RER9132: Strengthening Member State Technical Capabilities in Medical Radiation Protection (2014 2015)

Task 1.Development of diagnostic reference doses at clinically acceptable image quality

Modality: Comuted tomography (CT)

Instructions for project task implementation

Choose CT rooms for data collection
Collect data for each CT scanner in a separate file
Preferably collect data prospectively
Name the file in the following way: Country_City_CTscannerID.xls
In the form CT1 provide data for the CT scanner

Use form CT2 to collect data for patient examinations. Separate worksheets are provided for adult and paediatric ex
Collect in a separate worksheet data for each of the following examinations (related to the most common indication
Adult

Head (acute stroke)

Children Head (Brain +soft tissues)

Chest (lung cancer)

Chest/thorax

Chest high resolution (interstitial lung disease)

Abdomen

Abdomen (liver metastases)

Abdomen and pelvis (abscess)
Chest-abdomen-pelvis (cancer)

For each examination, collect data for at least 20 adult patients (age >15) and 50 pediatric patients of different size/
For each patient, indicate the Image quality score (three level scale), see instructions in the form
Additional instructions are included in the forms

Radiation Protection (2014 2015)

e image quality

e provided for adult and paediatric examination. You may use one or both for a particular scanner.

ated to the most common indication is given in the parenthesis):

ain +soft tissues)

50 pediatric patients of different size/age pooled together. No weight restriction applies.

uctions in the form

Contact details
Country
City
Hospital
Name of the person completed the form
Position/profession
The forms completed on (Day/Month/Year)
e-mail

Data for the CT scanner

CT manufacturer
CT model
Year of installation
Year of manufacturing
Number of detector rows
Automatic exposure control (tube current modulation) available?
CTDI / DLP display available?
If Yes, CTDI displayed in CTDIw or CTDIvol?
If Yes, was CTDI display verified by measurements? Agreement (%)?
CTDI for pediatric body displayed for which phantom (16 cm or 32 cm)?
Annual workload (No of adult examinations/year)
Annual workload (No of paediatric examinations/year)

Lateral body width, cm*

Patient body AP diameter, cm *

Scout image/images: AP; PA;

Lat?

Weight (kg)

Height (cm)

Age

Gender (m/f)

Data of examination

Patient No

Patient data

Average
Standard deviation
Minimum

#DIV/0!
#DIV/0!
0

#DIV/0!
#DIV/0!
0

Maximum
0
0
Median
### #VALUE!
Third quartile
### #VALUE!
NB: Please copy rows from above to provide more data

Lateral body
width

AP body
diameter

*For AP and lateral body width, select an image in the middle of the scan region. Measure di
AP body diameter corresponds to patient width measured along minor (anterior-posterior) ax

AP body
diameter
Contrast material used: No - no contrast; O - oral; IV - intravenous; R - rectal
Protective shield used: Pb - lead shield; Bi - Bismuth shield; No - shield not used
Image quality scoring to be done by a radiologist:
1 - fully acceptable
2 - acceptable with remarks
3 - unacceptable

Contrast material used

Sequence label

Number of examination
seqences

Clinical indication

Exposure parameters

kV
mA mAs

### ###
### ###
0
0

###
###
0

0
0
### ###
### ###

0
###
###

of the scan region. Measure diameters, as shown on the image. Lateral body width corresponds to patient
ng minor (anterior-posterior) axis in middle image of main scan sequence.

nous; R - rectal
No - shield not used

trot (s)
DLP (mGy.cm) total for the
examination

Reference phantom (16 cm

or 32 cm)

CTDI (mGy): list in separate

rows for each
phase/secuence

Scanning mode

Scanning range (cm)

Beam width (NxT), mm

Pitch, p

posure parameters
Dose data displayed

###
###
0

###
###
0

#DIV/0!
#DIV/0!
0

#DIV/0!
#DIV/0!
0

0
###
###

0
###
###

0
#VALUE!
#VALUE!

0
#VALUE!
#VALUE!

width corresponds to patient width measured along major (transverse) axis in middle image of main scan s

Image quality score

Shielding used?

xis in middle image of main scan sequence.

Lateral body width, cm*

Patient body AP diameter, cm *

Scout image/images: AP; PA;

Lat?

Weight (kg)

Height (cm)

Age (in days for age <1

month; in months for < 1
year; in years for >1 y)

Gender (m/f)

Data of examination

Patient No

Patient data

NB: Please copy rows from above to provide more data

*For AP and lateral body width, select an image in the middle of the scan region. Measure di
image of main scan sequence. AP body diameter coresponds to patient width measured alo

AP body
diameter

Lateral body
width

Contrast material used: No - no contrast; O - oral; IV - intravenous; R - rectal

Protective shield used: Pb - lead shield; Bi - Bismuth shield; No - shield not used
Image quality scoring to be done by a radiologist:
1 - fully acceptable
2 - acceptable with remarks
3 - unacceptable

Scanning range (cm)

mA mAs trot (s)

Beam width (NxT), mm

kV

Pitch, p

Contrast material used

Sequence label

Number of examination
seqences

Clinical indication

Exposure parameters

le of the scan region. Measure diameters, as shown on the image. Lateral body width corrresponds to pati
ds to patient width measured along minor (antero-posterior) axis in middle image of main scan sequence.

venous; R - rectal
No - shield not used

Image quality score

Shielding used?

DLP (mGy.cm) total for the

examination

Reference phantom (16 cm

or 32 cm)

CTDI (mGy): list in separate

rows for each
phase/secuence

Scanning mode

Dose data displayed

ody width corrresponds to patient width measured along major (transverse) axis in middle
age of main scan sequence.

Somebody to support patient in

the room?

Sedation used?

Immobilisation means used

Indication
Head (acute stroke):

Chest (lung cancer):

Chest high resolution (interstitial

lung disease):

Head: acute stroke

Head:query stroke
Head:CVA
Head:heamorrhage
Head:head trauma
Head:headache or facial pain
Head:visual disturbancy
Head:aura/migraine, aura/migraine, atypical seizure
Head:confusion, vomiting, slurred speech, limb weakness
Head:existing aneurysm
Head:previous sugery: CVA, evaciation of hematoma, biopsy
Chest: lung cancer
Chest:query lung cancer/metastases/malignancy/tumour/neoplasm
Chest:query case of shadowing
Chest:query limphadenopathy
Chest:previous lymph node enlargement
Chest:bulky hilum (that not persist on plain film)

Chest HR:interstitial lung disease

Chest HR:query emphysema/pulmonary fibrosis/bronchiectasis
Chest HR severe brathlessness, hypoxia, query parenchymal involvment
Chest HR:subpleural ground-glass opacity

Abdomen (liver metastases):

Abdomen:liver methastases
Abdomen:query liver cancer/matastases/malignancy/tumour/neoplasm
Abdomen:abdominal pain
Abdomen:jaundice
Abdomen:abnormal liver lesion on ultrasound
Abdomen:liver enlargement on ultrasound

Abdomen and pelvis (abscess):

Abdomen and pelvis:abscess

Abdomen and pelvis:query abscess/infection/infected fluid

Other data for drop-down lis

Manufacturers
GE
Philips
Siemens
Toshiba
Hitachi
Other

Abdomen and pelvis:abdominal distension

Abdomen and pelvis:tenderness/pain/guarding/sepsis
Abdomen and pelvis:fever, leukocythosis and surgery in the last four weeks

Chest-abdomen-pelvis (cancer):

Chest-abdomen-pelvis:cancer

Paediatric head (trauma):

Paediatric head:trauma

er data for drop-down lists

Rows
YN
<16
Yes
16
No
64
128
320
Other

Phantom Gender
16 cm
Female
32 cm
Male

Scout
AP
PA
LAT

Contrast
No contrast
Oral
Intravenous
Rectal

Mode
Axial
Helical

Shielding
No shielding
Lead
Bismuth

ImageQuality
Immobilisation
Fully acceptable
STR-strap
Acceptable with remark SWAD-swaddling clot
Unacceptable
Other

Support
Nobody
Paretnt
Staff
Other

CTDI
CTDIw
CTDIvol