[Intl_DxMedPhys] GE Pristina Flat Field Uniformity

Wed Jan 28 10:28:15 EST 2026

I used to test 10+ Pristina's per year and also experienced this artifact
frequently.

Erika, it's wild how much that Ag filter looks just like the artifact.
Thanks for sharing.

Mike Nimmo

On Wed, Jan 28, 2026, 9:17 AM Erika Ripley via Intl_dxmedphys_wd_osu_list <
intl_dxmedphys_wd_osu_list at lists.osu.edu> wrote:

> I have also had this issue, though not as extreme, on several GEs in the
> last couple years. I was also told about the cold tube calibrations and
> they were fixed by new collimators. Guess which one is the Ag filter on
> this one. -Erika Ripley,
> I have also had this issue, though not as extreme, on several GEs in the
> last couple years. I was also told about the cold tube calibrations and
> they were fixed by new collimators. Guess which one is the Ag filter on
> this one.
>
>
>
> -Erika Ripley, Ph.D., DABR, DABSNM
> Texas Licensed Medical Physicist
> 972-938-7626
>
> On Tue, Jan 27, 2026, 9:14 PM David Erickson via
> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
> wrote:
>
>> Hey Matt, I’ve seen this exact looking issue before recently (maybe two
>> months ago). Before I answer to this recent experience I will say that
>> sometimes the Rh/Ag combo doesn’t look amazing but upon inspection of the
>> RAWS per the manual, they
>> Hey Matt,
>> I’ve seen this exact looking issue before recently (maybe two months ago).
>>
>> Before I answer to this recent experience I will say that sometimes the
>> Rh/Ag combo doesn’t look amazing but upon inspection of the RAWS per the
>> manual, they don’t look as bad. Some are much better than others—-I test
>> about 20-30 a year. But recently it was different; terrible on mags and
>> terrible with the Bucky; even distracting in the phantom scoring.
>>
>> I was told by GE that their Ag filter makeup was recently changed within
>> the collimator (not entirely sure what that means) which is responsible for
>> this.
>>
>> I could not in good faith pass it when observed initially so a second
>> collimator was sent and swapped out. It was better than the first but still
>> not great—-better because apparently there is a new calibration procedure
>> with collimators having this new filter where calibrations have to be
>> completed slowly and on a “cold tube”. From my understanding this is a
>> known issue. The “cold tube” calibration procedure helps but images still
>> are not my favorite. Acceptable but not my favorite imo.
>> Interpreting rads were made aware initially too of this system and were
>> instructed to call out anything egregious—-all quiet thus far.
>>
>> Hope that helps. Let me know if you find out more or hear anything else!
>>
>> Respectfully,
>> David Erickson, MS, DABR
>> Diagnostic Imaging Medical Physics
>> david.dephysics at gmail.com
>>
>>
>> On Tue, Jan 27, 2026 at 10:31 High, Maynard via
>> Intl_dxmedphys_wd_osu_list <intl_dxmedphys_wd_osu_list at lists.osu.edu>
>> wrote:
>>
>>> 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
>>>
>>> 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
>>>
>>> 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
>>> <https://urldefense.com/v3/__https://www.google.com/maps/search/395*W.*12th*Avenue,**A0D*0A*Floor*4,*Room*424?entry=gmail&source=g__;KysrKyUlKysrKw!!KGKeukY!0rgZy4USbn1wfHqo0w-S8OhuB6d6rahNd5osjV5oUP0X93to6dSw02_wHB75eIcZx6gkssL1-D_pD607fJdN8YWizkqmFHhiVWaiK-dp8-CYoomZ$>
>>> is the cause, those artifacts will reappear. Repeat this for both the Rh
>>> and Ag filters.
>>>
>>>
>>>
>>> Unfortunately, on the older GE systems, there was no way to improve the
>>> filter wheel positioning accuracy. When we experienced the issue, we shut
>>> down six units and GE flew in mammo experts from Buc, France to investigate
>>> and mitigate the problem. The only solution was to obtain hand-picked
>>> filters from China that were as close to perfectly flat as possible which,
>>> for all intent and purpose, resolved the issue.
>>>
>>>
>>>
>>> Let us know if this turns out to be the root cause.
>>>
>>>
>>>
>>> All the best,
>>>
>>> Kevin
>>>
>>>
>>>
>>> [image: The Ohio State University]
>>> *Kevin Wunderle, PhD, FAAPM, FACR*
>>> Professor, Department of Radiology
>>>
>>> Diagnostic Medical Physicist
>>> 395 W. 12th Avenue,
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>>> Floor 4, Room 424
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>>>
>>> Columbus, OH, 43210
>>> 216-245-5513 Mobile
>>> kevin.wunderle at osumc.edu
>>>
>>>
>>>
>>>
>>>
>>> *From:* Intl_dxmedphys_wd_osu_list <
>>> intl_dxmedphys_wd_osu_list-bounces at lists.osu.edu> *On Behalf Of *Palmer,
>>> Matthew R. (BIDMC - Radiology) via Intl_dxmedphys_wd_osu_list
>>> *Sent:* Monday, January 26, 2026 4:39 PM
>>> *To:* DxMedPhys List <intl_dxmedphys_wd_osu_list at lists.osu.edu>
>>> *Subject:* [Intl_DxMedPhys] GE Pristina Flat Field Uniformity
>>>
>>> <https://urldefense.com/v3/__https://www.google.com/maps/search/395*W.*12th*Avenue,**A0D*0A*Floor*4,*Room*424?entry=gmail&source=g__;KysrKyUlKysrKw!!KGKeukY!x1Ye2myMoGx7t6eqSmrJb14MQRBKUizKko_mQ1eXOuhtKfOs0tQb9fMzPOzpUP1VlSFTl6uv92IHRrwQ0RopC1jCuHz7NqaQ_Jh5Gg$>
>>>
>>> <https://urldefense.com/v3/__https://www.google.com/maps/search/395*W.*12th*Avenue,**A0D*0A*Floor*4,*Room*424?entry=gmail&source=g__;KysrKyUlKysrKw!!KGKeukY!0kszxyLqvtUIy_W3EzgUgDxdfwUOKNj_lWsdN_QpN2i3VlVIIBU-cdSBnuhgI65qlzfXn8Ca7wytiUqZZE1LoU0KBeKhJqJKVpPlLT_-TOja$ >
>>>
>>>
>>>
>>> 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
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