Journal of the American College of Radiology : JACR
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Although there has been increasing recognition of the importance of reducing radiation dose when performing multidetector CT examinations, the increasing complexity of CT scanner technology, as well as confusion about the importance of many different CT scan parameters, has served as an impediment to radiologists seeking to create lower dose protocols. The authors seek to guide radiologists through the manipulation of 8 fundamental CT scan parameters that can be altered or optimized to reduce patient radiation dose, including detector configuration, tube current, tube potential, reconstruction algorithm, patient positioning, scan range, reconstructed slice thickness, and pitch. Although there is always an inherent trade-off between image quality or noise and patient radiation dose, in many cases, a reasoned manipulation of these 8 parameters can allow the safer imaging of patients (with lower dose) while preserving diagnostic image quality.
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Transition from film-screen to digital radiography requires changes in radiographic technique and workflow processes to ensure that the minimum radiation exposure is used while maintaining diagnostic image quality. Checklists have been demonstrated to be useful tools for decreasing errors and improving safety in several areas, including commercial aviation and surgical procedures. ⋯ The checklist and its accompanying implementation manual and practice quality improvement project are open source and downloadable at www.imagegently.org. The authors describe the process of developing and testing the checklist and offer suggestions for using the checklist to minimize radiation exposure to children during radiography.
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Processes for credentialing physicians and criteria used for delineating their practice-specific clinical privileges vary widely across the United States. The ACR and the ABR have jointly developed this resource document to define the requisite credentials for specialty board-certified diagnostic radiologists and subspecialty board-certified nuclear radiologists to be privileged to practice therapeutic nuclear medicine. ⋯ On the basis of their education, training, and clinical work experience, board-certified radiologists have the qualifications to supervise and perform therapies using unsealed radioisotopes. Optimum patient care is best served by a physician with training and expertise in supervising and performing radioisotope therapies in conjunction with multimodality imaging technologies for initial diagnosis and follow-up.
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The aim of this study was to determine what proportion of noninvasive diagnostic imaging (NDI) work done by radiologists occurred in each of the 4 primary places of service where imaging is conducted. ⋯ Radiologists' workload in hospital outpatient and inpatient facilities and offices grew from 2000 through 2006, but no further growth occurred thereafter. EDs were the only venue where growth continued. The vast proportion of radiology NDI RVUs (81% in 2011) are produced in hospital settings.