Clinical Image Testing: Ultrasound (Revised 1-21-2022)
Modified on: Fri, 21 Jan, 2022 at 3:28 PM
Facilities must apply for all modules routinely performed at that site (Obstetrical, Gynecological, General, Vascular, Pediatric) in order to be accredited. 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 from the Ultrasound Accreditation section of the ACR website so you can fill them out online later, 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 and must be clearly documented in the accompanying physician report. The ACR is not responsible for abnormal evaluations.
Each ultrasound submission will be evaluated for:
Gray scale - TGC, overall gain
Depth/field of view
Color and spectral Doppler settings (scale, gain, angle correction)
Refer to the specific Exam Requirements for each module for details
Imaging labeling - organ/anatomy of interest, transducer orientation plane, side (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
Date and time of examination
Date of birth or age
Type of examination
Technologist's initials, identification number or name (recommended)
Clinical images should represent your facility’s 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.
Reporting of Results
Physician reports are requested to confirm the date and type of examination performed for all examinations. Each ultrasound exam submitted must have a report that is clearly labeled. The physician report should follow the format outlined in the ACR Practice Parameter for Communication of Diagnostic Imaging Findings . A sonographer or technologist worksheet does not take the place of the physician report.
Vascular reports must contain diagnostic physiologic and anatomic findings. It is desirable that normal lab values for velocity measurements appear at the bottom of reports for reference; this is especially helpful with carotid examinations (for Duplex carotid exams the velocity table should be included). If velocity measurements are not on the report, please include a copy of the measurements.
Revision History for this Article
Description of Revision(s)
Article created; FAQs incorporated; No criteria changes
|2-3-2020||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|
|3-13-2020||Vascular reports||Removed diagnostic criteria|
|4-21-2020||Exam requirements for all modules||Added explanation of complete documentation/survey|
|5-5-2020||Clinical exam||DICOM images are required for upload submissions|
|6-8-2020||Exam identification||Added Do NOT anonymize images|
|2-16-2021||Requirements||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.|
|3-10-2021||Clinical Image Selection||Clarified evaluation requirements for Ultrasound submissions|
|1-21-2022||Updated notes under Clinical Image Selection and all exam requirement articles|
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