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MPPG Report 1.a - AAPM Medical Physics Practice Guideline 1.a: CT Protocol Management and Review Practice Guideline (2013) Category: MPPG Report The review and management of computed tomography (CT) protocols is a facility's ongoing mechanism of ensuring that exams being performed achieve the desired diagnostic image quality at the lowest radiation dose possible while properly exploiting the capabilities of the equipment being used. Therefore, protocol management and review are essential activities in ensuring patient safety and acceptable image quality. These activities have been explicitly identified as essential by several states, regulatory and accreditation groups such as the American College of Radiology (ACR) CT Accreditation program, as well as the Joint Commission in its Sentinel Event Alert, among others. The AAPM considers these activities to be essential to any quality assurance (QA) program for CT, and as an ongoing investment in improved quality of patient care. CT exam protocols are used to obtain the diagnostic image quality required for the exam, while minimizing radiation dose to the patient and ensuring the proper utilization of the scanner features and capabilities. Protocol Review refers to the periodic evaluation of all aspects of CT exam protocols. These parameters include acquisition parameters, patient instructions (e.g., breathing instructions), the administration and amounts of contrast material (intravenous, oral, etc.), and postprocessing parameters. Protocol Management refers to the process of review, implementation, and verification of protocols within a facility's practice. This is a complex undertaking in the present environment. The challenges in optimization of dose and image quality are compounded by a lack of an automated mechanism to collect and modify protocols system-wide. The manual labor involved in identifying, recording, and compiling for review and subsequent implementation of all relevant parameters of active protocols is not inconsequential. The clinical community needs effective protocol management tools and efficient methods to replicate protocols across different scanners in order to ensure consistent protocol parameters. The ability to quickly view and understand the myriad of CT protocol parameters contained within a single exam type is critical to the success of protocol review. The ability to quickly identify an outlier protocol parameter would also be hugely beneficial to the CT protocol review process. This MPPG only applies to CT scanners used for diagnostic imaging. It is not applicable to scanners used exclusively for: a.Therapeutic radiation treatment planning or delivery; b. Only calculating attenuation coefficients for nuclear medicine studies; or c. Image guidance for interventional radiologic procedures. Journal of Applied Clinical Medical Physics https://doi.org/10.1120/jacmp.v14i5.4462 Altmetrics for this report |
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