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Medical Imaging Capabilities and Limitations

2.Medical Imaging Capabilities and Limitations

1.Facility Name:
2.Please indicate for each of the following modalities whether or not your facility uses digital image acquisition (CR or DR) instead of plain film.
Already digital
We have a firm plan to change to digital
No firm plan to change to digital
Radiography
Mammography
DSA/Interventional
GI Fluoroscopy
3.Please indicate for each of the following modalities whether or not your facility uses a PACS (Picture Archiving and Communication System).
Already using a PACS
We have a firm plan to install a PACS
No firm plan to install a PACS
Radiography
Mammography
CT
MRI
Nuclear Medicine
GI Fluoroscopy
DSA/Interventional
Sonography
4.How often is final image interpretation performed by a...
Never
Infrequently
Sometimes
Frequently
Always
Radiologist?
Non-radiologist physician?
Non-physician?
5.Do you think it is necessary to train non-radiologist physicians (e.g. primary care physicians) at your facility in basic medical image interpretation?
6.Please indicate the average daily availability of each modality
Unavailable
7 days a week
6 days a week
5 days a week
4 days a week
3 days a week
2 days a week
1 day a week
Radiography
Sonography
Mammography
CT
MRI
GI Fluoroscopy
PET
SPECT
Planar Gamma Camera
DSA/Interventional
7.Please indicate the availability of the following radiology consumables.
Unavailable or not used
Usually in short supply
Usually available
Always available
Iodinated Contrast
Gadolinium Contrast
Barium oral contrast
Water soluble oral contrast
Film
Film Cassettes
Radiopharmaceuticals
Catheters and sheaths
Needles
Ultrasound probe sleeves
Ultrasound jelly
Gloves
Gauze
8.Please indicate how often patients are referred to your facility to undergo each of the following types of medical imaging.
Rarely to never
Sometimes
Frequently to always
Radiography
Mammography
CT
MRI
Nuclear Medicine
GI Fluoroscopy
DSA/Interventional
Sonography
9.If you received a donated piece of medical imaging equipment, would you be willing and able to accept the full responsibility of customs clearence? This could include filling out necessary forms and possibly also having a representative present at the port of entry (among other requirements that vary by country).
10.Please select the weight of donated medical equipment you could safely transport from port of entry to final destination.
11.What equipment(s) are you interested in receiving through donation? Please select all that apply.
12.Do radiology personnel at your facility use personal dosimeters to monitor their exposure to radiation over time?
13.Do you have an adequate supply of intact personal radiation protection equipment (lead aprons, leaded gloves, leaded shields, etc.)?
14.Do you follow national and/or regional guidelines for radiation safety?
15.For each of the following types of imaging equipment, please indicate the number of working (not broken) units at your facility?
16.For each of the following types of imaging equipment, please indicate the number of non-operational or broken units at your facility?
17.What is the total study volume at your facility for each of the following modalities? Please indicate units in your answer. For example, "patients per day", "studies per month", etc.
18.Please indicate how many of each type of CT scanner you currently have at your facility. If you do not have CT, leave blank,
19.Please indicate how many of each type of MRI scanner you currently have at your facility. If you do not have MRI, leave blank.
20.Comments?
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