X-Ray & CT Physics / Clinical CT

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1 Computed Tomography-Basic Principles and Good Practice X-Ray & CT Physics / Clinical CT INSTRUCTORS: Dane Franklin, MBA, RT (R) (CT) Office hours will be Tuesdays from 5pm to 6pm CLASSROOM: TIME: REQUIRED TEXTS: ATTENDANCE: GRADING POLICY: TBD Tuesday 6:00 pm 9:00 pm; Classes with exams may be from 6:00 pm 10:00 pm Computed Tomography for Technologists: A Comprehensive text by: Lois E. Romans Students must attend 80% of the classes to obtain CE credits. Attendance is highly recommended. Course grades will be based on the following: Exams 20% each, 80% total Homework 10% Mock CT registry 10% Letter grades will be assigned according to the following overall course percentages: A 94% or higher A % B % B 83-86% B % C % C 73-76% C % D % D 62-66% F 61% or lower

2 X-Ray and CT Physics Objectives: Upon completion of this course, the student will be able to understand and describe: 1. Describe the basic principles of x-ray physics. Including: a. X-ray generators, voltage waveforms, voltage rectification processes. b. X-ray tube design and heat loading characteristics. c. X-ray production processes, x-ray spectrum analysis. d. X-ray production processes and interactions. 2. Describe and understand the basic principles of computed tomography. 3. Understand the past and present operational modes of computed tomography. Including: a. First generation. b. Second generation. c. Third generation. d. Fourth generation. e. Helical vs. spiral scanning. 4. Describe and understand the essential components of a CT scanner. Including: a. Tube. b. Slip ring technology. c. Collimators (pre-patient and post-patient). d. Detector design and arrays. e. Data acquisition system. f. Filters 5. Describe CT image reconstruction and related terminology: a. Simple vs. filtered back projection. b. Reconstruction filters (low vs. high pass). c. Interpolation. d. Reconstruction interval. 6. Describe CT image display and related terminology: a. Pixel vs. voxel. b. Matrix. c. Image magnification.

3 d. Field of View (scan, recon and display). e. CT number. f. Attenuation coefficient. g. Window level, window width. h. Plane specification (x, y, z coordinates). 7. Describe the various scan parameters in CT and how each effects image quality. a. kvp. b. ma, mas c. Pitch. d. Scan time. e. Beam width and beam collimation. f. Slice width and slice thickness. g. Reconstruction variables. 8. Understand how CT image quality is assessed and the parameters associates with it. a. Spatial resolution b. Contrast resolution. c. Noise. d. Uniformity. e. Linearity. 9. Gain an understanding of the various quality control procedures performed on a CT scanner and the frequency with which these tests are performed. 10. Recognize the pattern and cause of various artifacts and describe how best to minimize or eliminate them. a. Beam Hardening b. Partial Volume Averaging c. Motion d. Metallic e. Edge Gradient f. Patient Positioning g. Equipment-Induced 1. rings 2. streaks 3. tube arcing 11. Understand the principles of CT dose and the dose descriptors related to it.

4 Clinical CT: This course is designed to give students the clinical background needed to understand CT exams and care for patients in this setting. This course will cover cross sectional anatomy, contrast agents, patient assessment for CT exams, and indications for commonly performed studies, CT procedures and protocols, and common pathology seen on CT. Course Objectives: At the completion of this course the student will be able to: Contrast Agents 1. Discuss the rationale for the use of contrast media. 2. Differentiate between negative, neutral and positive contrast agents. 3. Identify the physical properties of various contrast agents. 4. Describe the structural differences and characteristics of low and high osmolar injectable contrast media. 5. Identify the desired contrast agent employed for select exams. 6. Discuss the resources used to identify patients at risk of reacting to the contrast media. 7. Identify patient indicators for altering the selection of contrast media used to perform a given procedure. 8. Identify the strategies employed when faced with patients with a known history of a previous allergic reaction. 9. Recognize the indicators/symptoms associated with a patient experiencing a mild, moderate or severe reaction to contrast media. 10. Correctly adjust flow rates for various CT examinations. Cross Sectional Anatomy 1. Identify normal anatomical structures on sectional images of the head, neck, torso (chest, abdomen and pelvis), upper and lower extremities in axial, sagittal, and coronal planes. 2. Identify common pathology seen on CT exams. Patient Assessment for CT exams 1. Ask an appropriate history prior to each CT exam. 2. Check patient laboratory results prior to the CT examination for normal and abnormal results. 3. List and describe the instructions that need to be given to patients prior to and during the CT exam. 4. How to screen CT patients for various CT exams

5 CT Procedures and Protocols 1. Recite the patient preparation instructions necessary for various contrast and special studies. 2. Give a thorough procedure explanation for a CT exam as would be expected in the clinical setting. 3. Discuss the strategies for treating patients experiencing an adverse reaction to contrast media. 4. List and describe the most common indications for CT exams of the head, neck, chest, abdomen, pelvis, spine and extremities. DATE September 1 st LECTURE SCHEDULE Syllabus Review and Introduction X-Ray Interactions w/matter X-Ray Generators, Equipment Electronics September 8 th X-Ray Tube Design, Heat Loading Characteristics X-Ray Production & Emission CT Principles of Operation CH 1, 2 September 15 th CT Components CH 3, 4, 5 CT Detector Technology CT Reconstruction & Image Display September 22 nd Scan Parameters & Image Quality CH 6, 7 CT Artifacts Exam #1 (material from September 1 st through September 15 th ) September 29 th AAPM Report # 96 Factors Affecting Radiation Dose CH 14 & Dose Reduction Strategies October 6 th No Class October 13 th CT Quality Control CH 7, 9 Radiation Protection NYS CT QA Guide Data Management October 20 th Introduction to Clinical CAT Scan CH 8, 10, 11 Patient preparation and safety Post processing image reconstruction Exam #2 (material from September 22 nd through October 13 th )

6 October 27 th Contrast agents CH 12, 13 Injection techniques CT angiography November 3 rd November 10 th November 17 th November 24 th December 1 st Cross sectional anatomy, protocols, and pathology for CT of the head, facial bones, sinuses and temporal bones CH 15, 19 Cross sectional anatomy, protocols, and pathology for CT neck and chest CH 16, 20 Exam #3 (material from October 20 th through November 3 rd ) Cross sectional anatomy, protocols, and pathology for CT abdomen and pelvis CH 17, 21 Cross sectional anatomy, protocols, and pathology for CT spine and extremities CH 18, 22 Special procedures, PET CT fusion, Specialized Exams CH 23, 24 December 8 th Exam #4 (material from November 10 th through December 1 st ) Comprehensive review December 15 th Mock CT registry due electronically

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