[Intl_DxMedPhys] GE Pristina Flat Field Uniformity

Tue Jan 27 10:30:35 EST 2026

This "orange peel" artifact, whatever the cause is quite common in Pristina ACR accreditation phantom submissions. So common that as an ACR phantom reviewer, I cringe every time I see a Pristina phantom to score, because there is a good possibility of seeing this unacceptable artifact. In such cases I am then obliged to spend considerable time typing out recommendations to the site for corrective action. My advice usually is to 1) bring in GE service to address the artifact, and if that does not resolve the artifact, 2) escalate to a higher service level in GE and keep escalating until they send out an FSE who actually understands what is going on.
Thank you listers for the very informative posts. I feel now I can be a little more focused in my advice by adding that the artifact is commonly filter related.

Maynard High
Westchester Medical Center / NYMC
maynard.high at wmchealth.org<mailto:maynard.high at wmchealth.org>
914-493-1410

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu> On Behalf Of Wunderle, Kevin via Intl_dxmedphys_wd_osu_list
Sent: Monday, January 26, 2026 7:07 PM
To: Palmer, Matthew R. (BIDMC - Radiology) <mpalmer at bidmc.harvard.edu>; DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
Subject: [EXTERNAL] Re: [Intl_DxMedPhys] GE Pristina Flat Field Uniformity

Hi Matt,

I can offer an informed speculation. Many moons ago, I experienced something very similar on half a dozen GE Senograph FFDM units. The issue we encountered was due to imperfections in the x-ray filters and the imaging system's inability to perfectly align the filter wheel once it cycled.

Our experience mirrored your description with similar artifacts. After performing a flat-field calibration, the flat-field images looked great until the filter wheel was rotated. This could be done manually on the system interface, or it could happen automatically when the system was rebooted.

I suggest you (or your service person) perform your flat-field calibration, reshoot your flat-field artifact eval (which should look great), then manually cycle the filter several times and reshoot. If this is the cause, those artifacts will reappear. Repeat this for both the Rh and Ag filters.

Unfortunately, on the older GE systems, there was no way to improve the filter wheel positioning accuracy. When we experienced the issue, we shut down six units and GE flew in mammo experts from Buc, France to investigate and mitigate the problem. The only solution was to obtain hand-picked filters from China that were as close to perfectly flat as possible which, for all intent and purpose, resolved the issue.

Let us know if this turns out to be the root cause.

All the best,
Kevin

[The Ohio State University]
Kevin Wunderle, PhD, FAAPM, FACR
Professor, Department of Radiology
Diagnostic Medical Physicist
395 W. 12th Avenue,
Floor 4, Room 424
Columbus, OH, 43210
216-245-5513 Mobile
kevin.wunderle at osumc.edu<mailto:kevin.wunderle at osumc.edu>

From: Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu>> On Behalf Of Palmer, Matthew R. (BIDMC - Radiology) via Intl_dxmedphys_wd_osu_list
Sent: Monday, January 26, 2026 4:39 PM
To: DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu<mailto:intl_dxmedphys_wd_osu_list at lists.osu.edu>>
Subject: [Intl_DxMedPhys] GE Pristina Flat Field Uniformity

Dear Colleagues, Multiple times recently, I've found artifacts when performing the Artifact Eval and Flat Field uniformity test, on the 2D Rh/Ag acquisitions for the GE Pristina mammo unit. I've pasted in a portion of my iPhone snapshot
Dear Colleagues,

Multiple times recently, I've found artifacts when performing the Artifact Eval and Flat Field uniformity test, on the 2D Rh/Ag acquisitions for the GE Pristina mammo unit.  I've pasted in a portion of my iPhone snapshot from the AWS display.  The image quality isn't pristine(a) and I've introduced a Moire pattern (there's no 'zipper'-like artifact in reality) but I think you can see the mottled appearance pretty clearly.

After the FSE runs the gain cal, the artifacts disappear - for about a day then reappear.

FSE's feedback from GE experts is that not to worry - the artifacts won't affect clinical images.  That's hard to swallow.

I was astonished that the tech's weren't picking up the artifacts in their weekly QC so I ran their Flat Field test from the tech IQST Weekly QC page.  The images shown briefly (but not saved as far as I can tell) during the test sequence look perfect (although you can't adjust the window/level).

I'm wondering if anyone has had this problem or can shed any light on it.

Matt Palmer
BIDMC Radiology

Matthew R. Palmer, PhD, DABR
Director, Medical Imaging Physics, Department of Radiology
Assistant Professor, Harvard Medical School
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
office: 617-667-0176 fax: 617-667-2770
mobile: 617-794-1736 pager: 617-632-7243 #32214

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