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What This Guide Helps With
Troubleshoots abnormal image brightness or contrast caused by positioning, technique, display settings, obstructions, accessories, or image-chain problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Maintain Imaging Continuity
If image quality is inadequate for safe clinical interpretation or procedural guidance, stop using the affected system for patient-dependent imaging. Move the procedure to another verified imaging system when clinically necessary.
Do not continue fluoroscopy simply to troubleshoot an unreliable image.
Expected outcome: The patient is not dependent on an imaging system that cannot provide clinically usable images.
2. Confirm the Exact Image-Quality Complaint
Ask staff whether the image is consistently too dark, too bright, washed out, low contrast, or only abnormal in certain views or procedures. Determine whether the problem affects live fluoroscopy, stored images, or both.
Review an existing non-patient image or perform an approved test exposure using appropriate test material when permitted.
Expected outcome: The problem is reproduced and its scope is clearly defined.
3. Check Patient or Test-Object Positioning
Verify that the anatomy or test object is centered appropriately between the X-ray tube and image receptor. Check for unusually thick anatomy, extreme angulation, excessive source-to-image distance, or objects unintentionally blocking the beam.
Remove unnecessary radiopaque items from the field when safe.
Expected outcome: Proper positioning produces a more typical image. If image quality returns to normal, troubleshooting can stop after functional verification.
4. Inspect External Accessories and the Imaging Path
Check for table hardware, positioning aids, shielding, surgical equipment, cables, or other objects entering the X-ray field. Inspect the image receptor and exposed exterior surfaces for contamination or obstruction.
Do not disassemble the imaging chain.
Expected outcome: The X-ray path is clear and external contamination or obstruction is ruled out.
5. Verify Operator-Accessible Imaging Controls
Confirm that the system is using the intended imaging mode and that operator-accessible brightness, contrast, edge enhancement, or similar display adjustments have not been changed unintentionally.
Return controls only to approved clinical settings or known baseline settings.
Expected outcome: The displayed image responds normally to authorized adjustments. If normal contrast and brightness are restored, troubleshooting can stop.
6. Compare Automatic and Manual Technique Behavior When Appropriate
Using approved test conditions, determine whether the abnormal appearance occurs only during automatic exposure control or also when using permitted manual technique settings.
Do not alter calibration values or service-level exposure parameters.
Expected outcome: The issue is isolated to a particular operating mode or remains present regardless of normal user-accessible technique changes.
7. Check Monitor Display Performance
Inspect the monitors for abnormal brightness, dimming, loss of grayscale detail, glare, incorrect display adjustment, or obvious display degradation. Compare both monitors if the configuration permits.
If the stored image appears normal on one display but poor on another, suspect the display path rather than the acquisition chain.
Expected outcome: Monitor performance is either verified as normal or a display-specific problem is identified.
8. Compare Live and Stored Images
Review a stored image acquired under controlled conditions and compare it with the live display. Determine whether poor contrast exists in the acquired image itself or only during display.
Expected outcome: The fault is narrowed to acquisition, processing, or display behavior without invasive troubleshooting.
9. Perform Functional Verification
After correcting any external cause, perform an approved imaging-function check using suitable test material. Confirm that brightness, contrast, image detail, and display behavior are stable across normal movements and operating modes.
Expected outcome: Images are consistently usable and the original complaint cannot be reproduced. Troubleshooting can stop.
10. Escalate if Image Quality Remains Unacceptable
If positioning, controls, external obstructions, display adjustments, and basic imaging operation are normal but poor image quality persists, remove the system from clinical use pending further evaluation.
Expected outcome: An unreliable imaging system is prevented from returning to patient care.
If the Problem Persists
Common external causes have been ruled out. Remaining possibilities may involve the image receptor, X-ray generation system, automatic exposure control, image processing, calibration, monitor electronics, or another service-level imaging-chain issue.
The OEC 9800 should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate GE Healthcare documentation and approved imaging test equipment.
- Repaired, calibrated, or configured only by qualified personnel.
Return the system to service only after the required imaging performance, safety, and functional checks have been completed successfully.
Knowing when to stop external troubleshooting and escalate an image-quality problem is proper troubleshooting.
Clinical Use Tip
Poor image quality during fluoroscopy can affect procedural decisions; provide another verified imaging system rather than repeatedly exposing the patient while troubleshooting.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported that OEC 9800 fluoroscopy images appeared unusually dark with poor contrast during procedures."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found that an unintended display contrast adjustment on the monitor cart was causing the abnormal appearance."
Resolution
What action was taken.
Example:
"Restored the approved display setting and verified normal fluoroscopic image brightness and contrast using an approved test object."
Helpful Details to Include (If Known)
- Whether image was dark, bright, washed out, or low contrast
- Live versus stored image behavior
- Imaging mode in use
- Patient or test-object positioning
- Objects present in the X-ray field
- Monitor affected
- Display settings observed
- Results of controlled test imaging
- Whether both monitors displayed the same problem
- Final image-quality verification
- Final device status
- Whether image was dark, bright, washed out, or low contrast
- Live versus stored image behavior
- Imaging mode in use
- Patient or test-object positioning
- Objects present in the X-ray field
- Monitor affected
- Display settings observed
- Results of controlled test imaging
- Whether both monitors displayed the same problem
- Final image-quality verification
- Final device status
Final Thought
Begin with patient safety, positioning, controls, and the external imaging path before assuming an internal imaging-chain failure. Verify the correction under controlled conditions, escalate persistent image-quality problems appropriately, and document the complaint, cause, and resolution clearly.
That is successful troubleshooting.