Technical ultrasonic quality assurance in Danish Radiology Departments

Introduction

In general, there is a lack of technical quality assurance (TQA) in ultrasound, which threatens patients. This study aimed to map the level of ultrasound quality assurance in Danish Radiology Departments, assess the intra- and interrater reliability of the in-air method for evaluating transducer quality, and determine the prevalence of faulty transducers.

Methods

From October to November 2021, an anonymous survey focused on the extent of TQA was e-mailed to clinicians (via managers) responsible for ultrasound TQA. The six-item survey included both closed and open-ended questions. In addition, a sample of 63 ultrasound b-mode reverberation images was collected from four Danish Radiological Departments, later rated by two blinded radiographers on a dichotomous scale.

Results

A total of 46 participants responded to the survey. In the survey, 15 respondents reported not having a TQA procedure, while six thought a procedure existed but were uncertain. Various methods were reported for the respondents who answered that TQA was performed (n = 13).

Half of the respondents (n = 23, 50%) reported experiencing transducer malfunctions, and seven said they did not find the lack of regular testing problematic.

The interrater reliability was κ = 0.75 (95% CI.: 0.61–0.89), and the inter-rater reliability was κ = 0.84 (95% CI.: 0.70–0.98). Based on the agreement between the two raters, 20 out of 50 (40%) transducers were flawed.

Conclusion

This study demonstrates the general deficiency of TQA in Danish Radiological Departments, with 21 clinicians responsible for ultrasound TQA responding either not having a TQA procedure or being uncertain if one exists. Furthermore, the study reveals that the in-air method for assessing transducer quality demonstrates moderate to almost perfect reliability and that nearly half of the transducer tested exhibits visual faults.