotactic Breast Biopsy | Correlating mammogram was not performed within 60 days prior to stereo biopsyCalcifications not seen on both stereo pair views
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Radiation Oncology | Insufficient information in consultative noteIncomplete patient history and physical examinationIncomplete treatment prescriptionsLack of defined goals and requirements of treatment plan by radiation oncologist (i.e., dose constraints)No formal treatment planning quality assurance planLack of dose volume histogramsLack of proper treatment quality assurance prior to patient treatment (i.e., no IMRT QA)No written directive for brachytherapy procedure(s)Insufficient radiation oncologist coverage during patient treatmentLack of port film verificationLack of documented weekly patient visitsNo documented patient follow-up planNo formal quality assurance and improvement program documented (e.g., outcome studies, focus studies)No physician or physicist peer-review documentedEnd-of-treatment physics check not performed within a week
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Ultrasound | Failure to follow the accreditation instructionsSubmitting studies that do not meet the Exam RequirementsFailure to meet Exam Requirements with static imaging (cine loops are permissible for some exams; details of which exams allow cine clips are included in the specific Exam Requirements)Inadequate documentation of required anatomy Submitting post-surgical studiesImproper technical settingsImproper scanning techniquePoor image quality
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