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Exam Information
Official specifications published by ARDMS
Exam Format
120 min
110
555
Entry-Level Physics Requirement
Registration
$250 USD
Pearson VUE
Validity
Lifetime (when paired with specialty certification)
Maintain active status through MOC program; No need to retake SPI for additional credentials if maintaining active status
SPI Exam Topics and Domains
SPI is organized into 5 weighted domains.
1
Perform Ultrasound Examinations
23%
Provide patient care (e.g., comfort, safety)
Contrast agents knowledgeErgonomics knowledgeEstablished imaging protocolsGeneral patient care standardsSound and matter interactionMetric system of measurementTissue density, penetration and depthUltrasound limitationsConfidentiality & privacy guidelines
- Demonstrate knowledge of contrast agents and their safe use
- Apply ergonomic principles to prevent injury
- Follow established imaging protocols appropriately
- Provide patient-centered care with safety as priority
- Understand fundamental physics of sound-tissue interaction
- Use metric measurements accurately
- Recognize ultrasound limitations and contraindications
- Maintain patient confidentiality and privacy
Apply sonographic ergonomic techniques
Proper scanning techniques
- Demonstrate proper ergonomic scanning techniques
- Adjust equipment for optimal ergonomics
Differentiate interactions of sound and matter (e.g., echogenicity, reflection)
Echogenicity patternsReflection mechanisms
- Identify and differentiate echogenicity patterns
- Understand reflection mechanisms and their clinical implications
Modify exam based on gray-scale artifacts (e.g., reverberation, shadowing)
Reverberation artifactsShadowing artifacts
- Recognize common gray-scale artifacts
- Modify scanning technique to reduce artifacts
- Distinguish artifacts from pathology
Apply knowledge of reflectors to modify scanning technique
Reflector characteristics
- Understand reflector properties and behavior
- Adjust scanning technique based on reflector characteristics
Identify potential bioeffects
Thermal bioeffectsMechanical bioeffects
- Identify potential thermal bioeffects
- Recognize mechanical bioeffects risk
- Apply ALARA principle
Apply beam steering concepts
Electronic beam steering
- Understand beam steering principles
- Apply beam steering appropriately
Apply extended field of view function (e.g., panoramic imaging)
Panoramic imaging techniques
- Perform extended field of view imaging
- Recognize appropriate applications
Apply 3D/4D concepts
3D/4D imaging principles
- Understand 3D/4D imaging principles
- Apply 3D/4D imaging appropriately
Apply contrast imaging concepts
Contrast-enhanced ultrasound
- Understand contrast-enhanced ultrasound principles
- Apply contrast imaging safely
Manage initial patient encounter (e.g., verify ID, medical history, verify appropriateness of order)
Patient verificationMedical history reviewOrder verification
- Verify patient identity using two identifiers
- Obtain relevant medical history
- Confirm appropriateness of examination order
Analyze clinical history and previous imaging studies
Clinical correlation
- Analyze clinical history for exam planning
- Review and compare previous imaging studies
Demonstrate appropriate patient care and communication skills (e.g., privacy, confidentiality, safety)
Patient communicationPrivacy and confidentiality
- Communicate effectively with patients
- Maintain patient privacy and confidentiality
- Ensure patient safety throughout procedure
Document preliminary findings and images (e.g., paper-based, digital)
Documentation standards
- Document findings accurately
- Archive images properly in PACS/digital systems
2
Manage Ultrasound Transducers
7%
Select transducers for the test
Transducer componentsFrequency selection
- Understand transducer component functions
- Select appropriate transducer frequency for clinical application
Adjust transducer frequency
Multi-frequency transducers
- Adjust transducer frequency based on clinical need
- Optimize frequency for penetration and resolution
Apply 2D array transducer concepts
2D array technology
- Understand 2D array transducer technology
- Apply 2D array concepts in imaging
Apply 3D/4D transducer concepts
3D/4D transducer technology
- Understand 3D/4D transducer technology
- Apply 3D/4D imaging appropriately
Apply nonimaging transducer concepts
Continuous wave Doppler transducers
- Understand nonimaging transducer applications
- Recognize when to use specialized transducers
3
Optimize Sonographic Images
26%
Integrate optimization of axial resolution concepts
Axial resolution factors
- Understand axial resolution principles
- Optimize settings for best axial resolution
Integrate optimization of lateral resolution concepts (e.g., transmit focus, multiple focal zones)
Lateral resolution optimization
- Optimize lateral resolution through focus adjustment
- Understand focal zone impact on image quality
Integrate optimization of elevational resolution concepts
Slice thickness
- Understand elevational resolution
- Recognize slice thickness artifacts
Integrate optimization of temporal resolution concepts
Frame rate optimization
- Optimize temporal resolution for moving structures
- Balance frame rate with spatial resolution
Utilize magnification techniques (i.e., pre- & post-processing)
Read zoom vs write zoom
- Understand difference between pre- and post-processing magnification
- Apply appropriate magnification technique
Optimize image brightness (e.g., overall gain, TGC)
Gain controls
- Adjust overall gain appropriately
- Use TGC to compensate for attenuation
Apply harmonic imaging concepts
Tissue harmonic imaging
- Understand harmonic imaging principles
- Apply harmonic imaging to improve image quality
Apply PRF concepts (e.g., depth, penetration, frame rate)
Pulse repetition frequency
- Understand PRF and its relationships
- Adjust PRF for optimal imaging
Apply output power concepts
Acoustic power
- Understand output power controls
- Apply ALARA principle
Apply duty factor concepts
Duty factor
- Understand duty factor concept
- Relate duty factor to bioeffects
Apply dynamic range concepts (e.g., compression)
Dynamic range and compression
- Understand dynamic range principles
- Adjust compression for optimal contrast
Apply spatial compounding concepts
Spatial compounding
- Understand spatial compounding technology
- Apply spatial compounding appropriately
Apply knowledge related to gray scale (e.g., colorized B-mode, frequency compounding, persistence)
Gray scale optimization
- Optimize gray scale settings
- Use persistence appropriately
Apply edge enhancement concepts
Edge enhancement
- Understand edge enhancement principles
- Apply edge enhancement judiciously
Apply image depth concepts
Depth adjustment
- Adjust imaging depth appropriately
- Understand depth impact on frame rate
Apply M-mode concepts
M-mode imaging
- Understand M-mode imaging principles
- Apply M-mode for moving structures
4
Apply Doppler Concepts
34%
Apply Doppler angle to flow concepts
Doppler angle correction
- Understand Doppler angle impact on velocity measurement
- Maintain proper angle of insonation
Apply Doppler wall filter concepts
Wall filter settings
- Understand wall filter function
- Adjust wall filter appropriately
Apply Doppler sample gate concepts
Sample volume
- Position sample gate correctly
- Adjust sample volume size appropriately
Apply color priority over gray scale concepts
Color priority/persistence
- Understand color priority settings
- Optimize color/gray scale balance
Apply concepts related to color Doppler map
Color map selection
- Interpret color Doppler maps
- Select appropriate color map
Apply concepts to eliminate aliasing
Aliasing correction
- Recognize aliasing artifact
- Apply techniques to eliminate aliasing
Apply continuous wave Doppler concepts
Continuous wave Doppler
- Understand CW Doppler principles
- Apply CW Doppler appropriately
Apply pulsed wave Doppler concepts
Pulsed wave Doppler
- Understand PW Doppler principles
- Optimize PW Doppler settings
Apply color Doppler concepts
Color Doppler imaging
- Optimize color Doppler imaging
- Understand color Doppler limitations
Apply power Doppler concepts
Power Doppler imaging
- Understand power Doppler principles
- Apply power Doppler for low flow detection
Evaluate spectral Doppler waveform concepts
Waveform analysis
- Interpret spectral Doppler waveforms
- Recognize normal and abnormal flow patterns
Apply tissue Doppler concepts
Tissue Doppler imaging
- Understand tissue Doppler principles
- Apply tissue Doppler in cardiac imaging
Apply general hemodynamic concepts (e.g., pressure gradient, resistance)
Hemodynamics principles
- Understand hemodynamic principles
- Apply hemodynamic concepts to Doppler measurements
Apply Doppler artifacts concepts
Doppler artifacts
- Identify common Doppler artifacts
- Apply techniques to minimize artifacts
Perform Doppler measurements (e.g., velocity)
Doppler measurements
- Perform accurate Doppler velocity measurements
- Calculate hemodynamic indices
Apply spectral Doppler gain concepts
Spectral gain adjustment
- Adjust spectral Doppler gain appropriately
- Optimize waveform display
Apply spectral Doppler scale concepts
Spectral scale/PRF
- Adjust spectral Doppler scale appropriately
- Prevent aliasing through scale adjustment
Apply color Doppler gain concepts
Color gain adjustment
- Optimize color Doppler gain
- Balance sensitivity and noise
Apply color Doppler scale concepts
Color scale/PRF
- Adjust color Doppler scale appropriately
- Optimize for flow velocity range
5
Provide Clinical Safety & Quality Assurance
10%
Apply universal infection control protocols
CDC guidelines
- Apply CDC infection control guidelines
- Use appropriate PPE and hand hygiene
Document QA check on ultrasound machine
System QA documentation
- Document quality assurance checks
- Maintain QA records
Assess transducer integrity
Transducer testing
- Inspect transducers for damage
- Test transducer performance and safety
Verify ultrasound machine integrity
System integrity checks
- Verify ultrasound system integrity
- Perform routine system checks
Perform gray scale QA testing with tissue-mimicking phantoms
Phantom testing
- Perform phantom QA testing
- Interpret QA test results
Apply statistical parameter concepts (sensitivity, specificity)
Statistical concepts
- Understand sensitivity and specificity
- Apply statistical concepts to test evaluation
How do I earn this certification?
Passing SPI earns the SPI (Prerequisite Only) certification. It sits in the Diagnostic Medical Sonography track.
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How to study for this exam?
The most effective way to prepare for SPI is by using the PlanetCert Simulator to practice questions and review detailed explanations.
What's changed on this exam?
Current Status
- ACTIVE
- Last content update: 2024-01-01
Updates
- SIC Item Type Removed Question format now exclusively multiple-choice • Release date: 2025-09-03
- Harmonic Imaging Current Continues to be tested under Domain 3 (Optimize Sonographic Images) • Release date: Ongoing
- 3D/4D Imaging Current Tested under Domain 1 (Perform Ultrasound Examinations) and Domain 2 (Manage Ultrasound Transducers) • Release date: Ongoing
- Contrast Imaging Current Included in Domain 1 topics (contrast agents and contrast imaging concepts) • Release date: Ongoing
Who should take this exam?
Type: SPI Examination Requirement Pathway; Description: Completion of physics class or physics review course
Type: General Prerequisite Pathways 1-5; Description: Must meet education and clinical experience requirements
- Formal sonography education program completion
- Clinical ultrasound experience
- Physics coursework in ultrasound principles