Starting Small: Implementing a CT Protocol Optimization Program
Abstract
Purpose
This talk describes our organization’s CT optimization program, and how we implemented it to make efficient use of limited physicist time.
Methods
Our healthcare organization includes over 30 sites with CT scanners in multiple models, and several radiologist groups. We started optimizing and documenting protocol settings across models 3 years ago, with about 1/3 FTE physicist time available for this project. For effective use of physicist time, documentation responsibilities are divided between physicist and CT supervisors, with the physicist focusing on scan settings and reconstruction settings. The optimization process involves the physicist, the CT supervisor and one radiologist for each exam category (Neuro, Abdominal, Thoracic etc.) The radiologists provide requirements on reconstruction details, feedback on image quality and decisions on dose vs image noise tradeoffs. We have been working through protocols in an order based on exam frequency and clinical feedback.
Results
Our efforts began with common protocols such as routine Abdo/Pelvis, Head and Chest. The process yielded immediate results, as many protocols had potential improvements to make on at least some models. We have now improved and documented the majority of our protocols on most of our scanner models. The most common adjustments are dose settings, scan speeds, reconstruction kernel and IR settings, and slice thickness. This is an ongoing process, and the current protocols will be revisited regularly during protocol reviews.
Conclusion
Our protocol optimization program can be scaled to more sites as needed, and we plan to expand to more of our radiologist groups in the near future.