Imaging Equipment of MRI and CT

Scan Machine Participant Training

Manual
Imaging – Two

August 2023
Forward
Diagnostic health imaging technology has revolutionized healthcare, allowing for earlier
identification of medical disorders, less intrusive exploratory procedures, and improved patient
outcomes. Medical imaging plays a crucial role in medicine, supporting diagnosis and treatment
of diseases includes ultrasonography, x-rays, mammography, CT scans, MRI and nuclear
medicine.
The MOH in its five years Health Sector Transformation Plan (HSTP) prioritized improving
diagnostics services, equitable access, and management to quality health services to all segments
of the country. To realize this transformational agenda, and the national programmatic services
strategies, the ministry devised multiple initiatives including strengthening of diagnostics
services and expansion of cancer, Tumor, neurological disorder, musculoskeletal condition,
cardiovascular disorder, TB, and other programmatic services of diagnosis, therapy, and
treatment, which all of these require adequate availability of imaging equipment.
Currently, a lack of skilled personnel and the management of existing imaging equipment faced
challenges in Ethiopia's health care system. This has resulted in an interruption of services and
even less availability of these critical diagnostics. Biomedical professionals are required to
provide proper management and maintenance services of imaging equipment at health facilities,
to ensure that functionality of imaging machine and to provide uninterrupted health services.
Accordingly, it has been found necessary to develop standardized training materials to enhance
and equipped the capacity of biomedical professional to realize the proper maintenance,
utilization and operation of imaging equipment of MRI and CT Scan machines. I belief that this
training manual highly benefits for these professionals, and other health facility staffs engaged in
the management of imaging equipment.
Finally, I would like to take this opportunity to thank all stakeholders who participated in the
development of this training material.

Regasa Bayisa Obse

Pharmaceutical and Medical Devices Lead executive office
Lead executive officer

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Ministry of Health- Ethiopia

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Approval Statement of the Ministry
The Federal Ministry of health of Ethiopia has been working towards standardization
and institutionalization of In-Service Trainings (IST) at national level. As part of this
initiative the ministry developed a national in-service training directive and
implementation guide for the health sector. The directive requires all in-service training
materials fulfill the standards set in the implementation Guide to ensure the quality of in-
service training materials. Accordingly, the ministry reviews and approves existing
training materials based on the IST standardization checklist annexed on the IST
implementation guide.
As part of the national IST quality control process, this Imaging -Two IST training
package has been reviewed based on the standardization checklist and approved by
the ministry.

Assegid Samual Cheru

Human Resource Development and Improvement
Lead executive officer
Ministry of Health- Ethiopia

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Acknowledgment
Ministry of Health- PME LEO would like to express its gratitude and appreciation to all
participants and their respective organizations for their unreserved commitment and
support in the development of the training manual on Imaging – For Biomedical
professional. PME LEO recognizes and values the technical expertise and experiences
expressed in the document and it is hoped that this training material will contribute
towards the proper management and effective utilization MRI and ST scan machine
Our heartfelt appreciation is extended to each of the members whose role was immense
from inception to the preparation, coordination, and finalization of this training manual.

Contributor Name Profession Organization

Eyuel Berhanu Radiographer St. PHMMC
Samuel Asfaw Radiographer Yekatit 12
Anteneh Abate Technologist ELSMED
Aychiluhm Belay Biomedical Eng. Infinity
Muliye Kibabew Biomedical Eng. AAIT
Eyasu G/Mikael Biomedical Eng. St. PHMMC
Nuru Kasa Biomedical Eng. Yekatit 12
Zelalem Yigzaw Biomedical Eng. Canon
Alemu Abibi Biomedical Eng. MoH – PME LEO
Addisu Fayera Biomedical Eng. MoH-PME LEO
Abrahaley Beyene Biomedical Eng. MoH-PMED LEO

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Table of Contents

List of acronyms and abbreviation

List of figures

List of tables

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Introduction to the manual

Imaging equipment is a valuable tool that can be used to improve the diagnosis,
treatment, and safety of patients. The continued development of imaging technologies is
making it possible to create even more detailed and accurate images, which will lead to
even better patient care in the future. The specific applications of imaging equipment
will vary depending on the type of equipment and the needs of the user. However, all of
these applications rely on the ability of imaging equipment to create detailed images of
objects or areas of interest.
MRI and CT scans are two of the most common types of medical imaging equipment.
They are used to create detailed images of the body for diagnostic purposes. MRI uses
a strong magnetic field and radio waves to create images. It is a non-invasive procedure
that does not use radiation and is often used to image the brain, spinal cord, joints, and
soft tissues, whereas CT scans use X-rays to create images and provide more detailed
images of bones and other tissues and are often used to image the chest, abdomen,
pelvis, and other parts of the body. The clinical applications of MRI and CT scans
include:
 Diagnosis of cancer: MRI and CT scans can be used to diagnose cancer by
detecting tumors and other abnormalities.
 Assessment of injuries: MRI and CT scans can be used to assess the severity of
injuries, such as a stroke or a spinal cord injury.
 Planning of surgery: MRI and CT scans can be used to plan surgery by providing
detailed images of the affected area.
 Monitoring of treatment: MRI and CT scans can be used to monitor the
effectiveness of treatment, such as chemotherapy or radiation therapy.
Imaging equipment services are important for ensuring the quality of medical images
and the safety of patients. By keeping imaging equipment in good working order, these
services can help improve the accuracy of diagnoses and the effectiveness of
treatments.

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Imaging equipment services are a range of activities that help ensure the optimal
performance of medical imaging diagnostic services. These services can include
preventive maintenance, repairs, upgrades, and decommissioning. Preventive
maintenance helps identify and fix potential problems before they cause downtime or
damage to the equipment. Repairs are necessary to fix problems that have already
occurred.
Imaging equipment services faced challenges. Different surveys indicated that there is
very limited technical knowledge on how to maintain imaging equipment, a lack of
training for technicians and users, a lack of spare parts in the local market and service
providers, and a lack of planned calibration, preventive, and corrective maintenance that
resulted in the non-functionality of this equipment at service delivery points.
This training manual has two major parts: improving diagnostic services at all levels of
the health facility, and providing the necessary knowledge, skills, and attitudes on
imaging equipment of MRI and CT scans to properly operate, utilize, maintain, and
manage imaging equipment of MRI and CT scans safely and effectively. The document
is divided into two major parts. The first part provides an overview of basic concepts,
physics, components, operation, maintenance, troubleshooting, safety considerations,
and safety features of MRI. The second part covers the imaging equipment of a CT
scan machine, which includes background, clinical applications, working principles,
basic parts, functions, and operating procedures, troubleshooting techniques and
maintenance procedures, performance and verification testing, and safe use and
handling of the CT machine.
In response to these challenges, which are identified in the areas of imaging equipment
of MRI and CT scanners, PMD LEO developed this training manual to equip the
required competencies for biomedical engineers and other technical practitioners at
health facilities to improve and strengthen the management of imaging equipment such
as MRI and CT scanners and to realize the proper management and handling in order
to deliver safe, effective, and efficient service delivery.
Core competency

After completing this course, the participants will have the following core competencies:

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  Explain clinical application of imaging equipment of MRI and CT Scan machine.
 Describe working and operation principle of imaging equipment of MRI and CT
Scan machine.
 Perform installation and commissioning of the imaging equipment MRI and CT
Scan machine.
 Follow trouble shooting techniques of the imaging equipment of MRI and CT
Scan machine.
 Perform preventive and corrective maintenance of imaging equipment of MRI
and CT Scan machine.
 Perform proper handling and safe use of the Imaging equipment of MRI and CT
scan in the health facilities.
 Perform imaging equipment MRI and CT Scan machine maintenance and
troubleshooting.

Course Syllabus
Course description: This --- days course is designed to equip with the basic
knowledge, skill and attitude required to manage imaging equipment of MRI and CT
Scan for Biomedical professional at MOH, , Regional, Zonal, and Health facilities. The
course starts with basic concepts of MRI and CT scan, followed by descriptions of the
clinical application, physics, components, operation, maintenance, troubleshooting,
performance and verification testing of MRI and CT Scan. Finally, the course addresses
attitude of MRI and CT Scan safety consideration, features and handling.
Course goal:
The goal of this course is to improve participants competency on imaging equipment of
MRI and CT Scan machine management system.
Participant learning objectives:
At the end of this course, participants will be able to:
 Describe the basics clinical application of MRI and CT scan Machine
 Describe purpose of MRI and CT Scan Machine
 Explain working principle of MRI and CT Scan Machine

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  Explain basic parts and function of MRI and CT scan Machine.
 Follow and perform troubleshooting techniques and procedures for MRI and CT
Scan machine
 Practice safe handling of ultrasound and x-ray machine
 Practice preventive and curative maintenance for MRI and CT Scan machine
 Apply testing tool to conduct performance test and calibration as demanded
 Follow safety consideration and features of MRI and CT Scan Machine
Training Methods:
 Interactive lectures
 Group discussion
 Individual reflection
 Demonstration
 Field visit
Training material and Equipment
 Facilitator’s guide
 Participant manual
 Power point presentation
 Temperature monitoring devices
 Imaging equipment of MRI and CT Scan equipment
 LCD projectors
 White board and marker
 Flip chart and marker
 Computer
 Video demonstration – MRI and CT Scan
 Inspection and performance checklist
Participant Selection Criteria
Participants for this course will be biomedical professional at MOH, Regional, Zonal,
Health facilities and partners involved in diagnostics services of imaging equipment.
Facilitator/Trainer Selection
 Be a member(s) of the training material developer team or

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  Have training of trainers (TOT) level on Imaging equipment of MRI and CT Scan,
or
 Have basic imaging equipment of MRI and CT Scan trainings plus facilitation skill and
 Two years of experience in MRI and CT scan
Certification Criteria
 Certificates will be provided to basic training trainees who score 70% and above
on summative assessment and attend 100% of the course.
 For TOT trainees, certificate shall be provided to those who score 80% and
above on summative and formative assessments and attend 100% of the course.
 In addition to summative the assessment, TOT participants will be will be
evaluated against selected set of facilitator/trainer roles,
Continuing Educational Unit (CEUs)
 15 CEUs
Methods of evaluation
Trainees/participant Evaluation
Formative
 Direct observation with feedbacks
 Group activities and presentations
 Pre-test
 Group exercises
 Demonstration using checklists.
Summative
For Basic Training
 Post test – 100%
For TOT training
 Teach back session– 40%
 Post Test - 60%
Course Evaluation
 Daily Evaluation
 End of training evaluation
 Participant oral feedback

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  Practice evaluation
Course duration:
 --- days
Suggested Class Size
 Suggested training class size shall be 30 participants for basic and TOT 25 per
training venue.
 At least three trainers each staying for the whole duration of the training are
needed for each training session.
Suggested Class Compassion:
 Trainer to participant ratio will be 1:6
Training Venue
 Accredited /CPD centers with attachment center.

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Course schedule:

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 Part – One
Imaging Equipment of MRI Machine

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Chapter One: Basics of MRI Machine

Allocated Time: 30hrs

Course Description: This chapter describes handling, operation, troubleshooting and

maintenance of MRI machines. It covers clinical applications, working principles, main
components, troubleshooting techniques, maintenance, safety procedures and handling
MRI machines.

Chapter objective: At the end of this chapter, participants will be able to:

Operate, safely handle, troubleshoot, and maintain MRI machine.

Enabling Objective:

At the end of this chapter the participant will be able to: -

❖ Describe basics of MRI

❖ Differentiate basic parts and function of MRI Machine
❖ Explain working principle of MRI Machine
❖ Practise safe handling of MRI machine

Chapter outline:

1. Introduction
1.1 Background of MRI Machine
1.2 Basic physics of MRI
1.2.1 Nuclear Magnetic Resonance (NMR)
1.2.2 Magnetization
1.2.3 Precession
1.2.4 Relaxation Processes
1.2.5 RF Pulses
1.2.6 Gradient Fields

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 1.2.7 Signal Detection and Image Formation
1.3 Exercise
1.4 Summary

1. Introduction:

Activity 1.1 brainstorming

What do you know about MRI machines and its types?

10 min

1.1 Historical background of MRI

Magnetic Resonance Imaging (MRI) is a medical imaging technique that uses a

powerful magnetic field and radio waves to generate detailed images of the body's
internal structures. The development of MRI involved contributions from various
researchers and scientists over several decades. Here's a historical background of MRI:
1. Discovery of Nuclear Magnetic Resonance (NMR):
The foundation of MRI can be traced back to the discovery of nuclear magnetic
resonance (NMR) phenomenon in the 1940s. In 1946, Felix Bloch and Edward
Purcell independently discovered that atomic nuclei with an odd number of
protons or neutrons can absorb and emit electromagnetic radiation when placed
in a magnetic field. This discovery earned them the Nobel Prize in Physics in
1952.
2. Development of Magnetic Resonance Imaging (MRI):
In the early 1970s, Raymond Damadian, a physician and scientist, explored the
possibility of using NMR to detect and diagnose diseases. He proposed that

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 differences in the NMR signals between normal and abnormal tissues could be
used to create images of the human body.
3. First MRI Experiments:
In 1971, Paul Lauterbur, a chemist, demonstrated the feasibility of creating two-
dimensional images using NMR signals. He used magnetic field gradients to
spatially encode the NMR signals emitted by different tissues, effectively creating
an image. Lauterbur's work laid the foundation for the development of modern
MRI.
4. Clinical Implementation and Commercialization:
In the late 1970s and early 1980s, significant advancements were made in MRI
technology. Researchers and engineers, including Sir Peter Mansfield and Paul
C. Lauterbur, developed methods to improve image quality, reduce scan times,
and refine imaging techniques. These advancements led to the clinical
implementation and commercialization of MRI systems.
5. Advancements in MRI Technology:
Over the years, MRI technology has continued to advance. High-field magnets,
improved imaging sequences, and sophisticated image processing techniques
have enhanced the quality and diagnostic capabilities of MRI. Functional MRI
(fMRI) was introduced in the 1990s, allowing researchers to study brain activity
by detecting changes in blood flow and oxygenation.

The introduction of higher magnetic field strengths, measured in Tesla, has been a
significant advancement in MRI technology. Initially, MRI systems operated at field
strengths of around 0.1 to 0.3 Tesla. However, as researchers and engineers worked to
improve the technology, higher field strengths became possible.

In the 1980s and 1990s, the development of superconducting magnets allowed for the
construction of MRI systems operating at 1.5 Tesla. These higher field strengths
provided improved image quality and faster scan times, leading to broader clinical
applications.

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Further advancements led to the introduction of even stronger MRI systems. Today, it is
not uncommon to find clinical MRI systems operating at 3 Tesla or higher. High-field
MRI systems, such as 7 Tesla, are being used for specialised research and clinical
applications, offering exceptional image resolution and the ability to visualise fine
anatomical details.

The use of higher Tesla magnets in MRI has enabled more precise and accurate
imaging, enhancing the diagnostic capabilities of the technology. However, it's important
to note that higher field strengths also come with certain challenges, such as increased
costs, technical complexities, and potential safety considerations.

Today, MRI is widely used in medical practice for diagnosing a variety of conditions,
including
❖ brain and spinal cord disorders
❖ joint and musculoskeletal problems
❖ Abdominal and pelvic abnormalities
❖ Chest and cardiovascular disease
❖ Gynaecology and obstetric evaluation
❖ Tumour and cancer.
❖ It has become an essential tool in modern healthcare, providing non-invasive
imaging with excellent soft tissue contrast and detailed anatomical information.

1.2 Basic physics of MRI

This section of the manual will provide an in-depth explanation of the fundamental
physics principles underlying MRI. It will cover topics such as nuclear magnetic
resonance, magnetization, precession, relaxation processes, radiofrequency pulses,
gradient fields, signal detection, and image formation. The manual will aim to present
these concepts in a clear and accessible manner, allowing readers to develop a solid
understanding of the physical principles that govern MRI technology.

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MRI (Magnetic Resonance Imaging) is a medical imaging technique that utilizes the
principles of physics to generate detailed images of the internal structures of the human
body. Understanding the basic physics of MRI is essential for comprehending how the
technology works. Here are the key concepts involved:

1.2.1 Nuclear Magnetic Resonance (NMR):

❖ MRI is based on the phenomenon of nuclear magnetic resonance, which occurs

when atomic nuclei with an odd number of protons or neutrons are placed in a
magnetic field.
❖ In the presence of a magnetic field, these nuclei align themselves either
parallel (low energy) or antiparallel (high energy) to the primary field (B0).

Nuclei with no applied field (B0) Nuclei

with applied field(B0)

1.2.2 Magnetization:

When a patient is placed in the MRI machine, the greater portion of protons in their
body's hydrogen atoms align with the external/primary magnetic field. This alignment
results in the net magnetization (M) of the patient's tissues.

Hydrogen is used as MR Active Nuclei in clinical MR because:

● It's Very Abundant in Human body composed of 70%

● Its Solitary proton gives it a relatively large Magnetic moment (Gyromagnetic
Ratio)

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 ● It gives best and most intense signal among all Nuclei

1.2.3. Precession and precessional Frequency

Precession refers to the spinning motion of the aligned protons around the Z direction
(long axis) of the external/primary magnetic field. This precession rate is referred to as
the Larmor frequency or Precessional frequency (W).

When protons precess together around the long axis of the primary magnetic field, this
is known as in-phase. Similarly, when the protons precess separately, it is known as
out of phase.

❖ When the protons precess, they create a tiny magnetic field of their own, which
can be detected by the MRI machine.

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The precessional frequency W is proportional to the field strength of the external
magnetic field.

Frequency w at which a spin precesses about an external magnetic field It is

dependent on type of nucleus and strength of the magnetic field B0

W ̴ B0

W = g * B0

g (gamma) is known as Gyromagnetic ratio

For 1H, the g is 42 MHz/Tesla

Precessional Frequency Chart

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1.2.4 Relaxation Processes:

Pulses of RF energy are used to generate the signal, which cause tissues to absorb RF
power.
The RF Energy is applied and transferred to the proton. The proton absorbs the energy
and is forced to the transverse plane.
The RF pulse is terminated and the protons are pulled back to the main magnetic field –
releasing the energy that is absorbed… BUT HERE IS WHERE we are going to go a
little deeper… the Hydrogen protons in different tissues – return “home” at different
rates! Thus beginning the ability to differentiate between tissues.

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There are two relaxation processes that occur after the protons are perturbed by
radiofrequency (RF) pulses:

❖ T1 Relaxation (Longitudinal Relaxation): It involves the realignment of protons

with the external magnetic field after an RF pulse is applied.

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 ❖ T2 Relaxation (Transverse Relaxation): It refers to the loss of phase coherence
among the precessing protons due to interactions with their surroundings.

1.2.5 RF Pulses(B1):

A radiofrequency (RF) pulse is a short burst of electromagnetic energy in the

radiofrequency range that is used in magnetic resonance imaging (MRI) to manipulate
the magnetic properties of protons in the body.

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The RF pulse is typically applied perpendicular to the main magnetic field (B0) in an
MRI scanner. Its purpose is to perturb the alignment of the protons' magnetic moments,
causing them to absorb energy and transition to a higher energy state.

The RF pulse is characterised by several parameters:

Flip Angle: The flip angle is the angle by which the protons' magnetic moments are
rotated away from their original alignment with the main magnetic field. It is determined
by the amplitude and duration of the RF pulse. The flip angle influences the amount of
magnetization and the contrast in the resulting MRI image. Maximum signal is achieved
at 90 degree flip.

Frequency: The RF pulse is tuned to a specific frequency known as the Larmor

frequency. The Larmor frequency is directly proportional to the strength of the main
magnetic field (B0) and corresponds to the resonant frequency at which the protons
absorb and emit electromagnetic energy.

Pulse Shape: The shape of the RF pulse can vary, but commonly used shapes include
rectangular, sinc, and Gaussian. The choice of pulse shape affects the frequency
content of the pulse and can influence the excitation profile and image quality.

Pulse Duration: The duration of the RF pulse determines how long the protons are
exposed to the electromagnetic energy. Shorter durations are typically used for

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excitation pulses, while longer durations can be used for refocusing or manipulating the
phase of the protons.

The application of an RF pulse is crucial for several MRI sequences, such as spin echo,
gradient echo, and inversion recovery. By manipulating the timing, duration, and
characteristics of the RF pulse, different contrasts and imaging effects can be achieved
in MRI. It's important to note that the RF pulses used in MRI are carefully designed and
controlled to ensure patient safety and optimise imaging quality.

Excitation: Excitation is applying strong RF Field (with Rotating Magnetic Field

Component B1) Perpendicularly to B0 at larmor Frequency

During Excitation, protons flip from Low energy state to high energy state and the
precising protones will be in phase coherence,

Resonance: Exchange of Energy between two systems at specific Frequency is called

Resonance. In MR an RF Pulse will Resonate with precessing Nuclei if its transmitted at
larmor Frequency of the nuclei. Exactly much of the RF Pulse and Nuclear Precessional
Frequencies is necessary for Resonance.

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Example of Resonance using Tuning Fork.

1.2.6 Gradients

Gradients are electromagnets built into the scanner that alter the strength of the magnet
over distance.

Spatial Encoding: Each point along the gradient has its own unique frequency

Amplitude of the gradients is: The rate of increase in the magnetic field – over a
distance and measured as mT/m.

The significance of amplitude is the spatial resolving power (FOV, matrix and slice
thickness)

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Slew Rate:Slew Rate is measured as T/m/s it reflects how rapidly the gradient can be
ramped to the height of the gradient flat top. The significance of Slew Rate is imaging
speed:
Min TR, min TE, min ESP

Fig: Amplitude and Slew Rate

1.2.7 Signal Detection and Image Formation:

❖ After the RF pulses and gradient fields are applied, the protons emit
radiofrequency signals as they return to their original states.
❖ These signals are detected by specialised coils within the MRI machine and
processed to generate image data.
❖ The detected signals are used to create a spatial map of the proton density and
relaxation times, which are then transformed into detailed anatomical images.
❖ Signal Generation: MRI uses a strong magnetic field and radiofrequency (RF)
pulses to generate signals. The patient is placed in the MRI scanner, where the
body's hydrogen atoms align with the magnetic field.

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 ❖ RF Excitation: RF pulses are applied to the patient, causing the hydrogen atoms
to absorb energy and enter an excited state.
❖ Relaxation: After the RF pulse is turned off, the excited hydrogen atoms return to
their original state, releasing energy. This energy is detected as an MRI signal.
❖ Signal Reception: Specialised coils in the MRI machine detect the weak MRI
signals emitted by the hydrogen atoms in the patient's body. These coils act as
receivers and capture the signals.
❖ Signal Processing: The detected signals are amplified and undergo various
processing steps, such as filtering and digitization, to convert them into a usable
format for image reconstruction.
❖ Fourier Transform: The processed signals undergo a mathematical operation
called the Fourier transform, which separates the signals into different frequency
components.
❖ Spatial Encoding: To determine the location of the MRI signal, gradient magnetic
fields are applied during the scanning process. These gradients encode spatial
information into the MRI signals.
❖ Image Reconstruction: Using the Fourier-transformed signals and the spatial
information encoded by the gradients, a computer reconstructs a detailed image
of the imaged area.
❖ Image Enhancement: Further image processing techniques, such as filtering,
contrast adjustment, and image fusion, may be applied to enhance the image
quality and improve visualisation.
❖ Image Display and Analysis: The reconstructed MRI image is displayed on a
monitor and can be analysed by radiologists and other medical professionals to
diagnose and evaluate various conditions and abnormalities.

It's important to note that this is a simplified summary of the complex process of MRI
signal detection and image formation. MRI technology involves advanced physics
principles and sophisticated algorithms to produce high-quality images for medical
diagnosis and research purposes.

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1.3 Activity

1.3.1 Group discussion

In a group of four discuss and explain how MRI physics is used in

diagnosing brain disorders?
Time: 15 min

1.4 Summary

Understanding these fundamental concepts of nuclear magnetic resonance,

magnetization, precession, relaxation processes, RF pulses, gradient fields, and signal
detection is crucial for grasping the basic physics behind MRI. This knowledge forms
the foundation for operating and interpreting images produced by MRI machines.

1.5 Exercise

1. What and how does MRI use to generate detailed images of the body's internal
structures?
2. Who discovered the phenomenon of Nuclear Magnetic Resonance (NMR)?

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Chapter Two: MRI Machine Overview

Allocated Time: 50 hrs

Course Description: This course provides a comprehensive overview of MRI

machines, covering the fundamental principles, components, and functionality of these
advanced medical imaging devices. Trainees will gain a solid understanding of the core
elements that make up an MRI machine and how they work together to produce high-
quality diagnostic images..

Chapter objective: At the end of this chapter, participants will be able to have a
comprehensive understanding of MRI machines, focusing on their fundamental
principles, components, and functionality.

Enabling Objective:

At the end of this chapter the participant will be able to: -

❖ Understand the principles behind MRI technology, including the role of magnetic
fields, radiofrequency pulses, and relaxation processes in image formation.
❖ Identify the key components of an MRI machine, such as the magnet system,
gradient coils, RF system, RF coils, and computer system, and explain their
individual functions within the imaging process.
❖ Explain the importance of magnet strength and its measurement in Tesla (T) for
image quality and diagnostic capabilities.
❖ Describe the purpose and operation of gradient coils in spatially encoding the MR
signal and generating detailed images.
❖ Discuss the role of the RF system and RF coils in transmitting and receiving
radiofrequency pulses for resonance and signal detection.
❖ Understand the computer system's role in controlling and coordinating the timing,
sequencing, and data acquisition processes within an MRI machine.

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Chapter outline:

2. MRI Machine Overview

2.1 Basic Components
2.1.1 Magnet
2.1.2 Gradients
2.1.3 Radiofrequency (RF) System
2.1.4 Patient Table
2.1.5 Operator Console
2.1.6 Magnet and Cryogen
2.2 System Architecture
2.3 RF Cage and Room Layout
2.4 Safety Features
2.5 Activity
2.6 Summary
2.7Exercise

2 MRI Machine Overview

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 Activity 2.1 brainstorming

How does the superconducting magnet in an MRI machine

generate and maintain a strong magnetic field?

5 min

MRI (Magnetic Resonance Imaging) is a medical imaging technique that uses a

combination of magnetic fields, radiofrequency pulses, and computer algorithms to
generate detailed images of the internal structures of the body. An MRI machine
consists of several key components and features that work together to perform the
imaging process and ensure safety.

2.1 Basic Components:

2.1.1 Magnet:
The magnet is one of the most critical components of an MRI machine. It generates a
strong and uniform magnetic field that interacts with the hydrogen atoms in the patient's
body. The magnetic field aligns the hydrogen atoms, and when disturbed by
radiofrequency pulses, they emit signals that are used to create images.
There are three main types of magnets used in MRI machines:
Superconducting magnets
These magnets use coils made of superconducting wire, which is typically a niobium-
titanium alloy. These coils are cooled to extremely low temperatures using liquid helium,
allowing the wire to conduct electricity with almost no resistance. Superconducting
magnets can achieve high magnetic field strengths (typically 1.5 Tesla to 3 Tesla or
higher) and provide excellent image quality. Superconducting scanners are the most
expensive due to their size, fringe fields, and cooling requirements.

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Superconductivity is simply the ability of a material to conduct Electricity with zero
resistance. Superconductors have to be cold before they will enter the superconductive
state with perfect conductivity.

Superconductivity:

A macroscopic quantum phenomenon where material exhibits ZERO resistance under

certain conditions

q Critical temperature (Tc)

Temperature marking the onset of superconductivity of the material. The resistivity of

the material drops to an immeasurably low value.

NbTi à Tc@ 9K

q Critical field (Hc)

Magnetic field marking the breakdown of superconducting self shielding effect.

NbTi à Hc@ 10T (at 4.2K)

q Critical current (Ic)

Limiting current a superconductor can carry in superconducting state (at given B,T)

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Permanent magnets:

Permanent magnets have a fixed magnetic field strength and do not require cryogenic
cooling, so their operational costs are extremely low. They are typically used in lower-
field MRI machines, such as those with field strengths ranging from 0.2 Tesla to 0.4
Tesla. Permanent magnets are more compact and easier to maintain but generally offer
lower image quality compared to superconducting magnets and also they are heavier
than superconductive scanners.
Permanent magnets have very small fringe fields and need smaller room requirements.

Fig. Examples of Permanent Magnets

Resistive magnets:
Resistant MRI magnets work at room temperature with standard conductors like copper
in the form of a solenoid or Helmholtz pair coil. A solenoid is a cylindrical wire coil. While

34
making these magnets is relatively cheap, it requires a significant constant current flow
during magnetization and imaging.

The coil has an electrical resistance that requires cooling of the magnet. Resistive
magnets have high operational costs due to the use of electricity and increased
environmental cooling requirements. Both permanent and resistive MRI scanners are
limited to low-field applications, primarily open MRI and extremity scanners. These
magnets are useful for claustrophobic patients.

Fig: Examples of resistive (air core) magnets

2.1.2 Gradient System

Gradients are electromagnetic coils that are used to introduce spatial information into
the MRI process. They produce varying magnetic fields in different spatial directions,
allowing for the localization of the signals emitted by the patient's body.
The gradients are typically applied in the x, y, and z directions, corresponding to the
three dimensions of space. By applying gradients, the MRI machine can differentiate the
signals coming from different locations within the patient's body. This spatial information
is crucial for creating detailed and precise images.
The gradients are controlled by the MRI system, which can vary their strengths and
orientations. By manipulating the gradients, the system can encode spatial information
into the MRI signals, allowing for the reconstruction of images with specific slice
thicknesses, orientations, and resolutions.
There are three sub components of A gradient system.

35
 1. Gradient Coils
2. Gradient Driver
3. Gradient processor
Gradient Coils.
Gradient coils are an essential component of magnetic resonance imaging (MRI)
systems. They are used to create spatial variations in the magnetic field within the MRI
scanner. By manipulating the strength and direction of these magnetic field gradients,
gradient coils enable the encoding of spatial information in MRI images.
The primary purpose of gradient coils in MRI is to spatially localise the signals emitted
by the patient's body during the imaging process. A typical MRI system consists of three
gradient coils, one for each spatial dimension: X, Y, and Z. Each coil generates a
magnetic field gradient along its respective axis.
When the gradient coils are energised, they produce a linearly varying magnetic field
strength along the axis of the coil. This varying field strength causes the protons in the
patient's body to resonate at different frequencies depending on their position. By
precisely controlling the strength and timing of the gradient fields, different regions of
the body can be selectively excited and their signals localised.
The gradient coils work in conjunction with the main static magnetic field produced by
the superconducting magnet in the MRI system. The combination of the static magnetic
field and the gradient fields allows for spatial encoding of the signals emitted by the
patient's body.
During an MRI scan, the gradient coils are rapidly switched on and off to create the
necessary field gradients for encoding spatial information. These rapid changes in
magnetic field strength produce the characteristic knocking or thumping sounds
commonly associated with MRI scans.

36
Gradient Coils
Z axis -Gradient Coil

37
Gradient Working Principle

Without gradients there would be no spatial information. The operator of the MR system
controls the appearance of the images by manipulating the RF and gradient pulses. The
gradients allow the operator to pinpoint a spatial location – a slice or a volume – in a
patient to be imaged.

-ve

38
 Z axis +ve

Gradients contribute to the spatial resolution of an image. When a gradient is applied

(turned on), it will create a change in the main magnetic field (B zero). The rate at which
the magnetic field changes in the bore depends on the distance from iso-center and the
amount of current applied to the gradient coil. The further away the location is from iso-
center, the more the magnet field will be changed.

• Let’s look at a z-axis gradient to show how a gradient field is created.

• A fiberglass cylinder, like the bore of the magnet, is wound with conducting wire at
each end of the cylinder. They display opposite polarity.
-ve
isocenter

39
 Z axis +ve

• When current runs through this wire, magnetic fields are created that are
strongest near the wire. When current runs in the opposite direction (through
the wire at the other end of the cylinder), a similar but opposite field is
created.

• The gradient coils create magnetic fields that alter the main field (B0) in a
controlled and predictable manner so that the main field is no longer
homogeneous. The use of gradients provides regulated inhomogeneity with a
purpose; it doesn’t change the direction of B0. Instead, it slightly changes the
strength of B0 at specific points, causing a known spatial variation in the
magnetic field. This allows the system to identify the locations of every spin in
a patient’s slice.

• The closer you get to the plus Polarity gradient, the stronger the magnetic
field will be, as compared to isocenter. The closer you get to the minus
Polarity gradient, the weaker the magnetic field will be, as compared to
isocenter.

40
 ● A 1.0T magnet has a Larmor frequency of about 42.57 MHz.
● It is easier to show the change in the strength of the field when a gradient
is applied
● if we convert Tesla to Gauss. 1.0T = 10,000 gauss.
● In this example, 2 cm toward the negative polarity results in a strength of -
2 gauss, or 9,998 gauss; 2 cm toward the positive polarity results in a
strength of +2 gauss, or 10,002 gauss, and so forth.
● This changes the Larmor Frequency by .0085 MHz either positive or
minus, depending on the direction from the isocenter.
● every position along the Z-axis has a unique Larmor frequency because of
the magnetic field created by the Z gradient. This is the case for the X and
Y gradients, as well!
● To get the protons that are 2 cm toward the feet to precess (resonate),
assuming that is toward the negative polarity Z gradient, one would have
to apply an RF frequency of 42.5614 MHz

Gradients – Slice Thickness and Bandwidth

• using an RF pulse with only a single frequency would make the slice too
thin to be useful and the signal would be too small to make an image.

41
 • A slice must have thickness, covering a range of frequencies (a
bandwidth). To help define a slice, an RF pulse utilises a rectangular pulse in
the frequency domain to include a bandwidth of frequencies. The Signal
system uses a shaped RF sync pulse. That sync pulse was created by doing
a Fourier Transform on the rectangle pulse to go from frequency domain to
time domain.

• In many applications, this special RF pulse has a fixed frequency

bandwidth of 1250 Hz. The pulse is designed so that it is on for 3.2
milliseconds. Its frequency width is from - 625 Hz to +625 Hz around the
centre frequency of the RF pulse.

Gradients – Bandwidth

• To understand how this works, consider a 1.5T magnet, with a center

frequency of 63,865,387 Hz throughout the bore with gradients turned off, and
at isocenter with gradients on.

• Using the 1250-Hz-wide RF pulse to excite the nuclei in a slice located at

isocenter, the positive edge of the slice would have a frequency of 63,865,387
Hz plus 625 Hz = 63,866,012 Hz.

• The negative edge would have a frequency of 63,865,387 Hz minus 625 Hz

= 63,864,762 Hz. The negative edge would have a frequency of 63,865,387
Hz minus 625 Hz = 63,864,762 Hz.

• This supplies the bandwidth, or distribution of frequencies (1250 Hz), that is

needed across a rectangular slice.

Slice Selection

• When the amplitude of the gradient is increased it goes from a thicker slice
to a thinner one.

42
 • The maximum amplitude of the gradient's magnetic field limits slice
thickness.

• The recent increase in maximum gradient amplitudes on MRI systems has

reduced the minimum slice thickness from three millimetres to one millimetre.

• Remember that as the slice becomes thinner, we have fewer protons

contributing to the signal, therefore, SNR will be reduced significantly.

In actual practice, slice selection involves turning on the slice-select gradient and
transmitting the RF pulse, and at the same time. Slice selection gradient is always the
axis along the direction perpendicular to the slice plane, using the linear variation of
resonant frequencies along that direction.

43
A procedure called landmarking is the basis of both slice prescription and slice
calculations.

Landmarking: The computer uses the isocenter information to calculate the gradient
strengths and RF frequencies that are appropriate for each prescribed slice. In some
instances, the patient is actually moved within the bore. This helps ensure that in every
exam, at least one slice is at isocenter.

•Landmarking is the placing of the patient at the proper location in the magnet, relative
to whatever anatomy is to be scanned. The alignment lights are aimed at a specific
point on the patient (the sternal notch, for example), and the Landmark button is
pressed. The patient is moved into the bore of the magnet so that the point at which the
landmark alignment lights intersect in the patient is moved to the magnet isocenter. The
landmark connects the patient to the magnet coordinates.
•A typical scan prescription is based on the anatomy of the patient. The computer
programs calculate locations in the patient relative to isocenter. For example, for a slice
not at isocenter, the computer calculates the distance from isocenter to the slice, and
offsets the frequency of the RF pulse relative to w0.

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Gradient Driver

Gradient amplifiers transform command waveforms from the system’s pulse generation
into high current waveforms suitable for driving the gradient coil. Most gradient
amplifiers used in MRI are current source amplifiers, then produce voltage waveforms to
drive the current waveform into the coil. Since typical impedance of gradient coil
include resistance and inductance components, the voltage waveform can display
inductive and resistive effects with time.

Gradient Processor system.

There are different types of Gradient processors depending on the product type and
brand. And example below is for GE Hfd, GP3 system.
The main functions of GP3:
1.Receive Gradient driver data from STIF
2.Perform ECC and send analog driver signal to amplifier
3.Monitor the status of gradient power supply
4.Report Error message and gradient status to host via CAN or MDS
5.Control the GSW to choose different resonance module
6.Do DC offset to compensate the floating voltage

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2.1.3 Radiofrequency (RF) System:
The RF system in an MRI machine is responsible for transmitting radiofrequency pulses
into the patient's body and receiving the resulting signals. It consists of RF coils, RF
amplifiers, and other components.
RF coils: RF coils are used to transmit the RF pulses into the patient's body and receive
the signals emitted by the excited hydrogen atoms. These coils come in various designs
and configurations depending on the type of imaging being performed. Common types
of RF coils include surface coils, which are placed close to the area of interest, and
body coils, which encompass a larger region. The RF coils are designed to maximise
the sensitivity and signal-to-noise ratio during data acquisition. Generally RF Coils are
antennas that interact with a subject in MRI by emitting and receiving RF Energy.

46
RF Body Coil
RF body coil assembly consists of,
● A copper RF Coil,
● chip Capacitors,
● Dynamic Disable Board and Dynamic Disable Bias Boards.

47
RF Transmit Path

48
Receive Path

49
RF amplifiers:
RF amplifiers provide the necessary power to generate strong RF pulses. These pulses
are used to manipulate the protons in the patient's body, causing them to emit signals
that can be detected and used to create images. The RF amplifiers ensure that the
transmitted pulses are of sufficient strength to achieve the desired imaging parameters.
RF amplifiers can be Air cooled or water cooled depending on the types. Their power
capacity starts from 2kw -35kw depending on the type and strength of the Magnetic
field.
RF Amp has below main functions
● Head/Body Mode Switching
● CAN Communication Link decoding, control and status communication between
the system and RF amplifier
● RF Power Amplification
● RF Power Sampling for power monitoring by Universal Power Monitor(UPM)
Other components: The RF system also includes components such as filters,
modulators, and detectors. Filters help shape the RF pulses, ensuring that they are
within the desired frequency range. Modulators control the timing and duration of the RF

50
pulses. Detectors receive and amplify the signals emitted by the patient's body, allowing
them to be processed and converted into images.

2.1.4 Patient Table:

The patient table is a movable platform on which the patient lies during the MRI scan. It
is designed to provide comfort and flexibility in positioning the patient within the
magnet's field of view.
The patient table typically has various adjustable features to accommodate different
scanning positions and patient sizes. These features may include height adjustment, tilt
adjustment, and lateral movement. The table may also have cushioning or padding to
enhance patient comfort during the scan.
To ensure patient safety, the patient table is equipped with safety mechanisms. These
mechanisms may include emergency stop buttons that allow the technologist to halt the
scan immediately if needed. The table may also have weight limits to prevent
overloading and ensure the stability of the scanning process.

Here are some key features and considerations related to MRI tables:

1. Construction and Materials: MRI tables are constructed using non-magnetic materials
to ensure compatibility with the strong magnetic field produced by the MRI system.

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Common materials used include non-ferrous metals, such as aluminium or carbon fibre,
which do not interfere with the magnetic field or cause image artefacts.

1. Patient Comfort: MRI tables are designed to provide comfort to patients during the
scan. They often feature cushioning or padding to enhance patient comfort during the
imaging procedure, which can sometimes be lengthy. The table may also have
adjustable features, such as height adjustment and tilting capabilities, to accommodate
different patient sizes and positions.

1. Safety and Accessibility: Safety is a crucial aspect of MRI tables. They are designed
to ensure patient safety by providing proper immobilisation and support. The table
should have sturdy construction and be able to withstand the weight of the patient.
Additionally, it should be designed to allow easy and safe patient transfer onto and off
the table, considering accessibility for patients with mobility limitations.

1. Compatibility with Imaging Coils: MRI tables are designed to accommodate the use of
various imaging coils. These coils are placed around specific body regions to enhance
image quality. The table should have cutouts or gaps in the appropriate locations to
allow the imaging coils to be properly positioned close to the region of interest.

1. Radiofrequency (RF) Transparency: MRI tables need to be RF transparent, meaning

they do not interfere with the radiofrequency signals used in MRI imaging. RF
transparency prevents image artefacts and ensures accurate signal reception and
transmission. Non-metallic materials and designs that minimise electromagnetic
interference are employed to maintain RF transparency.

1. Motion Control: Some advanced MRI tables may have motion control capabilities.
These tables can move the patient smoothly and precisely within the scanner during
dynamic imaging sequences or specialised applications such as functional MRI (fMRI).
Motion control features allow for precise adjustments and positioning during the scan to
capture the desired imaging data.

52
MRI tables are an integral part of the MRI imaging process, providing a stable and
comfortable platform for patients while ensuring compatibility with the unique
requirements of MRI systems. Their design and construction prioritise patient safety,
comfort, and image quality, contributing to successful MRI examinations.

2.1.5 Operator Console:

The operator console serves as the control centre of the MRI machine, allowing the
technologist or operator to interact with the system. It typically consists of a computer
workstation with a user interface and dedicated software for image acquisition,
reconstruction, and manipulation.
The operator console provides a range of functionalities to control the imaging process.
It allows the technologist to adjust scan parameters, such as the imaging sequence,
slice thickness, and field of view. The console also provides real-time visualisation of
acquired images, enabling the technologist to monitor the scanning process and make
adjustments as necessary.
Additionally, the operator console allows the technologist to communicate with the
patient during the scan. It may include an intercom system or a two-way audio
communication feature to ensure that the patient feels comfortable and can
communicate any concerns or issues. Main Components of the operator Table are

● Primary Display

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 ● Keyboard Mouse
● Scan Control Intercom Module (SCIM)
● Microphone and Speaker– Internal to SCIM
● Pneumatic Patient to Operator Alert Sys

Scan Intercom Control Module:

The SCIM shall include the following functionality:
1.Dedicated key entry for scan and table control
2.Intercom audio communication to/from patient
3.E-Stop control
4.Switching keyboard and mouse control between works station and pc(unused now)

Main Components of operator Console are:

The Operator Console houses the components necessary to support the Operators'
interaction with the MRI system:

•Host PC

•Host PC Operating System

•Ethernet Switch

•USB to RS422 Converter

•GOC Audio Assembly

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2.1.6 Cryogen
Cryogen" refers to a substance that is used to achieve and maintain very low
temperatures. Cryogens are typically used in various scientific, industrial, and medical
applications where extremely low temperatures are required.
Magnet Cooling

● The compressor pressurises gaseous helium to reliquify it;

55
 ● The compressor is water cooled or air cooled,
● The coldhead allows liquid helium back into the magnet and gaseous helium out
of the magnet.
● The coldhead gets its power from the compressor
● There are heaters to keep the pressure in the magnet constant in the case that
the vacuum and coldhead are too efficient.
● A constant pressure is desired to keep the magnetic field stable.
● The magnet monitor, or MagMon, makes sure all parameters are maintained and
reports any errors.

Liquid Helium (LHe): Helium, when cooled to its liquid state (-269 degrees Celsius or -
452 degrees Fahrenheit), becomes a cryogen with exceptional cooling properties.
Liquid helium is used in cryogenic research, superconducting magnet systems (such as
in MRI scanners and particle accelerators), and in cooling certain scientific instruments.
For a superconductive magnet, there will be >1000 Litres of liquid helium inside the
magnet maintaining the Superconductive state of the main Coil.
 Flashes to gas quickly when subjected to heat
 Is lighter than air
 The gas will rise until the upper air pressure forces it down
Frostbite: As a gas, it can freeze your skin in seconds. The liquid rarely collects or
penetrates clothing when it is splashed. However, when there is a stream or pool of
liquid, it will penetrate clothing and cause frostbite.
Asphyxiation: When inhaled, it reduces the pressure in your lungs and removes
oxygen from the bloodstream, causing a risk of asphyxiation. Inhaling the boiled-off gas
will alter the sound of your voice. Your buddy should maintain a conversation with you
and listen for changes in your voice.
Normal magnet out-gassing or venting during ramping is easily handled by the magnet
room ventilation systems (when they are properly implemented). When possible, take
steps to avoid venting gases into the room.

56
Superconductive magnets have two major cooling components to keep the liquid helium
inside the magnet at specific Temperature and Pressure.

Cold Head

A "coldhead" is a component of a cryogenic system that is responsible for cooling a

specific device or area to very low temperatures. It is often used in conjunction with a
cryocooler, which is a device that provides the necessary refrigeration to achieve and
maintain low temperatures.

The coldhead typically consists of several key components:

Compressor: The compressor is the main component of the coldhead and is

responsible for compressing and circulating the refrigerant gas or working fluid within
the system. It creates the necessary pressure and flow rate to drive the cooling process.

Heat Exchangers: The coldhead includes one or more heat exchangers that transfer
heat between the refrigerant and the surroundings. The heat exchangers facilitate the
cooling process by absorbing heat from the target device or area and releasing it to the
environment.

Expansion Valve: The expansion valve is a crucial part of the coldhead's refrigeration
cycle. It controls the flow of the refrigerant, allowing it to expand rapidly, which causes it
to cool down significantly. This cooled refrigerant then absorbs heat from the target
area, thereby achieving low temperatures.

57
58
2.2 System Architecture:

The system architecture of an MRI machine involves the integration of various

components and subsystems to ensure the proper functioning of the imaging process.
These components include the magnet, gradients, RF system, patient table, operator
console, and associated electronics.
The components are interconnected through a network of cables and interfaces,
allowing for data transmission and control signals between different subsystems. The
magnet, gradients, and RF system are controlled by the MRI system's main console,
which coordinates the timing and synchronisation of the various components during the
scan.
The system architecture also includes data acquisition and processing systems. The
signals received from the RF coils are digitised and processed by dedicated hardware
and software algorithms. These algorithms reconstruct the signals into images, applying

59
mathematical techniques such as Fourier transformation to convert the raw data into
meaningful visual representations.

60
Zone I: This region includes all areas that are freely accessible to the general public.
This area is typically outside the MR environment itself and is the area through which

61
patients, health care personnel, and other employees of the MR facility access the MR
environment.

Zone II: This area is the interface between the publicly accessible, uncontrolled Zone I
and the strictly controlled areas of Zones III and IV. Typically, patients are greeted in
Zone II and are permitted to move freely throughout Zone II, under the supervision of
MR Personnel, prior to entry into Zone III. It is recommended that patient preparation for
the MRI examination take place in Zone II. This preparation includes MRI screening,
medical history, and appropriate patient gowning.

Zone III: This area is the region in which free access by unscreened Non-MR Personnel
or ferromagnetic objects and equipment can result in serious injury or death due to
interactions between the individuals or equipment and the MR scanner's particular
environment. Access by Non-MR Personnel to and supervision over Zone III (including
Zone IV; see below) is controlled by, and entirely under the supervision of, Level 2 MR
Personnel. Non-MR Personnel must be accompanied by, or under the immediate
supervision of and in visual contact with, an individual who is of Level 2 MR Personnel
status throughout their stay in Zones III or IV, except in the changing room and/or
bathroom, where verbal communication is sufficient. To avoid misunderstandings or
questions of responsibility, each Non-MR Personnel individual entering Zone III must
have a specifically identified Level 2 MR Personnel individual (typically—but not
necessarily—an MR technologist) responsible for them throughout their stay in Zone III.
This function of the Level 2 MR Personnel is directly under the authority and
responsibility of the MRMD or the Level 2 MR Physician of the day for the MR facility.
Zone III regions should be physically restricted from general public access by key locks,
passkey locking systems, or any other reliable, physically restricting method that can
differentiate between MR Personnel and Non-MR Personnel. The use of combination
locks is discouraged because combinations often become more widely distributed than
initially intended, resulting in the possibility of a facility restriction violation. Only MR
Personnel should be provided free access, via methods such as the access keys or
passkeys, to Zone III. There should be no exceptions to this guideline. Specifically, this

62
includes hospital or facility administrative staff, physicians, security personnel, and other
Non-MR Personnel. Zone III should be demarcated and clearly indicated as being
potentially hazardous. Among the energies that render the MR environment potentially
harmful are static magnetic fields. Being 3-dimensional, Zone III controlled-access
areas may project not just around but also above and below the room housing the MR
scanner. This imposes a potential magnetic field hazard on individuals on floors other
than that on which the scanner is found. Similarly, the typical rooftop cryogen vent
location is associated with potential hazards during an active quench (loss of
superconductivity/magnetic field), and access to that vent is a Zone III region. These
Zone III potentially harmful access areas should be clearly identified, and their potential
hazard should be clearly marked, even in typically unoccupied areas such as rooftops
or storage rooms. For this reason, magnetic-field-strength spatial plots for all MRI
systems should be analyzed in both horizontal and vertical orientations, identifying
areas around, above, and/or below the scanner, which may pose potential hazards, and
quench vent pathways should also be considered when defining Zone III regions.

Zone IV: This area is synonymous with the MR scanner room itself (ie, the physical
confines of the room where the scanner is located). Zone IV, by definition, will always
be located within Zone III, as it is the MR magnet and its cryostat that generate the
existence of Zone III. Zone IV should also be clearly labelled as being potentially
hazardous because of the presence of very strong magnetic fields. As part of the Zone
IV site restriction, all MR installations should provide for visual observation by Level 2
MR Personnel to access pathways into Zone IV. By means of illustration only, the MR
technologists would be able to directly observe and control, via line of sight or via video
monitors, the entrances or access corridors to Zone IV from their normal positions when
stationed at their desks in the scan control room. Importantly, controlled site-access
restriction to Zones III and IV must be maintained during resuscitation and other
emergent situations for the protection of all involved. The entrance to Zone IV should be
clearly marked with a prominently displayed red illuminated sign stating “The Magnet is
Always On,” except for in the case of resistive MR systems, which should have a red
illuminated sign stating “The Magnet is On” when it is energised. Ideally, signage should

63
inform the public that the magnetic field exists even during an intentional or inadvertent
power loss. This light and sign should be illuminated at all times and should be provided
with a battery backup energy source to continue to remain illuminated in the event of a
loss of power to the facility. The entry door to Zone IV (ie, the MR scanner room) should
be closed except when it must remain open for patient care or room/MR system
maintenance. During the times that the door to the MR system room must remain open,
a “caution” barrier is recommended at the entry to Zone IV to inhibit unintended
passage of personnel and/or materials from Zone III to IV. Examples of caution barriers
include easily adjusted straps or plastic chains secured across the doorway to Zone IV.

2.3 Safety Features:

MRI machines incorporate several safety features to ensure the well-being of both
patients and operators. Some of the key safety features include:
● Magnetic field safety: MRI machines have strict safety protocols to prevent
unwanted exposure to the strong magnetic field. The scanning room is equipped
with magnetic shielding to contain the magnetic field within the designated area.
All metallic objects, such as ferromagnetic materials, are strictly prohibited in the
scanning room to prevent them from becoming hazardous projectiles in the
presence of the magnetic field.
● Gradient and RF safety: The gradients and RF pulses used in MRI imaging are
carefully controlled to prevent harm to the patient. Specific absorption rate (SAR)
limits are implemented to ensure that the RF energy deposited in the patient's
body remains within safe levels. Gradient performance and switching rates are
also monitored to prevent excessive heating of tissues and minimize
physiological effects.
● Emergency stop mechanisms: MRI machines are equipped with emergency stop
buttons or switches that allow immediate termination of the scan in case of an
emergency or patient discomfort. These mechanisms provide a quick and
accessible means to halt the scan and ensure patient safety.
● Monitoring systems: Safety monitoring systems are integrated into MRI machines
to continuously monitor various parameters, such as temperature, pressure, and

64
 motion. These systems can detect anomalies or potential risks during the scan
and trigger alarms or automatic shutdowns to mitigate any potential harm. Main
safety monitors of the MR are Oxygen Monitors and Magnet Rundown Units.
MRU(Magnet Rundown unit):
❖ Used during an emergency situation, such as when person is trapped against
magnet by a ferrous object, to rapidly decrease magnet field down to a level
where a person can be safely removed.Pushing AND releasing the front red
button marked RUNDOWN or RUN DOWN will start a magnet quench.

Oxygen Monitor
A Helium leak would displace the oxygen in a room, suffocating anyone inside.
Because it is colourless and odourless, an oxygen deficiency monitor is required for
detection. A person closed inside the room would not notice the leak on their own, and
it would be too late. In the event of a helium leak, an O2 monitor would sound at the
first detection of oxygen displacement, warning anyone inside the room of the danger
and allowing them to evacuate in plenty of time.

65
 ● Patient comfort features: To enhance patient comfort and reduce anxiety, MRI
machines may include features such as ambient lighting, music, or video
displays. These features help create a more relaxing environment for the patient
during the imaging process.
Overall, MRI machines are designed with a comprehensive set of safety features and
protocols to ensure the well-being of patients and operators, while delivering high-
quality diagnostic imaging.

2.5 Activity

2.5.1 Group discussion

In a group of four, list the components of the MRI machine and

explain their function.
Time: 15 min

2.6 Summary

66
An MRI (Magnetic Resonance Imaging) machine is a powerful diagnostic tool used in
medical imaging to visualise internal body structures in exceptional detail. It operates
based on the principles of magnetism and radiofrequency signals. The main
components of an MRI machine include the superconducting magnet, gradient coils, RF
system, RF coils, and a computer system.

The superconducting magnet generates a strong and uniform magnetic field, typically
measured in Tesla (T). Gradient coils enable spatial encoding by producing varying
magnetic fields that allow for precise localization of signals. The RF system and RF
coils transmit radiofrequency pulses into the body, causing the hydrogen atoms in the
tissues to emit signals that are detected by the coils.

Controlled by a computer system, the MRI machine coordinates the timing, sequencing,
and data acquisition processes. The operator console provides a user interface to
control imaging parameters, optimise image quality, and adhere to safety protocols.
Patient positioning is facilitated by an adjustable table to ensure accurate imaging and
patient comfort.

2.7 Exercise
1. Discuss MRI machine functional diagram in detail.
2. Briefly explain system architecture of an MRI machine
3. How has the development and advancements in MRI technology revolutionised
the field of medical imaging and impacted patient care?

67
Chapter Three: MRI Machine Operation

Allocated Time: 50 hrs

Course Description: This chapter describes handling, operation, troubleshooting and

maintenance of MRI machines and safe and accurate acquisition of diagnostic images.
It covers clinical applications, working principles, main components, troubleshooting
techniques, maintenance, safety procedures and handling MRI machines.

Chapter objective: At the end of this chapter, participants will be able to:

68
Operate, safely handle, troubleshoot, maintain MRI machine and safe and accurate
acquisition of diagnostic images

Enabling Objective:

At the end of this chapter the participant will be able to: -

❖ Describe basics of MRI

❖ Differentiate basic parts and function of MRI Machine
❖ Explain working principle of MRI Machine
❖ Apply troubleshooting techniques and procedures for MRI machine
❖ Practise safe handling of MRI machine
❖ Apply safety rules and principles of MRI

Chapter outline:

3. MRI Machine Operation

3.1 Activity
3.2 Powering On and Off
3.3 Software interface and controls
3.3.1 Scan parameters
3.3.2 Image reconstruction
3.3.3 Post processing tools
3.4. patient preparation
3.4.1 Screening and Safety checks
3.4.2 Positioning and comfort
3.5 Scan Execution
3.5.1 Selecting scan protocols
3.5.2 Initiating the scan
3.5.3 Monitoring the scan progress
3.6 Scan Completion and patient transfer
3.6.1 Discontinuing the scan
3.6.2 Assisting patient transfer

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 3.7 Activity
3.8 Summary
3.9 Exercise

3. MRI Machine Operation

Activity 3.1 brainstorming

Can you explain the basic steps involved in operating

an MRI machine?

5 min

MRI machine operation involves a series of steps and procedures to ensure the safe
and accurate acquisition of diagnostic images. Let's delve into each aspect in detail:
3.2 Powering On and Off:
Powering on the MRI machine is typically a multi-step process that requires following
the manufacturer's instructions. It usually involves checking the power connections,
ensuring that all necessary cables are securely connected, and activating the power
supply. Some MRI machines may have additional safety features, such as self-check
routines or startup calibration procedures, which should be performed before

70
proceeding with patient scans. It is important to adhere to the recommended startup
procedures to ensure a safe and smooth operation.
Similarly, when powering off the machine, it is crucial to follow the shutdown procedure
provided by the manufacturer. This typically involves closing any software applications,
ensuring data is saved, and safely shutting down the power supply. Properly powering
off the MRI machine helps protect its components and ensures that it is ready for the
next use.

3.3 Software Interface and Controls:

The software interface and controls of the MRI machine allow operators to configure
scan parameters, perform image reconstruction, and utilize post-processing tools.
Familiarising yourself with the software interface is essential for efficient operation.
3.3.1 Scan Parameters:
The software interface provides options to adjust various scan parameters to customize
the imaging process according to the specific diagnostic requirements. These
parameters include the sequence type, slice thickness, field of view, and imaging
parameters such as repetition time (TR), echo time (TE), and inversion time (TI), among
others. Each parameter influences the characteristics of the acquired images. For
example, the sequence type determines the contrast and weighting of the images, while
the slice thickness affects the level of detail captured in each image slice. The operator
selects the appropriate parameters based on the desired diagnostic information and the
specific requirements of the patient being scanned.
Understanding the impact of each parameter on the resulting images is essential for
achieving optimal image quality. It is important to consider patient factors, such as the
presence of implants or specific clinical indications, when selecting scan parameters.
Regular calibration and quality control checks should also be performed to ensure the
accuracy and consistency of the acquired images.
3.3.2 Image Reconstruction:
After acquiring the raw imaging data during the scan, the software reconstructs the
images based on the selected scan parameters. The image reconstruction process
involves applying mathematical algorithms to convert the acquired data into meaningful

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images. These algorithms correct for artifacts, noise, and distortions, and generate high-
resolution images that accurately represent the anatomy and pathology being imaged.
Different MRI machines may utilize different reconstruction techniques, such as Fourier
transformation or iterative reconstruction algorithms. Understanding the specific
reconstruction methods employed by the MRI machine being operated is crucial for
optimizing image quality. It is important to ensure that the reconstruction parameters are
properly set to generate high-quality images that aid in accurate diagnosis.
3.3.3 Post-Processing Tools:
The software interface may provide various post-processing tools to further analyze and
manipulate the acquired images. These tools allow operators to enhance image
visualisation, measure anatomical structures, perform quantitative analyses, and create
multi-planar reconstructions or 3D renderings. They can also facilitate image fusion,
where images from different modalities or time points are combined for comprehensive
evaluation.
Post-processing tools can improve diagnostic accuracy, aid in surgical planning, and
assist in the assessment of treatment response. Familiarising yourself with these tools
and techniques enables efficient utilisation and enhances the interpretative capabilities
of the acquired images.
3.4 Patient Preparation:
Proper patient preparation is essential to ensure their safety, comfort, and cooperation
during the MRI procedure.
3.4.1 Screening and Safety Checks:
Before the scan, thorough screening procedures should be performed to ensure patient
safety. This includes gathering information about the patient's medical history,
assessing for any contraindications or conditions that may interfere with the magnetic
field, and verifying the absence of metallic implants or devices that could be affected by
the MRI's strong magnetic field. The operator should review the patient's history and
consult with the referring physician or radiologist if there are any concerns or
uncertainties.
Additionally, safety checks should be conducted to minimise risks during the procedure.
This may involve screening the patient and their clothing for ferromagnetic objects, as

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these can become hazardous in the strong magnetic field. The operator should also
ensure that the MRI suite is free from potentially dangerous items, such as oxygen
tanks or medical equipment that may be affected by the magnetic field. Following
established safety protocols and guidelines is crucial to prevent accidents and ensure a
safe scanning environment.
3.4.2 Positioning and Comfort:
Accurate patient positioning is crucial to obtain high-quality images and ensure the
success of the MRI scan. The operator must carefully position the patient on the MRI
table while taking into consideration the specific imaging requirements. This may involve
using positioning aids, such as cushions or straps, to ensure proper alignment and
immobilisation. Patient comfort should be prioritised, as it promotes cooperation and
reduces motion artefacts during the scan. Effective communication with the patientto
address any concerns and ensure their comfort throughout the procedure is also vital.
The operator should explain the procedure, provide clear instructions, and address any
questions or anxieties the patient may have. Regularly checking on the patient's well-
being and comfort during the scan helps maintain their cooperation and ensures a
positive experience.

3.5 Scan Execution:

Executing the scan involves selecting appropriate scan protocols, initiating the scan,
and monitoring its progress.
3.5.1 Selecting Scan Protocols:
Based on the clinical indication, patient characteristics, and desired imaging sequences,
the operator selects the appropriate scan protocols. Scan protocols are pre-defined sets
of imaging parameters that determine the specific sequences and acquisition
techniques used to obtain the necessary diagnostic information. The operator must
have a comprehensive understanding of the available protocols and their respective
applications. They should consider factors such as the area of interest, pathology being
evaluated, patient age, and any specific requirements or considerations provided by the
referring physician or radiologist.

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Selecting the correct scan protocols ensures that the acquired images provide the
desired diagnostic information, while optimising scan time and patient comfort.
3.5.2 Initiating the Scan:
Once the scan protocols have been selected, the operator initiates the scan using the
software interface. It is important to verify that all parameters are correctly set before
starting the scan to ensure accurate data acquisition. The operator may fine-tune
certain parameters based on patient-specific factors, such as the patient's ability to
tolerate longer scan times or the need to adjust imaging parameters for patients with
specific pathologies.
The operator should ensure that the patient is in the correct position, immobilised as
required, and adequately prepared for the scan. They should communicate clearly with
the patient, informing them of the start of the scan and advising them to remain as still
as possible during the imaging process.
3.5.3 Monitoring the Scan Progress:
During the scan, the operator must closely monitor its progress to ensure its proper
execution. This involves observing the patient for any signs of discomfort or distress,
ensuring their cooperation and compliance with the instructions, and addressing any
unexpected events or artefacts that may require intervention.
Continuous vigilance is necessary to maintain the safety and quality of the scan. The
operator should monitor the patient's vital signs and communication system, if available,
to ensure their well-being throughout the procedure. They should also keep an eye on
the scan console or monitor to ensure that the acquired images are being generated
correctly and that there are no technical issues affecting the image quality.
If any issues arise during the scan, such as the patient experiencing claustrophobia or
discomfort, the operator should be prepared to respond promptly and appropriately.
This may involve pausing the scan, addressing the patient's concerns, and providing
reassurance or modifications to the scan setup, if necessary.

3.6 Scan Completion and Patient Transfer:

After completing the scan, the operator must properly discontinue the procedure and
assist the patient in transferring from the MRI table.

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3.6.1 Discontinuing the Scan:
Following the manufacturer's guidelines, the operator must discontinue the scan in a
controlled and safe manner. This involves ensuring that all acquired data is saved,
terminating the scan sequence, and returning the MRI machine to a stable state. The
operator should verify that all necessary images have been acquired and that the data
is stored securely for further processing and interpretation.
Additionally, the operator should ensure that any contrast agents used during the scan
are properly disposed of according to institutional protocols and regulatory guidelines.
Proper disposal helps minimize any potential risks associated with contrast agents and
maintains a safe healthcare environment.
3.6.2 Assisting Patient Transfer:
Once the scan is completed, the operator assists the patient in safely transferring from
the MRI table to a stretcher or wheelchair, if necessary. This may involve using
appropriate lifting and transfer techniques to ensure the patient's safety and prevent any
injuries during the transfer process.
During the transfer, the operator should communicate with the patient and address any
post-scan instructions or information they may need. This can include informing the
patient about the completion of the scan, explaining any potential side effects or post-
procedure care instructions, and providing any necessary documentation or follow-up
appointments.

3.7 Activity

3.7.1 Group discussion

In a group of four discuss and explain how often MRI machines

should undergo maintenance and calibration?
Time: 10 min

3.8 Summary

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By following these detailed steps and procedures during MRI machine operation,
operators can ensure the safe and accurate acquisition of diagnostic images while
prioritising patient safety, comfort, and cooperation. Adhering to established protocols,
guidelines, and manufacturer instructions is essential for efficient and effective MRI
machine operation.

3.9 Exercise

1. What are some common challenges or issues that can arise during MRI machine
operation?
2. What are the common safety precautions that need to be followed when
operating an MRI machine.
3. Can you provide some tips for troubleshooting common issues that may arise
during MRI machine operation?

Chapter Four: Maintenance and Troubleshooting

Allocated Time: 60 hrs

Course Description: This chapter describes maintenance (preventive and corrective)

and troubleshooting to ensure safe handling, reliable operation and performance of an
MRI machine. It covers clinical applications, working principles and safety procedures
MRI machines.

Chapter objective: At the end of this chapter, participants will be able to:

Maintain, troubleshooting, Operate and safely handle of the MRI machine

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Enabling Objective:

At the end of this chapter the participant will be able to: -

❖ Differentiate basic parts and function of MRI Machine

❖ Explain working principle of MRI Machine
❖ Apply troubleshooting techniques, procedures and maintenance for MRI machine
❖ Perform preventive and curative maintenance for MRI machine
❖ Practise safe handling of MRI machine
❖ Apply safety rules and principles of MRI

Chapter outline:

4. Maintenance and Troubleshooting

4.1 Activity brainstorming
4.2 Planned Preventive Maintenance
4.2.1 Cleaning and Disinfection
4.2.2 Mechanical Inspection
4.2.3 Coil and Cable Care
4.3 Cryogen Management
4.3.1 Handling and Storage
4.3.2 Cryogen Refilling/Replacement
4.4 Troubleshooting Common Issues
4.4.1 Error Code Interpretation
4.4.2 System Log Analysis
4.5 Component Replacement
4.5.1 Safety Precautions
4.5.2 Tools and Techniques
4.6 Activity
4.7 Summary
4.8 Exercise

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4. Maintenance and Troubleshooting:

Activity 4.1 brainstorming

What are the most common problems that occur with MRI machines?
10 min

Maintenance and troubleshooting are essential aspects of ensuring the reliable

operation and performance of an MRI machine. By following routine maintenance
procedures and effectively troubleshooting common issues, healthcare facilities can
minimise downtime and optimise the functionality of their MRI equipment.
4.2 Planned Preventive Maintenance:
Routine maintenance involves a series of tasks aimed at keeping the MRI machine in
optimal condition. By regularly performing these maintenance activities, potential
problems can be identified early on and addressed before they escalate. The key
components of routine maintenance include cleaning and disinfection, mechanical
inspection, and coil and cable care.

MRI (Magnetic Resonance Imaging) machines are complex medical devices that
require regular preventive maintenance to ensure their optimal performance and
longevity. Here are some key aspects of MRI preventive maintenance:

Manufacturer Guidelines: Follow the manufacturer's guidelines for maintenance and

service intervals. They provide detailed instructions specific to the MRI model you are
using.

Scheduled Maintenance: Create a maintenance schedule based on the manufacturer's

recommendations. It typically includes routine inspections, calibration, and performance
testing. Common intervals are annual, semi-annual, or quarterly maintenance.

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Inspection and Cleaning: Regularly inspect the MRI machine for any signs of physical
damage, loose connections, or abnormal wear. Clean the system components, such as
the gantry, coils, and patient table, following the manufacturer's instructions using
approved cleaning agents.

Coil Maintenance: Inspect the MRI coils for any signs of wear, tears, or damage. Clean
the coils regularly and replace any damaged or malfunctioning coils as needed.

Cryogen Monitoring: If your MRI system uses superconducting magnets, monitor the
cryogen levels (typically liquid helium or nitrogen) to ensure they are within acceptable
limits. Follow the manufacturer's guidelines for cryogen maintenance and
replenishment.

Software and Firmware Updates: Keep the MRI system's software and firmware up to
date with the latest versions provided by the manufacturer. Regularly check for updates
and follow the manufacturer's instructions for installation.

System Performance Testing: Perform regular performance tests to ensure the MRI
system meets the required performance standards. This includes evaluating image
quality, signal-to-noise ratio, and other parameters specified by the manufacturer.

Safety Checks: Regularly inspect safety features of the MRI system, such as
emergency stop buttons, interlocks, and patient safety devices. Ensure they are
functioning correctly and perform necessary repairs or adjustments as required.

Documentation: Maintain detailed records of all maintenance activities, including dates,

performed tasks, and any issues encountered. This documentation helps track the
maintenance history and assists in troubleshooting if problems arise.

Professional Service: Engage qualified service engineers or technicians who are trained
and experienced in MRI maintenance and repair. They can perform more in-depth
inspections, troubleshoot complex issues, and conduct specialised tests.

PM methodology

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Schedules

There are two distinct PM schedules, (A) Warranty IB PM and (B) IB Out of Warranty
(IBOW) PM, that are used to ensure the specified system performance for the customer,
while ensuring optimization of system access time for maintenance.

Warranty PM tasks are defined by considering that the equipment is new, clean and
calibrated during manufacture and at installation. That ensures specified engineering
operational performance beyond the first 12 months of service following install. The
investment in installation checks, the newness of the equipment, and the other
contractual service covered by the 12-month warranty period following install allows for
PM efficiencies and more up-time for the customer during the warranty period.

The primary (minimum) technical recommended PM schedules and tasks during the
warranty period require approximately 7 hours of applied maintenance time per year,
divided into two warranty PM schedules. A summary of the PM tasks and schedule
times including warranty PM core system, GE option systems, and tasks authorised as
remote/digital option are given in the listed warranty schedules.

● Schedule 1 Warranty Planned Maintenance (done 2th-3th month from the system
install date)
○ Warranty PM tasks and schedule designed for on-site only.
○ On-site GE system option warranty PM (W1) task time: 60 minutes
○ On-site core warranty PM (W1) task time: 240 minutes (4 hours)
● Schedule 2 Warranty Planned Maintenance (done 8th -9th month from the system
install date)
○ Warranty PM tasks and schedule designed for on-site only.
○ On-site core warranty PM (W2) task time: 287 minutes (4 hours and 47
minutes)

The recommended warranty PM schedules are applicable only for the MR products that
are in scope. Any other upgraded systems would adapt the IBOW PM (post-warranty)
schedules given below for use in the warranty period.

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It is possible that local regulation, or a unique customer requirement (commercial
concession), may dictate additional PMs beyond the technical minimum PM schedules,
W1 and W2, during the 12-month warranty period after install. There are two
recommended options for that case:

● The region or country could complete the IBOW PM schedules (A, B, C,

D) per the specific Tasks assigned on each Schedule.

4.2.1 Cleaning and Disinfection:

Cleaning and disinfection are crucial for maintaining a hygienic environment and
preventing the spread of infections within the MRI suite. It is important to follow the
manufacturer's guidelines for cleaning the exterior surfaces of the MRI machine using
appropriate cleaning agents that are safe for use on medical equipment. High-touch
areas such as control panels, handles, and patient tables should be regularly
disinfected to minimise the risk of cross-contamination.
Additionally, specific components such as coils and cables require specialised cleaning
techniques. Following the manufacturer's instructions, these components should be
inspected for any signs of damage or wear and cleaned using recommended cleaning
agents and procedures to ensure their longevity and performance.
4.2.2 Mechanical Inspection:
Mechanical inspection involves a comprehensive assessment of the MRI machine's
mechanical components to ensure they are functioning correctly. This includes checking
for loose or damaged parts such as bolts, screws, or mechanical connections. Any
identified issues should be promptly addressed by tightening or repairing the affected
components. Furthermore, verifying the proper alignment of moving parts such as the
patient table or gantry is essential for smooth operation and patient safety. Regular
mechanical inspections help identify and rectify any mechanical issues that may affect
the performance of the MRI machine. Lubrication of mechanical components is also an
important aspect of routine maintenance. Following the manufacturer's
recommendations, appropriate lubricants should be applied to minimise friction and
wear, thereby extending the lifespan of the mechanical parts.

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4.2.3 Coil and Cable Care:
Coils and cables are critical components of an MRI machine that require special care.
These components are susceptible to wear and damage due to frequent use and
handling.
During routine maintenance, it is necessary to inspect the cables and connectors for
any signs of wear, fraying, or damage. Damaged cables should be repaired or replaced
promptly to ensure accurate imaging and patient safety. Proper cleaning procedures for
coils should be followed to maintain their performance and prevent any degradation in
image quality. Storage of coils when not in use is also essential to protect them from
damage or tangling, ensuring they remain in good condition for future use.

4.3 Cryogen Management:

Cryogen management is a critical aspect of MRI maintenance, particularly for systems
that rely on superconducting magnets. Cryogens, such as liquid helium, are used to
cool the magnets and maintain their superconducting state.
4.3.1 Handling and Storage:

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Proper handling and storage of cryogens are essential for both operator safety and the
longevity of the MRI system. This involves following strict safety protocols, including
wearing appropriate personal protective equipment (PPE) and using specialised
equipment for transferring and storing cryogenic liquids.
Cryogens should be stored in well-ventilated and designated areas that comply with
safety regulations. Regular monitoring of cryogen levels and conditions is necessary to
ensure an adequate supply and prevent leakage or evaporation.
4.3.2 Cryogen Refilling/Replacement:
Over time, cryogen levels may deplete, requiring refilling or replacement. This
procedure should be performed according to the manufacturer's guidelines and safety
procedures.
Cryogen refilling or replacement often involves coordinating with specialised personnel
or vendors who are trained in cryogen management. After the process, necessary
system checks and calibrations should be conducted to ensure that the MRI machine
operates optimally.

4.4 Troubleshooting Common Issues:

Despite regular maintenance, MRI machines can experience issues during operation.
Troubleshooting these issues promptly is crucial to minimise downtime and ensure
accurate diagnostic imaging. Below are some common actual Cases and
troubleshooting methods with possible resolutions mechanism.
4.4.1 Troubleshooting Gradient Coil

Gradient Diags work well; a failure means a service problem

• Checks below are done with all gradient cables connected in normal configuration.

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• Manual DC resistance measurements with DMM (System Power OFF!).

• Measure and record + to – lead of each coil and confirm all are similar. – All should
measure about 0.3 ohm. – This checks gradient coils, cables, filters.

• Measure and record from + and – lead of any one coil to + and – lead of any other coil.
– All measurements should be similar; high ohms.

– This checks gradient coils, cables, filter

Measure and record each + lead to system ground and each – lead to system ground.

– X & Y will show similar values (~160k Ohm).

– Z will be less (up to 100k Ohm less) than average of X & Y measured values.

– This checks gradient amps, filters, cables.

4.4.2 Leakage Troubleshooting

Operation of the magnet in the CØBO (Controlled Zero Boil-Off) mode with internal
helium pressure >1.1Psi for latest Magnets and >3.9 for old model Magnets, increases
the potential of helium leaks. A number of small helium leaks will have a significant
effect on boil-off and result in the measurable loss of helium over time.

♦ Ice or condensation on plenum plumbing indicates a leak in the helium plumbing.

♦ Major helium leaks will depressurize the helium vessel and can result in cryo pumping
and icing inside the vessel.

. Observe Magnet Monitor helium level data over a month or more. A slow helium level
decrease is evidence of leaking helium

Leak troubleshooting Flow Chart for LCC Magnets

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Commercial leak detector fluids or instruments available in the HVAC industry can be
used to determine small leaks in the helium plumbing and venting. Some examples
available through HVAC distributors are Bird Dog Quart Spray (P/N DOG-1Q), Big Blue
(P/N Rt100S or Rt100G), Snoop, Portable Leak Detector.

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Plumbing and O-Ring Leaks

● Replacement O-rings and a Burst Disc are contained in the Field Spare Parts Kit
● Remove the outlet plumbing (Vent Adapter side) for the 5.25 psig relief valve
and the 7.25 psig bypass valve.
● Attach a small balloon tightly to the exhaust side of the 5.25 psig relief valve and
the 7.25 psig bypass valve.
● Observe any expansion of the balloon from leaking helium gas.
● Replace any valve with suspected leaks, and retest the new valve for leaks

Leaks at Burst Disc

Small (micro) bubbles may appear between the gasket and flange. This is normal for
this gasket material. Make sure the Belleville washers are flattened and no major leaks
(continuous bubbles over 0.08 in. or 2 mm in diameter) are present. Foam Like bubbles
may be present.

● Ramp the magnet down to zero field in conformance with Magnet Ramp down to
Zero Field.
● Remove the Vent Adapter. Check the Burst Disc for cracks or significant leaks
around the gasket. Replace any cracked or leaking Burst Disc in conformance
with Burst Disc Replacement.

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SNR Troubleshooting

How to proceed when system is having Image quality Issue with specific Coil,

Step1 : Verify customer complaint

● Check if you can verify the issue using the specified coil and a phantom with
Service protocol…this will rule out that the issue is patient related or related to
the customer pulse sequence. If the issue cannot be verified with the phantom
and service protocol you will need to use the customer’s specific pulse sequence
giving the issue, to rule it out. If their pulse sequence checks out you’ll need to
see if their issue is repeatable on other patients

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Step2 : Isolate the issue to the specific coil

● Test other coils plugged into the same port or run MCRv to verify the port is
good. If other coils or MCRv fails, test a different port (i.e. head vs body). If all
coils / ports fail, suspect something systemic (i.e. what do all ports have in
common) …may be RF transmit, an RF Switch Board, Receiver or ICN?

Step 3: After isolating the issue to a specific coil check for the obvious

 Check coil connections on both ends to make sure there are no bent or
recessed pins.
 Check to make sure there are no sub-FRUs (i.e. can you replace just the
cable vs the entire coil), and can you isolate the issue further somehow.

Step 4 : If nothing obvious sticks out and there are no sub-FRUs replace the coil and
verify the fix

TPS Not responding/hardware/sw reset failure Troubleshooting

Error:

 System hang up after browser initialised error message display TPS not
responding.
 System can boot up, but report TPS no responding, let’s reset TPS, but reset
not successful
 system intermittently stop, let’s TPS reset.

Analysis

 TPS/ISE no responding express host computer not receiving TPS/ISE’s

feedback signal, so I think the system is not ready.
 So this problem relate to software, Bit-3, fibre optic chain, TPS/ISE chassis

Solution

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  Software (SH SCMC,2000) The system can not boot up to application
window. Repeating load software and exchanging all parts of the computer,
no use. Later I replace one Application CDROM to do LFC, ok. **Having a
communication between host computer and PC when system boot up**

Cradle Issue Troubleshooting

Case: Intermittently Erratic Carriage Movement

Symptom: Intermittently Erratic Carriage Movement. The customer complain that the
cradle move so fast into the magnet bore erratically

Error message : none

Note: Erratic Carriage movement due to wrong control signal or wrong machinery
control.

Block diagram of the system

Troubleshooting

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  Check the motor voltage of cradle movement
 Replace the encoder module
 Replace the limit switch board
 Replace the speed reducer
 Replace the coupling
 Check the Home sensor position
 Check the Clutch tension

After doing above T/S procedure, it’s still happen the same issue

Step 2: check to see if the signals are reversing polarity by checking them signals at the
Dock/Light board as a starting point when the problem is happening.

Functional Check:

 In the normal condition using the DVM to check the cradle movement voltage.
 Cradle in slow : -5 Voltage
 Cradle out slow : +5 Voltage
 Cradle in fast : -17 Voltage
 Cradle out fast : +17 Voltage
 Cradle back to Home position : +17 Voltage
 All Looks Ok

Due to the intermittent issue, we set up the DVM on the Longitudinal motor to check the
motor voltage anytime. Finally, we find the abnormal voltage, when the erratic carriage
issue happens. The DVM display-34V during the fast erratic carriage movement into the
bore.The voltage change from +17V to –34V suddenly, so the customer see the cradle
move into the bore fast.

Solution 1: After replacing the Dock/Light board in the SSM module and Fix the issue.

Solution: 2 for the same issue but another solution

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The carriage sometimes moves erratically while being driven into and out of the bore.
Sometimes scans are interrupted due to apparent table movement. During these events
the customer sometimes notices corduroy artefacts on the images. FE ran spike noise
check but can't find anything wrong. Table malfunction is very intermittent.

Conclusion:

FE checked many cables for damage and replaced many items including SRI for this
problem. Replacing the longitudinal encoder in the rear pedestal finally solved both the
intermittent movement and artefact problems.

EPI White Pixel Troubleshooting:

White Pixels in the raw data (also known as Spike Noise), is one of the most common
problems in MR and can be even more problematic in EPI scans due to the vigorous
gradients applied during these scans (hence a EPIWP test). These white pixels in the
raw data can cause Corduroy artefacts and Ghosting problems if they occur during the
EPI Reference scan.

("Corduroy" refers to the parallel line patterns that are often seen in the affected image.
These lines are caused by intensified or bright areas in raw data "White Pixels".) These
intensified areas are typically created by arcs or "Spike Noise" received by the system.
The source of these arcs can be any current carrying conductor. This includes cables
and electronic components. Also any conductor in a changing magnetic field (i.e.
gradient fields) or any conductor moving in a magnetic field will have eddy currents
flowing in it. This could include the rear pedestal, magnet enclosure frame, or any loose
metal object. The arcing is usually happening in the magnet room. As long as the Scan
Room's RF shielding is working, any arcing outside the room should be attenuated by
the RF shield and filters. The only exceptions are the RF transmit and receive chains
since the RF cables are not filtered. Although it happens very rarely, it is possible for
digital data handling problems during the data acquisition to create White Pixels. White
Pixels requires thorough troubleshooting to reduce the time and cost to repair it.

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Corduroy can appear very differently from image to image. It may only be apparent on
one image in the series or on every image. It may be just subtle fine lines that are hardly
noticeable or it may completely envelope the entire image. It may even look like an SNR
problem where the image is "grainy". The magnitude of the arc and where it happens in
raw data "K-space" determines how it will effect the image. Arcs or white pixels near the
centre of K-space have more effect on the image. These many variations of corduroy
artifact can lead one to believe there are multiple problems when it is really just one
source.

Typical problem scenarios

The majority of my noise sources have been gradient induced, often only affecting a
single axis, sometimes two. Quite often it is from loose hardware (i.e. nuts & bolts in
rear pedestal) or connections (poor mating of centre pins to body hybrid, etc.). Inspect
and tighten all you can. Another common cause is coupling. Make sure all the Gradient
cables are separated from all the receive lines.

Solution Flow Charts

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Table/Cradle Troubleshooting

Issue : Table Not Moving Up When Pressed

Possible Causes:

● Cradle not in-home position.

● Up Foot switch not functioning.
● Table might have reached Top most condition.
● The home sensor not actuated by the Cradle.
● Cable connections might have disconnected.
● Up Limit switch have activated/failed.
● Electrical Actuator Power supply cable Failure/Disconnected.
● Control Board or Electrical Actuator failure

Checks and Solutions

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1-Check whether cradle is in Home position

2- If Cradle is at home position, then check for both foot switch spring action by pressing
the Foot switch. If foot switch is not working properly, replace the foot switch

1-If the foot switch is functioning properly, then the table might have reached Top
most condition. Press down the foot switch; check whether Table is coming
down. If Table is coming down, Press Up foot switch check whether table is
going up.

2-If the table is going up, then the Table Height adjustment needs to be adjusted.
If the table is not moving Up, Check for Home sensor functioning. If the home

94
 sensor is functioning properly, then remove the Table FRP covers.Check for
cable connections are properly connected.

3- If cable connections are connected properly, then remove the scissors cover
of the Table,

4- Check for the cable connection near the Up Limit switch

5- If cables are connected properly, then check for the UP Limit switch actuation.

6 - If the table limit switch is not functioning properly, then loosen the two screws
holding the Limit switch replace the Limit switch with the new Limit switch.

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 ● Disconnect the Cables connected to the Limit Switch.
● Remove the Screws connected to the Limit switch
● Fix the New Limit switch.

7 -If Cradle is at home position, then check for down foot switch spring action by
pressing the Foot switch. Refer toFigure 10 If foot switch is not working properly,
replace the foot switch
4.4.1 Error Code Interpretation:
When an error occurs, the MRI machine typically displays an error code or message on
its interface. Interpreting these error codes is essential for understanding the underlying
issue. The system manual or documentation provided by the manufacturer contains a
list of error codes and their corresponding meanings. By identifying the specific error
code displayed, healthcare professionals can take appropriate actions such as
contacting technical support or following prescribed troubleshooting procedures.
4.4.2 System Log Analysis:
MRI machines maintain system logs that record various events and activities. Analyzing
these logs provides valuable insights into the system's performance and potential
issues. Accessing the system log files through the software interface or system console
allows healthcare professionals to review log entries, identify abnormal events,
warnings, or error messages, and use this information to diagnose and address
problems efficiently. System logs can also serve as valuable references when seeking
technical support.
4.5 Component Replacement:

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In some cases,faulty or damaged components within the MRI machine may need to be
replaced to restore its functionality.
4.5.1 Safety Precautions:
Component replacement should be approached with utmost care to ensure operator
safety and prevent further damage to the equipment. Following safety protocols and
guidelines provided by the manufacturer is crucial. This includes adhering to electrical
safety practices such as disconnecting power sources and using appropriate personal
protective equipment (PPE) to mitigate the risk of electrical hazards.
Before starting the component replacement process, it is important to ensure that the
replacement components are compatible with the MRI system and that they have been
sourced from reliable and authorised suppliers. Installing incompatible or substandard
components can compromise the performance and safety of the MRI machine.
4.5.2 Tools and Techniques:
The specific tools and techniques required for component replacement may vary
depending on the MRI system and the component being replaced. Generally, the
following steps are involved:
1. Identification: Identify the faulty or damaged component that needs to be
replaced. This can be determined through troubleshooting, error code
interpretation, or diagnostics.
2. Sourcing Replacement: Obtain the replacement component from a reliable
source, ensuring it is compatible with the MRI system and meets the required
specifications.
3. Preparation: Before starting the replacement process, ensure that the MRI
machine is powered off, disconnected from power sources, and any necessary
safety precautions have been taken.
4. Disassembly: Follow the manufacturer's instructions to disassemble the relevant
parts of the MRI machine to access the component that needs to be replaced.
This may involve removing covers, panels, or connectors.
5. Replacement: Carefully remove the faulty component and replace it with the new
one. Follow any specific instructions provided by the manufacturer, such as
torque specifications for screws or connectors.

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 6. Reassembly: Once the replacement component is installed, reassemble the MRI
machine by reversing the disassembly steps. Ensure all connections are secure
and components are properly aligned.
7. Testing and Calibration: After component replacement, perform any necessary
system tests or calibrations to ensure the proper functioning of the MRI machine.
This may involve running diagnostic routines or verifying system parameters.
It is important to note that component replacement procedures should be carried out by
trained personnel or technicians who have a thorough understanding of the MRI
machine's operation and the specific replacement requirements for each component.
Following proper procedures and guidelines is crucial to maintain the safety and
performance of the MRI system.

4.6 Activity

4.5.1 Group discussion

In a group of four, What are the most common causes of downtime

for an MRI machine?

Time: 15 min

4.7 Summary

MRI machines are complex and expensive medical imaging devices that rely on
magnetism and radiofrequency to produce images. Regular maintenance, cleaning, and
inspection are essential for optimal performance and to prevent long-term defects or

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associated problems from its usage. Both preventive and corrective maintenance play a
crucial role, and technicians and operators are required to follow the terms of use and
utilize periodic inspection and testing . Some of the most common problems that occur
with MRI machines include blurry images, excessive vibrations, low helium levels,
power outages, and defects in the cold head and calibration of the gradient coils . The
best practices for maintaining an MRI machine include deep cleaning, mechanical tests,
system calibration, performance recording, and diagnostics. Specific tasks include
inspecting the MRI scanner’s cryogen levels, taking note of the compressor’s pressure
and run time, checking the shield temperature voltage, determining the signal-to-noise
ratio, doing the left ventricular gradient shim, configuring the gradient calibration,
checking and setting the radiofrequency power output, inspecting and cleaning intakes,
monitors, and workspace fans, checking the blower filter, taking note of the chiller fluid
level and valve, ensuring the table drive clutch set screws are properly fastened,
checking the trolley assembly, inspecting the unit’s adsorber and coldhead.

4.8 Exercise

1. What are the best practices for maintaining an MRI machine?

2. How often should an MRI machine be serviced?
3. What are the most important components of an MRI machine that require
maintenance?
4. How can you troubleshoot common problems with an MRI machine?
5. What are the safety considerations when performing maintenance on an MRI
machine?

Chapter Five: MRI Safety

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Duration: 40 hrs
Chapter description
This chapter describes the powerful magnetic fields of the MRI machine and how to utilize
radiofrequency energy, making it crucial to implement safety measures to protect patients,
staff, equipment and the environment.

Chapter Objective
By the end of this chapter, participants will be able to apply MRI safety rules and principles
to project the patient, staff, equipment and operate and safe handling of the MRI machine.

Enabling Objectives

At the end of this chapter the participants will be able to:

● Explain safety consideration on performing examination and maintenance on MRI.
● Practice safe handling procedures of MRI machine
● Apply safety rules and principles of MRI

Chapter outline

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 Introduction
 Magnetic Field Safety
 Radio Frequency Safety
 Electrical Safety
 Emergency Procedures
 Summary

5.1 Introduction

Activity: Brainstorming

1. What are the safety considerations when

performing examination and maintenance on an
MRI machine?
2. What are the safety protocols for handling
patients with implants or devices?

Time: 15min

The powerful magnetic field of the MR system can attract objects made from certain
metals (i.e., metals known to be ferromagnetic, such as iron) and cause them to move

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suddenly and with great force. This can pose a possible risk to the patient or anyone in
the object's "flight path." Therefore, great care is taken to ensure that external objects
such as ferromagnetic screwdrivers and oxygen tanks are not brought into the MR
system room.

As a patient, it is vital that you remove all metallic belongings in advance of an MRI
examination, including external hearing aids, watches, jewelry, cell phones, and items of
clothing that have metallic threads or fasteners. Additionally, makeup, nail polish, or
other cosmetics that may contain metallic particles should be removed if applied to the
area of the body undergoing the MRI examination.

Various clothing items such as athletic wear (e.g., yoga pants, shirts, etc.), socks,
braces, and others may contain metallic threads or metal-based anti-bacterial
compounds that may pose a hazard. These items can heat up and burn the patient
during an MRI. Therefore, MRI facilities typically require patients to remove all
potentially problematic clothing items prior to undergoing an MRI.

Therefore, all MRI facilities have comprehensive screening procedures and protocols
they use to identify any potential hazards. When carefully followed, these steps ensure
that the MRI technologist and radiologist know about the presence of any metallic
objects so they can take precautions as needed.

In some unusual cases, due to the presence of an unacceptable implant or device, the
exam may have to be cancelled. For example, the MRI exam will not be performed if a
ferromagnetic aneurysm clip is present because there is a risk of the clip moving and
causing serious harm to the patient. Besides possible movement or dislodgement,
certain medical implants can heat substantially during the MRI exam as a result of the
radio waves (i.e., radiofrequency energy) used for the procedure. MRI-related heating
may result in an injury to the patient. Therefore, as a patient, it is very important for you
to inform the MRI technologist about any implant or other internal or external object that
you may have prior to entering the MR scanner room.

MRI has been successfully performed for many years now on millions of patients
worldwide. There is no Ionizing radiation used in MRI Instead we use a combination of

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 magnets and radio frequencies to help obtain very detailed images of the human body.
Safety considerations of paramount importance in any environment where MRI
(Magnetic Resonance Imaging) machines are utilized. MRI machines generate powerful
magnetic fields and utilize radiofrequency energy, making it crucial to implement safety
measures to protect patients, staff, and equipment. Here are the key safety
considerations:

5.2. Magnetic Field Safety

MRI machines generate a strong magnetic field, typically measured in Tesla units (T).
The main safety concern with magnetic fields is the interaction with ferromagnetic
objects, which are objects that can be strongly attracted to magnets. When
ferromagnetic objects are brought into the MRI environment, they can become
projectiles, posing a risk to individuals and causing damage to the equipment. It is
important to establish strict protocols to prevent the entry of ferromagnets into the MRI
room and to educate staff and patients about the potential dangers.

Magnetic fields attract tools to the magnet, may attract dust and particles that are
magnetic, and will affect magnetic items such as credit cards, magnetic tapes,
prosthetics, and implanted medical devices etc. These characteristics pose safety
problems for personnel as well as creating the potential for physical damage to
expensive and sensitive research equipment. Some general precautions should be
taken when working in and around high magnetic fields.
 Compressed gas cylinders shall be secured at all times. Tools shall be nonmagnetic in
nature if used within the 100 gauss lines.
 Footwear shall provide secure footing, protection from spilled cryogenic liquids, and
protection from falling objects. Bare feet and open toed shoes shall not be worn
when working in areas with potential foot hazards. Caution shall be taken when
working around magnets if wearing steel-toed safety shoes.

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 Credit and ATM cards should be kept beyond the 10 G line. Steel, iron and other
magnetic objects shall be secured and fastened down or kept behind the 100 G
line.
 Equipment must be arranged in the work area neatly to allow a reasonable working
area. Cables and power cords shall be kept off the floor as much as possible to
prevent tripping hazards. Maintain evacuation routes in the event of an emergency.
 Tour groups and unescorted visitors shall not enter rooms or areas that contain
energized magnets.
 In the event of an emergency resulting in a life or limb threatening circumstance, power
to the magnet shall be turned off. In the event that an object is drawn into the
magnet, do not attempt to remove it until the magnet is de-energized. If a magnet
quenches, all personnel shall leave the immediate area to allow the gas to
dissipate. Be alert when operating magnets at field for any abnormal sounds,
noises or conditions.

5.1.1 Safety in handling Magnets

In some circumstances, strong permanent magnets or magnetic assemblies can be

dangerous or cause injury or inconvenience to persons or property. This warning must
be read prior to handling or operating a permanent magnet or magnetic assembly.

Accidental Injuries Caused by Handling Permanent Magnets

 Magnets can fly together or to steel objects causing severe pinching or lacerations to
the skin.
 Magnets can shatter on impact causing eye injury. Goggles must be used when
handling.
 Children must not be permitted to handle or play with magnets.
 Avoid flame or heating, grinding, or cutting of magnets. These procedures
carry a risk of oxygen absorption and possible shattering. Enclosed magnets
may explode if heated.

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Other Health Considerations, Long-term daily handling of permanent magnets may
represent a health risk. However, as a simple precaution, we recommend:
 Avoid unnecessary handling and uninformed handling/assembly of magnets.
 Avoid long-term close bodily contact with strong magnets.
 Keep strong magnets away from the head, eyes, heart, and trunk.
 Continuous daily exposure should not exceed 2,000 gauss or 0.2 tesla.
 Maximum one-off exposure should not exceed 20,000 gauss or 2 teslas

· Persons with cardiac pacemakers must not allow magnetism within close proximity
of their chest or be in an environment above .5mt (5 gauss). As a general guide,
persons with cardiac pacemakers should not come closer than 300mm from the working
or field-throwing face of magnets such as small plate magnets, grate magnets, probe
magnets, magnet bars, spherical magnets, etc.

Permanent magnets can cause damage to electronic equipment such as (but not limited
to):
 Smart cards
 Credit cards
 Phone and gift cards,
 Computer equipment, laptops, mobile phones
 Video, cassette, and audio tapes

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5.1.2 Personal Protective Equipment (PPE)

Personal Protective Equipment is essential for individuals working in the MRI

environment to minimize the risk of accidents or injuries caused by the strong magnetic
field. Non-magnetic PPE, such as gowns, footwear, and head covers, is provided to
prevent individuals from being pulled towards the magnet. The PPE is made of
materials that do not contain ferromagnetic components, such as zippers or buttons.
Additionally, individuals are required to remove metallic objects, including jewelry,
watches, and pens, before entering the MRI environment to avoid potential hazards.

Wear the appropriate PPE under these conditions:

 If directly exposed to 50 volts and above (AC or DC).
 If there are arc flash warning labels posted on electrical panels (examples
below).
 If arc flash warning labels are not posted, default to PPE outlined in the local
codes.
 When validating zero energy in electrical panels after applying LOTO.
 When performing energised PDU testing or troubleshooting.
 When performing A1/480 panel work.

PE Hazard Class Category 1

1. Hard hat

2. Hearing protection

3. Safety glasses

4. Arc-rated helmet with face shield (rated 4 Cal/cm2) with chin/neck protector

5. Leather gloves

6. Flame-resistant pants and long-sleeve shirt (ATPV arc rating minimum 4 Cal/cm2)
or coveralls

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7. Safety shoes

8. Cotton underwear (short-sleeve shirt and briefs/shorts) (not pictured)

PE Hazard Class Category 2

1. Hearing protection

2. Safety glasses

3. Arc-rated helmet with face shield (rated 8 Cal/cm2) with chin/neck protector

4. Class 0 rated gloves with leather protectors

5. Flame-resistant pants and shirt (ATPV arc rating minimum 8 Cal/cm2) or coveralls

6. Safety shoes

7. Cotton underwear (short-sleeve shirt and briefs/shorts) (not pictured)

Arc Flash Safety

Arc flash is a high-energy discharge of highly-conductive plasma, which can cause
destruction to anything in its path. It is important to take the proper precautions when

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servicing energised equipment where voltage exceeds 50 volts. All unguarded
equipment being serviced posing immediate exposure to voltages greater than 50 volts
requires appropriate Personal Protective Equipment (PPE) be worn. Arc flash hazards
are very complex and different than electrical shock hazards. Many variables are
associated with the causes of arc flash. As such, arc flash precautions are
recommended for both energized and de-energized conditions. If in doubt, do not
proceed and consult your EHS and technical specialists for guidance. This document
defines general guidelines, Lock Out/Tag Out (LOTO) steps, and minimum PPE
required for arc flash avoidance when servicing the equipment. Devices such as, Main
Disconnect Panels (MDP) and unguarded Power Distribution Unit (PDU) electrical
connections, are examples of equipment requiring arc flash protection. The level of
protection required is dependent on exposure potential. Arc flash risks are recognized
globally as a potential hazard. The approach to employee protection is guided by local
regulatory requirements. In Europe, arc flash hazards must be addressed by conducting
a risk assessment, which will result in the appropriate precautions and required PPE. In
jurisdictions, including but not limited to the United States, Canada and Brazil, arc flash
compliance requires training and specified PPE, dependent upon the anticipated hazard
level. Where regulations require specific PPE, the following is applicable:
 Arc Flash PPE is required when working on live electrical components
ranging from 50 to 480 volts.
 Arc Flash PPE is also required during the zero-energy verification stage
during LOTO. It must be assumed that there is still live electrical energy (and
the potential for an arc flash) until verification with a voltmeter is completed.

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5.3 Radio Frequency (RF) Safety

RF Safety refers to the precautions taken to minimize the risks associated with the
radiofrequency energy used in MRI for imaging purposes. RF safety is a critical aspect
of MRI operations to ensure the safety of both patients and staff. RF (Radiofrequency)
refers to the electromagnetic fields used in MRI to generate the signals necessary for
imaging. Here are some key points regarding RF safety in MRI
SAR (Specific Absorption Rate): SAR is a measure of the rate at which RF energy is
absorbed by the human body during an MRI scan. It is important to monitor and control
the SAR levels to prevent excessive heating of tissues. MRI systems have built-in safety
mechanisms to limit SAR levels and ensure they remain within established guidelines.
Patient Screening: Before performing an MRI scan, it is essential to screen patients for
any contraindications or conditions that may increase the risks associated with RF
exposure. This includes assessing patients for the presence of metallic implants,
electronic devices, or other objects that may be affected by the strong magnetic fields or
RF energy.
RF Shielding: MRI rooms are typically equipped with RF shielding to minimize the
transmission of RF signals outside the scanning area. This helps prevent interference
with other electronic devices and reduces the potential for RF exposure to individuals
outside the MRI room

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RF Coil and Cable Safety:

RF coils and cables are used to transmit and receive the radiofrequency signals
necessary for MRI imaging. Regular inspection and maintenance are important to
ensure the integrity and safety of these components. Damaged or frayed cables can
pose electrical and safety hazards, such as increased resistance or risk of electrical
shock. Routine checks are conducted to identify any signs of wear or damage, and
damaged components are promptly repaired or replaced following appropriate
procedures and manufacturer guidelines.

RF Exposure Monitoring:

RF exposure monitoring involves measuring and assessing the amount of RF energy

received by individuals working in the MRI environment. Monitoring devices, such as
dosimeters or monitors, may be used to measure RF exposure and ensure it remains
within acceptable limits. These devices are typically worn by individuals during MRI
procedures to track their exposure levels. Monitoring is important to prevent excessive
RF energy absorption, which can lead to thermal effects or other health risks.

To prevent excessive heating and possible burns in association with MR procedures,

the following guidelines are recommended:
1. The patient should change into a gown or other appropriate attire that does not
contain metallic material.
2. Prepare the patient for the MR procedure by ensuring that there are no
unnecessary metallic objects contacting the patient’s skin (e.g., drug delivery
patches with metallic components, jewelry, necklaces, bracelets, key chains,
etc.).
3. Prepare the patient for the MR procedure by using insulation material (i.e.,
appropriate padding) to prevent skin-to-skin contact points and the formation of
“closed-loops” from touching body parts.
4. Insulating material (minimum recommended thickness, 1-cm) should be placed
between the patient’s skin and transmit RF coil that is used for the MR procedure

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 (alternatively, the transmit RF coil itself should be padded). There should be no
direct contact between the patient’s skin and the transmit RF body coil of the MR
system. This may be accomplished by having the patient place his/her arms over
his/her head or by using elbow pads or foam padding between the patient’s
tissue and the transmit RF body coil of the MR system. This is especially
important for MR examinations that use the transmit RF body coil or other large
RF coils for transmission of RF energy.
5. Use only electrically conductive devices, equipment, accessories (e.g., ECG
leads, electrodes, etc.), and materials that have been thoroughly tested and
determined to be safe or otherwise acceptable for MR procedures.
6. Carefully follow the MR Safe or MR Conditional criteria and recommendations for
implants and devices made from electrically-conductive materials (e.g., bone
fusion stimulators, neurostimulation systems, cardiac devices, cochlear implants,
etc.).
7. Before using electrical equipment, check the integrity of the insulation and/or
housing of all components including surface RF coils, monitoring leads, cables,
and wires. Preventive maintenance should be practised routinely for such
equipment.
8. Remove all non-essential electrically conductive materials from the MR system
prior to the MR procedure (i.e., unused surface RF coils, ECG leads, EEG leads,
cables, wires, etc.).
9. Keep electrically conductive materials that must remain in the MR system from
directly contacting the patient by placing thermal and/or electrical insulation
between the conductive material and the patient.
10. Keep electrically conductive materials that must remain within the transmit body
RF coil or other transmit RF coil from forming conductive loops. Note: The
patient’s tissue is conductive and, therefore, may be involved in the formation of
a conductive loop, which can be circular, U-shaped, or S-shaped.
11. Position electrically conductive materials to prevent “cross points”. A cross point
is the point where a cable crosses another cable, where a cable loops across
itself, or where a cable touches either the patient or sides of the transmit RF coil

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 more than once. Even the close proximity of conductive materials with each other
should be avoided because cables and RF coils can capacitively-couple (without
any contact or crossover) when placed close together.
12. Position electrically conductive materials (e.g., cables, wires, etc.) to exit down
the center of the MR system, not along the side of the MR system or close to the
transmit RF body coil or other transmit RF coil.
13. Do not position electrically conductive materials across an external metallic
prosthesis (e.g., external fixation device, cervical fixation device, etc.) or similar
device that is in direct contact with the patient.
14. Allow only properly trained individuals to operate devices (e.g., monitoring
equipment) in the MR environment.
15. Follow all manufacturer instructions for the proper operation and maintenance of
physiologic monitoring or other similar electronic equipment intended for use
during MR procedures.
16. Electrical devices that do not appear to be operating properly during the MR
procedure should be removed from the patient immediately.
17. RF surface coil decoupling failures can cause localized RF power deposition
levels to reach excessive levels. The MR system operator will recognize such a
failure as a set of concentric semicircles in the tissue on the associated MR
image or as an unusual amount of image non-uniformity related to the position of
the transmit RF coil.
18. Do not permit patients to wear clothing items (e.g., sportswear, underwear, yoga
pants, etc.) that have metal-based fibers.
19. Closely monitor the patient during the MR procedure. If the patient reports
sensations of heating or other unusual sensation, discontinue the MR procedure
immediately and perform a thorough assessment of the situation.

5.4 Electrical Safety

Electrical safety measures are in place to prevent electrical hazards and ensure the
safe operation of the MRI system.

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High Voltage Safety
The high voltage present in the RF amplifier is the most dangerous hazard in the RF
subsystem. Lethal potentials in excess of 4100 volts, with momentary current capability
greater than 100 amps, are present in the amplifiers and their power supplies during
operation. Interlock switches are provided on the covers of power supply and amplifier
decks to minimize the danger of electrocution; however, they should never be taken for
granted. All circuit breakers on the RF cabinet must be off and tagged, and cabinet
power cords must be unplugged before opening any modules containing high-voltage
circuitry. Allow at least five minutes for filter capacitors to discharge before removing
any module covers for service. For tube-based amplifiers: Always assume that a circuit
is "hot" until proven otherwise. Discharge high-voltage circuitry by shorting to ground
and across terminals of floating power supplies before touching components. Do not
rely on bleeder resistors to discharge capacitors. While they will eventually reduce
voltages to safe levels, bleeder circuits have time constants as long as several minutes
to limit heat dissipation during normal operation.

Grounding and Electrical Isolation:

Grounding is the process of connecting electrical equipment to the Earth's ground to

prevent the buildup of electrical charges. In the MRI environment, proper grounding
techniques are used to ensure the safe flow of electrical currents and minimize the risk
of electrical shocks. Electrical isolation techniques are also employed to separate the
electrical circuits of the MRI system from the main power supply. This isolation helps
prevent electrical interference and protects against electrical faults that may occur in the
main power system.

Electrical Component Handling:

Handling electrical components, such as during maintenance, repairs, or installations,

requires proper training and adherence to safety protocols. This includes de-energizing
the equipment before handling, using appropriate tools and personal protective
equipment, and following lockout/tagout procedures to ensure the equipment is safely

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isolated from energy sources during maintenance activities. Qualified personnel are
responsible for handling electrical components to minimize the risk of electrical
accidents and ensure the safety of individuals involved.

Ramping Precautions
A superconducting magnet at field is a high-energy storage device capable of
discharging rapidly (quenching), creating a high voltage across the main leads. Make
sure the following precautions are observed when ramping a superconducting magnet:
 When working with the main lead connections that are installed into a ramped
magnet, do not touch both main lead extensions at the same time or allow them
to come in contact with one another.
 Allow main lead extensions to cool before fully inserting them into a ramped
magnet to prevent any possibility of a quench.
 Make sure the power supply has passed all functional checks, and the input
power cable is disconnected before connecting it to the main power leads.
 Make sure the final magnet “parking” current and voltage polarity have been
recorded and will be available if a ramp-down is required. An incorrect polarity
connection will result in a magnet quench. Use the appropriate hold-down tool to
properly secure ramp leads to the magnet ensure the safe operation of the MRI
system.

5.5 Emergency Procedures

Emergency procedures are established to address potential emergencies and ensure

the safety of individuals in the MRI environment.

Power Failure:

Power failures can occur unexpectedly, and it is crucial to have protocols in place to
handle such situations. Backup power systems, such as uninterruptible power supplies
(UPS) or emergency generators, are typically installed to provide temporary power
during outages. These systems are designed to maintain power to critical equipment,

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including the MRI machine, lighting, and emergency systems. Protocols are established
to safely shut down the MRI machine and remove patients from the scanner if a power
failure occurs.

Patient Emergencies:

During an MRI procedure, a patient may experience a medical emergency. Staff

members are trained in emergency response protocols, including CPR and first aid, to
provide immediate assistance. Emergency equipment and supplies, such as
defibrillators, oxygen, and emergency medications, are readily available within the MRI
suite to assist in managing patient emergencies. Staff members are trained to
effectively communicate with emergency medical services (EMS) and provide
necessary information about the patient's condition and location within the facility.
Prompt and coordinated actions are taken to ensure the safety and well-being of the
patient.

Equipment Malfunctions:

Equipment malfunctions can occur during MRI procedures and may pose safety risks to
patients and operators. Regular maintenance and inspections are conducted to
minimise the risk of malfunctions. If an equipment malfunction is detected, the affected
equipment is taken out of service until the issue is resolved. Qualified service personnel
are contacted to assess and repair the equipment. Staff members are trained to
recognize common equipment malfunctions and understand the appropriate steps to
take to ensure the safety of all individuals involved. This may include following specific
troubleshooting protocols, contacting the manufacturer for support, or implementing
backup plans to ensure continuity of patient care.

By implementing comprehensive safety considerations and protocols in each of these

areas, MRI facilities can create a safe environment for patients, staff members, and
visitors. Regular training, maintenance, and adherence to safety guidelines are
essential to minimise risks and promote the safe operation of MRI systems.

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5.6 Summary

4.5.1 Group discussion

In a group of four, What are the most common accidents that

occur in MRI rooms? and How can you prevent accidents in an
MRI room?

Time: 15 min

MRI machines are powerful medical imaging devices that use strong magnetic fields
and radio waves to produce images of the body. MRI safety is of utmost importance to
ensure the well-being of both patients and radiology technologists. Some of the safety
considerations when performing maintenance on an MRI machine include ensuring that
the machine is turned off, verifying that there are no ferromagnetic objects in the room,
and following proper lockout/tagout procedures. The risks associated with MRI scans
include hearing loss, burns, and projectile injuries caused by ferromagnetic objects. To
ensure patient safety during an MRI scan, it is important to screen patients for any metal
implants or devices, provide them with earplugs or headphones to protect their hearing,
and monitor them throughout the procedure. The safety guidelines for MRI operators
and technicians include wearing appropriate personal protective equipment (PPE),
following proper protocols for handling patients with implants or devices, and ensuring
that all ferromagnetic objects are removed from the room before scanning. The most
common accidents that occur in MRI rooms include projectile incidents, burns, and
quenching events. To prevent accidents in an MRI room, it is important to follow proper
safety protocols, ensure that all personnel are properly trained, and maintain a safe
environment.
5.8 Exercise

1. What are the risks associated with MRI scans?

2. How can you ensure patient safety during an MRI scan?

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 3. What are the safety guidelines for MRI Technologists and biomedical
engineers/technicians?

6 Additional Resources
6.1 Manuals and Documentation:
Manuals and documentation provided by the MRI system manufacturer are valuable
resources for understanding the operation, maintenance, and safety considerations
specific to the equipment. These resources typically include:
❖ User Manuals: User manuals provide detailed information on the operation of the
MRI system, including system controls, software functionality, and recommended
procedures. They often include safety guidelines specific to the equipment.
❖ Service Manuals: Service manuals are intended for qualified service personnel
and provide in-depth technical information for maintenance, troubleshooting, and
repair of the MRI system. They include detailed diagrams, specifications, and
procedures.
❖ Safety Guidelines and Documentation: Manufacturers typically provide safety
guidelines and documentation specific to their MRI systems. These documents
outline safety considerations, recommended practices, and precautions to be
followed during installation, operation, and maintenance.
It is important for MRI facility personnel to familiarise themselves with the relevant
manuals and documentation provided by the manufacturer and ensure that they are
readily accessible for reference when needed.
6.2 Training and Certification:
Training and certification programs are essential for individuals working in MRI
environments to acquire the necessary knowledge and skills to operate the equipment
safely. These programs can be offered by various organisations, including:
❖ Manufacturers: MRI system manufacturers often provide training programs
tailored to their specific equipment. These programs cover topics such as system
operation, safety considerations, image acquisition techniques, and
troubleshooting.

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 ❖ Professional Associations: Professional associations, such as the American
Society of Radiologic Technologists (ASRT) or the American College of
Radiology (ACR), may offer MRI-specific training and certification programs.
These programs ensure that individuals have a comprehensive understanding of
MRI principles, safety practices, and patient care.
❖ Educational Institutions: Many universities, colleges, and technical schools offer
MRI technology programs as part of their curriculum. These programs provide
comprehensive training on MRI principles, safety protocols, image interpretation,
and patient care.
It is important for individuals working in MRI environments to undergo appropriate
training and obtain relevant certifications to ensure they have the necessary knowledge
and skills to perform their duties safely and effectively.
6.3 Manufacturer Support:
Manufacturers of MRI systems typically offer support services to assist facilities with
technical issues, maintenance, and safety concerns. Manufacturer support can include:
❖ Technical Support Hotlines: Manufacturers provide dedicated hotlines or support
channels where facility personnel can contact technical experts for assistance
with troubleshooting, equipment operation, or safety-related queries.
❖ Preventive Maintenance Programs: Manufacturers may offer preventive
maintenance programs to ensure that the MRI system is regularly inspected,
calibrated, and serviced according to recommended schedules. These programs
help identify potential issues before they become major problems and ensure the
safe and reliable operation of the equipment.
❖ Software Upgrades and Updates: MRI system manufacturers release software
upgrades and updates periodically to enhance system performance, address
known issues, and incorporate new features. Manufacturers provide support to
facilities for the installation and implementation of these updates to maintain
system functionality and safety.
❖ Field Service Engineers: Manufacturers often have a team of field service
engineers who can be dispatched to facilities for on-site maintenance, repairs, or

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 safety-related inspections. These engineers are trained by the manufacturer and
have in-depth knowledge of the specific MRI system.
Facilities can rely on manufacturer support to address technical concerns, ensure
compliance with safety guidelines, and maintain the optimal performance of their MRI
systems.
It is important for MRI facility personnel to establish and maintain a strong relationship
with the manufacturer to access the necessary resources and support for safe and
efficient operation of the equipment

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 Part – Two
Imaging Equipment CT-Scan Machine

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 Chapter XX: Computed Tomography (CT) Machine

Allocated Time: 25 Hrs.

Course Description
This chapter is designed to provide participants with knowledge, skills and attitude required for
handling, operation, and maintenance of CT machine. It covers clinical applications, working
principles, main components, troubleshooting techniques and safety procedures for CT machine.
Chapter Objective: At the end of this chapter, participants will be able to operate, safely handle,
troubleshooting and maintain CT machine based on the acquired knowledge, skill and attitude
Enabling Objectives: At the end of this chapter the participant will be able to:
 Describe clinical application of CT Machine
 Differentiate basic parts and function of CT Machine
 Explain working principle of CT Machine
 Apply troubleshooting techniques and procedures for CT Machine
 Practice safe handling of CT Machine
 Perform preventive and curative maintenance for CT Machine
 Apply performance and verification testing

Chapter Outlines

2.1 Introduction to CT Machine

2.2 Clinical applications of CT Machine

2.3 Working principle CT Machine
2.4 Basic parts, functions and operating procedure of CT Machine
2.5 Troubleshooting techniques and Maintenance procedure of CT Machine
2.6 Performance and Verification Testing
2.7 Safe use and handling of CT Machine

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2.8 Summary

2.1 Introduction

Activity 1.1 brainstorming

What do you know about CT machines and its history?

10 min

The discovery of X-ray radiation has been a major scientific breakthrough. This has been
attributed to Wilhelm Conrad Röentgen (Germany) who conducted the first cathode tube
experiments (Crookes tube) in November 8, 1895. This radiation has fluorescence
characteristics, sensitizes the film, and penetrates opaque objects. Röentgen called this radiation
type X-ray radiation. X-rays are irradiated and penetrate through three-dimensional objects. X-
rays which penetrate through objects are recorded on films or detectors as two-dimensional
images. This is generally referred to as radiography. Information disappears owing to overlap,
tissues with minute absorption coefficients cannot be easily discriminated, and scattering X-rays
cause adverse influences on imaging formation. The individuals who perform CT scans are
known as radiologists or radiography technologists.

The term “computed” in CT (computed tomography) indicates calculated or reconstructed, and

the term “tomography” is a compound word comprising the term “tomo” (which meaning to
“cut” or “section” in Greek) and “graphy” (which means “to describe” in Greek), meaning
imaging of an object by analyzing its slices. CT scanner operations are based on X-rays. The
typical energy used in general CT is in the range of 100 kV to 150 kV.

The algorithms used for CT image reconstruction are based on mathematical foundations of the
Radon transformation (Radon theorem) published in 1917 by Johann Radon (Austrian
mathematician), who also provided the formula for the inverse transform. The Radon theorem

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states that the image reconstruction is possible from projections: an image distribution function
could be obtained from an infinite set of its projections acquired by the rotational scanning.

In the early 1960s, Allan M. Cormack, an American physicist with a South African origin,
published the mathematical computation technique based on which the cross-sectional images of
internal distributions could be calculated from projection of attenuation data owing to X-rays
which penetrated the body at different angles based on the rotation of the X-ray source and
electronic detector around a three-dimensional object. The X-ray-based CT scanner was invented
in 1972 by the British engineer Godfrey N. Hounsfield. Hounsfiled shared the Nobel Prize in
Physiology and Medicine jointly with Allan M. Cormack for the development of CT in 1979.
The first clinical CT scanners included a head scanner which was installed at the Atkinson
Morley Hospital, London, UK, in 1972, and a whole-body scanner at Georgetown University
Medical Center, USA, in 1976. In the early stages of head CT scanners, the image acquisition
characteristics were associated with an acquisition time of 7 minutes, an image matrix of 80×80
pixels, a scan field of 25 cm, and a spatial resolution of 1.3 mm.

Generally “computed tomography,”, refers to a computerized x-ray imaging procedure in which

a narrow beam of x-rays is aimed at a patient and quickly rotated around the body, producing
signals that are processed by the machine’s computer to generate cross-sectional images, or
“slices.” These slices are called tomographic images and can give a clinician more detailed
information than conventional x-rays. Once a number of successive slices are collected by the
machine’s computer, they can be digitally “stacked” together to form a three-dimensional (3D)
image of the patient that allows for easier identification of basic structures as well as possible
tumors or abnormalities.

2.2 Clinical Application CT Machine

Activity 1.2: brainstorming

Whats are the clinical applications of CT scanner?

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 5 min

CT scan has several importance in the treatment plan of a patient if we see diagnostic imaging
some of the basic uses of a CT scan machine for both diagnostic purpose are listed below.

 Examine internal and bone injuries from vehicle accidents or other trauma
 Diagnose spinal problems and skeletal injuries
 Detect osteoporosis
 Detect many different types of cancers and determine the extent (spread) of the tumors
 Locate infections
 Look for injuries, stroke-causing clots, hemorrhaging, and other issues in the head
 Image the lungs to reveal blood clots in the lungs’ vessels, excess fluid, pneumonia, and chronic
pulmonary obstructive disease (COPD)
 Determine the cause of chest or abdominal pain, difficulty breathing, and other symptoms
 Diagnose dangerous vascular diseases that can cause stroke, kidney failure, and death
 Additionally, CT scans are used to assist with biopsies and other medical procedures, and help
with treatment planning for organ transplants, gastric bypass, and cancer, among other things.
 CT head scanners can be used to scan only the head. CT body scanners are used for scanning
primarily the head. When scanning the body, body scanners are used mostly for suspected
abdominal problems, such as pancreatic tumors, abscesses, or jaundice.
 Although uses of CT head scanning have varied from institution to institution, the most common
diagnoses made were mass lesions (mostly tumors), cerebrovascular disease (including stroke,
hemorrhage, and aneurysm), and diseases with enlargements of the ventricular space of the brain
(hydrocephalus and cerebral atrophy).
 To investigate multiple organ injury due to trauma and accidents
 To confirm the presence of cysts, solid tumors in various parts of the body
 To know the size and extent of damage of organs as a result of the lesions
 To investigate problems related to the spinal cord such as osteoporosis
 To diagnose the sudden abdominal pain, blood in the urine, and renal infection

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 To ensure presence of tumor and to determine the stage of a tumor
 To identify stones in the urinary bladder
 To plan radiation treatments for tumors
 To guide minimal invasive procedure such as Biopsy
 To locate the bleeding and damage in the organs
 CT scans can detect bone and joint problems, like complex bone fractures and tumors.
 If you have a condition like cancer, heart disease, emphysema, or liver masses, CT scans can
spot it or help doctors see any changes.
 They show internal injuries and bleeding, such as those caused by a car accident.
 They can help locate a tumor, blood clot, excess fluid, or infection.
 Doctors use them to guide treatment plans and procedures, such as biopsies, surgeries, and
radiation therapy.
 Doctors can compare CT scans to find out if certain treatments are working. For example, scans
of a tumor over time can show whether it’s responding to chemotherapy or radiation.

CT imaging is: one of the best and fastest tools for studying the chest, abdomen and pelvis
because it provides detailed, cross-sectional views of all types of tissue. often the preferred
method for diagnosing many different cancers, including lung, liver and pancreatic cancer, since
the image allows a physician to confirm the presence of a tumor and measure its size, precise
location and the extent of the tumor's involvement with other nearby tissue. An examination that
plays a significant role in the detection, diagnosis and treatment of vascular diseases that can lead
to stroke, kidney failure or even death.

CT is commonly used to assess for pulmonary embolism (a blood clot in the lung vessels) as
well as for abdominal aortic aneurysms (AAA). invaluable in diagnosing and treating spinal
problems and injuries to the hands, feet and other skeletal structures because it can clearly show
even very small bones as well as surrounding tissues such as muscle and blood vessels. CT
imaging is more often used to evaluate: lymphoma neuroblastoma congenital malformations of
blood vessels the kidneys Physicians often use the CT examination to: quickly identify injuries to
the lungs, heart and vessels, liver, spleen, kidneys, bowel or other internal organs in cases of
trauma. Guide biopsies and other procedures such as abscess drainages and minimally invasive

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tumor treatments. Plan for and assess the results of surgery, such as organ transplants or gastric
bypass. Stage, plan and properly administer radiation treatments for tumors as well as monitor
response to chemotherapy.

2.3 Working principle of CT Machine

1.3: Group discussion

Arrange yourself in a group where each group can have a maximum of

five persons. Then within your group discuss the general working
principles of CT machine and CT generation.
Time: 15min

Unlike a conventional x-ray which uses a fixed x-ray tube a CT scanner uses a motorized x-ray
source that rotates around the circular opening of a donut-shaped structure called a gantry.
During a CT scan, the patient lies on a bed that slowly moves through the gantry while the x-ray
tube rotates around the patient, shooting narrow beams of x-rays through the body. Instead of
film, CT scanners use special digital x-ray detectors, which are located directly opposite the x-
ray source. As the x-rays leave the patient, they are picked up by the detectors and transmitted to
a computer.
Each time the x-ray source completes one full rotation, the CT computer uses sophisticated
mathematical techniques to construct a two-dimensional image slice of the patient. The thickness
of the tissue represented in each image slice can vary depending on the CT machine used, but
usually ranges from 1-10 millimeters. When a full slice is completed, the image is stored and the
motorized bed is moved forward incrementally into the gantry. The x-ray scanning process is
then repeated to produce another image slice. This process continues until the desired number of
slices is collected.
Image slices can either be displayed individually or stacked together by the computer to generate
a 3D image of the patient that shows the skeleton, organs, and tissues as well as any
abnormalities the physician is trying to identify. This method has many advantages including the
ability to rotate the 3D image in space or to view slices in succession, making it easier to find the
exact place where a problem may be located.
Fundamental Principles of X-ray Computed Tomography (CT)

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Tomographic imaging consists of directing X-rays at an object from multiple orientations and
measuring the decrease in intensity along a series of linear paths. This decrease is characterized
by Beer's Law, which describes intensity reduction as a function of X-ray energy, path length,
and material linear attenuation coefficient. A specialized algorithm is then used to reconstruct the
distribution of X-ray attenuation in the volume being imaged.

Beer's Law: The simplest form of Beer's Law for a monochromatic X-ray beam through a
homogeneous material is:

I =Io exp ⁡[−µx ]

Where I0 and I are the initial and final X-ray intensity, µ is the material's linear attenuation
coefficient (unit’s 1/length) and x is the length of the X-ray path. If there are multiple materials,
the equation becomes:

Where each increment i reflects a single material with attenuation coefficient µi with linear
extent xi. In a well-calibrated system using a monochromatic X-ray source (i.e. synchrotron or
gamma-ray emitter) this equation can be solved directly. If a polychromatic X-ray source is used,
to take into account the fact that the attenuation coefficient is a strong function of X-ray energy,
the complete solution would require solving the equation over the range of the X-ray energy ( E)
spectrum utilized:

However, such a calculation is usually problematic, as most reconstruction strategies solve for a
single µ value at each spatial position. In such cases, µ is taken as an effective linear attenuation
coefficient, rather than an absolute. This complicates absolute calibration, as effective attenuation
is a function of both the X-ray spectrum and the properties of the scan object. It also leads to
beam-hardening artifacts: changes in image gray levels caused by preferential attenuation of low-
energy X-rays.

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Linear attenuation coefficients: The dominant physical processes responsible for X-ray
attenuation for most laboratory X-ray sources are photoelectric absorption and Compton
scattering. Photoelectric absorption occurs when the total energy of an incoming X-ray photon is
transferred to an inner electron, causing the electron to be ejected. In Compton scattering, the
incoming photon interacts with an outer electron, ejecting the electron and losing only a part of
its own energy, after which it is deflected in a different direction.

CT reconstruction: There are a number of methods by which the X-ray attenuation data can be
converted into an image. The most frequent approach is called "filtered back projection," in
which the linear data acquired at each angular orientation are convolved with a specially
designed filter and then back projected across a pixel field at the same angle. Filtered back
projection is an analytic reconstruction algorithm designed to overcome the limitations of
conventional back projection; it applies a convolution filter to remove blurring. It was, up until
recently the primary method in cross-sectional imaging reconstruction.

CT data Acquisition Configuration

Here we are about to discuss most common configurations for CT scanners. In planar beam
scanning, X-rays are collimated and measured using a linear detector array. Typically, slice
thickness is determined by the aperture of the linear array. Collimation is necessary to reduce the
influence of X-ray scatter, which results in spurious additional X-rays reaching the detector from
locations not along the source-detector path. Linear arrays can generally be configured to be
more efficient than planar ones, but have the drawback that they only acquire data for one slice
image at a time.

In cone-beam scanning, the linear array is replaced by a planar detector, and the beam is no
longer collimated. Data for an entire object, or a considerable thickness of it, can be acquired in a
single rotation. The data are reconstructed into images using a cone-beam algorithm. In general,
cone-beam data are subject to some blurring and distortion the further one goes from the central
plane that would correspond to single-slice acquisition. They are also more subject to artifacts
stemming from scattering if high-energy X-rays are utilized. However, the advantage of

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 obtaining data for hundreds or thousands of slices at a time is considerable, as more acquisition
time can be spent at each turntable position, decreasing image noise.

Parallel-beam scanning is done using a specially configured synchrotron beam line as the X-ray
source. In this case, volumetric data are acquired and there is no distortion. However, the object
size is limited by the width of the X-ray beam; depending on beam line configuration, objects up
to 6 cm in diameter may be imaged. Synchrotron radiation generally has very high intensity,
allowing data to be acquired quickly, but the X-rays are generally low-energy (< 35 keV), which
can preclude imaging samples with extensive high-Z materials.

Other variants are multiple-slice acquisition, in which a planar detector is used but data are
processed with a fan-beam reconstruction algorithm, and spiral scanning, in which sample
elevation is changed during data acquisition, potentially reducing cone-beam artifacts.

Figure 1: CT data acquisition configuration

Generation of CT Scanner
A. First generation: Translate-Rotate

 The x-ray beam is picked-up by a single detector.

 The x-ray source and detector then move together (translate)
 The two then rotate together to image a different angle
 This is repeated until a single slice is scanned
 The two then move down the patient to start imaging a different slice
 This method took 5 minutes per slice to scan

B. Second Generation: Translate-Rotate

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 The x-ray beam is picked-up by a row of up to 30 detectors.
 The x-ray source and detector then move together (translate)
 The two then rotate together to image a different angle
 This is repeated until a single slice is scanned
 The two then move down the patient to start imaging a different slice in the patient
 This method took 5-90 seconds per slice

Figure 2: 1st and 2nd Generation CT Scanner

C. Third Generation: Rotate-Rotate

 The x-ray beam hits a row of detectors wide enough to image the whole slice
 The two then rotate together to image a different angle
 This is repeated until a single slice is scanned then the array is moved to a different slice (axial
scanning). Alternatively, the detector array is continually moved down the patient as it rotates
(spiral scanning).
 This is the most commonly used method today and takes about 0.3 seconds to image a single
slice

D. Fourth Generation: Rotate-fixed

 There is a fixed complete ring of detectors

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 The x-ray source rotates around to capture a slice
 Both then move down the patient to begin imaging a different slice
 This is not commonly used today.

Figure 3: 3rd and 4th Generation CT Scanner

E. Electron Beam Scanner: (Sometimes described as 5th generation CT)

 An electron beam is deflected by an electromagnetic field onto a fixed array of tungsten anode
target underneath the patient.
 The electromagnetic field sweeps the electron beam across the target creating hundreds of x-ray
beams firing through the patient to the detector above the patient.
 Fast scanning of 50-250 milliseconds.
 Mainly used for certain cardiac imaging.

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 Figure 4: Electron Beam Scanner

2.4 Basic Parts, Functions and Operating Procedure of X-ray machine

1.4: Group discussion

Arrange yourself in a group where each group can have a maximum of

five persons. Then within your group discuss the CT scanner parts and its
function
Time: 15min

System Overview

This system overview to explain how different components work together to produce CT images.
Figure shown below presents a generic block diagram of a CT system. The actual system
architecture for different commercial scanners may deviate from this diagram, but the general
functionalities of all CT scanners are more or less the same.

For a typical CT operation, an operator positions a patient on the CT table and prescribes a
scanogram or scout view. The purpose of this scan is to determine the patient’s anatomical
landmarks and the exact location and range of CT scans. In this scan mode, both the x-ray tube
and the detector remain stationary while the patient table travels at a constant speed. The scan is
similar to a conventional x ray taken either at an A-P position (with the tube located in the 6 or

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12 o’clock position) or a lateral position (with the tube located in the 3 or 9 o’clock position).
Once such a scan is initiated, an operational control computer instructs the gantry to rotate to the
desired orientation as prescribed by the operator. The computer then sends instructions to the
patient table, the x-ray generation system, the x-ray detection system, and the image generation
system to perform a scan. The table subsequently reaches the starting scan location and maintains
a constant speed during the entire scanning process. The high-voltage generator quickly reaches
the desired voltage and keeps both the voltage and the current to the x-ray tube at the prescribed
level during the scan. The x-ray tube produces x-ray flux, and the x-ray photons are detected by
an x-ray detector to produce electrical signals. At the same time, the data acquisition system
samples the detector outputs at a uniform sampling rate and converts analog signals to digital
signals. The sampled data are then sent to the image generation system for processing. Typically,
the system contains high-speed computers and digital signal processing (DSP) chips. The
acquired data are preprocessed and enhanced before being sent to the display device for operator
viewing and to the data storage device for archiving.

Figure 5: Block diagram of a CT system

Once the precise location and range are determined (based on the scanogram image), the
operator prescribes CT scans based either on preset sets of protocols or newly created protocols.

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These protocols determine the collimator aperture, detector aperture, x-ray tube voltage and
current, scan mode, table index speed, gantry speed, reconstruction FOV and kernel, and many
other parameters. With the selected scanning protocol, the operational control computer sends a
series of commands to the gantry, the x-ray generation system, the table, the x-ray detection
system, and the image generation systems in a manner similar to that outlined for the scanogram
operation. The major difference between the processes is that the CT gantry is no longer
stationary. It must reach and maintain a constant rotational speed during the entire operation.
Since a CT gantry typically weighs more than several hundred kilograms, it takes time for the
gantry to reach stability. Therefore, the gantry is usually one of the first components to respond
to the scan command. All of the other operating sequences are similar to the ones described for
the scanogram operation.

In many clinical applications, the operational sequence may differ from the one described above.
For example, in interventional procedures, the x-ray generation may be triggered by a foot
paddle rather than a computer. In contrast-enhanced CT scans, the injection of the contrast agent
must be synchronized with the scan, which may require the integration of a power injector with
the CT scan protocols. In other operations, the generated x-ray images are sent directly to filming
devices to produce hard copies or to a PACS (picture archiving and communication system) for
viewing. These deviations, however, should not impact our general understanding of the CT
operation mechanism.

Basic Parts and Its Functions

A computed tomography (CT) unit consists of a gantry, a patient table, hardware equipment, an
operator console and optionally additional workstations. The gantry is a doughnut - shaped ring
containing the X - ray tube, the detector array and associated equipment the x-ray tube generates
the x-ray and direct towards the subject. The x-ray tube is fitted on a circumference of a gantry
so that the image can be obtained in all 360 degrees. The person will be placed inside the gantry.
A set of x-ray detectors is placed exactly opposite to the X-ray tube.

The radiation dose for a particular study depends on many factors such as volume scanned,
number and type of scan sequences, the desired resolution of image and the image quality. The

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intensity of x-ray can be regulated by controlling the anode voltage and beam current. The
timing, anode voltage (in kV) and beam current (in mA) are controlled by a computer through a
control bus. The central hole in the gantry accommodates the patient on a sliding table. The X -
ray tube rotates around a slice of patient anatomy. This slice represents the X - Y plane, with the
X - axis being horizontal and the Y - axis vertical. The isocenter of the gantry is the central point
of this plane. The third dimension is represented by the Z - axis, which is along the orientation of
the patient table. The patient bed is a sliding tray on a fixed table with an adjustable height and a
defined capacity of forward motion. The x-ray detectors are placed in a ring-shaped apparatus
which rotate around the patient. The detectors sense the intensity of x-ray as a function of
absorption property of the internal structure of body. Detection should be done by scintillation
system based on photo detectors. Detection which utilizes 8,16 or 64 detectors during continuous
motion of patient through the radiation beam to obtain much clearer images with high resolution
and image quality.
The operator console is located in another room or behind radio protective screening, and allows
operation of the CT units. Additional workstations can be used to review processed image data,
but usually not raw data processing.

Figure 6: overall look of CT

CT scanners create images using a series of X-rays generated by a tube that is rapidly rotated
around the examined object. X-rays are a type of electromagnetic energy that have properties of
both particles and waves and a level of energy between ultraviolet rays and gamma-rays in the
electromagnetic spectrum. CT scanning hardware consists of the following units:

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1. Generator

The generator produces an electrical current that runs into the X-ray tube and through the
cathode wire filament. The current passes its electrons to the filament. The difference in electric
charge between the cathode filament and anode across the vacuum draws the electrons toward
the anode.
The generator provides the electrical power that is necessary to generate x-rays using two types
of electrical current. A high voltage (20-150 kilovolts) supply determines the maximum intensity
of the X-rays that can be produced. Increasing this voltage increases the electrical potential
difference between the anode and cathode. A low fixed voltage (about 10 kilovolts) supply to the
cathode filament enables continuous electron emission through a thermionic reaction.

2. The Gantry and Slip Ring

The gantry is the backbone of a CT system, so the amount of mechanical design effort placed on
the gantry cannot be taken lightly. The rotating side of the gantry typically contains the x-ray
tube, detector, high-voltage device, tube-cooling tank, slip ring, and other supporting devices, as
shown in figure below.
A scanning unit, also known as a gantry, is the structure that contains the X-ray tube, shielding
elements, and photon detectors. The X-ray tube and photon detectors are positioned to face each
other and are built to rotate 360 degrees in one direction around the patient. The gantry tilt is the
angle formed between the X-ray tube plane and the vertical plane; in many modern machines,
gantry tilt ranges between -25 degrees and +25 degrees. Gantry tilt can be changed by the CT
operator according to the exam objectives, such as to reduce image artifacts or improve a
healthcare provider's ability to conduct an invasive CT-guided procedure. The use of slip rings in
gantries allows continuous complete circular movements of the internal elements without the
internal circuits and cables becoming entangled. The gantry contains a space for the table and the
patient to pass through. CT was first available for head imaging only, but in 1976 a larger gantry
was developed allowing whole-body scans.

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 Figure 7: Gantry of an older vintage third-generation CT scanner
Another key component of the CT system is the slip ring. Its function is to supply power to the
rotating side of the gantry, transmit command signals both ways, and send the CT projection data
to the stationary side. A schematic diagram of a slip ring is shown in the figure below. Although
the slip ring was introduced to CT in the early 1980s to facilitate continuous gantry rotation, it
became the de facto standard only after the invention of the helical scan mode. The data signals
and the power to the x-ray tube both flow between the continuously rotating gantry and the
stationary CT components through the electrical, optical, or RF connections on the slip ring.
Although this task is seemingly simple, the slip ring design is a complicated technology. To
appreciate this complexity, consider the bandwidth of a typical data transmission. For a typical
multislice scanner (to be discussed in Chapter 10), there are roughly 1000 channels per detector
row, and each rotation contains nearly 1000 projections or views. To avoid excessive storage on
the rotating side of the scanner, the data transfer rate needs to be in sync with the data

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 Figure 8: Schematic diagram of a slip ring.
A. X-ray Tube

The X-ray tube converts moving electrons (i.e., electricity) into photons with the energetic
properties (the wavelength and amplitude) of X-rays. The X-ray tube is composed of a cathode
assembly, an anode assembly, and a rotor, all contained in a tube envelope and together forming
a structure called the tube insert. All gas atoms in the space inside the tube envelope have been
evacuated, forming a vacuum.[4] Modern CT scanner X-ray tubes usually are provided with 20-
60 kiloWatts of electrical power.
The X-ray tube cathode filament (often made of tungsten) expels the electrons that are delivered
to it through a process called thermionic emission. The current from the X-ray generator passing
through the filament boils off electrons.[5] The emitted electrons are accelerated by the potential
difference (i.e., the difference in charge) between the cathode and anode toward the anode (often
also made from tungsten). The higher the voltage applied to this process (often 80 to 140
kiloVolts), the more the source accelerates the electrons. When the electrons collide with the
focal spot in the anode, they generate electromagnetic radiation having the energy of X-rays via
two methods:
 Characteristic X-rays: These occur when an accelerated free-electron strikes the target atom’s
nucleus and ejects one of the atom’s inner shell electrons, which escapes the atom as a photon.[6]

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 Bremsstrahlung (braking) X-rays: These occur when an accelerated free electron passes
through the target atom and has its course deflected by the nearby subatomic particles causing it
to lose its kinetic energy. As a function of the first law of thermodynamics, energy is conserved,
and the kinetic energy lost by the free electron is gained by other nearby particles, such as an
outer shell electron in a cathode’s atom. The loosely bound outer shell electron can then also be
emitted as a photon that has the energetic properties (i.e., travels with the wavelength and
amplitude) of an X-ray.

The focal spot size can be altered according to the desired image resolution. In general, the
smaller the focal size, the higher the image resolution. The process described in X-ray generation
converts electric energy into 99% heat and only 1% photons. To absorb this large amount of heat,
the space between the tube envelope and the tube housing contains oil for equipment cooling and
insulation.

Figure 9: glass envelope x-ray tube

B. Detectors

The photon detector (also called a photovoltaic cell and more simply termed a detector) absorbs
and counts photons generated by the X-ray tube that passes through the patient. The detector
consists of two layers; the scintillator layer and the photon tide later. The scintillator layer
converts absorbed X-ray photons into visual light photons. The photon tide layer converts the
light photons into electrical signals.

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 First-generation CT scanners contained only 2 detectors, which allowed the generation of two
simultaneous views. In second-generation scanners, the number of stationary detectors was
increased to 30 detectors arranged in one row covering a 10-degree fan angle. The third
generation introduced many more (up to 900) stationary detectors arranged in multiple rows
(called multi-row detectors). Multi-row detectors allowed simultaneous scanning of multiple
tissue slices simultaneously, which reduced scan time, allowed greater resolution, and improved
efficiency in the use of X-ray tube power. Fourth-generation CT scanners contain up to 4500
stationary detectors arranged in a circle around the patient.

.
Figure 10: A solid-state 64-row detector.
C. X-Ray Shielding Elements

X-rays that do not travel in a straight path from the X-ray tube to the detector that is in line with
the beam but instead reach an off-path detector interfere with the machine’s ability to reconstruct
an accurate representation of what signal was derived from what original location. This
phenomenon, and other types of inaccuracies in image processing, result in image “noise,” which
reduces the contrast between imaged structures that is a critical element for maintaining image
quality and enabling interpretation of the anatomy and pathology.
As with other types of imaging equipment that use X-rays, CT machines contain collimators,
which are materials capable of absorbing the low-energy portion of the X-ray spectrum. These
materials both shield (i.e., reduce the overall X-ray exposure of) persons nearby at the time of the
scan and reduce scattered radiation, thereby reducing image noise. CT scanners include two
types of collimators, the source collimator (also called a diaphragm) and the detector collimator
(also called a grid). The diaphragm configures the X-rays produced by the X-ray tube into a

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 beam shape. Despite the formation of a highly focused beam, as the X-ray photons pass through
the patient, the patient’s atoms deflect the photons away from their original inline course and
scatter them in all directions. The grid absorbs many of the photons traveling off their intended
path before they strike offline detectors and can be submitted for image processing, where they
will interfere with the measurements obtained from the inline photon beams. The grid also
decreases the number of photons needed for image production, thereby indirectly lowering the
patient’s total radiation exposure.
3. Filter and Collimator

Filter is placed between the x-ray source and the patient (similar to that used in plain film
radiography). Removes low energy (soft) x-rays that do not contribute to image formation but do
increase patient dose. As the low energy x-rays are removed there is a narrower spectrum of x-
ray energies creating a more monochromatic beam. Image reconstruction is based upon the
assumption of a single energy monochromatic beam.
Collimator: The Collimator is placed between the filter and the patient, which are materials
capable of absorbing the low-energy portion of the X-ray spectrum.

Figure 11: Filter and Collimator

4. Patient Table

The patient's table moves through the gantry during the scan. The distance the table moves
during a complete rotation of the gantry is referred to as the table pitch or detector pitch. Table
pitch equals the forward table movement in millimeters (mm) during a complete gantry rotation
divided by beam collimation (the slice thickness in mm). Faster moving tables are described as

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 having greater pitches. Increased table speed reduces scanning time and radiation but also can
reduce image resolution if the circuitry of the machine cannot process the information as quickly
as the table moves.

Figure 12: patient Bed

5. Console

The workstation attached to the CT machine where you can see the display of the output from
scanner. The part of the x-ray imaging system most familiar to the radiologic technologist is the
operating console. The operating console allows the radiologic technologist to control the x-ray
tube current and voltage so that the useful x-ray beam is of proper quantity and quality.

Figure 13: console or workstation

SOP for a CT scan Machine Maintenance
Purpose: The purpose of this SOP is to provide guidelines for the maintenance of the CT scan
machine to ensure its optimal performance and reliability.

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Scope: This SOP applies to the CT scan machine located in the healthcare facility.

Regular Inspections:
 The biomedical engineer should perform regular inspections of the CT scan machine to
identify any signs of wear, damage, or malfunction.
 The engineer should check the integrity of cables, connectors, and other components.
 The engineer should ensure that all safety features, such as radiation shielding, are in
place and functioning properly.
Cleaning:
 The biomedical engineer should clean the CT scan machine regularly to remove dust,
debris, and other contaminants.
 The engineer should use appropriate cleaning agents and follow the manufacturer's
guidelines for cleaning.
 The engineer should pay special attention to sensitive areas, such as the gantry, detector,
and console.
Calibration:
 The biomedical engineer should perform regular calibration of the CT scan machine to
ensure accurate and consistent imaging results.
 The engineer should follow the manufacturer's guidelines for calibration procedures.
 The engineer should use appropriate calibration phantoms and tools to perform the
calibration accurately.
Quality Assurance Testing:
 The biomedical engineer should conduct regular quality assurance (QA) testing to ensure
that the CT scan machine is performing within acceptable parameters.
 The engineer should follow established QA protocols and guidelines.
 The engineer should record and analyze QA test results to identify any deviations or
trends.
Software Updates:
 The biomedical engineer should keep the CT scan machine's software up to date by
installing manufacturer-recommended updates and patches.
 The engineer should follow the manufacturer's guidelines for software updates.

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  The engineer should ensure that all necessary backup procedures are followed before
performing any software updates.

Preventive Maintenance:
 The biomedical engineer should perform preventive maintenance tasks as recommended
by the manufacturer.
 The engineer should follow the manufacturer's guidelines for preventive maintenance
activities, such as lubrication, belt tension adjustment, and filter replacement.
 The engineer should keep a maintenance log to record all preventive maintenance tasks
performed.
Documentation:
 The biomedical engineer should maintain documentation of all maintenance activities
performed on the CT scan machine.
 The documentation should include details of inspections, cleaning, calibration, QA
testing, software updates, preventive maintenance, and any other relevant information.
 The documentation should be updated in the equipment's maintenance and repair history.
Responsibilities:
 Biomedical engineers are responsible for following this SOP while performing
maintenance on the CT scan machine.
 Biomedical engineers are responsible for ensuring that all safety protocols are followed
during maintenance activities.
 Biomedical engineers are responsible for maintaining documentation of all maintenance
activities performed on the CT scan machine.
SOP for CT scan Installation
Purpose: The purpose of this SOP is to provide guidelines for the installation of the CT scan
machine by biomedical engineers.
Scope: This SOP applies to the CT scan machine installation in the healthcare facility.
Pre-Installation Planning:
 The biomedical engineer should review the manufacturer's installation guidelines and
ensure that all necessary resources and tools are available.

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  The engineer should coordinate with relevant departments, such as facilities management
and IT, to ensure a smooth installation process.
 The engineer should ensure that the installation area is prepared and meets the necessary
requirements for the equipment.
Safety Precautions:
 The biomedical engineer should follow all safety protocols and guidelines during the
installation process.
 The engineer should wear appropriate personal protective equipment (PPE) as required.
 The engineer should ensure that the installation area is safe and secure for both the
equipment and personnel involved.
Equipment Assembly:
 The biomedical engineer should assemble the CT scan machine according to the
manufacturer's instructions.
 The engineer should ensure that all components are properly connected and secured.
 The engineer should follow all safety protocols while assembling the equipment.
Electrical and Network Connections:
 The biomedical engineer should connect the CT scan machine to the electrical supply and
network infrastructure as required.
 The engineer should follow electrical safety guidelines and ensure that all connections are
properly grounded.
 The engineer should coordinate with IT personnel if network connectivity is required.
Calibration and Testing:
 After installation, the biomedical engineer should calibrate and test the CT scan machine
to ensure proper functioning.
 The engineer should follow the manufacturer's guidelines for calibration and testing
procedures.
 The engineer should record calibration and testing results for documentation purposes.
Training and Handover:
 The biomedical engineer should provide training to relevant staff members on the proper
use and maintenance of the installed CT scan machine.

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  The engineer should demonstrate key features, safety precautions, and troubleshooting
procedures.
 The engineer should hand over any relevant manuals, documentation, and contact
information for future reference.

Documentation:
 The biomedical engineer should maintain documentation of the installation process,
including pre-installation planning, assembly, connections, calibration, testing, training,
and handover details.
 The documentation should be updated in the equipment's maintenance and repair history.
Responsibilities:
 Biomedical engineers are responsible for following this SOP while installing the CT scan
machine.
 Biomedical engineers are responsible for ensuring that all safety protocols are followed
during equipment installation.
 Biomedical engineers are responsible for maintaining documentation of all installation
work performed on the CT scan machine.

2.5 Troubleshooting techniques and Maintenance procedure of CT Machine

1.5: Group discussion

Arrange yourself in a group where each group can have a maximum of

five persons. Then within your group discuss basic troubleshooting steps
and common maintenance scenarios in CT scanner.
Time: 15min

Trouble shooting is logical, systematic process that enables one to determine "what" happened,
"why" it happened and “where” it happened. It is a method to develop effective fixes for the
"why" it happened.

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2.5.1. Steps of troubleshooting
Plan and Preparation
Before you begin to troubleshoot any piece of equipment, you must be familiar with safety rules
and procedures for working on electrical equipment.
 Be Safe!
 Before you start troubleshooting and repairing any advanced medical imaging equipment,
you need to have a solid understanding of the basic principles, components, and functions
of each device.
 You should also be familiar with the main parts of each device, such as the scanner, the
gantry, the console, the power supply, the cooling system, and the image-processing unit.
 Turn off power, ground yourself, and use gloves when appropriate
 Next, gather information regarding the equipment and the problem.
 Be sure you understand how the equipment is designed to operate it.
 Operation or equipment (Service) manuals and Electrical drawings are great sources of
information and are helpful.
 If there are equipment history records, you should review them to see if there are any
reoccurring problems
 Receive the maintenance request for intervention
 Gather as much information as possible from the user and the machine itself (this may
cover error code and visual inspection for damage.
 Prepare the necessary tools/ kits
Step 1: Observation
Observe and identify what happened most faults provide obvious clues as to their cause. Through
careful observation and a little bit of reasoning, most faults can be identified as to the actual
component with very little testing. When observing malfunctioning, look for visual signs of
mechanical damage such as indications of impact, chafed wires, loose components or parts lying
in the bottom of the cabinet and look for signs of overheating, especially on wiring, relay coils,
and printed circuit boards. The smell for burnt insulation and listening to the sound of the
equipment operating may give you a clue to where the problem is located. Checking the

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temperature of components can also help find problems, but be careful while doing this, some
components may be alive or hot enough to burn you. Pay particular attention to areas that were
identified either by past history or by the person that reported the problem.
Step 2: Define Problem Area
At this stage you apply logic and reasoning to your observations to determine the problem area
of the malfunctioning. For instance, use the documentation technique, communication technique,
or the feedback to record, report and evaluate you are troubleshooting and repair process. This is
due to that when equipment malfunctions, certain parts of the equipment will work properly
while others not and the key is to use your observations to rule out parts of the equipment or
circuitry that are operating properly and not contributing to the cause of the malfunction.
Therefore you should continue to do this until you are left with the target part(s). Also to help
you define the problem area you should have a schematic diagram of the circuit, in addition to
your noted observations.
Starting with the whole circuit as the problem area, take each noted observation and ask yourself,
"What does this tell me about the circuit operation?" If an observation indicates that a section of
the circuit appears to be operating properly, you can then eliminate it from the problem area. As
you eliminate each part of the circuit from the problem area, make sure to identify them on your
schematic. This will help you keep track of all your information.

Step 3: Identify Possible Causes

Once the problem area(s) have been defined, it is necessary to identify all the possible causes of
the malfunction. This typically involves every component in the problem area(s). It is necessary
to list (write down) every fault which could cause the problem no matter how remote the
possibility of it occurring. Use your initial observations to help you do this. During the next step
you will eliminate those which are not likely to happen.
Step 4: Determine Most Probable Cause
Once the list of possible causes has been made, it is then necessary to prioritize each item as to
the probability of it being the cause of the malfunction. Although, it may seem to be possible for
two components to fail at the same time, it is not very likely.
The following list shows the order in which you should check components based on the
probability of being defective:-

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1. Components that burn out or have a tendency to wear out: i.e. mechanical switches, bearing,
fuses, relay contacts, and light bulbs. (Remember, every component have a reason for being
malfunction.)
2. Coils, transformers, and other devices with windings: These usually generate heat and with
time, can malfunction.
3. Connections: especially screw or bolted type. Over time these can loosen and cause a high
resistance. In some cases this resistance will cause overheating and eventually will burn open.
4. Defective wiring: Pay particular attention to areas where the wire insulation could be damaged
causing short circuits.
5. Checking the mechanical movements (gantry and couch)
6. Checking/Cleaning the slip ring, brushes, fans and Dust cleaning
7. Checking the error log and software
Checking Application software.
Checking CT Gantry.
8. Observing the system under operation (LEDs, batteries, messages, etc.)
9. X-ray tube filament current adjustment
10. Calibration
11. Image quality check
Checking the Network
12. Checking the site conditions (temperature, humidity, power supply, UPS)
Step 5: Test and Repair
Once you have determined the most probable cause, you must either prove it to be the problem
or rule it out by inspection/observation or by using test instruments. These help you to narrow
the problem area and identify the problem. Important Rule: when taking meter readings, predict
what the meter will read before taking the reading. If you are taking the reading of high voltage
output use an oscilloscope. Use the circuit schematic to determine what the meter/ oscilloscope
will read if the circuit is operating normally. If the reading is anything other than your predicted
value, you know that this part of the circuit is being affected by the fault. Depending on the
circuit and type of fault, the problem area as defined by your observations, can include a large
area of the circuit. It creates a very large list of possible and probable causes.

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Use a “divide and eliminate” approach to eliminate parts of the circuit from the problem area.
The results of each test provide information to help you reduce the size of the problem area, until
the defective component is identified. Once you have determined the cause of the faulty
operation of the circuit, replace the defective component. After replacing the component, you
must test operate all features of the circuit, to be sure, you have replaced the proper component
and that there are no other faults in the circuit.
Step 6: Follow-up
After the completion of maintenance work, do not forget to do the necessary follow up to check
whether the machine works properly.
2.5.2 Tools used to troubleshoot CT scan machines
 Digital voltmeter (DVM)
 Biomedical Repair Toolkit, Type 1
 Oscilloscope
 IC Tester
 Temperature and Hygrometer Recorder
 Noise Level meter
 Light Intensity Meter
 Automatic Electrical safety Analyzer
 Screwdriver Set (Different size and type Philips (+),flat( -), Hex (*), Allen type, ...)
 Wire nipple
 Pliers
 Soldering iron, Soldering lead, solder paste and de-soldering tool/sucker
 Wrench set (Open, Adjustable, Open/Closed, Closed, …)
 Tweezers
 Hammer
 Wire (As jumpers)
 Cutter/ Knife
 Insulation tape (Preferably differ size and color)
 Screws, nuts, washers(different size)
 Paper file (of different grade)
 Dosimeter

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  Perpendicularity measuring tools
 Phantoms
 Torque wrench (25-130 Nm)
 Protective conductor meter
 Leakage current measurement adapter
 Vacuum cleaner
 Soft cloth or lint-free towel
 Cleaning agent
 Air filter
 Self-adhesive copper foil
The following are some common areas where trouble could happen to CT scan machines.
Common failure of CT scan machine and their troubleshooting mechanism.
Fundamental structural chracterrsiics of CT scanner. It determine the basic direction for troubleshooting
of malfunction.
Basic Hardware part of CT scanner divided in to four.
1 X-ray detector gantry
2）Computerized console
3）Patient table for positioning
4）Structurally and functionally, CT scanners consist of the following components:
The part responsible for controlling computer scanning and image reconstruction
The mechanical part for patient positioning and scanning, which includes the scanning gantry
and the bed
High-voltage X-ray generator and X-ray tube for producing X-rays
Data acquisition and detection component for extracting information and data

 Power supply to the x-ray machine/room

 X-ray generator (power supply unit)
 Mechanical damage
 Calibration Issues
 Tube, tube stand/ support
 Control console
 Software problems

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  Table
 Cloudy filters and sensors
 UPS and AC Problems

1. Troubleshooting the power supply of CT scan machine

A three-phase power supply to the x-ray machine is usually an easily accessible to identify an
electrical problem. It enters the x-ray generator via electrical components such as Breakers. The
common problem is either power outage or phase missing that happen to power supply of the CT
scan room.
Using DVM measure the voltage between L1 & L2, L1 & L3 and/or L2 & L3 at the entry and
exit points to identify if there is power outage/ phase missing. To locate which phase exactly is
missing measure each phase against the neutral wire (i.e. L1 & N, L2 & N, L3& N). The cause of
power failure may be due to faulty leaking components such as fuses, breakers or contactor.
It is also advisable to measure voltage between the neutral wire and the earth. If there is an
unbalance in the power usage, the neutral wire carries some voltage higher than the acceptable
value and this may cause problem.

Figure 14: 3 phase

2. Troubleshooting the power within the HV generator

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 Power entering the x-ray system (more specifically the high voltage generator) is used to produce
high voltage DC that is used to produce radiation at the x-ray tube. The three-phase power
entering the high voltage generator passes through different components such as AC/DC
converter (low voltage side), High frequency generator (Inverter or DC/AC converter),
transformer, AC/DC converter (rectifier).

Mains
50Hz Rectifier/
Filter
HV
Doubler/ DC
Inverter
Multiplier Supply

Battery
optional
DC to high HV Rectifier/Filter
Frequency Transformer
AC converter
Figure 15: generic block diagram of power supply
3. Calibration Issues
You want to make sure your CT scanner is working properly and providing accurate scan results.
That’s why it’s important to make sure your CT scanner is calibrated correctly. To find out if the
calibration is correct, you’ll want to scan an object with a phantom with known radio density.
This provides important information to determine whether the measurements show the proper
number of Hounsfield Units or HUs. You can do this automatically or manually, depending upon
which calibration tool was included when you purchased your CT scanner. If you don’t have a
calibration tool, you’ll have to buy one separately.
4. X-Ray Tube Failure
When an X-ray tube malfunctions or fails, you end up with poor image quality or no images at
all. Factors that can contribute to tube failure include age, wear and tear and improper
maintenance. Usually there’s an issue in the vacuum seal within the tube or the tube has been
damaged. If you are experiencing a tube failure, it’s important to turn off the X-ray beam quickly
in order to ensure the safety of the healthcare providers and patient. You will need to contact an
engineer and reschedule the patient’s appointment.
X-ray CT machine production control relies on several components including high-frequency
inverters, high-voltage transformers, X-ray tubes, control circuits, and high-voltage cables.

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 Common faults include:

X-ray tube failures: These include rotating anode failure, manifested by loud rotating noise, and
serious cases where switching becomes impossible or the anode is stuck, resulting in overcurrent
when exposed. Filament failures can cause no radiation. Glass core leakage leads to rupture or
leakage, preventing exposure and causing vacuum drop and high-voltage ignition.

High-voltage generation failures: Faults in the inverter circuit, breakdowns, short-circuits in the
high-voltage transformer, and ignition or breakdown of high-voltage capacitors often cause the
corresponding fuse to blow. Exposure becomes impossible or is automatically interrupted due to
protection.

High-voltage cable faults: Common issues include loose connectors causing ignition,
overvoltage, or high voltage. In early CT machines, prolonged use can lead to wear and tear on
high-voltage ignition cables, resulting in internal short-circuits. These failures usually correspond
to a blown fuse.
Mechanical Damage

As equipment ages, mechanical failures increase every year. In the early days of CT, a reverse rotation
mode was used in the scan cycle, with a very short rotation speed that switched from uniform to slow and
stopped repeatedly. This led to a higher rate of mechanical failure. Issues such as unstable speed,
uncontrollable spinning, braking problems, and belt tension issues were common. Additionally, cable
wear and fractures occurred

5. Cloudy filters and sensors

Your machine can be affected by ambient humidity and temperature because water vapor can
condense on the lenses and sensors of your CT scanner. To avoid these kinds of issues keep your
machine at 72° F or 22° C. If you happen to live in a very dry climate, make sure your imaging
machine is located out of direct sunlight. Other culprits that can make your machine malfunction
can be dust particles and other contaminants inside the air filter system. Be sure to change out the
CT scanner’s filters every three months and clean them with compressed air and soap-based
cleaners on a regular basis. It’s important not to clean filters with alcohol. It’s also wise to use
HEPA filters for all rooms that are adjacent to the room used for scanning. These HEPA filters
can capture dust particles before they are exposed to the sensitive components in a CT scanner.
6. Troubleshooting the Control console

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 The common problem with the control console is the wear of frequently used soft keys,
especially preparation and exposure is done using the control console. The solution is to replace
the damaged soft key pad. Together with the control console there is a remote switch (dual type-
prep and exposure) used. This dual switch is used to prepare the exposure process (first stage
switch) and expose.
Check Power Supply: Make sure the control console is properly connected to the power
supply. Check the power switch and circuit breaker to ensure that they are on. If there is no
power, check the power cord for any damage or loose connections.
Check Communication: Make sure that the control console is properly communicating with the
scanner. Check the network connection and cables for any damage or loose connections. Restart
the control console and scanner to reset the communication.
Check Display: If the display is blank or distorted, check the connection between the control
console and display monitor. Check the display settings and adjust as necessary. If the display is
still not functioning properly, try connecting a different monitor to the control console.
Check Software: If there are issues with the software, restart the control console and scanner to
reset the software. Check for any error messages or alerts on the control console. Contact
technical support if the issue persists.
Check Peripherals: If there are issues with peripherals, such as the keyboard or mouse, check
the connection and replace if necessary. Restart the control console and scanner to reset the
peripherals. Contact technical support if the issue persists.
Check User Profiles: If there are issues with user profiles, make sure that they are properly
configured and logged in. Check user permissions and access rights, Contact technical support if
the issue persists and Contact Technical Support:
If none of the above troubleshooting steps resolve the issue, contact technical support for further
assistance Provide details of the issue, error messages, and any relevant information to help
diagnose and resolve the issue.
7. Troubleshooting steps for CT scan software problems:

Check System Requirements: Make sure that the computer or workstation meets the minimum
system requirements for the CT scan software. Check the operating system, RAM, processor, and
graphics card requirements. Upgrade the system if necessary.

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 Check Software Updates: Make sure that the CT scan software is up to date with the latest
updates and patches. Check the manufacturer's website for any available updates. Install the
updates and patches as necessary.
Check Network Connection: Make sure that the computer or workstation is properly connected
to the network. Check the network settings and firewall settings to ensure that they are not
blocking the CT scan software. Restart the network and computer to reset the connection.
Check Hardware Connections: Make sure that all hardware components, such as the scanner
and control console, are properly connected and configured. Check the cables, connectors, and
ports for any damage or loose connections. Restart the scanner and control console to reset the
connection.
Check Error Messages: If there are any error messages or alerts, check the manufacturer's
documentation or support website for troubleshooting steps. Follow the recommended steps to
resolve the issue.
Check User Profiles: If there are issues with user profiles, make sure that they are properly
configured and logged in. Check user permissions and access rights. Contact technical support if
the issue persists.
Reinstall Software: If none of the above troubleshooting steps resolves the issue, try reinstalling
the CT scan software. Uninstall the software and reinstall it using the manufacturer's installation
instructions. Contact technical support if the issue persists.
Contact Technical Support: If none of the above troubleshooting steps resolve the issue,
contact technical support for further assistance. Provide details of the issue, error messages, and
any relevant information to help diagnose and resolve the issue.

8. Troubleshooting steps for CT scan patient table issues:

Check Power Supply: Ensure that the patient table is properly connected to the power supply.
Check the power switch and circuit breaker to ensure they are turned on. If there is no power,
check the power cord for any damage or loose connections.
Check Control Panel: Verify that the control panel for the patient table is functioning properly.
Check for any error messages or indicators on the control panel. Restart the control panel to reset
any potential software glitches.

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Check Movement and Positioning: If the patient table is not moving or positioning correctly,
check for any obstructions or obstacles that may be impeding its movement. Ensure that the
table's motor and mechanical components are in good working condition. Lubricate the moving
parts as per the manufacturer's guidelines.
Check Safety Features: Ensure that all safety features of the patient table are operational.
Check for proper functioning of safety locks, brakes, and emergency stop buttons. If any safety
features are not working correctly, discontinue use and contact technical support.
Check Communication: Verify that the patient table is properly communicating with the CT
scan machine and control console. Check the network connection and cables for any damage or
loose connections. Restart the CT scan machine and control console to reset the communication.
Contact Technical Support: If none of the above troubleshooting steps resolve the issue,
contact technical support or the manufacturer for further assistance. Provide details of the issue,
any error messages, and any relevant information to help diagnose and resolve the problem.

Remember, it is crucial to prioritize patient safety at all times. If there are any concerns about the
patient table's functionality or safety, it is advisable to refrain from using it until a qualified
technician resolves the issue.

CT Scanner Maintenance Check list

1 General Check: Performing regular general checks on your CT scanner is crucial to maintain its
optimal performance and reliability. These checks ensure that the CT scanner room and equipment are in
good condition, minimizing the risk of operational disruptions and ensuring the safety of patients and
staff.
2 Visual Inspection: A thorough visual inspection of the CT scanner room and equipment is the first step
in maintenance. Inspect for any signs of damage, leaks or abnormalities that could affect the CT scanner's
operation. Keeping the room clean and free of debris is essential to prevent any interference during scans.
3 Emergency Equipment: Verify the accessibility and condition of emergency equipment
such as fire extinguishers and first aid kits.

4 Environmental factor: Maintain optimal conditions in the CT scanner room by monitoring

temperature and humidity levels. Proper ventilation and air quality are essential for the CT
scanner's performance and the comfort of patients undergoing scans.

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5 System check: Performing thorough system checks is essential to ensure the CT scanner operates at
peak performance levels, delivering accurate and reliable imaging results. These checks encompass
various critical components that contribute to the overall functionality and safety of the CT scanner.

6 Cooling system: Inspect the cooling systems, such as chillers, to ensure they are operating within
optimal temperature ranges. Proper cooling is essential for preventing overheating and maintaining
the longevity of CT scanner components. Monitor coolant levels regularly and check for any signs of
leaks that could affect performance.

7 X ray Tube and Generator: The X-ray tube is a vital component of the CT scanner responsible for
producing the necessary radiation for imaging. Regularly check the X-ray tube's condition, including
the filament and cooling mechanisms, to ensure optimal functionality and safety. Verify the
performance of the generator and its associated safety interlocks to prevent potential hazards during
scans.

8 Gantry and Table: Ensure the gantry components are operating smoothly and are properly aligned.
The gantry plays a critical role in positioning and rotating around the patient during scans,
necessitating optimal functionality for accurate imaging. Verify the functionality of the patient table
movements and locks to facilitate precise patient positioning and safety.

9 Detector system: Inspect the detector panels for any damage or defects that could affect image
quality. Perform calibration checks as per manufacturer guidelines to maintain accuracy and
consistency in imaging. Regular maintenance of detector systems ensures reliable diagnostic results
and enhances patient care.

10 Patient Handling system: Ensure the proper functioning of patient positioning devices to facilitate
accurate scan alignment and patient comfort. Verify the operation of patient monitoring systems, such
as ECG and pulse oximetry, to monitor patient vital signs during scans effectively.

11 Software and Imaging Checks: Conducting regular software and imaging checks is crucial for
maintaining the CT scanner's functionality and ensuring high-quality diagnostic imaging. These
checks encompass various aspects of software updates, imaging protocols, and quality assurance
measures essential for optimal CT scanner performance.

12 System software: Verify that the CT scanner software is up-to-date with the latest patches and
updates. Updated software not only enhances performance but also addresses security vulnerabilities,
ensuring safe operation and data integrity. Regular updates to the software help healthcare facilities
comply with regulatory requirements and manufacturer recommendations.

13 Imaging Protocol: Check the functionality of imaging protocols to ensure they align with specific
diagnostic needs and patient conditions. Customizable imaging protocols enhance workflow
efficiency and imaging accuracy, providing healthcare professionals with the flexibility to adjust
settings as needed for different scan types.

14 Quality Assurance: Perform daily QA tests to evaluate the CT scanner's performance and imaging
quality. These tests include image quality checks and dose measurements to verify compliance with

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 established standards and ensure consistent diagnostic accuracy. Documenting QA results helps track
performance trends over time and address any deviations promptly.

15 Safety Protocol: Verify the functionality of safety systems such as dose monitoring and emergency
interlocks to prevent potential hazards during CT scans. Ensuring these protocols are in place and
operational mitigates risks associated with radiation exposure and other safety concerns.

16 Documentation: Proper documentation not only ensures regulatory compliance but also facilitates
efficient troubleshooting and future maintenance planning for CT scanners.

17 Manufacturer Guideline: Adhering to manufacturer guidelines is crucial for maximizing the

lifespan and efficiency of CT scanners. These guidelines provide specific instructions on maintenance
intervals, recommended parts replacement, and calibration procedures tailored to each CT scanner
model

Troubleshooting chart for CT machine

Safety Inspection & System Checks

Tab. 1: Maintenance Interval & Time

Maintenance
Maintenance type: Estimated total time:
interval:
Safety Inspection & Every 12 months approx. 2 hours
System Checks (Without options)

Tab. 2: Safety Inspection steps & System Checks

Estimated
Component: Maintenance step / Activity: Type:
time:
System Switching ON the System — 2 min.
System Evaluating the System Status PM 5 min.
PHS Lifting the table top to the upper position — 1 min.
Gantry Checking the Tilt Function PM 2 min.
System Visual Inspections: SI 10 min.

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 Checking the Component Housings
Checking the Cables & Connectors
Checking the Accessories
Checking the Phantoms & Holder
Checking the Warning Labels
Monitor Ceiling System Visual Inspection: SI (5 min.)
Or Monitor Cart Checking the Component Housings
(option) Checking the Cables & Connectors
Monitor Ceiling System Functional Checks: PM (2 min.)
(option) Horizontal/vertical movement
Mechanical end stops
Load balance of the support arm
Gantry Checking/replacing the Air Filters PM 4 min.
Gantry Removing the Right Stand Cover — 2 min.
Gantry Checking the Surge Protector Device in the SI 1 min.
PDS
Gantry Cleaning the ICS/IRS Air Inlets PM 5 min.
Gantry Cleaning the UPS Air Inlet & UPS PM 5 min.
Compartment
Gantry Checking the UPS Battery Condition PM 2 min.
Mobile-CT Switching OFF the Gantry rot. and PHS
(option) power
— (2 min.)
Disconnecting the USB-Haloriel cable at the
ICS (X31)
Removing the Gantry & PHS covers — (20 min.)
Inspection and Checks at Gantry & PHS:
Visual inspection for damage SI (60 min.)
Checking the attachment screws
Reinstalling the Gantry & PHS covers — (20 min.)

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 Switching OFF the Service Switch S4 at the
PDS-Control
— (2 min.)
Reconnecting the USB-Haloriel cable at the
ICS (X31)
System Switching OFF the System — 1 min.
Gantry Testing the PDS Protection Function SI 10 min.
RCMA test (Residual Current Monitor)
F12 circuit breaker (RCCB)
F2 circuit breaker (isolation transformer)
LCB Testing the LCB Protection Function SI (5 min.)
(option) RCMA test (Residual Current Monitor)
System Switching ON the System — 2 min.
System Measuring the Protective Conductor SI 10 min.
Resistance
PHS / PMM Measuring the Leakage Current SI 10 min.
Gantry Reinstalling the Right Stand Cover — 2 min.
System Functional Tests: SI 10 min.
Emergency STOP Circuit
Radiation Monitor (110%)
Radiation Indicators
Door Switch
Patient Positioning Accessories
System Quality Assurance Test PM 25 min.
System Cleaning the System PM 5 min.
System Maintenance documentation (protocol) — 5 min.

Full system maintenance

Tab. 3: Maintenance Interval & Time

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 Estimated
Maintenance type: Maintenance interval:
total time:
Full System approx. 4
Maintenance hours
Every 36 months
(Including Safety (Without
Inspection) options)
Tab. 4: Maintenance Steps
Estimated
Component: Maintenance step / Activity: Type:
time:
System Switching ON the system — 2 min.
System Evaluating the System Status PM 5 min.
PHS Lifting the table top to the upper position — 1 min.

Gantry Checking the Tilt Function PM 2 min.

Gantry /
Wireless RMC Replacing the Rechargeable Batteries PM (3 min.)
(option)

Visual Inspections:
 Checking the Component Housings
 Checking the Cables & Connectors
System SI 10 min.
 Checking the Accessories
 Checking the Phantoms & Holder
 Checking the Warning Labels

Monitor Ceiling Visual Inspection:

System / Monitor Cart  Checking the Component Housings SI (5 min.)
(option)  Checking the Cables & Connectors

Monitor Ceiling Functional checks:

System  Horizontal/vertical movement PM (2 min.)
(option)  Mechanical end stops

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  Load balance of the support arm
Gantry Checking/replacing the Air Filters PM 4 min.
Gantry Removing the Right Stand Cover — 2 min.
Switching OFF the Gantry rot. and PHS
Gantry power (Service switch S4 at the PDS- — 1 min.
Control)
Disconnecting the USB-Haloriel cable at
Gantry — 1 min.
the ICS (X31)
Gantry Removing the front and rear covers — 10 min.
Checking the Surge Protector Device in the
Gantry SI 1 min.
PDS
Gantry Cleaning the ICS/IRS Air Inlet PM 5 min.
Cleaning the UPS Air Inlet and UPS
Gantry PM 5 min.
Compartment
Gantry Checking the UPS Battery Condition PM 2 min.
Checking the Belt Tension of the Rotation
Gantry PM 5 min.
Drive
Gantry Replacing the Brush Block PM 20 min.
Gantry Lubricating the Main Bearing PM 10 min.
Replacing the Battery on the
Gantry PM 5 min.
Environmental Monitoring board
Gantry Checking the Cooling Fans PM 1 min.
Gantry: Removing the Gantry left stand
— (2 min.)
cover
Gantry: Visual Inspection and Checks
Mobile-CT
 Visual Inspection for damage SI (50 min.)
(option)
 Checking the attachment screws
Gantry: Reinstalling the Gantry left stand
— (2 min.)
cover

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 PHS Removing the Covers — 10 min.
Lubricating the Patient Table:
PHS  Tabletop guide carriages PM 15 min.
 Vertical drive
PHS: Visual Inspection and Checks
Mobile-CT
 Visual Inspection for damage SI (10 min.)
(option)
 Checking the attachment screws
Switching OFF the Service switch S4 at
Gantry — 1 min.
the PDS-Control
System Switching OFF the System — 2 min.
Testing the PDS Protection Function
 RCMA Test (Residual Current Monitor)
Gantry  F12 circuit breaker test (RCCB) SI 3 min.
 F2 circuit breaker test (isolation
transformer)
LCB Testing the LCB Protection Function
SI 3 min.
(option)  RCMA test (Residual Current Monitor)
Reinstalling the front/rear Covers &
Gantry — 10 min.
Funnel
Reconnecting the USB-Haloriel cable at
Gantry — 1 min.
the ICS (X31)
System Switching ON the System — 2 min.
PHS Reinstalling the Covers — 10 min.
Measuring the Protective Conductor
System SI 10 min.
Resistance
PHS / PMM Measuring the Leakage Current SI 10 min.
Gantry Reinstalling the right stand Cover — 2 min.

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 Functional Tests:
 Emergency STOP Circuit
 Radiation Monitor (110%)
System SI 10 min.
 Radiation Indicators
 Door Switch
 Patient Positioning Accessories
System Quality Assurance Test PM 25 min.
System Cleaning the System PM 5 min.
System Maintenance documentation (protocol) — 5 min.

2.5.3 CT scan Machine Maintenance Procedure

2.5.3.1 Corrective maintenance
 Arrange maintenance work place
 Identify power outlet
 Insert glove on your hand
 Perform unplug power
 Unplug the transducer probe
 Identify the machine cover design for easily open the machine
 Locate the unscrew
 Use the right screw driver to unscrew
 Put on the nut into nut holder accordingly
 Remove cover carefully
 Put cover in right place
 Disassembling control console
 Identify and inspect each nut position
 Identify cable labeling and wire color
 Perform take picture if possible
 Perform your labeling using pencil or any color
 Remove/unplug cable data bus
 remove/unscrew the nut or remove pin lock

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  Remove carefully the board
 Put board in right place

Disassembling x-ray generator (Gantry)

 Identify and inspect generator cover design
 Identify key position and nuts
 Locate nut or pin lock
 Use the right screw driver to unscrew the nuts
 Put on the nut into nut holder accordingly
 Identify cable labeling and wire color
 Perform take picture if possible
 Be Carefully high voltage shock
 Perform your labeling using pencil or any color

Disassembling Table /couch

 Identify and inspect the table locking mechanism
 Locate the unscrew nut or pin lock or locking mechanism
 Use the right screw driver to unscrew the nuts
 Put on the nut into nut holder accordingly
 Remove table and table box cover
 Put table/couch in right place

Poor image quality

 Check software
 Check by increasing and decreasing KV, ma and ma
 Check detector or Film
 Check grid, voltage and other parameters
 Check settings

Software
 Check software compatibility
 Check software a n d the updated software if necessary
 Check the space of hard disk

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  Check memory

2.5.3.2 Preventive Maintenance of CT scan Machine

A CT scan Room PM occurs at least once (or twice) a year. A full CT room PM will take several
hours to two days to complete. Get the preventive maintenance instructions from the service
manual.

It should include activates on all the main system components as well as on Automatic Exposure
Control and on Image Quality. These may cover activities such as removing vacuum dust and
dirt out of equipment, check all wiring and connections, check all mechanical (table, tube stand)
movements, check alignment of tube to receptors, Check all lamps and indicators, check if
various modes of operations are functional, Check level of oil in the tubes, lubricate moving
mechanical parts as per manufacturer recommendation, Check Image Quality, Clean the floor
and every equipment surface to avoid wear and rusting of the components.

Preventive maintenance steps for CT scan:

Regular Cleaning:
Regularly clean the CT scan machine and all its components, including the gantry, table, and
control console.
Use manufacturer-recommended cleaning solutions and follow the instructions for use.
Clean the equipment after each use to prevent the buildup of dust and debris.
Calibration and Testing:
Regularly calibrate and test the CT scan machine to ensure that it is functioning correctly.
Follow the manufacturer's guidelines for calibration and testing procedures.
Record calibration and testing results for documentation purposes.
Inspection of Components:
Regularly inspect all components of the CT scan machine, including the gantry, table, control
console, and peripherals.
Check for any signs of wear and tear, damage, or malfunction.
Replace any damaged or faulty components as soon as possible.
Software Updates:

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Regularly update the CT scan software to ensure that it is up to date with the latest updates and
patches.
Check the manufacturer's website for any available updates.
Install the updates and patches as necessary.
Preventive Maintenance Schedule:
Create a preventive maintenance schedule for the CT scan machine and follow it consistently.
Include regular cleaning, calibration, testing, and inspection of components in the schedule.
Document all preventive maintenance activities for future reference.
Staff Training:
Train all staff members who operate or maintain the CT scan machine on proper usage and
maintenance procedures.
Provide information on safety protocols, cleaning procedures, calibration and testing procedures,
and troubleshooting steps.
Ensure that all staff members are aware of their roles and responsibilities in maintaining the
equipment.
Technical Support:
Establish a relationship with technical support or the manufacturer to ensure that you have access
to technical assistance if needed.
Contact technical support if there are any issues with the CT scan machine that cannot be
resolved internally.
Follow up on any recommended repairs or maintenance activities recommended by technical
support.
Remember, preventive maintenance is essential to ensure that the CT scan machine is
functioning correctly and providing accurate results. By following these steps, you can help
prolong the life of the equipment and minimize downtime due to repairs or malfunctions.
Safety and precaution during maintenance
 During a maintenance procedure one may face different types of safety issues such as
fire, electric, mechanical and radiation to name but a few. During investigating a possible
electrical problem
 Always ensure power is turned off and unplugged from the power point.

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  If the equipment is part of a fixed installation, besides switching the generator power off,
ensure the isolation power switch for the room is also switched off.
 With battery operated mobiles, ensure the battery isolation switch is in the off position.
 Discharge using appropriate tools the energy holding components such as Capacitors
 Before you begin to troubleshoot any piece of equipment, you must be familiar with
safety rules, as per manufacture guide on the manual and procedures for working on
electrical equipment. Apply a safety rule:
 Perform Turn off power always and the equipment unplug it before you begin to work
 If you have to run tests while the equipment is operation, perform turn the equipment on,
make your test carefully and then turn the equipment off again.
 Use Wear apron, eye goggle, glove and bottom shoes or sneakers
 Try to do the work with one hand while keeping the other in your pocket .that keeps the
possible current path away from the heart
 Don‘t attempt repair work when you are tired or rushed hot
 Use only plastics screwdriver for shock protection during service operation
 Place ground yourself
 use glove and apron when appropriate read pre caution and safety from equipment
manual

2.6 Performance and Verification Testing

1.6: Group discussion

Arrange yourself in a group where each group can have a maximum of

five persons. Then within your group discuss the common testing
techniques in CT scanner.
Time: 10min

Daily Quality Control Tests:

Perform daily quality control tests to ensure that the CT scan machine is functioning correctly.
Check the uniformity of the CT numbers and the noise level of the images.

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Record the results of the tests for documentation purposes.
Weekly Quality Control Tests:
Perform weekly quality control tests to ensure that the CT scan machine is functioning correctly.
Check the slice thickness, spatial resolution, and low contrast detectability of the images.
Record the results of the tests for documentation purposes.
Calibration of CT Numbers:
Calibrate the CT numbers to ensure that they are accurate and consistent.
Use a phantom with known CT numbers to calibrate the machine.
Follow the manufacturer's guidelines for calibration procedures.
Calibration of Dose:
Calibrate the dose to ensure that it is accurate and consistent.
Use a phantom with known dose levels to calibrate the machine.
Follow the manufacturer's guidelines for calibration procedures.
Calibration of Laser Positioning:
Calibrate the laser positioning system to ensure that it is accurate and consistent.
Use a phantom or test object to verify the accuracy of the laser positioning.
Follow the manufacturer's guidelines for calibration procedures.
Calibration of Table Positioning:
Calibrate the table positioning system to ensure that it is accurate and consistent.
Use a phantom or test object to verify the accuracy of the table positioning.
Follow the manufacturer's guidelines for calibration procedures.
Calibration of Automatic Exposure Control:
Calibrate the automatic exposure control (AEC) system to ensure that it is accurate and
consistent.
Use a phantom or test object to verify the accuracy of the AEC system.
Follow the manufacturer's guidelines for calibration procedures.
Remember, it is essential to follow the manufacturer's guidelines for test and calibration
procedures to ensure that they are performed correctly. Regular testing and calibration of the CT
scan machine can help maintain its accuracy and consistency, which is crucial for providing
accurate diagnoses and treatments.

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Geometric Performance Geometrical performance pertains to the basic aspects of the system
functioning that are related to spatial reproducibility and accuracy. The purpose of each test is listed
below, and descriptions of the tests are given in the appendix in tabular form (section 6.1, Table 5). •
Laser alignment accuracy: To ensure that the laser alignment lights correctly indicate the scan position. •
Table indexing accuracy: To ensure that the table moves as indicated. • Image position accuracy: To
ensure that the prescribed image location indicated in a CT localizer radiograph correctly corresponds to
the image position • Image thickness accuracy: To ensure that the nominal reconstructed image
thickness is similar to the actual reconstructed image thickness • Gantry tilt accuracy: To ensure that the
nominal gantry tilt is similar to the actual gantry tilt and that the gantry returns to a vertical position
after being tilted
Radiation Output Performance Radiation performance pertains to characterization of the radiation
output of the CT system. The purpose of each test is listed below and descriptions of the tests are given
i• Half-value layer: To measure the half-value layer of the CT system’s x-ray source and ensure that it is
within regulatory limits • Exposure reproducibility: To ensure the radiation output of the system is
consistent across repeated identical exposures

Exposure time reproducibility: To ensure the exposure time is consistent across repeated iden tical
exposures • Exposure linearity: To ensure the radiation output of the system is linearly proportional to
mAs • Exposure time accuracy: To ensure the nominal exposure time is similar to the actual exposure
time • Tube potential accuracy: To ensure the nominal tube potential is similar to the actual tube
potential • Radiation beam profile: To ensure the nominal radiation beam width is similar to the actual
beam width • Displayed CTDIvol accuracy: To ensure the displayed CTDIvol is similar to the actual
CTDIvol •
CT localizer radiograph dose: To measure the exposure from the localizer radiograph
Basic Image Quality Performance Image quality performance pertains to the aspects of system
performance that are related to character ization of reconstructed images. The purpose of each test is •
CT number accuracy: To ensure the CT numbers reported by the scanner are within an accept able
tolerance for known materials • CT number uniformity: To ensure acceptable uniformity in CT numbers
across the image field of view • Artifact assessment: To ensure the images are free from artifacts. • Line-
pair (high-contrast) resolution: To estimate the limiting high-contrast (in-plane) spatial resolution of the
system • Noise magnitude: To characterize the first-order noise properties of the CT system and to

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ensure the noise is consistent over time • Low-contrast contrast-to-noise ratio (CNR): To estimate the
low-contrast performance of the CT system and ensure that it is acceptable for diagnosis • Slice
sensitivity profile (SSP): To estimate the high-contrast z-direction spatial resolution of the system

2.7 Safe use and handling of CT Machine

1.7: Group discussion

Arrange yourself in a group where each group can have a maximum of

five persons. Then within your group discuss the safe use and handling
required for CT scanner.
Time: 10min

As shown in the SOP document all steps including start up, shut down, alignment, and
emergency procedures for all CT machines must be written and readily available to and
acknowledged by all users. The safety and basic operations sections in the manufacturer’s
manual can be used but a standalone specific CT manual is strongly recommended.
The CT operation must follow basic radiation safety practices. CT machine has the potential of
delivering very high dose rates over limited areas. Injury can result from a second's exposure or

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less in the direct beam. Hence all X-ray sets are provided with safety devices to prevent
inadvertent exposure as far as is compatible with the function of the equipment. Exposure to X-
rays can also occur through scattering as it reflects off surfaces such as targets, ancillary
equipment, walls and floors. Although less intense than the primary beam, significant exposure
could occur over a period of time. Exposure to others not involved in the work may occur if the
primary beam is not properly terminated. In addition to those present elsewhere in the room,
exposure could affect those on the other side of walls or passing a window.
Safety and precaution

Safe work practice steps for CT scan:

Radiation Safety: Follow all radiation safety guidelines and regulations when working with the
CT scan machine. Wear appropriate personal protective equipment (PPE), including lead aprons,
gloves, and thyroid shields. Limit the amount of time spent in the scanning room and keep a safe
distance from the machine during operation.
Patient Safety: Ensure that the patient is properly positioned and secured on the patient table
before starting the scan. Verify that the correct scanning protocol and parameters are selected for
the patient. Monitor the patient throughout the scan and be prepared to stop the scan if necessary.
Electrical Safety: Follow all electrical safety guidelines and regulations when working with the
CT scan machine. Ensure that all electrical components are properly grounded and that there are
no exposed wires or connections. Use caution when working with electrical components or
connections.
Chemical Safety: Follow all chemical safety guidelines and regulations when working with
cleaning solutions or other chemicals. Use appropriate PPE when handling chemicals, including
gloves and eye protection. Store chemicals in a secure location away from patients and other
equipment.
Infection Control: Follow all infection control guidelines and regulations when working with
patients or equipment. Use appropriate PPE when handling patients or equipment that may be
contaminated. Clean and disinfect equipment and surfaces after each use.
Emergency Procedures: Be familiar with emergency procedures, including fire safety,
evacuation procedures, and emergency response plans. Know the location of emergency

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equipment, such as fire extinguishers and first aid kits. Be prepared to respond quickly and
appropriately in case of an emergency.
Remember, safety should always be a top priority when working with the CT scan machine. By
following these safe work practice steps, you can help ensure that you and your patients are
protected from potential hazards or risks associated with CT scanning.
Avoiding electrical hazards
Electrical shocks do not just happen--they are caused. Generally, they are the result of
Carelessness or ignorance. The radiology specialist operates elaborate electronic equipment. The
Maintenance of this equipment is not his responsibility. However, he must understand the basic
Principles of electrical protection so he can recognize potential hazards and take actions to have
then eliminated before an accident does occur.

Safe Work Practices with CT machine

The CT scanner must only be operated by skilled, properly trained personnel with the required
knowledge of x-ray safety practices and the proper use of x-ray equipment. The operator is
responsible for the use of the system in compliance with the applicable standards. The unit must
not be operated when electrical, mechanical, or radiological faults are present or when any of the
indicators or alarm devices are malfunctioning.
The system safety circuits and devices must not, for any reason, be moved, modified, or omitted.
 The monitor trolley key switch may only be activated by authorized personnel and only
during the use of the system. Once system use has been completed, the key must be
removed and stored in a safe place.
 Only use the proper handles to move the unit.
 Avoid collision with obstacles.
 Cleaning and disinfecting agents, including those used on patients, may create an
explosive, gaseous mixture. Use only those products in compliance with the applicable
rules.
 Unplug the unit from the mains before cleaning it.
 Ensure that no liquid seeps into the unit, so as to avoid short-circuiting or corroding the
electrical and electromechanical parts.

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  Provide and use the appropriate personal protective equipment (PPE) [i.e. lead gloves and
aprons].
 Post a technique chart at the control panel or exposure switch to specify parameters for
routine exams.
 Use personnel dosimeters.
 Remain at least 6 feet (2 meters) away from an x-ray radiation source. Radiation is
significantly reduced by distance.
 Do not be near CT equipment, if not required, move away.
 Never stand in the line with the direct x-ray beam.
 Do not hold the tube housing during exposure, there is danger of electric shock.
 Ensure x-ray machines emit an audible signal when the exposure has ended and the timer
automatically re-sets to the initial setting or zero.
 Maintain records of maintenance, repairs, and modifications performed on each x-ray
machine including the name of the person who performed the service and the date
performed.
Proper handling of CT machine
Proper care and maintenance of CT equipment will help protect financial investment and help to
achieve optimal performance with your equipment. These key recommendations will help to
keep CT machine in its optimal operation.
1. Perform regular preventive maintenance
Preventive maintenance is critical to help keep CT equipment running at peak performance, in
compliance of all regulatory and safety standards, and within the operating standards determined
by the manufacturer. Only authorized and certified service personnel should perform work on the
equipment. With preventive maintenance, sometimes one can detect errors or component wear
before they become a bigger problem.
2. Use and manipulate equipment properly
Proper use and manipulation of equipment is key to keep it working properly. Thus, it is
important to keep your staff trained in its use. Having a well-trained staff will help improve
utilization and operational efficiency along with reduced opportunity of error, repeat exams and
patient inconvenience.

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3. Don’t overlook component care
The care and maintenance of components are often overlooked. However, these are also
important to the full functioning of the machine system. Their downtime would negatively
impact the quality of imaging equipment. Components include batteries, filters and the detectors.
Here are some recommendations that will help you keep your components in good condition and
help provide the
best image quality.
4. Operate equipment within its technical specifications
Knowing the technical specifications of CT equipment will provide valuable information on the
capabilities of system. Proper use of the equipment will allow you to considerably reduce the
amount of corrective maintenance. You can find your equipment’s technical specifications in the
user manual you received with the equipment.
5. Provide the optimum environment for your X-ray equipment
Another factor for CT equipment care is the operating environment. Always keep equipment at
the appropriate temperature. You can find the operating temperature recommended by the
manufacturer in your operation manual. A good electrical system is also needed. Electrical
problems that suddenly interrupt the operation of the equipment can cause damage to the
application or programs that keep your equipment running. It is also recommend that equipment
has a circuit breaker. This provides an uninterrupted supply of power even in the event of a grid
failure. This will allow you to keep your equipment running long enough to complete the
imaging exam that is under way, and then turn off the equipment properly afterward.
6. Usage
 Every time, before shutdown and boot, instrument pointer, such as K volt table pointer
should be turned to the minimum position, then you can appropriately adjust to the
normal conditions of state, after the equipment boot, so that you avoid the pointer hit to
be suddenly powered on or off.
 When the machine is working, user should pay attention to intermittent time of the
machine by reading, the x-ray tube surface temperature (generally not more than 50℃).
 By avoiding adjustment of the control knob or a sudden shutdown, machine components
should be kept in safe state after work. If you notice unusual sounds, smells, data, the

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 technician should promptly shut it down, then cut off power, and call for trained
maintenance staff.
 The service team should regularly inspect all electrical, electronic and mechanical
connections; clean the dust, rust oil and pay attention to avoid oils contact with the high
voltage cables.

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