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The purpose of this work was to develop a method for systematically testing the reliability of a CR system under realistic daily loads in a non-clinical environment prior to its clinical adoption. Once digital imaging replaces film, it will be very difficult to revert back should the digital system become unreliable. Prior to the beginning of the test, a formal evaluation was performed to set the benchmarks for performance and functionality. A formal protocol was established that included all the 62 imaging plates in the inventory for each 24-hour period in the study. Imaging plates were exposed using different combinations of collimation, orientation, and SID. Anthropomorphic phantoms were used to acquire images of different sizes. Each combination was chosen randomly to simulate the differences that could occur in clinical practice. The tests were performed over a wide range of times with batches of plates processed to simulate the temporal constraints required by the nature of portable radiographs taken in the Intensive Care Unit (ICU). Current patient demographics were used for the test studies so automatic routing algorithms could be tested. During the test, only three minor reliability problems occurred, two of which were not directly related to the CR unit. One plate was discovered to cause a segmentation error that essentially reduced the image to only black and white with no gray levels. This plate was removed from the inventory to be replaced. Another problem was a PACS routing problem that occurred when the DICOM server with which the CR was communicating had a problem with disk space. The final problem was a network printing failure to the laser cameras. Although the units passed the reliability test, problems with interfacing to workstations were discovered. The two issues that were identified were the interpretation of what constitutes a study for CR and the construction of the look-up table for a proper gray scale display.
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