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What This Guide Helps With
Use this guide for unexpected CT artifacts, nonuniformity, distortion, noise, or image degradation that may arise from positioning, accessories, environment, or system performance.
Step-by-Step Troubleshooting
1. Protect the Patient and Avoid Unnecessary Repeat Exposure
Stop repeated patient scanning when image quality is clearly unacceptable. Determine whether another scanner should be used rather than exposing the patient again during troubleshooting. Expected outcome: Troubleshooting proceeds without unnecessary additional radiation exposure.
2. Confirm the Artifact or Quality Complaint
Review representative images and determine whether the issue is consistent, intermittent, anatomy-specific, protocol-specific, or limited to one examination. Record what staff observed without attempting to diagnose an internal component from image appearance alone. Expected outcome: The image-quality problem is reproducible or clearly characterized.
3. Check Patient Positioning and Motion Factors
Determine whether patient motion, off-center positioning, external objects, leads, jewelry, supports, or other removable items could explain the artifact. Expected outcome: Obvious patient-positioning or external-object causes are identified or ruled out.
4. Inspect Table Accessories and Scan Field
Verify that headrests, pads, positioning aids, cables, and other accessories are appropriate and properly placed for the examination. Check for foreign material within the scanned area. Expected outcome: No external accessory or object is introducing the image abnormality.
5. Verify Protocol and Reconstruction Selections
Confirm that the expected scan protocol, reconstruction, orientation, and other normal operator-selectable settings were used. Compare with a known-good examination workflow when appropriate. Expected outcome: The complaint is not caused by an unintended protocol or reconstruction selection.
6. Determine Whether the Problem Is Patient-Specific
Review whether the same issue occurs with other examinations or only under a particular patient condition. Avoid changing service-level calibration or configuration settings. Expected outcome: The issue is separated from patient-specific causes when possible.
7. Perform Approved Phantom or Quality-Control Testing
Use the appropriate facility-approved or manufacturer-supported quality-control test to evaluate scanner image quality without a patient. Expected outcome: Test images meet expected institutional or manufacturer acceptance criteria. If they do, the scanner itself is less likely to be the cause and troubleshooting can stop after confirming the original external cause.
8. Review Recent Changes
Check whether the condition began after maintenance, software activity, calibration, a power event, room work, accessory replacement, or environmental change. Expected outcome: Any external event associated with the onset of the problem is documented for further service evaluation.
9. Escalate Failed Image-Quality Testing
If artifacts remain during controlled phantom testing or quality-control performance is unacceptable, remove the scanner from clinical use until evaluated. Expected outcome: A scanner with objectively unacceptable image quality is not used for patient imaging.
If the Problem Persists
Patient positioning, external objects, accessories, protocol selection, and controlled quality testing have been evaluated. Persistent artifacts may involve detector performance, calibration, X-ray generation, mechanical alignment, reconstruction, environmental interference, or another service-level subsystem.
The scanner should be:
- Removed from service
- Labeled Out of Service
- Sent for repair or service evaluation
- Evaluated using Siemens Healthineers documentation, approved phantoms, and approved test equipment
- Repaired, calibrated, or configured only by qualified personnel
Complete appropriate image-quality and functional verification before clinical use. Knowing when to stop external troubleshooting is proper troubleshooting.
Clinical Use Tip
Do not repeatedly rescan a patient solely to determine whether a suspected scanner artifact will disappear.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"CT staff reported a recurring artifact on SOMATOM X.cite images during head examinations."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found a removable positioning accessory extending into the scan field."
Resolution
What action was taken.
Example:
"The accessory was repositioned, approved phantom images were reviewed without the artifact, and normal image quality was confirmed before return to service."
Helpful Details to Include (If Known)
- Description and location of artifact
- Whether all exams or one protocol were affected
- Patient positioning
- Accessories in the scan field
- Protocol and reconstruction used
- Whether patient motion was present
- Phantom or QC test results
- Recent maintenance or calibration
- Environmental changes
- Final image-quality result
Final Thought
Minimize repeat exposure, rule out positioning, accessories, protocol selection, and other external causes first, then use controlled quality testing to determine whether service escalation is required.
That is successful troubleshooting.