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Program Information

Tailoring CT Protocols to the Patient's Age, Size, and Clinical Scenario


D Bakalyar

F Ranallo
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K Applegate




D Bakalyar1*, F Ranallo2*, K Applegate3*, (1) Henry Ford Health System, Detroit, MI, (2) University of Wisconsin, Madison, WI, (3) University of Kentucky, Lexington, KY

Presentations

7:30 AM : A brief introduction to the effects of size on dose and image quality in CT - D Bakalyar, Presenting Author
7:50 AM : Dispelling myths and making adjustments: How the physicist should account for size and age when designing CT protocols - F Ranallo, Presenting Author
8:40 AM : Meeting the imaging needs of the pediatric radiologist: The effect of patient size, age and clinical circumstance on optimizing the CT image - K Applegate, Presenting Author

MO-AB-201-0 (Monday, July 31, 2017) 7:30 AM - 9:30 AM Room: 201


Though acceptable CT images may be obtained from a broad range of scanning parameters, the results are often far from optimal. The basic objective in selecting CT scanning parameters for any specific exam is to produce consistently diagnostic images at the lowest dose. In addition to the differences in capabilities between scanner models, the variation in size, age, condition and diagnostic need of each patient have an impact on the selection of these optimal CT parameters. Combined, all of these elements can present challenges in designing and modifying CT scanner protocols. One consideration is radiation dose. CT scanners provide pre-scan estimates of CTDIvol and DLP. Proper use of this dose information, along with the adjustments for patient size provided by the size specific dose estimate (SSDE) of TG204 and TG220 are useful not only for dose comparisons but for creating and modifying protocols and for inter-scanner translation of protocols. Even for the same patient dose, the fine tuning of scan parameters such as tube potential, current, pitch, rotation time, kernels and iterative reconstruction can significantly affect the quality of the scan. Though the effect of patient size is ameliorated substantially by automatic modulation of the tube current (mA) during the scan, optimization of the protocol, especially for large and small patients, may require informed compromise. Pediatric patients, even after patient size is considered, can have substantially different scanning requirements than do adults. Understanding these differences can sometimes lead to a superior scan at a possibly lower radiation dose. Two medical physicists and a radiologist will present information that will lead to a better understanding in the design and implementation of CT protocols.

I: A brief introduction to the effects of size on dose and image quality in CT (Donovan M. Bakalyar, Ph.D.)
II: Dispelling myths and making adjustments: How the medical physicist should account for size and age when designing CT protocols (Frank N. Ranallo, Ph.D.)
III: Meeting the imaging needs of the pediatric radiologist: The effect of patient size, age and clinical circumstance on optimizing the CT image (Kimberly E. Applegate, MD)

Learning Objectives:
1. To make effective use of dose parameters in optimizing protocols
2. How best to adjust scanning parameters for optimization of protocols
3. To understand imaging requirements for pediatric patients

Handouts


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