R--Diagnostic Medical Physics Support/Services

Sources Sought: The Department of Veterans' Affairs (DVA/VA), James A. Haley Veteran's Hospital located in Tampa, FL, is conducting a market survey to determine the availability of SERVICE DISABLED VETERAN OWNED SMALL BUSSINESSES (SDVOSB) and VETERAN OWNED SMALL BUSSINESSES (VOSB) capable and interested in providing Diagnostic Medical Physics Support/Services for Radiographic, Fluoroscopic, Computerized Tomography (CT) Scanner, Mammography and Dental equipment at James A. Haley Veterans Hospital and outlying centers. The Contractor must be able to provide a qualified radiation physicist (certified by American Board of Radiology) who can respond within 48 hours. The Diagnostic Medical Physics Support includes requirements of VHA Handbook 1105.04, Fluoroscopy Safety, dated July 6, 2012, http://vaww./va.gov/vhapublications/ViewPublications.asp?pub_ID=2764, radiation protection standards in 29 CFR 1910.1096, American College of Radiology (ACR) and Mammography Quality Standards Act (MQSA) requirements and all other applicable federal, state and local regulations. This procurement is being conducted under FAR Part 13. The NAICS Code is 541690 and the size standard is $15 million dollars. Responses to this announcement shall determine if sufficient competition exist in order to set this procurement aside for SDVOSB and/or VOSB business concerns. Please provide interest in this solicitation by responding to this announcement no later than 3:00 p.m. August 26, 2015. Documentation of technical expertise must be presented in sufficient detail for the Government to determine that your company possesses the necessary functional area expertise, experience and personnel to compete for this acquisition. Responses to this notice shall include the following: (a) company name (b) address (c) point of contact (d) phone, fax, and email (e) DUNS number (f) Cage Code (g) Tax ID Number (h) Type of small business, e.g. Services Disabled Veteran Owned small Business, Veteran-owned small business, 8(a), HUB Zone, Women Owned Small Business, Small disadvantaged business, or Small Business HUB Zone business and (i) GSA contract number if applicable (j) must provide a capability statement that addresses the organizations qualifications and ability to perform as a contractor for the work described below. This Sources Sought Notice is for planning purposes only and shall not be considered as an invitation for bid, request for quotation, request for proposal, or as an obligation on the part of the Government to acquire any products or services. Your response to this Sources Sought Notice will be treated as information only. No entitlement to payment of direct or indirect costs or charges by the Government will arise as a result of contractor submission of responses to this announcement or the Government use of such information. This request does not constitute a solicitation for proposals or the authority to enter into negotiations to award a contract. Please provide all interest to me by email at [email protected] NLT 3:00 p.m. August 26, 1015. All correspondence submitted, either by email shall have "Sources Sought Notice - Diagnostic Medical Physics Support/Services" on the document(s). Telephone replies will not be honored. Statement of Work The Department of Veteran Affairs (VA) has a requirement for Diagnostic Medical Physics Support at James A. Haley Veteran' Hospital, (JAVH) and outlying clinics. The contractor shall furnish all labor, equipment, transportation and parts necessary to provide Diagnostic Medical Physics support at the James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd., Tampa, Florida 33612 in accordance with the Schedule of Services and Prices for the period October 1, 2015 through and including September 31, 2016. In addition, the Government may exercise their option to extend the term of the contract four (4) additional option year periods subject to the required need and the availability of funds. Services provided by the contractor must comply with the terms and conditions stated herein and must adhere to VHA Handbook 1105.04, Fluoroscopy Safety, dated July 6, 2012, http://vaww./va.gov/vhapublications/ViewPublications.asp?pub_ID=2764. 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). Qualifications 1. Performance a. Each respondent shall have an established business, with an office and full time staff to include a "fully qualified" physicist. b. "Fully Qualified" is based upon training and experience in the field. For training, the FSE(s) must be a qualified radiation physicist defined as an individual who is certified by the American Board of Radiology (ABR) in the appropriate disciplines of radiological physics including diagnostic, therapeutic and medical nuclear physics (for example: if performing inspections in Nuclear Medicine, the physicist must be qualified by the ABR in that discipline). For field experience, the physicist shall have a minimum of five years of experience with respect to performing radiation protection survey services. c. The physicist shall be authorized by the contractor to perform the radiation protection survey services. All work shall be performed by a "Fully Qualified" physicist. Contractor shall provide certification from the American Board of Radiology (ABR) for the physicist who will perform work for each appropriate discipline of radiology physics including diagnostic, therapeutic, and medical nuclear physics or submit written documentation which demonstrates equivalent competency in the disciplines. The Contracting Officer (CO) may authenticate the training requirements, request training certificates or credentials from the contractor at any time for any personnel who are servicing or installing any VA equipment. The CO and/or Contracting Officer's Representative (COR) specifically reserves the right to reject contractor personnel and refuse them permission to work on the VA equipment. Services to be Provided 1. Mandatory Services to be Performed by the Qualified Diagnostic Medical Physicist a. The qualified diagnostic medical physicist shall perform imaging equipment (x-ray equipment, nuclear medicine cameras, and PET/CT cameras) 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 (Radiation Safety Officer) prior to the qualified 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 results shall be provided to the service supervisor and RSO within 5 working days after completion of the inspection. All imaging equipment shall be inspected at least annually, not to exceed 14 months except for imaging equipment specifically identified in this SOW for a lessor period of time b. Acceptance testing of all new or relocated imaging equipment shall be performed prior to first clinical use. The acceptance testing shall comply with ACR or MQSA requirements. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the qualified 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 results shall be provided to the service supervisor or RSO within 5 working days after completion of the inspection. c. Full inspections of imaging equipment after repairs or modifications that may affect the radiation output or image quality shall be performed within 48 hours after the facility contacts the contractor. Any deficiencies or non-conformances discovered during the inspection shall be verbally communicated to the service supervisor or RSO prior to the qualified 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 results shall be provided to the service supervisor or RSO within 5 working days after performing of the inspection d. Consultation for additional services as needed, i.e., safety training shall be provided e. CT protocols shall be reviewed at least annually f. Shielding design calculations for each new, replaced, or relocated x-ray imaging system shall be provided. 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 qualified 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 5 workings days after the shielding survey has been completed. g. The qualified diagnostic medical physicist shall assist in the development of and review annually 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. A written report of the results shall be provided to the service supervisor or RSO within 5 working days after performing of the inspection. h. Follow-up inspections shall be performed to verify compliance of any necessary corrective action performed to correct deficiencies found. 2. Equipment Inspections The Contractor shall conduct equipment inspections or quality control surveys of the imaging equipment listed below. The Contractor 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. 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 spatial 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 rate (or air kerma rate). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation [e.g., magnification mode, frame rate, and any other mode selected) must be documented for each measurement.] (14) Fluorographic (image recording) entrance exposure rate (or air kerma rate) for cine imaging, if performed and entrance exposure (or air kerma) for spot images (if performed). Maximum output and output using a phantom representing a standard size patient for all clinically used settings. [The mode of operation (e.g., magnification mode, frame rate, etc.) must be documented for each measurement.] (15) Image receptor entrance exposure. (16) Equipment radiation safety functions. (17) Patient dose monitoring system calibration. This includes, for radiographic systems, the metric of dose to the image receptor (IEC Exposure Index or proprietary index) and, for fluoroscopy systems, the displays of cumulative air kerma and, if available, DAP. (18) Display monitor performance. (19) Digital image receptor performance. (20) Grids used with portable x-ray units shall be imaged for uniformity. (21) For radiographic units, measurement of entrance skin exposure (or air kerma) for a standard size patient for common radiographic projections and comparision to published diagnostic reference levels and achievable doses (e.g., ACR practice parameter. Note: The information on entrance exposure rates (or air kerma rates) from fluoroscopy and from fluorography, in Items (13) and (14) above, for each fluoroscope, shall be in a format suitable for providing to the physicians who operate the fluoroscope. 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. 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 2012 ACR Computed Tomography Quality Control Manual. 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. 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, with comparison to published diagnostic reference levels and achievable doses (e.g., NCRP Report No. 172). (8) Technique Chart Evaluation. (9) Image uniformity (artifact evaluation). Dental CBCT Acceptance and Performance Testing 1. Acceptance Testing. Acceptance testing and measurement of air kerma at the isocenter for each kVp station for a range of clinically used mAs settings will initially be performed when the CBCT unit is installed, and following any move of the CBCT to another area inside or outside the initial clinical site. This testing is to ensure equipment performance is in agreement with the manufacturer's technical specifications. 2. Performance Testing. Each CBCT unit shall undergo periodic quality control tests to insure performance of the machine has not significantly deteriorated and is operating within the manufacturer's technical specifications. This performance testing is performed by a qualified expert annually, at intervals not to exceed 14 months, and after repairs to the CBCT unit which may affect the radiation output or image quality. 3. Some manufacturers provide a phantom and procedures to perform machine specific quality assurance (QA) tests. In cases where the manufacturer provides a phantom and procedures to perform specific tests but the tests are not included in this SOW, then the manufacturer's machine-specific QA tests shall be performed in addition to the QA tests in this SOW. Acceptance and Annual physics testing for Dental CBCT 1. Radiation output Repeatability Make four measurements of the air kerma at the isocenter at a clinically used setting. The measurements should be less than +/-5% of the average of the five measurements and the measurements should be less than +/- 5% of the previous year's measurement. 2. Radiation Output Reproducibility Measure the air kerma at the isocenter for each kVp station and a range of clinically used mAs setting. Compare the results to the baseline values established at the initial acceptance testing. The values should be +/-5% of the baseline. 3. kVp Accuracy Measure the kVp at all clinically used settings. The measured kVp should be +/-5% of the selected kVp. 4. kVp Repeatability Make five kVp measurements each for two clinically used kVp settings. All measured values should be +/-5% of the mean kVp. 5. kVp Reproducibility Measure the kVp at all available kVp settings. The measured values should be +/-5% of the baseline. 6. Beam quality Measure the half value layer (HVL) for aluminum. The minimum shall comply with Section F.4.d of the Suggested State Regulations for Control of Radiation, Conference of Radiation Control Program Directors. 7. Radiation field of view (FOV) Measure the width of the radiation field at the isocenter. The width of the beam should be 3 mm or 30% of the total nominal collimated width. 8. Image Quality Image the phantom provided by the manufacturer or another suitable phantom. Assess high contrast spatial resolution, uniformity of transaxial images, and image noise. Imaging uniformity shall be assessed over the entire range of axial images. 9. Accuracy of Linear Measurements Using images of an appropriate phantom, assess the accuracy of distance measurements. 10. Accuracy of Patient Dose Metric Indication Assess the accuracy of the indicated dose metric (typically DAP). 11. Patient Dose Assessment From a scan or scans using the facility's standard techniques, record the dose metric (typically DAP) and compare to achievable levels and diagnostic reference levels (if available) 12. Review of the technical QA program The qualified 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. 13. Display Monitors Perform a visual analysis of the SMPTE test pattern. 1. Display the test pattern on the imaging console. Set the display window width/level to the manufacturer-specified values for the pattern. Do not set the window/level by eye; doing so invalidates the procedure. 2. Examine the pattern to confirm that the gray level display in the imaging console is subjectively correct. a. Review the line pair patterns in the center and at each of the corners. b. Review the black-white transition. c. Look for any evidence of "scalloping" (loss of bit depth) or geometric distortion. 3. Use a photometer to measure the maximum and minimum monitor brightness (0% and 100% steps) 4. Measure additional steps within the pattern to establish a response curve. 5. Measure the brightness near the center of the monitor and near all 4 corners (or all 4 sides, depending on the test pattern used). 14. Viewing Conditions Assess the viewing conditions for the area in which the monitor used to evaluation the CBCT studies is located. E. Mammography The qualified 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 qualified 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. Inspection items may include: (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 Work Station (RWS) tests. F. PET The physics inspection shall conform to the ACR PET Phantom Instructions for Evaluation of PET Image, ACR Nuclear Medicine Accreditation Program PET Module. The performance of each PET scanner shall be evaluated at least quarterly. 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. G. Nuclear Medicine The physics inspection shall conform to the ACR annual performance tests for nuclear medicine cameras. The qualified diagnostic medical physics shall also perform the quarterly testing as outlined by the ACR. 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 (2) System Uniformity (3) Intrinsic or System Spatial Resolution (4) Relative Sensitivity (5) Energy Resolution (6) Count Rate Parameters (7) Formatter/Video Display (8) Overall System Performance for SPECT (9) System Interlocks (10) Dose Calibrators (Geometry, if applicable, Accuracy) (11) Thyroid Uptake and Counting Systems H. Display Monitors The annual performance evaluation shall include testing of image acquisition display monitors for maximum and minimum luminance, luminance uniformity, resolution, and spatial accuracy. The image acquisition display monitors for nuclear medicine, PET, CT, and MRI units shall be tested.