image wisely ct protocols

“Image Wisely” is a social marketing campaign that promotes radiation awareness and education in adult imaging. The protocols represent a sampling of currently available scanner models and are not intended to provide comprehensive information for all available scanner models. Updated September 2016 | Download PDF. Other strategies to reduce dose occur at the ordering stage when referring doctors and patients are made aware of duplicate exams and referring doctors are educated about alternative exams with lower dose or no radiation. AAPM Releases Adult CT Colonography Protocols The American Association of Physicists in Medicine (AAPM), through its Alliance for Quality Computed Tomography, has posted adult CT colonography protocols that include manufacturer and model-specific protocols for all of the applicable manufacturers of CT equipment currently sold in the US. Within the radiology department, all CT protocols were reviewed and optimized for dose reduction. Home-grown and commercial software solutions have been developed to track radiation exposure by machine, CT protocol, geographic location, and patient, which is important to document processes and have data to promote quality improvement. Nuclear Medicine Radiation Dose Tool; Pediatric Injected Activity Tool; About Quality & Practice; Dosimetry; Advertisement. Educational Materials. An example is a renal split bolus where injection of contrast is performed first, then after, a set delay, a second bolus of contrast is administered and imaging is performed once. 2015 Nov;12(11):1185-90. doi: 10.1016/j.jacr.2015.02.021. Image Wisely home page. We lacked data on clinical features and disease severity, particularly from sites with multiple follow-up CT examinations. 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. Currently many new strategies and technologies are being developed to address concerns over CT radiation exposure. Minimize “image creep” so only the area requested is imaged. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Johnson PT, Mahesh M, Fishman EK. Standardization of protocols across sites. Epub 2015 Apr 16. Review. Smith-Bindman R, Moghadassi M, Wilson N, et al. Download PDF. Representatives from other areas, such as nursing, should also be consulted as necessary. 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. Decision support to determine appropriateness of the exam before ordering are assuring appropriate CT exams are being performed. Protocols, or scan instructions, are the core of every CT examination. Confirm that CT techniques for adult head, abdomen-pelvis, 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 mGy respectively). Image Wisely encourages practitioners to optimize the amount of radiation used in Outpatients presenting with chronic back/leg pain without red flags should begin with an L3-S1 CT Lumbar Spine Protocol unless otherwise stated. The protocol team should assure that protocols are appropriate for the clinical indication and that the scan parameters, including radiation dose, are tailored to the specific imaging task. AB - To reduce the radiation dose associated with CT scans, much attention is focused on CT protocol review and improvement. Image Gently - CT Scan Radiation, CT Scan Radiation Risk, CT Scan X Ray, There's no question: CT helps us save kids' lives. Consider the use of “split bolus” techniques with a power injector to gain different physiologic information (as in multiphase exams) with one radiation exposure. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA More is not better; adult-size KV and mAs are not always necessary for small bodies. Watch on-demand . Terms and Conditions | Privacy, Resources for Patients and Referring Practitioners, https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/CT-Protocols-and-Radiation-Dose. Network radiology exam databases and software to load outside examinations into regional PACs have been developed to prevent unnecessary duplication of CT exams. Epub 2015 Apr 16. Review. Rego S.L., Yu L., Bruesewitz M.R., et al.. Bruesewitz M.R., Yu L., Vrieze T.J., et al., Coursey C., Frush D.P., Yoshizumi T., et al., “Pediatric Chest MDCT Using Tube Current Modulation: Effect on Radiation Dose With Breast Shielding,”, Geleijns J., Salvadó Artells M., Veldkamp W.J., et al., “Quantitative Assessment of Selected In-Plane Shielding of Tissues in Computed Tomography Through Evaluation of Absorbed Dose and Image Quality,”, Geleijns J., Wang J., McCollough C., “The Use of Breast Shielding for Dose Reduction in Pediatric CT: Arguments Against the Proposition,”. Have a medical physicist run regular periodic quality improvement (QI) sessions on CT exams to make sure dose is within prescribed ranges. • Popular radiation safety cases for technologist, physician, and medical physicist credit. Image Wisely and Choosing Wisely: Importance of Adult Body CT Protocol Design for Patient Safety, Exam Quality, and Diagnostic Efficacy. Protocols, or scan instructions, are the core of every CT examination. ≥1.5 cm in short axis for jugulodigastric nodes 2. Communicating Risks and Benefits of Patient Shielding in Radiology. Asymmetric positioning can result in decreased image quality and an increase in patient dose. Imaging wisely: patient safety in CT Imaging wisely: patient safety in CT Lu, Zheng; Thomas, Stephen 2016-03-12 00:00:00 tribute to approximately 49% of collective effective The past decade has seen a significant growth in diag- radiation dose from medical exposure in the U.S. [4]. » http://www.aapm.org/pubs/CTProtocols/, Image Wisely encourages practitioners to optimize the amount of radiation used in Image Gently; Image Wisely; Scope of Practice; Webinars; Journals Articles; Dose Optimization. Minimize “image creep” so only the area requested is imaged. Multiphase exams expose a body part more than once during the CT exam and thus increase dose per exam. Make sure the exam is truly clinically indicated. (Low Dose) CT Protocols Christopher Cagnon, PhD Assoc. Use automatic exposure control techniques of tube current modulation (available from all manufacturers) to reduce dose. Be the patient’s advocate. A radiologist, medical physicist, and lead technologist should regularly review departmental CT protocols to make sure they are optimized. All aspects of the exam should be included in the protocol, including patient positioning, nursing instructions, scan parameters, reconstruction/reformatting instructions, and any other information necessary for the imaging team to complete the CT study successfully. Judicious Use of Multiphase Abdominal CT Protocols. ≥1 cm for other nodes. McCollough CH, Chen GH, Kalender W, et al. To routinely review imaging protocols to ensure that the least radiation necessary to acquire a diagnostic-quality image is used for each ... After you submit your pledge, look for the Image Wisely confirmation email containing a link to your pledge certificate. September 2019 — Pamela Johnson, MD, discussed harmonizing abdominal CT protocol utilization without compromising quality of care during an Image Wisely ® Facebook Live event. Work with your physicist, radiologist and department manager to review your adult CT protocols; then use the simple CT protocols on this Web site to “down-size” the protocols for kids. In younger patients, consider follow-up with modalities that use lower or no radiation dose (ultrasound or MRI). Image Safely Resources; Protocols; Parents; CT in Minor Head Injuries; Cardiac Imaging; MRI. A third area with potential to reduce radiation dose involves specific CT protocol development to maximize diagnostic yield while tailoring dose to the appropriate indication and patient size. AAPM - CT Scan Protocols, CT Dose Check and Education Slides; FDA - Computed Tomography; NEMA XR-29 Updated 6/26/18; Pediatric Radiation Safety. The Mission of Image Gently is Radiation Safety in Pediatric Imaging to improve safe and effective imaging care of children worldwide like: pediatric X ray imaging, x ray pediatrics, CT scan x ray, radiation from dental x rays. Continue reading U.S. ACR Practice Parameters and Technical Standards, American College of Radiology, 2013. Make sure an alternative imaging exam such as ultrasound or magnetic resonance imaging (MRI) is not available which could provide the same information without radiation exposure, particularly in pediatric and pregnant patients. New Image Gently “Universal” CT Protocols are now available for Head, Thorax and Abdomen. All aspects of the exam should be included in the protocol, including patient positioning, nursing instructions, scan parameters, reconstruction/reformatting instructions, and any other information necessary for the imaging team to complete the CT study successfully. Available at: Yu L., Lui X., Leng S., et al., “Radiation Dose Reduction in Computed Tomography: Techniques and Future Perspective,”, McCollough C.H., Primak A.N., Braun N., et al., “Strategies for Reducing Radiation Dose in CT,”. And be sure to take the pledge to Image Wisely! Image Gently ® has created many educational materials and offer them here on the website. Due to logistic and data privacy issues, we did not obtain CT image datasets or assess image quality with different CT protocols used at the participating sites. Resources for Patients and Referring Practitioners, https://www.radiology.wisc.edu/sections/msk/protocols.php, How I do it: Managing radiation dose in CT, CT radiation: Key concepts for gentle and wise use, Achieving routine submillisievert CT scanning: Report from the summit on management of radiation dose in CT, Adaptive statistical iterative reconstruction technique for radiation dose reduction in chest CT: A pilot study, Quality initiatives: CT radiation dose reduction: how to implement change without sacrificing diagnostic quality, Radiation Dose Management: A Comprehensive Optimization Process for Improving Patient Safety, Acute appendicitis in young adults: Low- versus Standard-Radiation-dose contrast-enhanced abdominal CT for diagnosis. Methods . • Direct links to RSNA scientific posters addressing radiation exposure that have been vetted by the Image Wisely executive committee. 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 exam have also increased. OUTLINE • Dose and image quality requirements • Protocol examples from vendors • Axial vs. Helical and other scanning considerations • Is 120 kVp the optimal tube potential? CT HEAD PROTOCOLS. Pre-load specific CT protocols on individual CT scanners to avoid potential technologist error in entering parameters. Asymmetric positioning can result in decreased image quality and an increase in patient dose. i. Derivation and approval of all components of the protocols should be completed by a team consisting at least of a radiologist, a medical physicist, and a technologist. Tailoring CT Protocols to the Patient's 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. Use of the split bolus in this example results in physiologic information about both the ureters and the renal parenchyma with only one radiation exposure. Patel MD, Ascher SM, Paspulati RM, et al. Michael F. McNitt-Gray, PhD, David Geffen School of Medicine, UCLA, Los Angeles, CA Smith-Bindman R, Wang Y, Yellen-Nelson TR, et al. These advances have resulted in our ability to image faster, capture rapidly moving structures such as the heart, and improve both temporal and spatial resolution. Changes to protocols are implemented only with consensus of the core team, with consideration of all aspects of the CT examination, including image quality, radiation dose, patient care and safety, and workflow. Ultrasound Protocols ; International Activities/ Resources.

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