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What This Guide Helps With
Troubleshoots degraded fluoroscopic images caused by positioning, obstruction, settings, detector contamination, accessories, environment, or imaging-chain problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Avoid Unnecessary Exposure
If image quality is inadequate for safe clinical interpretation, stop using the affected system for patient imaging and provide another verified imaging option. Do not repeatedly expose the patient while troubleshooting image quality.
Expected outcome: Diagnostic or procedural decisions are not made from unreliable images, and unnecessary radiation exposure is avoided.
2. Confirm the Image Complaint
Determine whether the problem is noise, lines, bands, fixed artifacts, nonuniformity, blur, low contrast, image dropout, or poor detail. Ask whether the issue affects all images or only particular positions, techniques, or procedures.
Expected outcome: The image-quality problem is clearly characterized and reproducible.
3. Inspect the Imaging Field
Check for objects between the X-ray source and detector, including table hardware, cables, positioning devices, protective equipment, surgical accessories, or other equipment entering the field.
Expected outcome: No unintended object is degrading the image. If removing an obstruction restores normal image quality, troubleshooting can stop after verification.
4. Verify C-Arm and Patient Positioning
Confirm that the geometry and positioning are appropriate for the intended image and that excessive distance, extreme angulation, or poor centering is not contributing to degraded results.
Expected outcome: Positioning supports normal image acquisition and image quality improves if geometry was the cause.
5. Inspect External Imaging Surfaces
Inspect accessible detector and imaging surfaces for contamination, residue, covers, protective drapes, or damage that could create visible artifact. Clean only using approved methods.
Expected outcome: External imaging surfaces are clean and undamaged.
6. Review Clinical Imaging Settings
Verify that the selected imaging mode and operator-accessible settings are appropriate for the examination. Compare the setup with a known normal configuration if available. Do not alter restricted calibration or service parameters.
Expected outcome: Appropriate clinical settings are selected and image quality is consistent with the intended mode.
7. Compare With a Standard Test Object
Without a patient and using approved radiation-safety practices, acquire an image of an appropriate test object or phantom. This separates equipment performance from patient anatomy or positioning.
Expected outcome: The test image is free from unexplained artifact and demonstrates stable image quality.
8. Reposition the C-Arm and Repeat the Test
Acquire comparison images through representative C-arm positions. Determine whether the artifact remains fixed on the display, follows the detector, changes with positioning, or disappears.
Expected outcome: The behavior helps distinguish external obstruction or positioning problems from an imaging-chain issue.
9. Check Displays and Workstation
Verify that poor appearance is not limited to a single monitor or display path. Compare available displays where possible and inspect external display connections.
Expected outcome: The displayed image accurately represents the acquired image and no external display problem is present.
10. Perform Final Image Verification or Escalate
If image quality is restored, complete applicable image-quality and functional testing before return to service. If artifact, excessive noise, or poor quality persists, remove the system from service.
Expected outcome: Only a system with verified acceptable image quality is returned to clinical use.
If the Problem Persists
External obstructions, positioning, surfaces, clinical settings, displays, and basic image acquisition have been checked. Remaining causes may involve detector calibration, detector performance, X-ray generation, image processing, internal communication, monitor electronics, or another service-level imaging problem.
Remove the OEC Elite from service, label it Out of Service, and send it for repair or bench evaluation. Evaluate using GE Healthcare documentation, approved imaging phantoms, radiation-measurement equipment, and applicable image-quality testing procedures. Calibration and internal adjustment should be performed only by qualified personnel.
Return to service only after required image-quality, functional, and radiation-safety checks pass. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Do not compensate for unexplained poor image quality by simply increasing exposure; determine the cause before additional patient imaging.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Clinical staff reported a persistent dark artifact appearing in fluoroscopic images."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found an external positioning accessory projecting into the imaging field."
Resolution
What action was taken.
Example:
"The accessory was repositioned and test imaging confirmed the artifact was eliminated with normal image quality restored."
Helpful Details to Include (If Known)
- Description of artifact or noise
- Whether all imaging modes are affected
- C-arm position when observed
- Objects present in imaging field
- Detector surface condition
- Operator settings observed
- Test-object or phantom result
- Whether artifact moves with positioning
- Display comparison result
- Final image-quality status
Final Thought
Protect the patient from unnecessary exposure, rule out positioning, obstructions, settings, and display causes before assuming internal imaging failure, and verify image quality objectively before return to service. Escalate persistent degradation and document what changed.
That is successful troubleshooting.