Mayosmith, md, brigham and womens hospital, boston, ma updated september 2016 download pdf. Alessio, phd university of washington, seattle, wa paul e. As the demand for these services remains high, clinicians and patients have noticed the challenge in accessing these services. Given the rapid evolution of ct technology in the past decade, the number of applications for ct has expanded greatly and the techniques for performing the optimal. Promoting radiation safety protocols in computed tomography.
The efficacy of an image gently image wisely radiology departmental campaign consisting of the optimization of ct protocols to reduce dose while maintaining quality, and an educational effort to alter the ordering patterns of referring physicians at a multihospital academic center, was evaluated. Choosing the most appropriate imaging exam involves a collaborative decision between the radiologist and the referring healthcare provider based on the patients suspected. To convey the principles of the image wisely program to the imaging team in order to ensure that my facility optimizes its use of radiation when imaging patients. Radiation dose optimization concern issues with ct exposure abdominal ct is equivalent to 200 chest xrays on a ct scanner without dose reduction technology many of our newer ct scanners have dose reduction technology asir adaptive statistical iterative reconstruction, we will see slides in. Asrt, acr, rsna and the american association of physicists in medicine. Image wisely adult imaging the purpose of these ct protocol pages is to provide a reference for radiology residents, fellows and technologists when prescribing a ct examination. Image gently, ct imaging and radiation protection of. Benefits of ct exams mdct is faster than older ct scanners, reducing need for sedation and general anesthesia faster ct allows children to hold their breath ct scanning is painless, noninvasive and accurate ability to image bone, soft tissue and blood vessels all at same time in emergency room settings, ct exams are fast. Ct protocol faqs 2 the principals of properly centering small and pediatric patients are demonstrated in the scout images below, where the. As the demand for these services remains high, clinicians and patients have.
Typically 200 imaging protocols per scanner need the actual ct protocols. Butler, ms, facr, faapm, american college of radiology, reston, va download pdf. Imaging, particularly computed tomography ct pulmonary angiography, is a rapid, accurate and widely available test, but has limited value in patients who are very unlikely, based on serum and clinical criteria, to have significant value. Ct protocol selection in petct imaging image wisely. Ct scan protocols, ct protocols by manufacturer ge, siemens, phillips, toshiba. Computed tomography is the largest source of medical radiation exposure. Ct scanning ct protocols ct scan protocols imaging. Nuclear protocols pdf the table of contents is linked to the corresponding pages for quick access. Utilization of a patient dose tracking and monitoring. Radiation dose optimization for adult and pediatric protocols, as addressed in image gently and image wisely campaigns safe procedures for operation of ct equipment expected or typical dose levels for common ct exams dose notification and alert levels adult ct scan protocols i have read the documents and understand their content. The benefits of computed tomography are immense and certainly exceed the risks. Image gently embodies the hippocratic oath ideal, in that, whereas diagnostic imaging is an exceptional medical tool, health care practitioners must also agree to use it judiciously, minimize. To provide the best image quality at the lowest dose, proper patient positioning is always.
Download a reference card listing common imaging examination doses. Focal spot at 120 kv, if the ma is less than 570, the machine will default to the small focal. Ct imaging increasingly relies on the integration of. Confirm that ct techniques for adult head, abdomenpelvis, chest, and pediatric head and pediatric abdomen exams are at or below the reference levels suggested by the acr currently 75, 25, 21, 40, and 20. Brigham and womens hospital, boston, ma updated sept. In order to ensure that the lowest level of radiation exposure is used that provides only the necessary image quality for the diagnosis or procedure, physicians and ancillary professionals should be familiar with current recommendations on protocols and radiation management from professional organizations. R ct promoting radiation safety protocols in computed tomography. More recently, concern has been raised about the risk of carcinogenesis from medical radiation, with a focus on ct. Protocols, or scan instructions, are the core of every ct examination. Evaluating an image gently and image wisely campaign in a. The image wisely campaign, the adult counterpart to the image gently campaign, is based on the success of the alliance for radiation safety in pediatric imaging. Computed tomography ct is an imaging test that is widely used worldwide to establish medical diagnoses and perform image guided interventions. New joint commission radiology standards july 1, 2015 duke eldridge, m. Download a medical imaging tent card for your patients.
The constituent founding organizations are aapm, acr, asrt, and the radiological society of north america rsna, with individuals from the alliance providing consultation. Export to pdf and upload individually tracks protocol version. Please refer to the publications for the definitive standards. Kinahan, phd university of washington, seattle, wa computed tomography ct acquisition during positron emission tomography pet ct imaging is often performed for a variety of purposes. Computed tomography ct, sometimes called computerized tomography or computed axial tomography cat, is a noninvasive medical examination or procedure that uses specialized x. The purpose of these ct protocol pages is to provide a. Take the pledge to image wisely and view resources on. Ct imaging increasingly relies on the integration of a variety of knowledge and skills. Kinahan, phd, ct protocol selection in petct imaging image wisely, 2012.
Modalityspecific ct, nuclear medicine, and fluoroscopy information including links to vendor microsites for modelspecific imaging protocols. Therefore, it is critical that you start the scan immediately after the threshold or time delay specified in the protocols, since the indicated settings account for this delay. A radiologist is a physician who is an expert in interpreting images of the body obtained with xray, fluoroscopy, ultrasound, ct computed tomography or mri equipment. Standard imaging protocols this document includes typical imaging protocols for diagnostic imaging. Popular radiation safety cases for technologist, physician, and medical physicist credit. Radiation safety, ct dose optimization and safe procedures. Communicating and collaborating to improve imaging services the increasing demand for mri and ct scans has led to longer wait times for imaging services across the country. Prior to 2001 the vast majority of ct imaging of children was conducted using the same or similar. The utility of ct in patients of all ages is undeniable 14, and was paralleled by its increasing use over the last. Using the uw protocols, i sometimes find that parts of the image are too noisy, particularly towards the posterior part of the patient. In whole body petct imaging, the ct portion can be used for. Acr position statements american college of radiology. This method of multiple image acquisition requires a significant radiation burden quoted between 1535 msv 116, 117. Dec 01, 2010 image wisely hopes to work collaboratively with by contributing to the radiation safety content found on that site.
Unless otherwise noted, protocols that include intravenous contrast enhancement use a 300 concentration, low osmolality agent. Importance of adult body ct protocol design for patient safety, exam quality, and diagnostic efficacy. The pediatric radiologist tailoring ct protocols to the patients age, size, and clinical scenario image gently is an education, awareness, and advocacy campaign the mission of the image gently alliance is, through advocacy, to improve safe and effective imaging care of children worldwide. However, this is only true when they are ordered appropriately and studies are optimized to obtain the best image quality with the lowest radiation dose.
Communicating and collaborating to improve imaging services. New joint commission radiology standards july 1, 2015. The mission of image gently is radiation safety in pediatric imaging to improve safe and effective imaging care of children worldwide like. Other key features of the image wisely website include the following.
Aapm working group on standardization of ct nomenclature and protocols disclaimer the individuals involved in the production of this document along with the aapm, acr,asrt, mita, the fda and the image gently alliance and the image wisely alliance do not endorse any of the specific products mentioned in these slides. The purpose of this article is to a describe the importance of educating ra. Image wisely follows on the remarkable success of image gently, which since its january 2007 start continues to focus attention on safe imaging of pediatric patients. Mar 27, 2018 other key features of the image wisely website include the following. Standards 1 and 2 on assessment and analysis are your guide to ensuring an appropriate action plan is established for completing a ct exam.
Image gently embodies the hippocratic oath ideal, in that, whereas diagnostic imaging is an exceptional medical tool, health care practitioners must also agree to use it judiciously, minimize risks to patients, and remember, first, do no harm. With the goal of modulating patient radiation exposure, iv contrast enhanced multidetector ct mdct protocols should include a delayed post contrast acquisition defined as an acquisition after the portal venous, hepatic or nephrographic phases only if it will provide additional diagnostic information. Download a customizable medical imaging fact card for your patients. Confirm that ct techniques for adult head, abdomenpelvis, chest, and pediatric head and pediatric abdomen exams are at or below the reference levels. Such work has led to decreased radiation doses in pediatric ct protocols. On june 10, 20, the director of the center for devices and radiological health cdrh of the federal drug administration fda, jeffrey shuren, m. Radiographer knowledge and practice of paediatric radiation dose protocols in digital radiography in gauteng. A ct departments ability to image with low radiation doses is determined primarily by the ct scan protocols and the radiologists image quality expectations and to a lesser extent by the dose. To communicate optimal patient imaging strategies to referring physicians, and to be available for consultation. Aapm ct scan protocols the alliance for quality computed. Computed tomography ct, sometimes called computerized tomography or computed axial tomography cat, is a noninvasive medical examination or procedure that uses specialized xray equipment.
Mri protocols pdf the table of contents is linked to the corresponding pages for quick access. Assessment of imaging protocol and patient radiation exposure in pediatric computed tomography angiography. Ct protocol faqs 1 ct protocol frequentlyasked questions faqs critical comments on proper patient centering. Image gently image wisely the joint commissions revised requirements for diagnostic imaging services that go into effect july 1, 2014, specify that the organization verifies and documents that radiologic technologists who perform ct examinations participate in ongoing education. Some general information and philosophies on protocol design and optimization can be found at the following sites. Compare ct exposures to currently developing diagnostic reference levels drls to compare your protocols to regional and national values. Patients should remove metal items in the field of view e. The increasing demand for mri and ct scans has led to longer wait times for imaging services across the country. Computed tomography ct is an imaging test that is widely used worldwide to establish medical diagnoses and perform imageguided interventions. Image wisely is a collaborative effort of four charter members.
Iterative reconstruction techniques in abdominopelvic ct. Typical ct urography protocols have required multiple image acquisitions to obtain the unenhanced, contrastenhanced nephrographic, and contrastenhanced excretory phase images. Dec 28, 2016 typical ct urography protocols have required multiple image acquisitions to obtain the unenhanced, contrastenhanced nephrographic, and contrastenhanced excretory phase images. Included ct protocols were chestabdomenpelvis with contrast administration n 4621 ct studies of 1064 patients, abdomenpelvis with contrast administration n 876 ct studies of 261 patients. All aspects of the exam should be included in the protocol, including. Take the pledge to image gently and help provide safe and effective imaging of children worldwide. Timing of ct scan delay with respect to iv contrast. Presented at the radiological society of north america, chicago, il. American association of physicists in medicine aapm working group recognized by the fda. Slice counts dual source, 320 slice, 256 slice, 128 slice, 64 slice, 16 slice, 4. Ct protocols pdf the table of contents is linked to the corresponding pages for quick access. Patients should void immediately before imaging if the pelvis is being imaged. Developing dose and protocol monitoring from scratch ingrid reiser, phd dabr.
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