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Clinical Image Testing: Ultrasound (Revised 12-15-2023)

Revision History


Facilities must apply for all modules routinely performed at that site (Obstetrical, Gynecological, General, Vascular, Pediatric) in order to be accredited. Please see our article on Units for Emergency Use as needed. In the initial application, your facility selected the exams that you will submit from each module for accreditation.

Clinical exams submitted for accreditation review must match what was selected in the application. If you decide to change the type of exam you will be submitting, you must notify the ACR. The ACR will replace the exam within the application. All submissions will be returned if notification did not occur.

After you submit your application online, you must log into your account and fill out the forms for your Testing Package. You may print generic forms (a Clinical Data Sheet is attached below) for your convenience, but the data must be submitted online.

After your application is processed, the ACR assigns your facility a unique identification number (UAP#). This number appears on all correspondence from the ACR, on your online records and on all barcode labels, if applicable. Please use this number on all submitted materials and to identify your facility when contacting the ACR for assistance.

All testing materials must be submitted to the ACR within 45 calendar days from the date they were made available to the facility, or the application will be made inactive. The testing materials due date will be in the email sent to the facility when the application has been accepted and the testing materials have be sent. Failure to meet this due date will jeopardize completion of your accreditation. If your facility is renewing its accreditation, we cannot guarantee completion before your ACR certificate expires. If your site cannot submit the required materials by your due date, notify the ACR immediately. 

DICOM images are required for upload submissions. Non-DICOM images that are DICOM wrapped are not acceptable. 

Clinical Image Selection 

Clinical images for each type of ultrasound accreditation the facility is seeking (Obstetrical, Gynecological, General, Vascular, Pediatric) must be submitted.

Images must be clearly labeled and obtained within the established timeframe. All examinations submitted must have been performed within six 6 months of the date that the testing package link was released to the facility. No images will be accepted for review that predate this date by more than six months. Since we do not know exactly when the application will be processed, do not collect images until you have received instructions with the testing material.

Clinical images for Obstetrical, Gynecological, General, Vascular and Pediatric accreditation should be normal exams or as close to normal as possible. Exams with minimal pathology may be submitted only if no high-quality normal studies are available. Examinations containing abnormal findings must still meet the Exam Requirements. The ACR is not responsible for abnormal evaluations.

Each ultrasound submission will be evaluated for:

  • Image Quality

    • Gray scale - TGC, overall gain

    • Depth/field of view

    • Color and spectral Doppler settings (scale, gain, angle correction)

    • Resolution/detail

    • Proper transducer/frequency

  • Anatomic coverage 

    • Refer to the specific Exam Requirements for each module for details

  • Exam identification

    • Imaging labeling - organ/anatomy of interest, transducer orientation plane, side (if applicable), vessel segment (i.e., proximal, mid, distal if applicable)

    • Do NOT anonymize images. All information annotated on clinical examinations will be kept confidential by the ACR. The following identifying demographic data should be displayed on each image:

      • First and last name

      • Medical record number

      • Institution name

      • Date and time of examination

      • Date of birth or age of the patient

      • Type of examination (indicate on the Clinical Test Image Data Sheet)

      • Technologist's initials, identification number or name (recommended)

Clinical images should represent your facility‚Äôs standard exam protocols.  Please review the Exam Requirements associated with each exam type (see table below). All submissions MUST meet the Exam Requirements. Not meeting the Exam Requirements may result in a failure. 

Exam Requirements by Ultrasound Accreditation Type






Please note the following:

  • Refer to the Exam Requirements - all anatomy listed is required. Most failures are a result of not meeting the Exam Requirements. Facility specific protocols do not supersede the ACR Exam Requirements.

  • Complete documentation/survey means a series of several images throughout the entire organ in two planes. For example, from one side of the organ to the other in the longitudinal plane and from superior to inferior in the transverse plane.

  • Reviewers assume that all images submitted are examples of your best work. Images will be judged accordingly.

  • The supervising ultrasound physician must review and approve all clinical images before they are submitted.

  • Each study submitted must be obtained from a different patient. All images obtained at the time of the examination must be submitted and must be from the same patient.

  • Any clinical image submitted for accreditation review must be of an actual patient who needed the examination. Use of volunteers or models, including staff from your facility, is prohibited and may result in withholding, denial, or revocation of accreditation. Submitting images taken from a volunteer or model as clinical images from a patient may constitute fraud.

  • Do not submit post-surgical studies.

  • Most Exam Requirements must be met with static imaging, however, some exams do allow cine clips as part of the review process. Refer to the associated Exam Requirements for details. 

  • The use of a phantom test object is optional at this time; therefore, questions relating to characteristics associated with system sensitivity, image uniformity, and safety may be answered without the use of a phantom as a test object.

  • Keep all documents for your records and keep copies of everything you submit to the ACR for your records.


Revision History for this Article



Description of Revision(s)



Article created; FAQs incorporated; No criteria changes


Clarified clinical evaluation categories, corrected name of Practice Parameter for the Communication of Diagnostic Findings and clarified evaluation criteria of static imaging versus cine loops


Vascular reports

Removed diagnostic criteria


Exam requirements for all modules

Added explanation of complete documentation/survey


Clinical exam

DICOM images are required for upload submissions


Exam identification

Added Do NOT anonymize images



All exam requirements must be met with static imaging, except for First Trimester Endovaginal and Female Pelvis ovarian imaging- refer to the associated exam requirements for details.


Clinical Image Selection

Clarified evaluation requirements for Ultrasound submissions


Updated notes under Clinical Image Selection and all exam requirement articles


Reporting Results

Reporting results section removed because physician reports are no longer required.



Clinical Data Sheet attached


Added link to the Units for Emergency Use article


minor clarifications to exam identification requirements for date of birth or age and type of examination


Exam identification

Added clarification to image labeling requirements 


Updated US Clinical Data Sheet attachment

Previous: QC: Ultrasound/Breast UltrasoundNext: Exam Requirements: Obstetrical Ultrasound

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