Compliance with AAPM Practice Guideline 1.a: CT Protocol Management and Review - from the perspective of a university hospital.

Timothy P Szczykutowicz,Myron Pozniak,Frank N Ranallo,Robert K Bour

doi:10.1120/jacmp.v16i2.5023

Timothy P Szczykutowicz, Myron Pozniak + Show 2 more

Open Access

https://doi.org/10.1120/jacmp.v16i2.5023

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Abstract

The purpose of this paper is to describe our experience with the AAPM Medical Physics Practice Guideline 1.a: “CT Protocol Management and Review Practice Guideline”. Specifically, we will share how our institution's quality management system addresses the suggestions within the AAPM practice report. We feel this paper is needed as it was beyond the scope of the AAPM practice guideline to provide specific details on fulfilling individual guidelines. Our hope is that other institutions will be able to emulate some of our practices and that this article would encourage other types of centers (e.g., community hospitals) to share their methodology for approaching CT protocol optimization and quality control. Our institution had a functioning CT protocol optimization process, albeit informal, since we began using CT. Recently, we made our protocol development and validation process compliant with a number of the ISO 9001:2008 clauses and this required us to formalize the roles of the members of our CT protocol optimization team. We rely heavily on PACS‐based IT solutions for acquiring radiologist feedback on the performance of our CT protocols and the performance of our CT scanners in terms of dose (scanner output) and the function of the automatic tube current modulation. Specific details on our quality management system covering both quality control and ongoing optimization have been provided. The roles of each CT protocol team member have been defined, and the critical role that IT solutions provides for the management of files and the monitoring of CT protocols has been reviewed. In addition, the invaluable role management provides by being a champion for the project has been explained; lack of a project champion will mitigate the efforts of a CT protocol optimization team. Meeting the guidelines set forth in the AAPM practice guideline was not inherently difficult, but did, in our case, require the cooperation of radiologists, technologists, physicists, IT, administrative staff, and hospital management. Some of the IT solutions presented in this paper are novel and currently unique to our institution.PACS number: 87.57.Q

Highlights

444 Szczykutowicz et al.: Compliance with AAPM Practice Guideline 1.a et al[3] does describe a method to propagate CT protocols between vendors and among different platforms from a single vendor
One of the results of this effort was our compliance with a majority of the ISO 9001:2008 standards.[15]. We propose that following many of the ISO 9001:2008 clauses are beneficial to an institution’s CT protocol optimization effort
The duties we describe below should not be taken as the only way to divide responsibilities within a CT protocol optimization team, they merely reflect the current implementation of our quality management system at the University of Wisconsin Madison

Summary

Introduction

444 Szczykutowicz et al.: Compliance with AAPM Practice Guideline 1.a et al[3] does describe a method to propagate CT protocols between vendors and among different platforms from a single vendor. More work of this nature is needed. The future of CT protocol optimization and review using these tools will likely involve the convergence of basic science and big data as more metrics are being developed which can be applied directly to CT images and provide details on facets of CT images related to radiation risk or image quality (e.g., organ dose,(9) image noise,(10) and patient positioning[11])

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