Accurate Patient Positioning In Abdominal CT: Dual Approach for Centering Accuracy
Abstract
Purpose
Patient mispositioning in CT imaging contributes to inconsistent radiation dose delivery and suboptimal image quality, impacting patient safety and diagnostic outcomes. This study evaluates the efficacy of the use of dual topograms versus the effect of an educational program that integrates anthropomorphic phantom-based training with real-time feedback to improve technologist proficiency and understanding of patient positioning importance.
Methods
The study was implemented in two phases. Phase 1 introduced lateral topograms in addition to the single PA topograms used clinically. Phase 2 added interactive workshops, incorporating anthropomorphic phantoms and hands-on, personalized learning to reinforce positioning concepts and dose optimization principles. Python code combined with open source body segmentation tools were used to analyze institutional CT data for miscentering. Statistical analysis included relative risks (RR) and 95% confidence intervals (CI) to compare pre- and post-interventions mispositioning rates, and descriptive statistics for dose indices (CTDIvol) and contrast-to-noise ratio (CNR). Baseline mispositioning rates of 10–20% were assumed, with power calculations targeting a 50% reduction.
Results
Mispositioning rates in phase 1 decreased, with average vertical offsets improving from 1.72 ± 1.79 cm to 1.17 ± 1.47 cm (RR: 1.32; 95% CI: 1.12–01.51; N=200). Mispositioning rates from phase 2 decreased, 2.22 ± 2.52 cm to 1.79 ± 2.09 cm (RR: 1.25; 95% CI: 0.91–01.73; N=200. Additional data will be analyzed to increase statistical confidence. An open source tool was developed to quickly analyze patient centering from CT images in order to provide institutions with data on their practices.
Conclusion
This innovative framework integrates practical tools, interactive education, and statistical evaluation to transform CT technologist training. By fostering skill development, engagement, and long-term retention, the program enhances patient safety and diagnostic precision