How to Build a SPI Study Plan That Works

Daryan Rivero
Sep 5
3 min read

Updated: Sep 5

Hey future sonographers!

Preparing for the SPI exam can feel overwhelming. Physics, instrumentation, Doppler, resolution. Where do you even start? The truth is, success comes from building a realistic plan that fits into your life instead of trying to cram everything at once.

Before You Dive In

Most ultrasound programs rely on the classic "green textbook", Understanding Ultrasound Physics by Sidney Edelman. Many students choose to read it cover to cover, which I highly recommend to do a few times. But once you have, now you need to start studying strategically exactly for what ARDMS wants you to know and testing your knowledge. Hence, here’s a 4-week plan built directly from the ARDMS SPI Content Outline (v24.1).

👉 Pro Tip: In the last 1–2 weeks before your test date, shift your attention toward the heaviest-weighted domains: Doppler (34%) and Image Optimization (26%). These two sections make up more than half of the exam.

Step 1: Know the Content Outline

ARDMS publishes the SPI exam outline, and it’s your blueprint. Break down the sections:

1. Perform Ultrasound Examinations — 23%

2. Manage Ultrasound Transducers — 7%

3. Optimize Sonographic Images — 26%

4. Apply Doppler Concepts — 34%

5. Clinical Safety & Quality Assurance — 10%

Step 2: Time-Block Your Weeks

Don’t “wing it.” Use a calendar or planner to assign topics. For example:

Week 1 – Perform Ultrasound Exams (23%) + Clinical Safety & QA (10%)

Principles of ultrasound operation (system controls, gain, depth, focus)
Knobology and scanning principles
Patient preparation, ergonomics, and positioning
Safety concepts: ALARA, thermal index, mechanical index
Quality assurance: phantom testing, preventive maintenance
📖 Edelman Textbook Review
- Chapter 2: Sound
- Chapter 3: Pulsed Sound
- Chapter 21: Bioeffects & Safety
- Chapter 22: Quality Assurance

👉 Focus: This week sets your foundation, practice applying ultrasound basics and safety in your review.

Week 2 – Manage Ultrasound Transducers (7%) + Intro to Doppler Concepts

Transducer types (linear, curvilinear, phased, sector)
Footprint selection and frequency ranges
Beam steering and focusing
Doppler basics: frequency shift, angle correction, continuous vs pulsed wave
📖 Edelman Textbook Review
- Chapter 8: Transducers
- Chapter 9: Sound Beams
- Chapter 17: Doppler Principles (intro sections)

👉 Focus: Spend less total time here, but master the basics, especially transducer physics, since this connects to Doppler performance.

Week 3 – Optimize Sonographic Images (26%)

Image resolution (axial, lateral, contrast, temporal)
Depth, gain, TGC, dynamic range adjustments
Artifacts: shadowing, enhancement, reverberation, mirror, aliasing in imaging
Harmonics and compound imaging
Gray scale vs color vs power Doppler optimization
📖 Edelman Textbook Review
- Chapter 10: Axial & Lateral Resolution
- Chapter 11: Display Modes
- Chapter 13: Real-Time Imaging
- Chapter 14: Pulsed Echo Instrumentation
- Chapter 15: Displays, Image Storage, Recording
- Chapter 16: Image Processing
- Chapter 20: Artifacts

👉 Focus: This section is heavily weighted. Practice recognizing images and artifacts. Expect “what’s wrong with this image?” type questions.

Week 4 – Apply Doppler Concepts (34%)

Doppler shift equation
Spectral Doppler, Color Doppler, Power Doppler
Aliasing, Nyquist limit, PRF adjustments
Waveform interpretation: triphasic, biphasic, monophasic
Hemodynamics, Bernoulli’s principle, Poiseuille’s law
Clinical applications (carotids, venous reflux, OB Doppler)
📖 Edelman Textbook Review
- Chapter 18: Hemodynamics
- Chapter 19: Doppler
- Chapter 20: Doppler Artifacts (as part of artifacts review)

👉 Focus: Dedicate the most time here. Don’t stress over calculations. The SPI usually tests your ability to apply principles in real-world scanning situations (e.g., “How would you eliminate aliasing?”) rather than plugging numbers into formulas.