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Chapter 3 Radiography CHAPTER 3 RADIOGRAPHY ROLE OF RADIOGRAPHERS/MAMMOGRAPHY TECHNOLOGIST AND SONOGRAPHERS IN WESTMEAD BREAST CANCER INSTITUTE ................. 5 RADIOGRAPHY/MAMMOGRAPHIC TECHNOLOGIST STAFF TRAINING AND CONTINUING PROFESSIONAL DEVELOPMENT ..................................... 8 DESIGNATION OF IMAGE QUALITY REVIEW FOR RADIOGRAPHY STAFF ................................................................................................................... 9 PERFORMANCE FEEDBACK TO STAFF......................................................... 10 ANNUAL ASSESSMENT OF RADIOGRAPHIC COMPETENCY ...................... 11 QA / EVALUATION OF MAMMOGRAPHIC IMAGE .......................................... 13 TECHNICAL PROCEDURES- RADIOGRAPHY CRITERIA FOR MAMMOGRAPHY ............................................................................................... 14 POSITIONING – CRANIO-CAUDAL (CC).......................................................... 18 POSITIONING – MEDIO-LATERAL OBLIQUE (MLO) ...................................... 20 BREAST COMPRESSION IN MAMMOGRAPHY .............................................. 22 VIEW NAME/LATERALITY SELECTION ON GE SENGRAPHE DS ................ 23 RADIOGRAPHY- WORK-UP PROTOCOL ........................................................ 25 SIGNIFICANCE OF LATERAL VIEW................................................................. 26 ADDITIONAL VIEWS-CONED COMPRESSION (SPOT) .................................. 27 ADDITIONAL VIEWS-MAGNIFICATION VIEW ................................................. 28 ADDITIONAL VIEW- EXTENDED CRANIO-CAUDAL (CC) .............................. 29 FILM FORMAT FOR LARGE BREASTS ........................................................... 30 AUGMENTED BREAST (BREAST IMPLANTS/PROTHESIS) –PART 1 .......... 32 AUGUMENTED BREAST (BREAST IMPLANTS/PROTHESIS) –PART 2 ....... 34 IMAGING OF CLIENTS WITH MASTECTOMY ................................................. 35 MANAGEMENT OF FREE SILICONE INJECTION CLIENTS FOR BREAST SCREENING ....................................................................................... 36 CLIENTS WHO ARRIVE WITH PRIVATE IMAGES AT SCREENING SITES .................................................................................................................. 41 STANDARD MAMMOGRAPHY VIEWS ............................................................ 44 PROCESS FOR INCOMPLETE VIEWS FOR SCREENING MAMMOGRAM ................................................................................................... 45 CORRECT IDENTIFICATION OF PATIENTS/ CLIENTS FOR BREAST IMAGING PROCEDURE(S) ................................................................................ 46 INFORMATION ON HARDCOPY IMAGES ........................................................ 47 Supporting Women with Breast Cancer – Today and Every Day eVersion 3 – 2016 Page 1 MANAGEMENT OF EXAMINATION ON CERNER (COMPLETING/ADDING/INCORRECT ACCESSION) ...................................... 48 HOW TO MANUALLY PUSH IMAGES FROM ACQUISITION MONITOR TO ARCHIVE AND WORKSTATIONS ON GE DS UNIT ................................... 51 STAFF INTRODUCTION AND EXPLANATION OF PROCEDURE TO CLIENTS ............................................................................................................. 52 PROCEDURE- FOR CLIENTS PRESENTING WITH SKIN LESIONS/ BROKEN SKIN ................................................................................................... 54 CLIENTS WITH DISABILITIES FOR SCREENING MAMMOGRAM ................. 55 CLIENTS WITH PACEMAKERS FOR MAMMOGRAM ..................................... 57 PROCEDURE –FOR CLIENTS ARRIVING LATE FOR APPOINTMENT AT SCREENING SITES ...................................................................................... 58 MYER Online INDUCTION AND ORIENTATION COURSE (WHS online course) ............................................................................................................... 59 MYER RETAIL STORES –Staff Entrance ......................................................... 60 SCREENING WOMEN FROM DETENTION INSTITUTIONS ............................ 61 PROCESS TO FOLLOW FOR NETWORK FAILURE ....................................... 63 RADIOGRAPHERS UNIFORM AND IDENTIFCATION CARD/BADGES ......... 64 NOTIFYING OFSICK LEAVE FOR RADIOGRAPHERS ................................... 65 ON CALL PHONE PROCESS ............................................................................ 66 NOTIFICATION OF PHONE SYSTEM FAILURE .............................................. 67 ORDERING OF CONSUMABLES FOR SUNFLOWER CLINICS .................... 68 RADIOGRAPHY STAFF MEETINGS ................................................................. 69 DELETING OF IMAGES FROM GANTRY (GE UNITS) ..................................... 70 MAMMOGRAPHIC UNIT IDENTIFICATION NUMBER (SITE ID) ..................... 71 EMERGENCY COMPRESSION RELEASE PROCEDURE- SENOGRAPHE DS UNITS ................................................................................. 72 FAULT LOG AND RECORDING FOR ALL MODALITIES ................................ 73 QA – ACCEPTANCE TESTING ON NEW MAMMOGRAM X-RAY UNITS BY PHYSICIST ................................................................................................... 74 ANNUAL CERTIFICATE OF COMPLIANCE CERTIFICATE TESTING BY PHYSICIST ......................................................................................................... 75 QA - MONTHLY VISUAL CHECKS ON MAMMOGRAPHY UNITS .................. 76 INFECTION CONTROL – CLEANING THE DETECTOR PLATE ..................... 79 INFECTION CONTROL – CLEANING THE ULTRASOUND TRANSDUCER ................................................................................................... 80 INFECTION CONTROL – CLEANING THE BARD BIOPSY GUNS .................. 81 Supporting Women with Breast Cancer – Today and Every Day eVersion 3 – 2016 Page 2 REPEAT ANALYSIS – PERFORMED QUARTERLY ....................................... 83 QA - MAMMOGRAPHY SYSTEM CONSISTENCY CHECK – DAILY Calibration PROCEDURE .................................................................................. 84 TIME ALLOCATION FOR QUALITY ASSURANCE TESTING & PREPARATION BEFORE START OF SCREENING PROCESSES for Mobile Van 28 (VAN 1) ...................................................................................... 86 MOBILE VAN PACK UP & UNPACKING INSTRUCTIONS WITH QA & CLEAN UP PROCESS TIME .............................................................................. 88 COMPRESSION TESTING for GE and Hologic Units ..................................... 90 OTHER EQUIPMENT AND ACCESSORY CHECKS – VIEWBOXES ............... 91 RADIATION MONITORING BADGES................................................................ 92 SENORYX ENCOR UNIT AND PRONE VACB SYSTEM SET UP .................... 93 ASSESSMENT CLINIC Procedure .................................................................. 102 MT DRUITT BREAST ASSESSMENT CLINIC ................................................ 104 MT DRUITT SPECIMEN IMAGING USING TRIDENT UNIT ............................ 106 ULTRASOUND EQUIPMENT – QA TESTS ..................................................... 108 ULTRASOUND INSTRUMENTATION AND QUALITY CONTROL ................. 110 PERFORMING BREAST ULTRASOUND ........................................................ 111 ULTRASOUND GUIDED BIOPSIES ................................................................ 113 NEEDLE STICK INJURIES .............................................................................. 115 YELLOW Sharps BIN/Yellow Clinical Waste Bag ........................................ 116 ASSESSMENT – POST CORE BIOPSY CARE .............................................. 117 RADIOGRAPHY – OH&S - SHARPS DISPOSAL ........................................... 119 RADIOGRAPHY – OH&S BLOOD SPILLAGE ................................................ 120 RADIOGRAPHY – OH&S – USE OF GLOVES FOR MAMMOGRAMS .......... 121 DATA REQUIREMENTS FOR RADIOGRAPHERS USING THE DIGITAL GE MACHINE FOR DIAGNOSTIC PROCEDURES for all modalities ........... 122 PROTOCOL FOR UPRIGHT STEREOTACTIC BIOPSY (GE Machine) ........ 125 TO switch ON/OFF PHILLIPS ULTRASOUND MACHINE ........................... 129 USE OF SENORYX Encor UNIT ..................................................................... 130 PROTOCOL FOR USE OF SENORYX Encor UNIT WITH GE UPRIGHT STEREOTACTIC BIOPSY ATTACHMENT –Mount Druitt Clinic .................. 131 MAMMOGRAPHY EQUIPMENT –GE Senographe DS .................................. 134 ULTRASOUND EQUIPMENT ........................................................................... 137 HOLOGIC PRONE VACB TABLE .................................................................... 140 PRONE TABLE COMPRESSION PADDLE CLEANING ................................. 141 Supporting Women with Breast Cancer – Today and Every Day eVersion 3 – 2016 Page 3 PROCEDURE FOR REPEATING OR REJECTING IMAGES AND PERFORMING REPEAT/REJECT ANALYSIS- GE UNIT ............................... 142 SPECIMEN X-RAY FOR HOOKWIRE LOCALISATION AND VACB/CORE BIOPSY, ULTRASOUND OF HOOKWIRE LOCALISATION SPECIMEN ........................................................................................................ 144 CLINICAL PROCEDURE SAFETY .................................................................. 145 END OF THE DAY PACKUP PROCEDURES ................................................. 147 CLOSING AND SECURING THE ENTRANCE DOORS .................................. 147 HOW TO TURN ON AND OFF THE LIGHTS ................................................... 149 HOW TO OPERATE THE ENTRY STAIRS – MOBILE
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