Acceptance tests at radiographic and fluoroscopic X-ray units have to be carried out according to IEC 61223-3-1.

The constancy test for general direct radiography has to be done according to IEC 61223-2-11 (DIN 6868-3).

The test parameters are

• Dose measurements:  
• Radiation output from the X-ray source assembly 
• Radiation input to the image reception area (alternatively: measurement of the optical density at specific points of a radiogram) 
• Geometric characteristics 
• Resolution of high-contrast detail 
• Variation in optical density throughout a radiogram.

To carry out the test the following equipment is necessary:

• Dosimeter, e.g. DOSIMAX plus (the use of a double dosemeter – DOSIMAX plus duo or PID duo with two detectors - makes it possible to measure both dose values simultaneously, see Double dosemeter philosophy, page 6-8) 
• Test device ETR1 with centering tube 
• Densitometer

Additionally the film screen contact should be tested whenever a problem is suspected or at least once a year (ISO 4090) using the Test Device FFA 4090 R.

In the case of Fluoroscopic Installations using X-ray image intensifiers and during the recording of the exit screen of the X-ray image intensifier, the constancy test, in accordance with German Standard 6868-4, the following parameters has to be tested by using ETR1 and a dosemeter

• Optical density in RBV recordings 
• Spatial resolution 
• Contrast 
• Size of the useful beam field 
• Dose rate or dose

Digital Subtraction Angiographic (DSA) X-ray installations must be tested for specific functions in accordance with the standard IEC  61223-3-3  resp. DIN 6868-8, therefore  a special Test Tool is required for this, the RÖVI-8. This test device fulfils the special requirements of this standards and comprises the following components:

• an acrylic attenuator (150 x 150 x 57 mm) 
• a dynamic copper step wedge ranging from 0.2 to 1.4 mm, ascending with 
• an additional contrast step from 1.4 mm Cu to 0.2 mm 
• a moveable insert with Al stripes for vascular simulation

Tests must be carried out for the following:

• Dose per image 
• Dynamic range and contrast sensitivity 
• Spatial resolution 
• Artifacts