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Center for Curriculum and Transfer Articulation
Computed Tomography Procedure Protocols
Course: ICE265

First Term: 2016 Summer
 Lecture   3.0 Credit(s)   3.0 Period(s)   3.0 Load  
Subject Type: Occupational
Load Formula: S


Description: Standard procedures and protocols for Computed Tomography (CT) imaging in alignment with the American Society of Radiologic Technologists (ASRT) examination curriculum outline. Includes patient preparation and safety, choosing appropriate protocols, interventional procedures, contrast indicators, post-exam processing quality issues, and adapting to atypical scanning situations.



MCCCD Official Course Competencies
1. Explain the importance of CT and room equipment set up; patient preparation and safety; and Protected Health Information (PHI). (I)
2. Compare and contrast types of CT scanners and their features and benefits. (I, VIII)
3. Describe and discuss patient education; and pre- and post-procedure instructions. (I-V)
4. List the correct protocols for specific body organs or systems based on symptoms or pathology considerations. (II-IV)
5. List and describe selection of correct scan parameters. (II-IV)
6. Explain adaptation of CT protocols for atypical imaging situations. (II, IV)
7. Describe and identify requirements and processes for choosing the appropriate contrast. (V)
8. Analyze variations and options available with post exam processing. (VI)
9. Describe computed tomography (CT) imaging, archiving, and future applications. (VI-VIII)
MCCCD Official Course Competencies must be coordinated with the content outline so that each major point in the outline serves one or more competencies. MCCCD faculty retains authority in determining the pedagogical approach, methodology, content sequencing, and assessment metrics for student work. Please see individual course syllabi for additional information, including specific course requirements.
 
MCCCD Official Course Outline
I. Overview of CT Equipment and Scan Preparation
   A. Types of CT Scanners in Use Today
   B. Previous Exams/Reports
   C. Room, Equipment, and Patient Preparation
      1. Indications for exam (scanner and patient limitations)
      2. Verify order
      3. Contraindications for exam
      4. Contrast or non-contrast study
      5. Patient assessment and monitoring
         a. History and Physical
         b. Current medications and allergies
         c. History of present illness
         d. Reactions, complications and treatment
      6. Health Insurance Portability and Accountability Act (HIPAA), Protected Health Information (PHI), and Informed Consent
      7. Patient Preparation, Education, and Instructions: Pre and Post procedure
II. Scan Protocol Parameters
   A. Patient
      1. Positioning (patient orientation)
      2. Anatomical landmarks
      3. Patient information/identifiers
   B. Equipment Parameters
      1. Scout/topogram range
      2. Gantry bore size and isocenter
      3. Technical factors
         a. Azimuth
         b. Matrix
         c. Mode (helical vs. axial)
         d. Algorithm
         e. Pitch
         f. Slice thickness
         g. Slice interval
         h. Scan Field of View (SFOV)
         i. Display Field of View (DFOV)
         j. Milliamperes (MA)
         k. Kilovoltage (KV)
         l. Rotation time
   C. Adapting to Atypical Situations
      1. Patient positioning challenges and tips
      2. Scanning mode (helical vs. axial)
      3. Rotation time
   D. Radiation Safety and Dosimetry - Dose Reduction Protocols
      1. Image Wisely protocols
         a. Routine imaging protocols and dose
         b. Low dose screening scans
      2. Image Gently protocols
         a. Pediatric weight categories (thorax and abdomen)
         b. Age categories (skull and brain)
      3. Dose recording and display (DoseCheck, DoseWise, etc.)
III. Specific Exam Protocols
   A. Adult Central Nervous System (CNS), Head and Neck Protocols
      1. Head
      2. Facial bones
      3. Orbits
      4. Paranasal sinuses
      5. Internal Auditory Canal (IACS)/temporal bones
      6. Soft tissue neck
      7. Cervical spine
      8. Thoracic spine
      9. Lumbar spine
      10. Neurovascular
      11. CT Perfusion - stroke
      12. Myelogram
   B. Adult Body Protocols
      1. Chest (lung, thorax and pulmonary)
      2. Abdomen
      3. Pelvis
      4. Upper extremity
      5. Lower extremity
      6. Musculoskeletal
      7. Vascular
      8. CT Perfusion - tumor
   C. Pediatric CNS and Head Protocols
      1. Head
      2. Facial bones
      3. Orbits
      4. Paranasal sinuses
      5. Internal Auditory Canal (IACS)/temporal bones
      6. Soft tissue neck
      7. Cervical spine
      8. Thoracic spine
      9. Lumbar spine
      10. Neurovascular
   D. Pediatric Body Protocols - Multi-Phase And Single Phase Scanning
      1. Neck
      2. Chest
      3. Abdomen
      4. Pelvis
      5. Upper extremity
      6. Lower extremity
      7. Vascular
   E. Cardiac Protocols
      1. Screening
      2. Electrocardiogram (ECG)
      3. Procedure
         a. Calcium scoring
         b. Cardiac Computed Tomography Angiography (CTA)
      4. Prospective and Retrospective gating
      5. Injection timing
      6. Viewing formats
   F. Interventional Protocols
      1. Biopsy/Drainages
      2. Tube placements
      3. Ablations
      4. Miscellaneous Applications
IV. Non-Routine Procedures
   A. Emergency Department Exams/Emergency Room Trauma
   B. Oncology
   C. Computed Tomography (CT) Guided Surgical Localizations
   D. Protocol variations
V. Contrast
   A. Pre-Administration Requirements
      1. Lab values
      2. Medication screening
      3. Patient history
      4. Signed Informed consent
      5. Joint Accreditation Commission of Health Care Organizations (JACHO) and American College of Radiology (ACR) Patient Safety Practice Guidelines and Standards
   B. Oral Contrast
      1. Indications/contraindications
      2. Routes of administration
      3. Types and Dosages
   C. Intravenous (IV) Contrast
      1. Venous access
         a. Venipuncture
         b. Power ports
         c. Power PICS
         d. Power Central lines
         e. Power dialysis catheters
      2. Indications/contraindications
      3. Allergic prep protocol
      4. Aseptic/Sterile technique
      5. Dosages
      6. Intravenous (IV) injection parameters/catheters
      7. Extravasation
      8. Reactions
      9. Types of power injectors
VI. Post Exam Processing
   A. Reconstruction of Scan Data
      1. Algorithm
      2. Display Field of View (DFOV)
      3. Slice thickness/interval
   B. Reformations
      1. Multi-planar reformation (MPR)
      2. Maximum Intensity Projections (MIPs) versus Average Intensity Projections (AIP or AVE)
      3. 3-Dimensional processing
         a. Surface rendering (SR) or Shaded surface rendering displays (SSD)
         b. Volume rendered imaging (VR)
         c. Virtual CT endoscopy (VE) and perspective volume rendering (pVR)
   C. Window Width and Window Level Display
   D. Imaging Format/Picture Archiving and Communications System (PACS)
VII. Archiving
   A. Magnetic Tape
   B. Digital Acquisition Tape (DAT) Tape
   C. Optical Disc
   D. Compact Disc (CD)
   E. Laser Disc
   F. Digital video Disc (DVD)
   G. Cloud storage
VIII. Future Applications in CT Imaging
   A. Radiation Therapy - CT Simulation
   B. Fusion imaging - Positron Emission Tomography/Computed Tomography Imaging (PET/CT)
 
MCCCD Governing Board Approval Date: May 21, 2013

All information published is subject to change without notice. Every effort has been made to ensure the accuracy of information presented, but based on the dynamic nature of the curricular process, course and program information is subject to change in order to reflect the most current information available.