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CT Protocols: A Review of Modifications Over 24 Months at An Academic Medical Center

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T Oshiro

T Oshiro1*, M Bostani2 , J Sang3 , S Borgheian4 , M Devine5 , C Cagnon6 , M McNitt-Gray7 , (1) UCLA, Los Angeles, CA, (2) University of California, Los Angeles, Los Angeles, CA, (3) UCLA, Los Angeles, CA, (4) UCLA, Los Angeles, CA, (5) California State University, Northridge, Northridge, CA, (6) UCLA Medical Center, Los Angeles, CA, (7) UCLA School of Medicine, Los Angeles, CA


SU-I-GPD-P-7 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall

Purpose: Monitoring of CT protocols has been required for accreditation guidelines and is a good-practice philosophy. Many facilities implement a methodology which relies on CT technologists and review committees to self-identify and acknowledge when changes to scans are made. However, it is possible that unintended modifications could be made and may be missed by the review process.

Methods: A retrospective review from January 2015 to December 2016 of protocol parameter changes was performed on 11 CT scanners (excluding PET-CT) throughout an academic medical center using a semi-automated computer program (Visual Basic, ASP, HTML). This program was designed to analyze exported scanner protocol files (monthly) and identify parameter changes, and new or duplicate protocols.

Results: On average, the CT systems contained 223 protocols containing 753 (scans + localizer radiographs). Protocols included adult and child specific clinical scans as well as research-oriented examinations. The number of protocols remained fairly consistent on all scanners. However, the program identified scan and reconstruction parameter changes that numbered in the hundreds throughout the year.Manually reviewing a large quantity of variable changes on a monthly basis for all scanners would be time-prohibitive. Therefore, data filters were implemented to only display those scans with fields/parameters impacting patient dose (e.g. kVp, effective mAs, CTDIw, DLP). As a result, reported fluctuations reduced significantly and could be used as a tool for CT QC committee meetings.

Conclusion: Using a CT protocol analysis tool can be an effective way of double-checking modifications made to protocol files. Because of the large fluctuations in variables that potentially can be seen, filters can be created to reduce the amount of items flagged for review.

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