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RC 514 - CT imaging: the role of the radiographer and technological developments

Thursday, March 2, 08:30 - 10:00 Room: K Session Type: Refresher Course Topics: Evidence-Based Imaging, Radiographers Moderators: C. Beardmore (London/UK), R. Siemund (Lund/SE) Add session to my schedule In your schedule (remove)

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A. The role of the radiographer in interventional CT procedures

J. Santos; Coimbra/PT

Learning Objectives

1. To appreciate the clinical role of the most common CT interventional procedures.
2. To understand the role of the radiographer in CT interventional procedures.
3. To be aware of procedure optimisation in order to promote patient and staff safety.

Abstract

Computed tomography (CT) is a valuable medical tool to plan and guide interventional or therapeutic procedures. The interventional procedures can be performed based in 2 dimensions images (2D), image reconstructions (3D) or using CT fluoroscopy. These procedures allow continuous monitoring of needle course to the lesion. CT interventional typical diagnostic procedures are biopsies, which can be done as aspiration or fine-needle biopsies, punch biopsies, or drill biopsies. The goal is to acquire material for a microbiological analysis, to classify tumours before treatment or search for remaining living tumour cells after treatment. Various therapeutic procedures were drainages, tumour/ablation therapy, neurolysis, anesthesia injection and skeletal interventions can also be performed by CT. Several authors described CT fluoroscopy as successful method for percutaneous interventional procedures in the chest, spine, abdomen, and pelvis, however it is particularly more useful for deep structures, liver and lungs. Despise this applications CT fluoroscopy is the high radiation exposure procedure and radiation protection safety measures must apply. However the use of fluoroscopy CT is controversial and interventional procedures are regularly performed based on 2D images. Sterile conditions are required in all the interventions, the scanner room and the CT scanner needs to be carefully cleaned and disinfected, especially the CT table and the gantry. Planning the procedure is recommended in order to protect the staff and decrease the risk of patient’s over exposure and procedures complications. CT interventional procedures require teamwork and radiographers must be aware and involved in all the phases promoting the safety.

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B. Optimising CT doses

F. Zarb; Msida/MT

Learning Objectives

1. To appreciate the role of the radiographer in CT optimisation.
2. To learn about different ways of evaluating image quality resulting from CT dose optimisation strategies.
3. To discuss the impact of CT dose optimisation on patient radiation dose and image quality.

Abstract

Computed tomography (CT) is well documented as a main contributor to the radiation dose in medical imaging and constitutes the largest provider of radiation exposure to the population from medical imaging examinations. Once justified, CT examinations should be optimised to provide images from which a diagnosis can be obtained using the lowest radiation dose. The purpose of this presentation is to 1) outline the importance of the role of the radiographer throughout the optimisation process which should include all the links of the imaging chain, i.e. x-ray production, x-ray detection, image processing, image display and image interpretation; 2) learn about available methods in evaluating image quality during CT optimisation (the resultant image being the final link in the imaging chain) and 3) discuss the impact of CT optimisation on patient dose and image quality, i.e. limiting radiation exposure to the patient without compromising diagnostic efficacy.

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C. State-of-the-art CT technology

S. D. Mørup; Odense/DK

Learning Objectives

1. To appreciate new development in hardware and software with regards to image quality and radiation dose in CT.
2. To learn about the disadvantages of the new technologies in regards to the image quality and radiation dose.
3. To discuss how the radiographer can combine these new technologies with regard to image quality and radiation dose.

Abstract

In recent years, the manufacturers of computed tomography (CT) have developed several new applications that continue to make it possible to improve the image quality and reduce the radiation dose to the patient in CT. Radiographers must understand and appreciate these new applications and be able to use them wisely to achieve a dose reduction without compromising the image quality. There is no single method that works perfectly for all diagnostic challenges in CT and, therefore, the radiographer should be aware of the advantages and disadvantages when applying different new methods for dose reduction or for improving the image quality. This presentation discusses present challenges related to the new developments in CT, some of the developments are the organ effective modulation, which is a technique that delivers safer exams for patients by limiting the dose to radiosensitive organs like the breast or lens. Other applications are the automatic kV selection and improved software that can reduce metal artefacts without the use of dual energy or increasing the radiation dose.

Discussion and questions: Optimisation of care in CT: what else may be done?

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