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PROTOCOL DESIGN
Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists inNUCLEAR MEDICINE
Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS Using data from the American College of Radiology’s Dose Index Registry, the world’s largest registry of dose information, Kanal et al have established U.S. national dose levels for the 10 most common adult CT examinations based on patient size. IMAGE WISELY RADIATION SAFETY CASE: LOW DOSE RENAL CT Appropriate imaging of patients with renal colic can be accomplished by following published guidance and engaging the radiology care team. This case discusses how to choose and optimize imaging for patients with suspected urolithiasis or nephrolithiasis. CT DOSE FACT AND FICTION Computed tomography is undeniably valuable to modern medicine; however, questions regarding the safety of CT persist in the public mind. Daniel DeMaio presents an interesting perspective and thorough review of the benefits and risks involved with CTTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
RADIATION DOSE REDUCTION STRATEGIES IN CORONARY CTA RADOGC TECHNOLOGY , March/April 2020, Volume 91, Number 4 405 Shor eport Corbett gating reduced the 67% of the radiation dose. 3. However, prospective gating might not be effective for patients EDUCATION REQUIREMENTS The Joint Commission’s (TJC) newest set of Diagnostic Imaging Services Requirements went into effect on July 1, 2015. These requirements apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, and require that technologists who perform diagnostic computed tomography (CT) examinations participate in ongoing education, which includes HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Image Wisely home page. Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in Medicine. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenPROTOCOL DESIGN
Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists inNUCLEAR MEDICINE
Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS Using data from the American College of Radiology’s Dose Index Registry, the world’s largest registry of dose information, Kanal et al have established U.S. national dose levels for the 10 most common adult CT examinations based on patient size. IMAGE WISELY RADIATION SAFETY CASE: LOW DOSE RENAL CT Appropriate imaging of patients with renal colic can be accomplished by following published guidance and engaging the radiology care team. This case discusses how to choose and optimize imaging for patients with suspected urolithiasis or nephrolithiasis. CT DOSE FACT AND FICTION Computed tomography is undeniably valuable to modern medicine; however, questions regarding the safety of CT persist in the public mind. Daniel DeMaio presents an interesting perspective and thorough review of the benefits and risks involved with CTTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
RADIATION DOSE REDUCTION STRATEGIES IN CORONARY CTA RADOGC TECHNOLOGY , March/April 2020, Volume 91, Number 4 405 Shor eport Corbett gating reduced the 67% of the radiation dose. 3. However, prospective gating might not be effective for patients EDUCATION REQUIREMENTS The Joint Commission’s (TJC) newest set of Diagnostic Imaging Services Requirements went into effect on July 1, 2015. These requirements apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, and require that technologists who perform diagnostic computed tomography (CT) examinations participate in ongoing education, which includesNUCLEAR MEDICINE
Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in CHECKLISTS | IMAGE WISELY Image Wisely is a joint initiative of the American College of Radiology, Radiological Society of North America, American Society of Radiological Technologists and American Association of Physicists in SELECTING THE RIGHT TEST Selecting the Right Test and Considering Relative Radiation Dose: The Value of the ACR Appropriateness Criteria ®. Michael Bettmann, MD, FACR, Wake Forest University School of Medicine, Winston-Salem, NC DEDICATED SOLID STATE CARDIAC SYSTEMS FOR MYOCARDIAL Multiple Detector Systems. Myocardial perfusion imaging (MPI) has evolved from planar scintigraphy to single detector single-photon emission computed tomography (SPECT) imaging, to dual detector SPECT imaging to our present state of multiple (more than two) detectorSPECT imaging.
MYOCARDIAL PERFUSION SPECT Standard Myocardial Perfusion SPECT Protocols and Associated Patient Radiation Doses. Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival.SAFETY CULTURE
Culture Is a Key Driver of Radiation Safety. Since culture is defined in many different ways, it is often viewed as an ethereal topic. Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.” TRAINING CREDENTIALING AND PRIVILEGING Introduction. Although fluoroscopy is an essential tool for diagnosing and treating disease, rare applications have resulted in deterministic effects such as skin burns and hair loss. IMAGE WISELY RADIATION SAFETY CASE: CHILD-SIZING CT DOSE Developed by Image Gently ® and designed to provide practical explanations of some of the newer technologies and terminology in CT scans, this case reviews quality improvement as it relates to the performance of CT imaging. It discusses radiation risk and the relationship of image quality to patient dose. Authors: K. Strauss; M. Goske Target Audience: Radiologists, imaging technologists and DUAL-ENERGY CT AND RADIATION DOSE RADIATION SENSIBILITIES RICHARD L. MORIN, PHD, DONALD P. FRUSH, MD Dual-Energy CTand Radiation Dose Thomas Reher, MD INTRODUCTION As dual-energy CT scanners become CLINICAL ASPECTS OF GENERAL NUCLEAR MEDICINE NOVEMBER 2012 Cop/ WWW.IMAGEWISELY.ORG 3 yright © American College of Radiology Examples of Common General Nuclear Medicine Imaging Examinations and Performance HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenPROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading. DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
IMAGE WISELY RADIATION SAFETY CASE: LOW DOSE RENAL CT Case 12: Low Dose Renal CT. Appropriate imaging of patients with renal colic can be accomplished by following published guidance and engaging the radiology care team. This case discusses how to choose and optimize imaging for patients with suspected urolithiasis or nephrolithiasis. Authors: T. Reher, D. Gress, T. Hameed. TRAINING CREDENTIALING AND PRIVILEGING EDUCATION REQUIREMENTS The Joint Commission’s (TJC) newest set of Diagnostic Imaging Services Requirements went into effect on July 1, 2015. These requirements apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, and require that technologists who perform diagnostic computed tomography (CT) examinations participate in ongoing education, which includes CT DOSE FACT AND FICTION CT Radiation Dose and Risk: Fact vs Fiction. Computed tomography is undeniably valuable to modern medicine; however, questions regarding the safety of CT persist in the public mind. Daniel DeMaio presents an interesting perspective and thorough review of the benefits and risks involved with CT in his recent article for Radiologic Technology. HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenPROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading. DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
IMAGE WISELY RADIATION SAFETY CASE: LOW DOSE RENAL CT Case 12: Low Dose Renal CT. Appropriate imaging of patients with renal colic can be accomplished by following published guidance and engaging the radiology care team. This case discusses how to choose and optimize imaging for patients with suspected urolithiasis or nephrolithiasis. Authors: T. Reher, D. Gress, T. Hameed. TRAINING CREDENTIALING AND PRIVILEGING EDUCATION REQUIREMENTS The Joint Commission’s (TJC) newest set of Diagnostic Imaging Services Requirements went into effect on July 1, 2015. These requirements apply to accredited hospitals, critical access hospitals and ambulatory health care organizations, and require that technologists who perform diagnostic computed tomography (CT) examinations participate in ongoing education, which includes CT DOSE FACT AND FICTION CT Radiation Dose and Risk: Fact vs Fiction. Computed tomography is undeniably valuable to modern medicine; however, questions regarding the safety of CT persist in the public mind. Daniel DeMaio presents an interesting perspective and thorough review of the benefits and risks involved with CT in his recent article for Radiologic Technology. ACCREDITATION OF YOUR CT PROGRAM The ACR developed its CT Accreditation Program in 2002 to promote overall quality in the practice of CT and to be educational in nature. The program evaluates the qualifications of personnel, equipment performance, quality of clinical images, appropriateness of scan parameters/technique, scan performance characteristics, and radiationdose
SELECTING THE RIGHT TEST Selecting the Right Test and Considering Relative Radiation Dose: The Value of the ACR Appropriateness Criteria. ®. It is essentially universally accepted that imaging studies are not always used appropriately. Although overuse generates the greatest concern, both inappropriate overuse and underuse occur. Underuse may compromisepatient care
DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator of ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of childSAFETY CULTURE
Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.”. For the purpose of radiation safety during imaging procedures, safety culture can be described as a basic mindset or the way employees behave when they believe no one is watching. However, a more specific definition is needed sinceimproving
CHECKLISTS | IMAGE WISELY X-ray beam collimated to avoid unnecessary radiation exposure (especially radiosensitive organs, such as breast, thyroid, eyes and gonads) Last Image Hold or Fluoroscopy Store functions are used whenever possible. If exposures are necessary, use lowest magnification, frame rate IMAGE WISELY RADIATION SAFETY CASE: CHILD-SIZING CT DOSE Developed by Image Gently ® and designed to provide practical explanations of some of the newer technologies and terminology in CT scans, this case reviews quality improvement as it relates to the performance of CT imaging. It discusses radiation risk and the relationship of image quality to patient dose. Authors: K. Strauss; M. Goske Target Audience: Radiologists, imaging technologists and RADIATION DOSE REDUCTION STRATEGIES IN CORONARY CTA RADOGC TECHNOLOGY , March/April 2020, Volume 91, Number 4 405 Shor eport Corbett gating reduced the 67% of the radiation dose. 3. However, prospective gating might not be effective for patients IMAGE RECONSTRUCTION TECHNIQUES Image Reconstruction Techniques . Lifeng Yu, PhD. Mayo Clinic, Rochester, MN. Shuai Leng, PhD. Mayo Clinic, Rochester, MN (Updated Sept. 2016) Image reconstruction in CT is a mathematical process that generates tomographic images from X-ray projection CLINICAL ASPECTS OF GENERAL NUCLEAR MEDICINE NOVEMBER 2012 Cop/ WWW.IMAGEWISELY.ORG 3 yright © American College of Radiology Examples of Common General Nuclear Medicine Imaging Examinations and Performance HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenCOMPUTED TOMOGRAPHY
Continue reading. CT Protocol Design and Optimization. Resources for CT protocol design and optimization, dose-reducing techniques, and pros and cons of in-plane patient shielding. Continue reading. Image Reconstruction Techniques. Reconstructions that improve image quality can be translated into a reduction of radiation dose. Continuereading.
PROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading.SAFETY CULTURE
Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.”. For the purpose of radiation safety during imaging procedures, safety culture can be described as a basic mindset or the way employees behave when they believe no one is watching. However, a more specific definition is needed sinceimproving
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenCOMPUTED TOMOGRAPHY
Continue reading. CT Protocol Design and Optimization. Resources for CT protocol design and optimization, dose-reducing techniques, and pros and cons of in-plane patient shielding. Continue reading. Image Reconstruction Techniques. Reconstructions that improve image quality can be translated into a reduction of radiation dose. Continuereading.
PROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading.SAFETY CULTURE
Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.”. For the purpose of radiation safety during imaging procedures, safety culture can be described as a basic mindset or the way employees behave when they believe no one is watching. However, a more specific definition is needed sinceimproving
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator of DIAGNOSTIC REFERENCE LEVELS Diagnostic reference levels must be defined in terms of an easily and reproducibly measured dose metric using technique parameters that reflect those used in a site’s clinical practice. In radiographic and fluoroscopic imaging, typically measured quantities are entrance skin dose for radiography and dose area product for fluoroscopy. PEDIATRIC CT AND IMAGE GENTLY Pediatric CT and Image Gently. The utility of CT in patients of all ages is undeniable , and was paralleled by its increasing use over the last decade of the 20 th and the first decade of the 21 st centuries . Approximately 11% of the estimated 69 million CT scans performed in the US as of data reported in 2000 and 2007 were MODERN FLUOROSCOPY IMAGING SYSTEMS Fluoroscopy differs from most other X-ray imaging in that the images produced appear in real-time, allowing evaluation of dynamic biological processes and guiding interventions. Electronic fluoroscopy systems create this perception by capturing and displaying images at a high frame rate, typically 25 or 30 frames per second. MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
PREGNANT PATIENT
That is, non-ionizing options are always preferable to any test with ionizing radiation in pregnant patients. In particular, most pregnant patients with pelvic pain should initially be scanned with ultrasound. When the diagnosis with ultrasound is not clear, imaging can be performed with MRI, in particular when appendicitis is suspected (7). HOW TO UNDERSTAND AND COMMUNICATE RADIATION RISK Figure 1. Radiation – Deterministic and Stochastic Effects. A.1. Deterministic Effects (Cell Death) Cells are dying all of the time in the body from physical, chemical and other causes (i.e. “natural causes”). In most cases these cells are replaced or the body adapts to function normally when this occurs. TRAINING CREDENTIALING AND PRIVILEGING Introduction. Although fluoroscopy is an essential tool for diagnosing and treating disease, rare applications have resulted in deterministic effects such as skin burns and hair loss. DEDICATED SOLID STATE CARDIAC SYSTEMS FOR MYOCARDIAL Studies have shown that images from these solid state imagers using conventional myocardial perfusion imaging (MPI) doses of 10 mCi for rest and 30 mCi from stress acquired at four minutes for rest and two minutes for stress are of higher quality and at least of equal diagnostic value to those acquired on conventional two-detector SPECTcameras
HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenCOMPUTED TOMOGRAPHY
Continue reading. CT Protocol Design and Optimization. Resources for CT protocol design and optimization, dose-reducing techniques, and pros and cons of in-plane patient shielding. Continue reading. Image Reconstruction Techniques. Reconstructions that improve image quality can be translated into a reduction of radiation dose. Continuereading.
PROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading.SAFETY CULTURE
Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.”. For the purpose of radiation safety during imaging procedures, safety culture can be described as a basic mindset or the way employees behave when they believe no one is watching. However, a more specific definition is needed sinceimproving
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
HOME | IMAGE WISELYNEWSABOUT USCONTACT USIMAGING PROFESSIONALSREFERRING PRACTITIONERSIMAGING FACILITIES Visit Image Gently®. Advance a national dialogue on avoiding unnecessary medical tests, treatments and procedures. Visit Choosing Wisely®. Demonstrate to your patients, payers and referring physicians that you are committed to providing the safest and best quality care possible. Become an Accredited Facility. IMAGING PROFESSIONAL I wish to optimize the use of radiation in imaging patients and thereby pledge: To put my patients' safety, health and welfare first by optimizing imaging examinations to use only the radiation necessary to produce diagnostic-quality images.; 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 whenCOMPUTED TOMOGRAPHY
Continue reading. CT Protocol Design and Optimization. Resources for CT protocol design and optimization, dose-reducing techniques, and pros and cons of in-plane patient shielding. Continue reading. Image Reconstruction Techniques. Reconstructions that improve image quality can be translated into a reduction of radiation dose. Continuereading.
PROTOCOL DESIGN
CT Protocol Design. William W. Mayo-Smith, MD, Brigham and Women's Hospital, Boston, MA. Updated September 2016 | Download PDF. Computed tomography (CT) scanners have become markedly more complex over the past three decades, with a myriad of new options for performing CT examinations. Technical developments in the past have focused onhelical
NUCLEAR MEDICINE
Optimizing Oncologic FDG-PET/CT Scans to Decrease Radiation Exposure. Careful selection of patients to be imaged and the appropriate PET/CT imaging protocol should be a priority of the radiologist/nuclear medicine physician and the referring physician in order to avoid unnecessary repeated exposure. Continue reading.SAFETY CULTURE
Still, the importance of culture is known, as most agree, that “culture eats strategy for lunch.”. For the purpose of radiation safety during imaging procedures, safety culture can be described as a basic mindset or the way employees behave when they believe no one is watching. However, a more specific definition is needed sinceimproving
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator ofTHIS CERTIFICATE
01.18 This certificate is awarded to on (certificate expires December 31 of this year) for demonstrating their commitment to promote safetyin medical imaging.
ULTRASOUND AS AN ALTERNATIVE TO CT Use of Ultrasound as an Alternative to CT. In light of concern over radiation dose in CT, it is helpful to remember that ultrasound is the imaging modality of choice for a number of abdominal, pelvic, and cardiovascular indications. Because ultrasound does not use ionizing radiation it is particularly useful in children and in women of child DIAGNOSTIC REFERENCE LEVELS FOR ADULT CT EXAMS The study establishes patient-size based diagnostic reference levels (DRLs) and achievable doses (ADs) for the 10 most common CT head, neck and body examinations. A summary table of ADs and DRLs for median size patients is presented below. Except for head and brain without contrast, all exams used water-equivalent diameter as an indicator of DIAGNOSTIC REFERENCE LEVELS Diagnostic reference levels must be defined in terms of an easily and reproducibly measured dose metric using technique parameters that reflect those used in a site’s clinical practice. In radiographic and fluoroscopic imaging, typically measured quantities are entrance skin dose for radiography and dose area product for fluoroscopy. PEDIATRIC CT AND IMAGE GENTLY Pediatric CT and Image Gently. The utility of CT in patients of all ages is undeniable , and was paralleled by its increasing use over the last decade of the 20 th and the first decade of the 21 st centuries . Approximately 11% of the estimated 69 million CT scans performed in the US as of data reported in 2000 and 2007 were MODERN FLUOROSCOPY IMAGING SYSTEMS Fluoroscopy differs from most other X-ray imaging in that the images produced appear in real-time, allowing evaluation of dynamic biological processes and guiding interventions. Electronic fluoroscopy systems create this perception by capturing and displaying images at a high frame rate, typically 25 or 30 frames per second. MYOCARDIAL PERFUSION SPECT Myocardial perfusion single-photon emission computed tomography (SPECT) is a well-established, highly standardized test to detect significant coronary artery disease and to risk-stratify patients with regard to cardiac event-free survival. Recently there have been significant advancements in scintillation camera hardware and softwarethat allow
PREGNANT PATIENT
That is, non-ionizing options are always preferable to any test with ionizing radiation in pregnant patients. In particular, most pregnant patients with pelvic pain should initially be scanned with ultrasound. When the diagnosis with ultrasound is not clear, imaging can be performed with MRI, in particular when appendicitis is suspected (7). HOW TO UNDERSTAND AND COMMUNICATE RADIATION RISK Figure 1. Radiation – Deterministic and Stochastic Effects. A.1. Deterministic Effects (Cell Death) Cells are dying all of the time in the body from physical, chemical and other causes (i.e. “natural causes”). In most cases these cells are replaced or the body adapts to function normally when this occurs. TRAINING CREDENTIALING AND PRIVILEGING Introduction. Although fluoroscopy is an essential tool for diagnosing and treating disease, rare applications have resulted in deterministic effects such as skin burns and hair loss. DEDICATED SOLID STATE CARDIAC SYSTEMS FOR MYOCARDIAL Studies have shown that images from these solid state imagers using conventional myocardial perfusion imaging (MPI) doses of 10 mCi for rest and 30 mCi from stress acquired at four minutes for rest and two minutes for stress are of higher quality and at least of equal diagnostic value to those acquired on conventional two-detector SPECTcameras
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* Imaging Professional __ * Referring Practitioner __ * Imaging Facility __ * Association or Educational Program __NEWS
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May 17, 2021
NEW RSNA DOSE EXHIBIT: HOW LOW CAN YOU GO? DEVELOPMENT & IMPLEMENTATION OF A LOW DOSE SCOLIOSIS PROTOCOL IN PEDIATRIC PATIENTSContinue reading
GENERAL
April 23, 2021
NEW RSNA DOSE EXHIBIT: IS INCREASED DOSE REQUIRED FOR THE USE OF ANANTI-SCATTER GRID?
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April 21, 2021
RADIATION SAFETY CASE & FACEBOOK LIVE VIDEO ON PORTABLE CHEST X-RAYS THROUGH GLASS DURING THE COVID-19 PANDEMICContinue reading
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Catch up with previous Image Wisely Facebook Live events. These short videos cover a range of topics, from CT and the pregnant patient tolow-dose lung CT.
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RADIATION SAFETY CASES Assess your understanding of important radiation safety concepts with our series of free, web-based case studies. Each case provides expert feedback as well as references and resources for further study.View cases
RSNA RADIATION DOSE EXHIBITS Image Wisely is pleased to bring you this series of education exhibits from the RSNA annual meeting, highlighting aspects of radiation safety and patient dose. New exhibits are added monthly.See the latest
RADIATION SAFETY INFORMATION BY MODALITY GENERAL RADIATION SAFETY Resources discuss radiation safety topics applicable to all imagingmodalities
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Resources for patients on radiation safety in medical imaging REFERRING PRACTITIONERS Reliable information for referring practitioners to help manage patient imaging needsCOMPUTED TOMOGRAPHY
Resources to optimize CT procedures, the largest source of medicalradiation
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Resources to optimize nuclear medicine procedures, the second largest source of medical radiationFLUOROSCOPY
Resources to optimize fluoroscopy procedures, the third largest source of medical radiation. Now you can also receive a certificate for reading selected content.WHAT WE'RE READING
February 05, 2021
UTILITY OF LOW-DOSE CHEST CT FOR THE DIAGNOSIS OF COVID-19Continue reading
May 08, 2020
RADIATION DOSE REDUCTION STRATEGIES IN CORONARY CTAContinue reading
May 08, 2020
COMPARING ABSORBED DOSES OF PROPERLY & IMPROPERLY COLLIMATEDABDOMINAL EXPOSURES
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