Imaging Pearls ❯ Practice Management ❯ Protocols
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- Results: Implementation of the checklist led to further actions in 25.9% of cases. The most common actions were calls to referring providers to modify or clarify an order (24.3%), followed by verification of proper pre- medication in patients with allergy to iodinated contrast (12.7%) and contacting the radiologist for protocolling (12.7%).
Conclusions: Implementation of a pre-CT checklist that can be tailored to individual practices has potential to improve patients' safety and experience as well as providing a more efficient clinical operation.
Summary sentence: We present an easy-to-implement checklist to maximize CT throughput in an outpatient setting that can be customized to the needs of individual institutions and has the potential to improve patients' safety and experience.
The pre-CT checklist: A simple tool to improve workflow and patient safety T in an outpatient CT setting
Sheila Sheth, Beatrice Mudge, Elliot K. Fishman
Clinical Imaging 66 (2020) 101–105 - Summary sentence: We present an easy-to-implement checklist to maximize CT throughput in an outpatient setting that can be customized to the needs of individual institutions and has the potential to improve patients' safety and experience.
The pre-CT checklist: A simple tool to improve workflow and patient safety T in an outpatient CT setting
Sheila Sheth, Beatrice Mudge, Elliot K. Fishman
Clinical Imaging 66 (2020) 101–105 
The pre-CT checklist: A simple tool to improve workflow and patient safety T in an outpatient CT setting
Sheila Sheth, Beatrice Mudge, Elliot K. Fishman
Clinical Imaging 66 (2020) 101–105
- CT Scan Protocols
- “The goal in selecting protocols is not necessary to create the highest technical quality image but to generate a diagnostic image using the lowest dose possible.Strategies to reduce medical radiation exposure have in large part revolved around two aims; first, to achieve higherawareness regarding the significance of medical radiation exposure, and second, to leverage new technology to obtain high quality images from inherently noisier data. These two objectives are exemplified by widely publicized efforts on the part of professional medical imaging organizations such as ImageWisely (http://www.imagewisely.org) in the first case, and by the development of new iterative reconstruction algorithms for low-dose CT in the second.”
Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose
Sigal Trattner et al.
J Am Coll Radiol. 2014 March ; 11(3): 271–278 - "Most CT protocols for abdomen must be performed with wider detector configuration and non-overlapping pitch to maximize scanner dose efficiency. Routine acquisition of multiphase abdominal CT (pre- and post-contrast images or pre/post/delayed images) should be discouraged. Iterative reconstruction processing algorithms have been shown to reduce image noise compared to standard filtered back-projection reconstruction techniques, thus allowing scans to be performed at lower dose.”
Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose
Sigal Trattner et al.
J Am Coll Radiol. 2014 March ; 11(3): 271–278 - "Achieving a low dose scan is a team effort requiring tailoring of the scan to the patient and medical question, continuous quality improvement to implement emerging strategies for dose optimization, and awareness of the scanning team to the risk and hence the need for keeping the dose as low as possible. Attaining this goal in practice requires a considerable knowledge base, encompassing radiation physics, biology, and epidemiology, and spanning different clinical applications, team members, and patient populations.”
Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose
Sigal Trattner et al.
J Am Coll Radiol. 2014 March ; 11(3): 271–278
- Is there more information on a CT scan than we are currently using?
● Axial CT
● Multiplanar CT (coronal, sagittal, oblique)
● 3D Imaging ( SSD to MIP to VRT to CR)
● Augmented Reality
● AI and Deep Learning including Radiomics
● The unknown that is coming - CT Imaging of the Pancreas
● Challenges
● Detection of a pancreatic abnormality
● Classification of a pancreatic abnormality
● Differential diagnosis
● Staging of a tumor
● Patient management and triage
- OBJECTIVE. The objective of this study was to determine whether body fat percentage, measured using a portable handheld bioelectric impedance analysis (BIA) device, and body mass index (BMI, weight in kilograms divided by the square of height in meters) can estimate the amount of intraabdominal and intrapelvic fat and thereby predict the need for oral contrast material before abdominopelvic CT.
CONCLUSION. Using BIA in addition to BMI accurately predicts amount of intraabdominal and intrapelvic fat. This information may help guide the decision to use oral contrast material in patients presenting for abdominopelvic CT.
Using Body Mass Index and Bioelectric Impedance Analysis to Assess the Need for Positive Oral Contrast Agents Before Abdominopelvic CT
Wu Y et al.
AJR 2018; 211:340–346
- “Scout images are an integral part of any CT examination and should be carefully reviewed for findings that may or may not be included in the FOV of the study.”
Reviewing CT Scout Images: Observations of an Expert Witness Daffner RH AJR 2015; 205:589–591 - “Scout images are an integral part of any CT examination and should be carefully reviewed for findings that may or may not be included in the FOV of the study. As a longtime radiologic educator, I have emphasized to my students, residents, and fellows the importance of look- ing at all of the images of a CT or MRI exami- nation and at every portion of radiographs. We are responsible for everything on those images. The CT scout image is the modern equivalent of the edges of the film. As the late Dr. Jacobson said, the answer is often there.”
Reviewing CT Scout Images: Observations of an Expert Witness Daffner RH AJR 2015; 205:589–591 - “The CT scout image is the modern equivalent of the edges of the film. As the late Dr. Jacobson said, the answer is often there.”
Reviewing CT Scout Images: Observations of an Expert Witness Daffner RH AJR 2015; 205:589–591