The Harry S Truman VAMC(HSTVA) has a requirement for a board certified/eligible Diagnostic Medical Physicist to assist the HSTVA Radiation Safety Officer in the management of the VHA x-ray compliance program. A “qualified” Diagnostic Medical Physicist is an individual who is certified by the American Board of Radiology, American Board of Medical Physics, American Board of Health Physics, or the Canadian College of Physicists in Medicine.
The Contractor shall furnish all labor, material, supplies, equipment, and board certified/board eligible board certified/board eligible personnel to provide on-site diagnostic medical physics support or services for the Veterans Health Administration (VHA), under the terms and conditions stated herein and must adhere to VHA Directive 1129, dated Feb 04, 2015, VH1105.04, Fluoroscopy Safety, dated Dec 18, 2024, and VHA 1105.03 Mammography Program Standard, dated May 17, 2024, and unless otherwise agreed upon with the HSTVA Radiation Safety Officer or his designated alternate.
The Contractor shall comply with radiation protection standards in 29 CFR 1910.1096 and immediately report any unsafe conditions with the potential to adversely impact the facility radiation workers or patients to the Radiation Safety Officer (RSO).
The physicist must provide documentation of current board certifications. Board Certifications documents will be reviewed by the HSTVA RSO for appropriateness. The medical physicist is expected to be an integral part of the HSTVA expanding x-ray compliance and imaging QA programs. Reviewing the HSTVA QA programs is expected to be part of the service of the physicist, for example, reviewing the CT protocol optimization notebooks for each CT unit or reviewing the QA data from fluoroscopy machines or Nuclear Medicine machines.
All data gathering will be performed by the medical physicist or by individuals who are working under the direct supervision of the medical physicist on location unless a variation is agreed to by the HSTVA RSO. Direct supervision shall mean that the boarded medical physicist is physically on the primary HSTVA facility property.
A working day shall be considered Monday through Friday, not counting Federal Holidays, unless agreed upon with the RSO. Work may be performed during normal off hours with adequate coordination with the HSTVA RSO. There will be no extra charge for working during normal off hours. For example, performing checks on equipment during early evening hours or a Saturday/Sunday when the patient workload is less, and the equipment is more readily available.
Unless otherwise stated, the costs of performing the functions below are expected to be part of the cost of this contract. This would include reviewing various aspects of the HSTVA QA program. The cost of travel is to be incorporated into the cost of work for the various aspects of this contract.
The actual number and types of imaging units required to be checked may vary. The HSTVA is in the process of acquiring additional and replacement imaging systems. These additional imaging systems may or may not be located on the main HSTVA campus. New imaging systems that are acquired in the future which are located at offsite locations will be part of this contract. The cost of performing the various types of tasks should be based on a single machine and not on the total number that is anticipated. For example, the cost of performing an annual check for a Fluoroscopy unit regardless of the number of Fluoroscopy units on site, since the number may vary vs a reduced price per unit based upon a higher total of Fluoroscopy units. The price of performing an annual check on a fluoroscopy unit should be the same regardless of whether there is a single unit or whether there are ten units.
Depending on the actual type and age of the unit to be checked, some of the specifications may not be required. The actual number and types of imaging machines can vary as well as the extent of the scope of work that may be required for each machine. For example, not all dose ranges may be required to be checked for any or all of the fluoroscopy machines. Therefore, the cost should be based on the category of machine and the amount of data that will be collected and not solely on the individual machine. For example, a fluoroscopy machine requiring 3 sets of exposure settings verses a machine that is requiring 1 exposure setting.
In addition to the standard checks that are required by the ACR/VHA/JC, the physicist will also check the radiation output of each written fluoroscopy protocol for each specified machine. These fluoroscopy protocols are the written starting set up for the fluoroscopy machine. There may be a single written protocol or multiple protocols that would need to be checked for each fluoroscopy machine. These protocol checks are separate from any necessary protocols that would be required to perform annual machine checks or prior to clinical use checks. These protocols are to be checked prior to first clinical use, after repair of a component that effected radiation output, and during annual reviews.
Review of the technical QA program
The board certified/board eligible board certified/board eligible expert shall review the technical QA program. The review shall include a trend analysis of the QA data. The results of the technical QA program review shall be included in the written report. Any trends that identify problems shall be included in the report along with recommended corrective actions. The QA program includes CT, Fluoroscopy, Nuclear Medicine, PET/CT, Fluoroscopy, general diagnostic x-ray.
The physicist shall perform all work with his own equipment and phantoms unless agreed to ahead of time. All equipment shall be properly calibrated. The physicist shall produce the calibration certificates upon request to the RSO. The physicist is to provide reports in a format that is in accordance with VHA requirements which are required by the National Health Physics Program (NHPP). The NHPP is the VHA’s radiation regulators.
The medical physicist must be willing and able to provide phone and email consultation on radiation safety and related compliance issues on Nuclear Medicine, X-ray compliance and other modes of imaging to the HSTVA RSO. This shall be at no charge.
It is understood that terms of this contract may need to be altered due to changes of types of imaging equipment and or changes in HSTVA requirements.
The HSTVA is looking for pricing for 1 year plus 4 possible 1-year extensions, starting September 23, 2025 or as soon as possible thereafter to maintain proper compliance. The HSTVA has the option of not exercising an option year. The HSTVA has the option of terminating the contract due to lack of performance of the medical physicist in accordance with FAR 52.212-4(m)
Mandatory Services to be Performed
a. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall perform imaging equipment (x-ray equipment, nuclear medicine cameras, PET/CT, cameras, and MRIs) inspections to ensure compliance with the current American College of Radiology (ACR) and Mammography Quality Standards Act (MQSA) requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the board certified/board eligible board certified/board eligible diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A written report of the deficiency results shall be provided to the service supervisor and RSO within 5 working days after discovery. A comprehensive report shall be provided to the RSO within 30 days from the completion of the inspection. All imaging equipment, unless otherwise specified or required, shall be inspected at least annually, not to exceed 14 months.
b. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall perform acceptance testing of all new or relocated imaging equipment prior to first clinical use. The acceptance testing shall comply with the most current ACR or VHA standards, depending upon which one is the most stringent. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the board certified/board eligible board certified/board eligible diagnostic medical physicist leaving the facility. A written report of the deficiencies shall be provided to the service supervisor and RSO within 5 working days after discovery. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A comprehensive report shall be provided to the RSO within 30 days from the completion of the inspection.
c. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall perform a full inspection of imaging equipment after repairs or modifications that may affect the radiation output or image quality. A lesser board certified/board eligible board certified/board eligible medical physicist can perform the inspection only if the individual is under the Direct Supervision of a boarded physicist. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the board certified/board eligible board certified/board eligible diagnostic medical physicist leaving the facility. Deficiencies or non-conformances which represent unsafe conditions with the potential to adversely impact the facility radiation workers or patients shall be reported to the RSO immediately upon discovery. A written report of the deficiencies shall be provided to the service supervisor and RSO within 5 working days after performing of the inspection. A comprehensive report shall be provided to the RSO within 30 days from the completion of the inspection.
d. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall provide consultation for additional services as needed, i.e., safety training or establishing an adequate QA program to meet VHA/HSTVA standards.
e. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall review CT protocol optimization and other HSTVA imaging QA programs at least annually at no additional charge during the annual equipment inspections. This is to be incorporated into the cost of the contract as part of the annual CT, Fluoroscopy, Diagnostic x-ray, and MRI reviews. QA review and training not associated with an annual inspection shall be considered a separate item if the review and training has been requested and arrangements made through the HSTVA RSO or his/her delegate.
f. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall provide shielding design calculations for each new, replaced, or relocated x-ray imaging system. The calculations for each shall comply with the National Council for Radiation Protection and Measurements (NCRP) Report No. 147, and, for dental units, NCRP Report No. 145, and shall be documented in a written report which includes a diagram showing adjacent areas. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall perform a shielding survey to verify the structural shielding was installed per the shielding design report and complies with the design goals. A written report of the shielding survey shall be provided to the RSO within 30 workings days after the shielding survey has been completed. The RSO has the option of performing the calculations and submitting them to the boarded medical physicist for review. This would be a line item as needed cost. If this occurs, the medical physicist has the options of:
g. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall assist in the development of a comprehensive technical quality assurance (QA) program (e.g., technique charts, repeat/reject analysis monitoring, monitoring of exposure indices to radiographic image receptors, QA program for display monitors, QA for CT, monitoring of dose metrics from fluoroscopy studies), which complies with ACR recommendations, for all modalities. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall review at least annually the QA program. A written report of the results shall be provided to the service supervisor or RSO within 30 working days after performing of the inspection. A QA program is expected on all x-ray and Nuclear Medicine systems.
h. The board certified/board eligible board certified/board eligible diagnostic medical physicist shall perform a follow-up inspection to verify compliance of any necessary corrective action performed to correct deficiencies found. Depending on the circumstances, this could be done directly by the medical physicist or in cooperation with the RSO and/or his designate.
- The physicist will work with the facility’s RSO or his designee in the establishing and maintenance of a comprehensive x-ray compliance safety program. This program will adhere to the requirements and expectations of the Joint Commission, the VHA’s National Health Physics Program (NHPP), and the internal requirements of the HSTVA.
- The medical physicist shall perform an annual survey (not more than 14 months) of all diagnostic imaging equipment in accordance with the Joint Commission, and the NHPP VHA Directives particular to machine produced Ionizing radiation program, etc.
- The medical physicist will be available for consultation by phone and email for issues such as patient and staff radiation exposures, radiation safety issues, machine QA etc. at no additional charge.
- The medical physicist will assist in the review of CT protocols for optimization on at least a calendar year basis. This will include the PET/CT and SPECT/CT units if the units can perform diagnostic CT studies.
- The medical physicist will be able to perform shielding calculations based upon NCRP 147. Shielding calculations shall be submitted to the RSO.
- The medical physicist will be able to perform radiation surveys for shielding analysis if requested by RSO based upon NCRP 147. Survey reports shall be submitted to the RSO. The survey report will be submitted to the RSO within 14 calendar days of the survey being performed.
Equipment Inspections
The medical physicist shall conduct equipment inspections or quality control surveys of the imaging equipment listed below. The Medical Physicist shall ensure the imaging equipment’s compliance with applicable Federal regulations and ACR recommendations, and shall include, but not be limited to, monitoring the following basic performance characteristics. Criteria of inspections may change due to modifications from VHA/JC or HSTVA requirements.
A. Radiographic and Fluoroscopic Equipment
Physics inspections of radiographic and fluoroscopic equipment shall comply with the ACR Technical Standard for Diagnostic Medical Physics Performance Monitoring of Radiographic and Fluoroscopic Equipment. The performance of each radiographic and fluoroscopic unit must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Integrity of unit assembly.
(2) Collimation and radiation beam alignment.
(3) Fluoroscopic system resolution.
(4) Automatic exposure control system performance.
(5) Fluoroscopic automatic brightness control performance (high-dose-rate, pulsed modes, field-of-view [FOV] variation).
(6) Image artifacts.
(7) Fluoroscopic phantom image quality.
(8) kVp accuracy and reproducibility.
(9) Linearity of exposure versus mA or mAs.
(10) Exposure reproducibility.
(11) Timer accuracy.
(12) Beam quality assessment (half-value layer).
(13) Fluoroscopic entrance exposure. Maximum output for all clinically used settings. (These will be the established written fluoroscopy protocols that is associated with each individual machine which are signed by the appropriate Service Chief or his designate.)
(14) Image receptor entrance exposure.
(15) Equipment radiation safety functions.
(16) Patient dose monitoring system calibration.
(17) Video and digital monitor performance.
(18) Digital image receptor performance.
(19) Grids used with portable x-ray units shall be imaged for uniformity.
B. Computed Radiography (CR) and Digital Radiography (DR)
Physics inspections of CR and DR equipment shall comply with the American Association of Physicist in Medicine (AAPM) Report Number 93, Acceptance Testing and Quality Control of Photostimulable Storage Phosphor Imaging Systems or most current AAPM report. The performance of CR and DR must be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Component and Imaging Plate Physical Inspection and Inventory.
(2) Imaging Plate Dark Noise and Uniformity.
(3) Exposure Indicator Calibration.
(4) Linearity and Auto-ranging Response.
(5) Laser Beam Function.
(6) Limiting Resolution and Resolution Uniformity.
(7) Noise and Low-Contrast Resolution.
(8) Spatial Accuracy.
(9) Erasure Thoroughness.
(10) Aliasing/Grid Response.
(11) IP Throughput.
(12) Positioning and Collimation Errors.
C. CT Scanners
The physics inspection shall conform to the current edition of the ACR Computed Tomography Quality Control Manual or the most current edition. The performance of each CT scanner shall be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Review of Clinical Protocols.
(2) Scout Prescription and Alignment Light Accuracy.
(3) Image Thickness – Axial Mode.
(4) Table Travel Accuracy.
(5) Radiation Beam Width.
(6) Low-Contrast Performance.
(7) Spatial Resolution.
(8) CT Number Accuracy.
(9) Artifact Evaluation.
(10) CT Number Uniformity.
(11) Dosimetry (the scanner displayed CTDIvol values must be within +/- 20% of the measured CTDIvol values).
(12) Gray Level Performance of CT Acquisition Display Monitors.
D. Dental
The physics inspection shall conform to the Conference of Radiation Control Program Directors (CRCPD), Quality Control Recommendations for Diagnostic Radiography Volume 1 Dental Facilities July 2001 or most current edition. The performance of dental x-ray inspections shall be annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Collimation.
(2) Beam quality (half value layer).
(3) Timer Accuracy and Reproducibility.
(4) kVp Accuracy and Reproducibility.
(5) mA or mAs Linearity.
(6) Exposure Reproducibility.
(7) Entrance Skin Exposure Evaluation.
(8) Technique Chart Evaluation.
(9) Image uniformity (artifact evaluation).
Dental CBCT unit
- Look for any evidence of “scalloping” (loss of bit depth) or geometric distortion.
- Use a photometer to measure the maximum and minimum monitor brightness (0% and 100% steps)
- Measure additional steps within the pattern to establish a response curve.
- Measure the brightness near the center of the monitor and near all 4 corners (or all 4 sides, depending on the test pattern used).
E. Mammography
The board certified/board eligible board certified/board eligible diagnostic medical physicist
inspecting mammography equipment must meet the qualifications outlined in the MQSA and
shall provide the facility with up-to-date documentation demonstrating the board certified/board
eligible board certified/board eligible diagnostic medical physicist is MQSA qualified.
Inspections of mammography equipment must comply with the latest requirements posted on
the ACR Web site for the manufacturer of the digital mammography unit being inspected and
to the VA’s Mammography Directive and associated SOP’s.
(1) Mammographic Unit Assembly Evaluation.
(2) Collimation assessment.
(3) Artifact evaluation.
(4) kVp accuracy and reproducibility.
(5) Beam quality assessment – HVL measurements.
(6) Evaluation of system resolution.
(7) Automatic Exposure Control (AEC) function performance.
(8) Breast entrance exposure, AEC reproducibility, and average glandular dose.
(9) Radiation output rate.
(10) Phantom image quality evaluation.
(11) Signal–to–noise ratio and contrast–to noise ratio measurements.
(12) View box luminance and room illuminance.
(13) Review Workstation (RWS) tests.
F. MRI
The physics inspection shall conform to the most current edition of the ACR Magnetic Resonance Imaging Quality Control Manual. The performance of each MRI scanner shall be evaluated at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Magnetic field homogeneity.
(2) Geometric accuracy.
(3) Inter-slice RF interference.
(4) Slice position accuracy.
(5) High-contrast resolution
(6) RF coil performance.
(a) Volume coils’ signal-to-noise ratio
(b) Volume coils’ image uniformity
(c) Volume coils’ ghosting ratio
(d) Phased array coils' signal-to-noise ratio
(e) Surface coils’ signal-to-noise ratio
(7) Slice thickness accuracy
(8) Low-contrast detectability
(9) Soft copy displays
(10) Technologist’s QC program
(11) Site phantom inventory
(12) Site RF coil inventory
G. PET
The physics inspection shall conform to the ACR PET Phantom Instructions for Evaluation of PET Image, ACR Nuclear Medicine Accreditation Program PET Module. For PET/CT units the CT must be inspected at least annually per Item C above. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Uniformity.
(2) Spatial resolution.
(3) SUV analysis.
For systems in which the CT portion of the PET/CT unit is capable of operating as a diagnostic
CT unit, the CT portion is to conform to the standards of a standalone CT unit as required in
section C.
H. Nuclear Medicine
The physics inspection shall conform to the ACR annual performance tests for nuclear medicine cameras. The performance of each nuclear medicine scanner shall be at least annually. This evaluation should include, but not be limited to, the following tests (as applicable).
(1) Intrinsic Uniformity: fail criteria: > 5.0%
(2) System Uniformity: fail criteria: > 5.0%
(3) Intrinsic or System Spatial Resolution: fail criteria: > 3.5 mm bars
(4) Relative Sensitivity: fail criteria: COV > 2.5%
(5) Energy Resolution: fail criteria: > 12%
(6) Count Rate Parameters: fail criteria
(7) Formatter/Video Display
(8) Overall System Performance for SPECT
(9) System Interlocks
J. Display Monitors
The physics inspection shall conform to the AAPM On-line Report No. 03, Assessment of Display Perform for Medical Imaging Systems. QA program for image display monitors, including DICOM GSDF calibration of monitors used for interpretation. The performance of each display monitor shall be evaluated initially, acceptance testing, and at least annually thereafter. This evaluation should include, but not be limited to, the following tests (as applicable).
Acceptance testing (Table 7 from AAPM On-line Report No. 03)
(a) Geometric distortions
(b) Reflection
(c) Luminance response
(d) Luminance dependencies
(e) Resolution
(f) Noise
(g) Veiling glare
(h) Chromaticity
Annual testing (Table 8c from AAPM On-line Report No. 03)
(a) Geometric distortions
(b) Reflection
(c) Luminance response
(d) Luminance dependencies
(e) Resolution
(f) Noise
(g) Veiling glare
(h) Chromaticity
Other duties:
The Diagnostic Medical Physicist oversees the HSTVA x-ray/imaging safety program in association with the HSTVA Radiation Safety Officer. The Medical Physicist will provide recommendations of how the HSTVA QA program should be set up with the appropriate record keeping. The Medical Physicist or his associate will provide periodic training and record review to help ensure that the HSTVA is in compliance with VHA and Joint Commission requirements for imaging.
The current categories of imaging equipment are listed below. The statement of work will be amended as necessary to reflect new or modified equipment or changes in regulatory requirements and expectations. The number of fluoroscopy protocols is approximate and still in development. The actual number could be significantly lower or higher.
C-ARM Guerbet Hydra Vision DR CI121H695
C-ARM OEC Elite FAXXTE00937
C-ARM OEC Elite FAXXTE00938
C-ARM OEC Elite FBXXTE02497
C-ARM OEC Elite FBXXTE02498
C-Arm OEC 9900 Elite FBXXTE01609
C-Arm Phillips Azurion 470
CBCT Carestream CS 9600 NTPV7210146
CT Siemens Somatom Force (Sn Option) 76274
CT Siemens Somatom Edge 122244
CT Bi-Plane Phillips Phillips Xper FD10 (AP Tube) 722027178
CT Bi-Plane Phillips Phillips Xper FD10 (LAT Tube) 722027178
CT Bi-Plane Phillips Allura Xper FD20 (AP tube) (21)120
CT Bi-Plane Phillips Allura Xper FD20 (LAT tube) (21)120
CT Single-Plane Phillips Phillips Allura FD 20 722028914
DEXA Hologic QDR
Intra Oral Carestream CS 2200
Intra Oral Carestream CS 2200
Intra Oral Carestream CS 2200
Intra Oral Carestream CS 2200
Intra Oral Carestream CS 2200 HDXT045
Intra Oral Carestream CS 2200 HDXT055
Intra Oral Carestream CS 2200 HDXT046
Intra Oral Carestream CS 2200 HDXT041
Intra Oral Carestream CS 2200 HDXT043
Intra Oral Carestream CS 2200 HDXT042
Intra Oral Carestream CS 2200 HDXT044
Mammography Hologic Dimensions 3DM160101999
Mammography Mammography Secure View DX Monitors 2590313878
MRI Phillips Ingenia Ambition 1.5T 103820394
Panoramic Carestream Panoramic EAB9003
PET/CT GE Discovery PET
PET/CT GE Discovery CT GE ID: 573814PET
Portable GE Optima XR 220 DF2402100372WK
Portable GE Optima XR 220 DF2402100374WK
Portable GE Optima XR240AMX 1031816WK0
Portable GE Optima XR 220 DF2402000623WK
Portable GE Optima XR 220 DF2402000627WK
R/F GE Discovery 656 5397035
R/F - GE Discovery 656 573814R2
R/F - Fluoro Siemens Luminos Agile Max 63282
R/F - Radiographic Siemens Luminos Agile Max 449521956
SPECT/CT GE Optima 640 -SPECT 640W25379
SPECT/CT GE Optima 640 -SPECT 640Y25551
Federal Holidays observed by Harry S Truman Columbia VA are:
New Year’s Day
Labor Day
Martin Luther King Day
Columbus Day
President’s Day
Veterans’ Day
Memorial Day
Thanksgiving Day
Juneteenth
Christmas Day
Independence Day
Harry S Truman Columbia VA Health Care System Locations
Harry S Truman Columbia VAMC
800 Hospital Drive
Columbia, MO 65201
Rolla CBOC
13063 Old Wire Road
Rolla, MO 65401
