Rad Tech's Guide to Clinical Computed Tomography

Concise guide to the essential components of Computed Tomography Rad Tech’s Guide to Clinical Computed Tomography offers a clear and concise exploration of the essential principles and practices of clinical CT. Presented in an accessible format, the book blends foundational knowledge with the latest advancements in the field, including the integration of artificial intelligence (AI) and photon-counting computed tomography (PCCT). It also provides practical tools to help readers prepare for computed tomography registry examinations. Core topics include patient care principles for safe, effective, and ethical imaging; standard protocols for imaging neuroanatomy, musculoskeletal and thoracic systems, and abdominopelvic structures; interventional CT techniques; and quality assurance measures. The guide further explores the rapidly evolving landscape of CT, highlighting innovations such as remote scanning—technology that enables technologists to operate CT systems from off-site locations. Readers will find: Clinical applications of AI and PCCT, emphasizing their potential to enhance diagnostic accuracy and workflow efficiency Guidelines for the safe administration of contrast media, including patient screening and premedication protocols Key considerations in radiation safety, covering photon interactions, dose metrics (CTDI and DLP), and strategies to minimize exposure Protocol recommendations for imaging the neurological, musculoskeletal, thoracic, and abdominopelvic systems, along with interventional CT techniques and quality assurance measures Rad Tech’s Guide to Clinical Computed Tomography is an essential learning resource for students and new technologists in radiography, nuclear medicine, radiation therapy, and those pursuing post-primary CT certification, as well as for practicing technologists seeking up-to-date knowledge of emerging technologies and best practices.

Acknowledgements xi SECTION I Patient Care and Safety 1 1. Assessment. 3 Obtaining Medical History and Consent 3 Verification 4 Medical History 4 Consent: Informed Consent 5 Monitoring Vital Signs 6 Patient Transfers 9 Documentation 12 Intercommunication Within Healthcare Team 13 2. Contrast Media Administration 15 Screening and Preparation 15 Contraindications 16 Necessary Lab Values 18 Premedication 19 Contrast Administration Routes 20 Contrast Administration Methods 21 Classifications 22 Water-Soluble (Iodinated) Properties 23 Barium Properties 26 Adverse Reactions 27 Adverse Reaction Classifications 27 Adverse Reaction Categories 28 Complications 29 Post-Procedure Care 31 3. Radiation Safety Considerations 33 Target Interactions 33 Photon Interactions with Matter 34 General Units of Radiation Measurement 36 CT Radiation Dosimetry (CTDI, DLP, etc.) 36 Scan Geometry 38 Imaging Parameters to Reduce Patient Exposure 39 Technologist Considerations to Reduce Patient Exposure 43 National Guidelines and Advocacy Campaigns 46 Personnel Protection 47 SECTION II Procedural Protocols 49 4. Neuroanatomy Imaging Procedures 57 General Positioning Considerations for Head 57 Equipment Specifications for Head Protocols 57 CT Head Without (and With) Contrast 58 CT Temporal Bones/Internal Auditory Canals (IACs) Without (or With) Contrast 61 CT Orbits Without (or With) Contrast 63 CT Sinuses Without (or With) Contrast 65 CT Facial Bones Without (or With) Contrast 67 CTA Circle of Willis (COW) 67 CTV Dural Sinuses 70 CT Brain Perfusion 70 General Positioning Considerations for Spine 74 Equipment Specifications for Spine Protocols 75 Contrast Administration for Spine Imaging 76 CT Cervical Spine Without (or With) Contrast 76 CT Thoracic Spine Without (or With) Contrast 78 CT Lumbar Spine Without (or With) Contrast 79 5. Musculoskeletal Imaging Procedures 81 General Positioning Considerations for Musculoskeletal 81 Equipment Specifications for Musculoskeletal Protocols 82 Contrast Administration for Musculoskeletal Imaging 83 CT Shoulder and/or Scapula Without (or With) Contrast 84 CT Elbow Without (or With) Contrast 84 CT Hand/Wrist Without (or With) Contrast 87 CT Bony Pelvis and/or Hip(s) Without (or With) Contrast 89 CT Knee Without (or With) Contrast 89 CT Ankle/Foot Without (or With) Contrast 89 Additional Considerations for CTA/CTV of Extremities 93 CTA/CTV Upper Extremity 94 CTA/CTV Lower Extremity 94 6. Thoracic Imaging Procedures 101 General Positioning Considerations for Neck and Chest 101 Equipment Specifications for Neck and Chest Protocols 101 Contrast Administration for Neck and Chest Imaging 102 CT Soft Tissue Neck With (or Without) Contrast 103 CTA Neck Carotid Arteries 105 CTV Neck Jugular Veins 106 CT Chest With (or Without) Contrast 108 Low-Dose CT (LDCT) Chest 108 High-Resolution CT (HRCT) Chest 111 Additional Considerations for CTA/CTV of the Chest 111 Coronary Artery Calcium Score 114 CT Pulmonary Arteriography (CTPA)/ Pulmonary Embolism (PE) Study 116 CTA Chest Thoracic Aorta 118 CTV Chest Superior Vena Cava (SVC) 120 Coronary CT Angiography (CCTA) 120 CTA Transcatheter Aortic Valve Replacement (TAVR) 123 7. Abdomen and Pelvis Imaging Procedures 125 General Positioning Considerations for the Abdomen and Pelvis 125 Equipment Specification for Abdomen and Pelvis Protocols 125 Contrast Administration for Abdomen and Pelvis Imaging 126 CT Abdomen/Pelvis With (and/or Without) Contrast 127 CT Renal Stone Study 130 CT Kidneys (Urogram) 132 Additional Considerations for CT Angiography (CTA)/CT Venography (CTV) of the Abdomen and Pelvis 132 CTA Abdomen/Pelvis 134 CTA GI Bleed 135 CT Enterography 137 CTV Abdomen/Pelvis 139 8. Additional Procedures 141 Interventional CT-Guided Procedures 141 Coagulation Lab Work 142 Imaging Acquisition Methods 142 Radiation Considerations 144 Indications 144 Risks and Complications 146 Quality Control (QC) Procedures 147 QC Team Members 147 QC Testing Frequency 148 QC Records 148 Action Limits 150 QC Phantom Tests and Methods 150 Other QC Tests and Measures 155 Preventive Maintenance 157 SECTION III Emerging Trends and Future Directions in Clinical Practice 159 9. Remote Scanning 161 Premise of Remote Scanning 161 Personnel Roles and Responsibilities in Remote Scanning 162 Professional Society and Organizational Position Statements 164 Benefits and Opportunities 166 Safety Considerations 167 Challenges 167 Future of Remote Scanning 169 10. Photon-Counting CT and Artificial Intelligence (AI) 171 Photon-Counting CT (PCCT) 171 Benefits and Opportunities 171 Challenges 173 Artificial Intelligence (AI) 174 Current Practices 174 Benefits and Opportunities 178 Challenges 180 References 183 Index 193