For our team, protocols 1 and 2 are routine standard protocols for a thoracic ct examination. Ct angiographic source images with modern multisection ct. Questions regarding changes in the protocols should be directed to scott collins, rtr ct or lori garceau, rtr ct arrt. We assessed the sensitivity and specificity of a routine, standardized, multisection ct. To determine conversion factors for the new international commission on. Multisection ct angiography is a minimally invasive technique that can provide highresolution and highcontrast images of the arterial lumen. Monte carlo simulations were performed for spiral scanning protocols with different voltages. Overview of resources available for ct protocol optimization tim szczykutowicz, ph. For any given ct examination, the protocol will vary according the individual requirement of the imaging site. As multisection spiral computed tomography msct have been extensively used, it is important to consider the amounts of doses the patients are exposed during a computed tomography ct examination. Carotid cta aortic dissection carotid cta aortic stenosis neck, chest, abdomen, pelvis.
Patientspecific organ and effective dose estimates in. Overview of resources available for ct protocol optimization. Scanning protocols employed an electronbeam ct scanner model c150l. Safety and feasibility of a ct protocol for acute stroke. Depending on the objective of the protocol, the mean dlp varied from 97. The protocols provided in this text provide complete information regarding i patient. Multisection ct angiography compared with catheter angiography in diagnosing vertebral artery dissection article pdf available in american journal of neuroradiology 255. Chest ct scan at radiation dose of a posteroanterior and. To evaluate head ct protocol developed to improve visibility of the brainstem and cerebellum, lower bonerelated artefacts in the posterior fossa and maintain patient radioprotection.
Radiation dose to the conceptus from multidetector ct during early gestation. Multisection ct is superior to singlesection spiral ct in combining all these techniques in a timeoptimized protocol for compre. Aapm ct scan protocols the alliance for quality computed. Hospitals completed a web survey with detailed parameters for one patient per protocol, including. An emergency change, would be a request identified due to a medicationequipment shortagesupply issue, or dramatic shift in standard of clinical care that. A national survey on radiation dose in ct in the netherlands. Unless otherwise noted, protocols that include intravenous contrast enhancement use a 300 concentration, low osmolality agent. Can lowdose unenhanced chest ct be used for followup of lung nodules. 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. Subsecond multisection ct of regional pulmonary ventilation. Radiographic imaging systems can produce records of exposure and dose parameters for each patient. It can perform a fullbody scanning, or the gantry can be used without the table to scan the head. Effective dose was computed by using icrp publication 60 and publication 103 recommendations. Such images can aid in fitting the speech processor, especially in difficult cases.
I have read with great interest the recently published article of sharma et al. There is a wide range in the number of protocols used for helical ct in the abdomen and pelvis among the responding institutions. We assessed whether sequential ct can be replaced with thinly collimated multisection spiral ct without loss of image quality. Evaluation of 4 multisection ct systems in postoperative imaging of ci 35 introduction multisection ct msct has proven its ef cacy in the postoperative imaging of cochlear implant ci patients. Ctacquisition protocol for comprehensive phv evaluation at limited dose. The ct images are also impressive and they provide a good indication of the potential of this technique. We have read with great interest the letter by dr kloska 1 and a subsequent reply 2 concerning a study by sharma et al, 3 investigating the perfusion imaging correlate of cta source image ctasi lesions and would like to share our own data on this subject. From protocols to practice is an updated edition of mdct. Dose comparison in prospective versus retrospective. Scanning techniques and clinical applications1 multisection computed tomography ct was introduced in 1992 with the advent of dualsectioncapable scanners and.
The improved image quality of msct allows assessment of the precise intracochlear position of the electrode array and visualization of individual electrode contacts. The effective radiation dose in millisieverts was calculated by multiplying doselengthproduct by a conversion coefficient of 0. Multisection ct angiography compared with catheter. Compared with the normal pituitary gland, adrenocorticotropic hormonesecreting adenoma showed the least difference in contrast enhancement of the different functional microadenomas.
Twentyone hospitals participated in a dose survey for the 21 most frequently used ct protocols. Evaluation of 4 multisection ct systems in postoperative. Center the table height such that the external auditory meatus eam is at the center of the gantry. Ct protocol the collection of settings and parameters that fully describe a ct. However, such information is not readily available in the scan records. Jan 16, 2006 this book provides structured uptodate information on all routine protocols used for multislice multidetector row ct. These protocols have been approved unanimously by the ct ems medical advisory committee in an effort to establish the standard of ems patient care in the state of connecticut. A method that allows for variations in maternal body size and conceptus. European guidelines on quality criteria for computed tomography. Readjustment of abdominal computed tomography protocols in. Efficacy of highpitch ct protocols for radiation dose.
Protocol 3 is indicated when we wish to include morphological information on the coronary arteries in the standard thoracic ct examination, and protocol 4 is for any ct angiographic examination requiring standard morphological information to be linked. The purpose of this study was to develop a method to obtain accurate examination and patientspecific organ and effective dose estimates by use of available scan data and. Ct scan computed tomographycat scan centers and services. Reference mas is adapted automatically to the higher pitch values by the ct system itself due to technical limitations in the maximum tube current output of the xray tube when. Fully extended the arm should be supinated palm up, causing the radiusulna to be uncrossed. The purpose of this study is to investigate the feasibility of submillisievert ct of the skeletal pelvis of human cadavers using a standarddose protocol and four different reduceddose protocols reconstructed with filtered back projection fbp and iterative reconstruction ir. Multisection computed tomography ct was introduced in 1992 with the advent of dualsectioncapable scanners and was improved in 1998 following the development of quadsection technology. The book emphasizes the practical aspects of multidetector computed tomography ct and is intended to be a valuable tool for radiologists, residents, medical physics specialists, and radiology technologists in everyday clinical practice. Body sizeadapted ct protocol is a fundamental part of ct dose optimization because the minimal radiation dose required for diagnostic image quality would be varied even at the same diagnostic task depending on body size and habitus.
Ct angiography source images with modern multisection ct. In this poster we wanted to compare the dose administered to the patient during a cardiac ct scan performed with the retrospective and the prospective acquisition protocol using. Whilst some of this information is available with image data on the hospital picture archive and. Surveys 1 5 have shown that the contribution of ct to the total collective dose can be as high as 67% in the united states and 40% in europe, although ct examinations represent only about 11% and 4%, respectively, of all radiologic examinations. Patient should be supine, head first into the gantry, with the head in the headholder whenever possible. A variety of file formats are in use including plain text, bit map images showing pictures of written text and radiation dose structured reports as text or extended markup language files. We report the safety of this protocol in the first 53 patients imaged at our institution and the feasibility of. To assess radiation exposure due to ct in the netherlands. To our knowledge, the ability of multisection ct angiography in detecting vertebral artery va dissection has never been evaluated. Computed tomography dose index represents the dose to a 14. It has also been shown that malpositioning and kinking can. Multislice ct in cardiac imaging technical principles.
Effects of adaptive section collimation on patient radiation dose in multisection spiral ct article pdf available in radiology 2521. Image gently pediatric imaging image wisely adult imaging the purpose of these ct protocol pages is to provide a reference. Standard imaging protocols this document includes typical imaging protocols for diagnostic imaging. Ct protocol selection in petct imaging image wisely.
Remember that if you change parameters for any series in a multiphase study, you must make the same changes to the other series in that exam. While conventional ct involves mechanical rotation of an xray source around the subject, with electronbeam ct scanners a focused electron beam is. Capture and analysis of radiation dose reports for radiology. Routine abdomenpelvis please note that the routine abdomenpelvis protocol serves as a starting point for many examinations. Protocols table 1 summarizes the protocols used for performing the american college of radiology acr ct. Appropriate injection protocol is crucial, american journal of neuroradiology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at. Comprehensive imaging of ischemic stroke with multisection. On the basis of our findings, we agree with dr kloska that evaluation of acute ischemia with ctasi on stateoftheart multisection ct. In the article a survey of pediatric ct protocols and radiation doses in south korean hospitals to optimize the radiation dose for pediatric ct scanning, 1 which appeared in volume 94, issue 50 of medicine, the original figures 17 have been replaced with higherquality images. A practical approach, which was successfully published in 2006.
Axial mode provides the possibility of adjusting scanning parameters for the brain and posterior fossa. Export to pdf and upload individually tracks protocol version. Pdf multisection ct angiography compared with catheter. Developing dose and protocol monitoring from scratch ingrid reiser, phd dabr. Ct imaging increasingly relies on the integration of a variety of knowledge and skills. Clinical progress by the development of multislice ct msct technology beyond 16 slices can more likely be expected from further improved spatial and temporal resolution rather than from a mere increase in the volume coverage speed.
The introduction in 1998 of multidetector row computed tomography ct by the major ct vendors. Ct body chest colonography prep musculoskeletal neuro pedi protocols. Read ct angiographic source images with modern multisection ct scanners. Factors that infl uence a specifi c sites protocol parameters include the type of equipment available e. Multisection ct angiography compared with catheter angiography in diagnosing vertebral artery dissection chijen chen, yingchi tseng, tsonghai lee, huiling hsu, and laichu see background and purpose. A paired comparison of head ct performed without adaptive statistical iterative reconstruction asir and a clinically indicated followup with 40 % asir was acquired in one group of 55 patients. The objective of this study was to optimize ct protocols for wholebody pet ct by reducing radiation dose while minimizing effects on image quality. The otoscan is a multisection ct scanner intended for imaging in ear, nose, and throat settings and can be used to assess bone and soft tissue. Protocol 3 is indicated when we wish to include morphological information on the coronary arteries in the standard thoracic ct examination, and protocol 4 is for any ct angiographic examination requiring standard morphological information to be linked to study of the pulmonary perfusion. We present an evaluation of a recently introduced 64slice ct 64sct system, which makes use of a periodic motion of the focal spot in the. Stanford cardiovascular ct scanning and injection protocols.
American association of physicists in medicine aapm working group recognized by the fda. Use at least 22g needle follow gfr and metformin protocols for contrast studies lmp on pts of childbearing age shield children when possible. Materials and methods an observer study was conducted using data from 23 patients who were scanned with both a sequential collimation, 4 x 5 mm and a spiral technique. Pdf dental multisection ct for the placement of oral. Focal spot at 120 kv, if the ma is less than 570, the machine will default to the small focal spot, providing greater detail on the images. This reference is meant to serve as a guideline for prescribing ct examinations, and should be modified as needed for a particular patient. Review of portable ct with assessment of a dedicated head ct scanner z. In conclusion, in our study we found advantages in using asir in head ct protocols. Comprehensive imaging of ischemic stroke with multisection ct. With a recent increase in gantry speed from one to two revolutions per second, multisection ct scanners are now up to eight times faster than conventional.
The volume contains a detailed technical section and covers the prevailing investigations of the brain, neck, lungs and chest, abdomen with parenchymal organs and gastrointestinal tract, the musculoskeletal system and cta as well as dedicated protocols for the heart. Multisection ct as a valuable tool in the postoperative. The aim of the current study was to summarize msct doses in chinese patients to establish the diagnostic reference levels drls. Optimization of ct simulation imaging ingrid reiser dept. Pituitarytargeteddynamiccontrastenhancedmultisection. Any deviation from these protocols must be approved in writing by the ct ems medical advisory committee and the ct. Sex and agespecific conversion factors used to determine effective dose from dose length product. Can lowdose unenhanced chest ct be used for followup of. Radiologist can only oversee protocols relevant to their section generally cannot approve ct protocols for a different section i. The following cardiovascular ct scanning and injection protocols have been developed with the goal to derive theoretically sound and at the same time practicable scanning and injections protocols for the siemens sensation 64 multislice scanner at stanford. Pdf effects of adaptive section collimation on patient. To determine conversion factors for the new international commission on radiological protection icrp publica. Imatron, south san francisco, calif and a multisection subsecond spiral ct scanner model mx8000.
Advanced ct acquisition protocol with a thirdgeneration dual. In a recent investigation at our institution, 4 we analyzed 100 patients with acute ischemic stroke who underwent ctasi by using 2 different acquisition. Effects of adaptive section collimation on patient radiation dose in multisection spiral ct. On the basis of our findings, we agree with dr kloska that evaluation of acute ischemia with ctasi on stateoftheart multisection ct scanners depends primarily on the imaging protocol. Sex and agespecific conversion factors used to determine effective dose from doselength product. Alessio, phd university of washington, seattle, wa paul e. Background and purpose routine ct of the brain is traditionally performed with sequential ct. A data acquisition protocol for postoperative imaging of cochlear implants by using multisection ct msct is described. The full text of this article is available in pdf format. Sex and agespecific conversion factors used to determine effective dose from doselength product to determine conversion factors for the new. Erratum in the article a survey of pediatric ct protocols and radiation doses in south korean hospitals to optimize the radiation dose for pediatric ct scanning,1 which appeared in volume 94, issue 50 of medicine, the original figures 17 have been replaced with higherquality images. Radiography imaging standards manual orthopedic msk protocol trauma x protocol. How to appropriately calculate effective dose for ct using either.
Dental multisection ct for the placement of oral implants. Technique and applications 1 article pdf available in radiographics 307. The acquisition protocol for multisection ct angiography was 1. With the new protocol we improved image quality of the brainstem and cerebellum as well as reducing the total radiation dose. Most protocols include use of nonionic iv contrast material injected at a rate of 3 mlsec and a collimation of 7 mm.
Computed tomography ct is the most substantial contributor to the collective effective dose for all radiographic procedures. We hope you find this helpful in providing optimal patient care. Deak pd, smal y, kalender wa 2010 multisection ct protocols. The xcat ent is a conebeam ct scanner that is intended for intraoperative scanning of cranial bones and sinuses. Feasibility of submillisievert ct of the skeletal pelvis. Sex and agespecific conversion factors used to determine effective dose from doselength product radiology 2010 volume. Multidetector row ct systems and image reconstruction. The purpose of this study is to show how to calculate effective dose in ct using.
Multisection ct angiography is a minimally invasive technique that can provide highresolution and highcontrast images of the arterial lumen and wall. Multisection ct as a valuable tool in the postoperative assessment of cochlear implant patients 21 introduction cochlear implantation has become widely available and permits successful treatment of severe or pro found sensorineural hearing loss in patients who do not receive adequate bene t. A survey of pediatric ct protocols and radiation doses in so. On june 10, 20, the director of the center for devices and radiological health cdrh of the federal drug administration fda, jeffrey shuren, m. The effect of angular and longitudinal tube current modulations on the estimation of organ and effective doses in xray computed tomography. A survey of pediatric ct protocols and radiation doses in.
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