Computed Tomography Curriculum

©Copyright 2023 American Society of Radiologic Technologists. All rights reserved. Schools and educational programs have the ASRT’s permission to use the objectives sections of the curriculum as written. The remaining sections of the curriculum can be used with attribution for the purposes of course development, program promotion or course and program documentation. For other uses, contact the ASRT for reprint permission at curricula@asrt.org

Core Content

The professional practice of computed tomography (CT) requires specific knowledge and skills generally not obtained in basic educational programs. The core content section represents curriculum elements that are considered essential in educating technologists in the postprimary practice of CT computed tomography.

CT Procedures

Objectives

Discuss the preparation for CT procedures, including patient care, education, and documentation.
Explain the sequence of CT procedures, including equipment and parameters.
Describe CT procedures divided by anatomical location and body systems.
List specialty CT procedures, including interventional, pediatric, bariatric, and more procedures.

Content

CT Equipment Overview
Patient Care, Education and Management Review
Safety, Radiation and Dose Review
1. Communication
2. Informed consent
3. Patient preparation
4. Patient postprocedure instructions
Charting and Documentation Requirements
Anatomy Review
1. Skeletal system
2. Organ systems
3. Muscular system
4. Cardiovascular system
5. Central Nervous system
6. Respiratory System
Procedure Elements
1. Indications for each protocol
2. Contraindications for each procedure
3. Venipuncture
  1. Site selection
  2. Access
  3. Post access
  4. Supplies
  5. Sterile and aseptic technique
  6. Documentation
4. Venous access devices
  1. Angiocatheters (e.g., peripheral, diffusion tip)
  2. Conditional power injectable devices
    1. Subcutaneous ports
    2. PICCs
    3. Tunneled central venous catheters
    4. Nontunneled central venous catheters
    5. Dialysis access ports
5. Contrast media
  1. Pharmacology
  2. Types
  3. Routes of administration
  4. Dosage
  5. Contraindications
  6. Adverse reactions
  7. Methods of delivery
    1. Power injectors
      1. Types
        
        Single head injectors
        
        Dual head injectors
      2. Equipment setup
      3. Equipment operation
        
        Pounds per square inch (PSI)
        
        Keep vein open (KVO)
      4. Flow rates
      5. Bolus (timing, tracking)
      6. Multi-phase injection
      7. Operation
      8. Cleaning and preventive maintenance
      9. Accuracy
      10. Electrical safety
    2. Manual injection
6. Procedure parameters
  1. Scan range
  2. Anatomical landmarks
  3. Patient orientation
  4. Patient position
  5. Localizer image parameters
  6. Scan field of view (SFOV)
  7. Display field of view (DFOV)
  8. Mode
    1. Axial/sequential
    2. Helical/spiral
  9. Algorithm
  10. Gantry angle
  11. Technical factor selection
    1. kVp
    2. mA
    3. scan time mAs
    4. Table indexing
    5. Pitch
    6. Slice thickness
    7. Window level
    8. Window width
    9. Matrix size/voxel size
  12. Image annotation parameters
  13. Imaging planes
  14. Helical/spiral application
  15. Image archiving
  16. Charting and documentation requirements
  17. Bolus parameters and timing
  18. Workstation
  19. Other (e.g., dual energy application)
7. Identification of pathology
Procedures of the Head, Spine and Musculoskeletal System
1. CT head without and/or with contrast
  1. Routine
  2. Brain perfusion
  3. Stroke protocol
  4. Stealth/surgical planning
2. CT maxillofacial without and/or with contrast
  1. Orbits
  2. Nasal bones
  3. Facial bones
  4. Mandible
  5. Temporomandibular joints
3. CT paranasal sinuses without and/or with contrast
  1. Routine
  2. Stealth/surgical planning
4. CT temporal bones
  1. Internal auditory canals
  2. Posterior fossa
5. CT Vasculature
  1. CTA brain
  2. CTV brain
  3. CTA carotid
  4. CTV jugular
6. CT spine without and/or with contrast
  1. Cervical spine
  2. Thoracic spine
  3. Lumbar spine
  4. CT post-myelogram spine
7. CT upper extremity without and/or with contrast
  1. Shoulder girdle
  2. Humerus
  3. Elbow
  4. Forearm
  5. Wrist
  6. Hand
8. CT lower extremity without and/or with contrast
  1. Hip
  2. Femur
  3. Knee
  4. Tib/fib
  5. Ankle
  6. Foot
  7. CT post-arthrogram
9. CT Vasculature
  1. CTA upper extremity
  2. CTA lower extremity (runoff)
  3. CTV lower extremity
10. CT pelvic girdle without and/or with contrast
Procedures for the Neck and Thorax
1. CT soft tissue neck without and/or with contrast
  1. Routine
  2. Multi-phase
  3. CT esophagram
2. CT thorax without and/or with contrast
  1. Routine
  2. High resolution CT (HRCT)
    1. Axial/sequential
    2. Helical/spiral
  3. CT Vasculature
    1. CTA thoracic aorta
    2. CTA pulmonary
    3. Dissection protocol
    4. CTV pulmonary veins
    5. CTV superior vena cava
  4. Cardiac
    1. Calcium scoring
    2. Coronary CTA
    3. Transcatheter aortic valve replacement (TAVR)
  5. Low-dose lung screening
Procedures for the Abdomen and Pelvis
1. Routine abdominopelvic imaging
2. CT abdomen without and/or with contrast
  1. Pancreas (mass, pancreatitis)
  2. Liver
    1. Multi-phase
    2. Hemangioma perfusion
  3. Renal system
    1. Multi-phase
    2. Urogram
  4. Adrenal glands
  5. Gastrointestinal system
    1. Suspected appendicitis
    2. Colorectal study
    3. Enterography study
    4. CTA GI bleeding
  6. CT colonography
3. CT pelvis without and/or with contrast
  1. Pelvic cystogram
  2. Bladder
  3. Trauma
4. CT vasculature
  1. CTA abdomen/pelvis
  2. CTV abdomen/pelvis
Additional Interventional Procedures
1. CT-guided needle biopsies
2. CT-guided abscess drains
3. CT-guided aspirations
4. CT-guided percutaneous ablation (e.g., radiofrequency)
5. CT-guided device implantation
  1. Catheter placement
  2. Orthopedic instrumentation
6. CT-guided nerve root injection
7. Positron emission tomography (PET)/CT
Pediatric Procedures
1. Contrast media considerations
2. Immobilization
3. Communication and education
4. Sedation
5. Radiation protection
6. Technical factor selection and modifications
Bariatric Procedures
1. A. Contrast media considerations
2. Technical factor selection
3. CT equipment limitations
4. Radiation exposure concerns
Radiation Therapy Simulation Procedures

Cardiac CT

Objectives

Describe the anatomy and physiology of the heart.
Explain steps for cardiac CT procedures.
Discuss CT image reconstruction, resolution, viewing formats, and image assessment.
List dose reduction methods and artifacts in cardiac CT.

Content

Anatomy and Physiology of the Heart
1. Cardiac anatomy
  1. Chambers
  2. Coronary arteries
  3. Valves
2. Cardiac physiology
  1. Electrical conduction system
  2. ECG waveform
    1. Sinus rhythm
    2. Arrhythmias
3. Cardiac cycle
Patient Screening and Preparation
1. Clinical history
2. Indications for exam protocol
3. Contraindications for exam
4. Preprocedural medications
  1. Beta blocker
  2. Nitroglycerin
5. Intravenous access requirements
6. Electrocardiogram (ECG)
  1. Lead configurations
  2. Skin prep and lead placement
  3. Artifacts
7. Breath holding training
8. Shielding
9. Patient variations
  1. Weight
  2. Heart rate
  3. Arrhythmias
Procedures
1. Advantages/disadvantages of cardiac CT
2. Hardware
3. Software
  1. ECG-based tube current modulation
  2. Noninvasive fractional flow reserve (FFR)
  3. Coronary plaque characterization
4. Scanning parameters
  1. 1. Slice width
  2. Scan range
  3. Scan speed
  4. Injection timing
  5. Prospective gating
  6. Retrospective gating
5. Cardiac calcium scoring
  1. Indications/contraindications
  2. Scores
    1. Agatston score
    2. Weston score
6. CT heart angiography (e.g., coronary, TAVR, PVS)
  1. Indications/contraindications
  2. Injection protocols
    1. Volume
    2. Injection rate
    3. Delivery
    4. Scan delay
    5. Phases
Image Reconstruction
1. Reconstruction
  1. Single cycle
  2. Multi-cycle
2. Field of view
3. Slice width
4. Reconstruction kernel (algorithm)
5. Cardiac phase
6. ECG editing
Resolution
1. Spatial
2. Contrast
3. Temporal
Viewing Formats
1. 2-D
  1. Two chamber view
  2. Three chamber left ventricular outflow
  3. Four chamber view
  4. Double oblique cardiac long axis
  5. Cardiac short axis
2. 3-D
  1. MPR/curved MPR (cMPR)
  2. Volumetric
  3. MIP
Image Assessment
1. Regional and global evaluations
  1. Stenosis grading
  2. Cardiovascular disease staging
2. Ventricular function
3. Cardiac output
4. Ejection fraction
5. Cardiac viability
6. Wall thickness
7. Variants
  1. Stents
  2. Bypass grafts
  3. Congenital abnormalities
Dose Reduction Methods
Artifacts

Physiology and Pathology Correlation in Computed Tomography

Objectives

Describe diseases and pathologies of the immune, cardiovascular, and central nervous systems and their CT appearance.
List diseases and pathologies of the hematopoietic, lymph, and respiratory systems and their CT appearance.
Explain diseases and pathologies of the gastrointestinal, genitourinary, and hepatobiliary systems and their CT appearance.
Discuss diseases and pathologies of the head and neck and musculoskeletal systems, and their CT appearance.
Recognize diseases and pathologies of the affecting pediatric patients, and their CT appearance.

Content

Autoimmune System
1. Acquired immunodeficiency syndrome (AIDS)
2. Systemic lupus erythematosus (Lupus)
Cardiovascular System
1. Conditions
  1. Cardiomegaly
  2. Valvular disease
  3. Aortic pathology
    1. Aortic aneurysm
    2. Aortic dissection
    3. Coarctation
    4. Traumatic aortic tear
  4. Pulmonary pathology
    1. Pulmonary embolism
    2. Pulmonary artery dissection
  5. Congenital malformations
  6. Arteriovenous malformation (AVM)
  7. Stenosis
  8. Congestive heart failure (CHF)
  9. Coronary artery disease
    1. Calcium scoring
    2. Soft plaque atherosclerosis
  10. Pericardial effusion
  11. Tumors
    1. Benign (e.g., myxoma)
    2. Malignant (e.g., sarcoma)
    3. Metastases
2. Procedures
  1. Cardiac transplant
  2. Coronary artery bypass grafts (CABG)
3. Trauma
Central Nervous System (CNS)
1. Terminology of the brain (e.g., supratentorial, infratentorial)
2. Tumors
  1. Brain
    1. Benign (e.g., acoustic neuroma)
    2. Malignant (e.g., glioma)
    3. Metastases
  2. Spine
    1. Benign (e.g., hemangioma)
    2. Malignant (e.g., astrocytoma)
    3. Metastases
3. Cerebrovascular accident (CVA)
  1. Ischemic
    1. Infarct
    2. Transient ischemic attack (TIA)
  2. Hemorrhage
    1. Intracerebral
4. Trauma
  1. Spinal cord
  2. Brain
5. Cysts
6. Cranial Nerves
  1. Optic nerve (CN II)
  2. Internal auditory canal (CN VII, CN VIII)
7. Congenital abnormalities
  1. Brain
    1. Arnold-Chiari malformation
    2. Agenesis of the corpus callosum
    3. Dandy-Walker syndrome
    4. Encephalocele
    5. Hydrocephalous
    6. Craniosynostosis
  2. Spine
    1. Syringomyelia
    2. Hydromyelia
    3. Tethered cord
    4. Myelocele
    5. Meningocele
    6. Myelomengiocele
8. Orbit and visual pathways
9. Heterotopic gray matter
10. Seizures/epilepsy
11. Infections and Inflammatory diseases
  1. Encephalitis
  2. Meningitis
  3. Abscess
  4. Spondylitis
  5. Toxoplasmosis
  6. Arthritis
12. Atrophic and degenerative disorders
  1. Multiple sclerosis
  2. Alzheimer disease
  3. Parkinson disease
  4. Intervertebral disc herniation
  5. Spinal stenosis
  6. Osteoarthritis
  7. Degenerative disk disease
Head and Neck
1. Congenital anomalies
  1. Cleft palate
  2. Face bones
  3. Nose
  4. Eye
  5. Ear
  6. Mandible
2. Paranasal sinuses
  1. Mucocele
  2. Sinusitis
3. Soft tissue neck
4. Salivary gland
  1. Sialadenitis
  2. Salivary stone
5. Larynx and hypolarynx
6. Trauma
  1. Hematoma
    1. Epidural
    2. Subdural
    3. Subarachnoid
  2. Foreign body
7. Vascular pathology
  1. Circle of Willis aneurysm
  2. Dural venous sinus thrombosis
  3. Carotid dissection
  4. Carotid stenosis
Hematopoietic and Lymph System
1. Lymph node staging
2. Lymphoma
  1. Hodgkin
  2. Non-Hodgkin
3. Lymphosarcoma
4. Lymphadenopathy
5. Splenomegaly
6. Splenic trauma
Endocrine System
1. Pituitary adenoma
2. Adrenal pathology
  1. Addison disease
  2. Tumor
    1. Benign (e.g., adrenal adenoma)
    2. Malignant (e.g., adrenal carcinoma)
    3. Metastases
  3. Cushing syndrome
3. Pancreas pathology
  1. Pancreatic pseudocyst
  2. Pancreatitis
4. Thymus
  1. Pineal
    1. Acute
    2. Chronic
  2. Tumor
    1. Benign (e.g., thymomas)
    2. Malignant (e.g., thymus carcinoma)
    3. Metastases
Respiratory System
1. Masses
  1. Benign (e.g., hamartoma)
  2. Malignant (e.g., adenocarcinoma)
  3. Metastases
2. Infectious lung diseases
  1. Pneumonia
  2. Tuberculosis
3. Chronic lung diseases
  1. Asbestosis
  2. Chronic obstructive pulmonary disease (COPD)
    1. Emphysema
    2. Chronic bronchitis
  3. Bronchiectasis
4. Pulmonary edema
5. Acute respiratory distress syndrome (ARDS)
6. Pulmonary fibrosis
7. Pneumothorax
8. Hemothorax
9. Sarcoidosis
10. Pneumoconiosis
11. Pleural effusion
12. Atelectasis
13. Transplants
14. Trauma
15. Cystic Fibrosis
Gastrointestinal (GI) System
1. Masses
  1. Benign (e.g., adenoma)
  2. Malignant (e.g., colorectal cancer)
  3. Metastases
2. Abscesses/infections
3. Autoimmune (e.g., ulcerative colitis)
4. Cysts
5. Ascites
6. Pneumoperitoneum (intraperitoneal air)
7. Intussusception
8. Bowel obstruction
9. Appendicitis/appendicoliths/fecaliths
10. Diverticula/diverticulosis/diverticulitis
11. Congenital abnormalities (e.g., tracheoesophageal fistula)
12. Hiatal hernia
13. Ulcers
14. Ostomies
15. Fistula
16. Trauma
Genitourinary (GU) System
1. Urinary masses
  1. Benign (e.g., renal angiomyolipoma)
  2. Malignant (e.g., Wilms tumor)
  3. Metastases
2. Infection
3. Renal and urinary calculi
4. Polycystic disease
5. Renal transplant
6. Hydronephrosis
7. Congenital abnormalities
8. Trauma
9. Reproductive conditions
  1. Female
    1. Masses
      1. Benign (e.g., teratoma)
      2. Malignant (e.g., ovarian cancer)
      3. Metastases
    2. Cyst
    3. Infections
  2. Male
    1. Masses
      1. Benign (e.g., prostate hyperplasia)
      2. Malignant (e.g., testicular cancer)
      3. Metastases
    2. Infections
    3. Trauma
Hepatobiliary System
1. Masses
  1. Benign (e.g., hemangioma)
  2. Malignant (e.g., hepatocellular carcinoma)
  3. Metastases
2. Liver conditions
  1. Hepatitis
  2. Cirrhosis
  3. Hepatomegaly
3. Gallbladder conditions
  1. Cholecystitis
  2. Cholelithiasis
  3. Hemochromatosis
  4. Biliary obstruction
4. Congenital abnormalities
5. Infection
6. Transplants
7. Trauma
Musculoskeletal System
1. Tumors
  1. Bone tumors (e.g., Ewing sarcoma)
  2. Cartilaginous tumors (e.g., osteochondroma)
  3. Soft tissue tumors (e.g., liposarcoma)
  4. Metastases
2. Osteoporosis
3. Bone cysts
4. Skeletal dysplasia
5. Joint disorders
6. Infections
7. Inflammatory diseases
8. Arthritis/Gout
9. Fractures
10. Trauma
11. Spinal conditions
  1. Stenosis
  2. Scoliosis
  3. Spondylolysis
  4. Spondylolisthesis
  5. Fractures
  6. Herniated nucleus pulposus (HNP)
  7. Infections
Pediatric Pathologies
1. Congenital abnormalities
  1. CNS
  2. GI
  3. GU
  4. Cardiac
  5. Skeletal
2. Seizures
3. Vascular and cardiac diseases/malformations
4. Inflammation
5. Tumors
6. Pulmonary diseases
7. Orthopedic abnormalities
8. Infection
9. Fractures
10. Trauma
11. Non-accidental trauma/Child abuse
  1. Shaken baby syndrome
  2. Fractures
    1. Multiple fractures
    2. Skull fractures
    3. Bucket handle fractures
    4. Rib fractures
  3. Intracranial bleeding
    1. Subdural hematoma
    2. Epidural hematoma
    3. Intracerebral hemorrhage

Physics – Instrumentation and Imaging

Objectives

Recall the historical development of CT and the generations of CT scanners.
Describe CT scanner components and operations.
Explain the digital imaging and CT imaging steps, and their effect on image quality.
List radiation protection practices for CT.
Discuss helical CT, CTA, PET/CT, and other unique CT applications.

Content

Historical Development of Computed Tomography
1. Definition and evolution of terms
2. Research contributors to the development of CT
3. Historical development of CT
Computed Tomography Generations
1. First generation
2. Second generation
3. Third generation
4. Fourth generation
5. Fifth/Sixth generations
6. Spiral/helical CT
7. Multi-slice CT
8. Dual-source CT
CT Scanner Components and Operations
1. CT x-ray tube
  1. Differences from a conventional x-ray tube
  2. Heating capacity
2. CT filters
3. Collimators
4. Aperture size
5. Gantry/table features
  1. Gantry tilt
  2. Table height
  3. Positioning lasers
  4. Weight limitations
  5. Table materials
6. Detectors
  1. Types
  2. Detector arrays
7. Data acquisition system (DAS)
8. Consoles
  1. Workstation
  2. Processing/viewing station
9. Tube heating monitors
10. Archival methods
Digital Imaging
1. Steps of image digitization
  1. Scanning
  2. Sampling
  3. Quantization
  4. Analog to digital conversion
  5. Digital to analog conversion
2. Image characteristics
  1. Resolution
  2. Contrast
3. Scan projection radiography
4. Beam configuration
5. CT informatics
  1. Picture archiving and communication systems (PACS)
  2. Digital imaging and communications in medicine (DICOM)
  3. Hospital information system (HIS)
  4. Radiology information system (RIS)
Computed Tomography Process
1. Data acquisition
  1. Methods
    1. Axial/sequential
    2. Helical/spiral
    3. Volumetric
    4. CT Fluoroscopy
  2. Data acquisition system (DAS)
    1. Components
      1. Gantry
        
        Tube
        
        Generator
        
        Slip Ring
        
        Detectors
        
        Solid state
        
        Dual layer
        
        Photon counting
        
        Filters
        
        Collimators
      2. Encoding measurements into binary data
      3. Logarithmic conversion of data
      4. Transmission of data to computer
    2. Functions
      1. Measurement of transmitted beam
      2. Encoding measurements into binary data
      3. Logarithmic conversion of data
      4. Transmission of data to computer
  3. Data acquisition process
    1. Scanning/raw data/image data
      1. Ray sums
      2. Views
      3. Profiles/image data
        
        Pixels
        
        Matrices
        
        Voxels
      4. Sampling
        
        Angular
        
        Ray
    2. Attenuation
      1. Lambert-Beer law
      2. Linear attenuation coefficients
      3. CT numbers/Hounsfield numbers
    3. Selectable scan factors
      1. 1) Scan field of view (SFOV)
      2. Display field of view (CFOV)
      3. Matrix size/pixel size
      4. Slice thickness
      5. Window width
      6. Window level
      7. mA and kVp
      8. Scan time and rotational arc
      9. Kernel/filter algorithm
      10. Radiographic tube output
      11. Region of interest (ROI)
      12. Magnification
      13. Focal spot size and tube geometry
      14. Pitch
      15. Slice sensitivity profile (SSP)
2. Image reconstruction
  1. CT computer
    1. Minicomputer and microprocessors
    2. Array processors
  2. Reconstruction algorithms
    1. Conventional CT
      1. Back projection (historical only)
      2. Filtered back projection
    2. Iterative reconstruction
    3. Single detector row spiral
      1. Linear interpolation
    4. Multidetector row spiral
      1. Longitudinal interpolation with Z-axis filtering
      2. Interlaced sampling
      3. Fan-beam
      4. Convolution/algorithm
      5. Isotropic scanning
      6. In plane resolution
    5. 3-D
3. Image display, manipulation, recording and archiving
  1. Image display
  2. Display monitors
    1. Active-matrix liquid crystal displays (AMLCD)
    2. Cathode ray tube (CRT)
  3. Computer console basic tools use
    1. Pan
    2. Zoom
    3. Axial image scrolling
    4. Swivel
    5. Roll
    6. Rotate
    7. Inverse image
    8. Workstation basic tools
      1. Directory
      2. Imaging
      3. Report
      4. Delete
      5. Archive
      6. Copy
      7. Online help
    9. Image station application tool
      1. Cardiac
      2. Neurology
      3. Vascular
      4. GI
      5. Pulmonary
      6. Dental
      7. Orthopedics
      8. Bone mineral density
    10. Image viewing modes
      1. 2-D
      2. Slab
      3. Planar
      4. CT fluoroscopy
    11. Magnify
  4. Manipulation
    1. Image reformation
      1. Multiplanar reformation (MPR)
      2. Curved multiplanar reconstruction (cMPR)
      3. Retrospective reconstruction
    2. Image smoothing
    3. Edge enhancement
    4. Gray-scale manipulation
    5. 3-D processing
    6. Shaded surface rendering (SR)/display (SSD)
    7. Maximum intensity projection (MIP)
    8. Minimum intensity projection (MinIP)
    9. Volume rendering (VR)
      1. Virtual endoscopy/colonoscopy (VE)
      2. Vessel analysis (VA)
      3. Vessel tracking (VT)
    10. Radiation therapy treatment planning
    11. Fusion
    12. Segmentation
  5. Viewing modes
    1. 2-D
    2. Slab
    3. Planar
  6. CT fluoroscopy
  7. Recording and archiving
    1. DICOM
    2. PACS
    3. Data storage
Image Quality in CT
1. Definition
2. Determining factors
  1. Artifacts
  2. Contrast resolution
    1. Signal to noise ratio
    2. Contrast to noise ratio
    3. Scatter radiation reduction
  3. Linearity
  4. Noise
    1. Quantum noise
    2. Mottle
    3. Electronic
  5. Spatial resolution
    1. Detector size
    2. Matrix size/pixel size
    3. DFOV reconstruction interval
  6. Temporal resolution
    1. Gantry rotation time
    2. Acquisition mode
    3. Reconstruction methods
    4. Pitch
    5. Dual source/Spectral CT
3. Influencing factors
  1. Focal spot size
  2. Beam geometry
    1. Parallel
    2. Fan
    3. Cone
  3. Detector type
  4. Motion
  5. Subject contrast
  6. Iterative reconstruction methods
  7. Selectable factors
    1. mA
    2. Scan time
    3. Scan field of view (SFOV)
    4. Displayed field of view (DFOV)
    5. Slice thickness
    6. Interscan spacing
    7. Filtering
    8. kV
    9. Window level and width presets
      1. Organ mode
4. CT artifacts
  1. Identification of common types
    1. Partial volume averaging
    2. Aliasing artifacts
    3. Ring artifacts
    4. Ghosting
    5. Edge gradient effect
    6. Out of field artifact
    7. Beam hardening
    8. Cupping artifact
    9. Tube arcing
    10. Metal artifact
    11. Motion
    12. Noise
  2. Determination of cause
  3. Correction
5. Quality control (QC) programs in CT
  1. Definition of QC
  2. QC accreditation programs
    1. ACR accreditation program for CT
    2. Intersocietal Commission for Accreditation Commission of Computed Tomography Laboratories (ICACTL) (IAC)
    3. Medicare Improvements for Patients and Providers Act (MIPPA)
    4. The Joint Commission (TJC)
  3. Principles
    1. Acceptance testing
    2. Regular performance
    3. Problem testing
    4. Prompt interpretation of results
    5. Accurate and faithful records (bookkeeping of patients scanned)
    6. Appropriate CPT coding of exams
  4. Common QC test requirements
    1. Utilizing phantoms
    2. Choosing techniques
    3. Determining frequency
    4. Establishing acceptable limits from test results
    5. Common QC tests performed by the technologist
      1. Air calibration
      2. Hounsfield test
      3. Tube warm-up
      4. Phantom scan (manufacturers)
    6. CT number calibration
    7. Standard deviation of CT number in water
  5. Common QC measurements conducted by the physicists
    1. Contrast transfer and response function
    2. Line spread function
    3. Point spread function
    4. Modulation transfer function
    5. Edge response function
    6. High-contrast resolution
    7. Low-contrast resolution
    8. Accuracy of distance measuring device
    9. CT image uniformity and symmetry
    10. CT couch indexing
    11. CT couch back lashing
    12. Slice width
    13. Localization device accuracy (light field accuracy)
    14. Display monitor quality
    15. Hard copy output distortion
    16. Patient dose
    17. Ambient lighting conditions
  6. QC documentation
  7. CT artifacts
  8. Additional QC requirements for various CT procedures
Radiation Protection Practices for the CT Patient
1. Measuring patient radiation dose
  1. Dosimetry methods
    1. Thermoluminescent dosimeters (TLDs)
    2. Pencil ionization chamber
    3. CT dose measurement phantom
  2. CT dose metrics
  3. CT dose index (CTDI)
  4. CT dose index volume (CTDIvol)
  5. Multiple scan average dose (MSAD)
  6. Dose length product (DLP)
    1. Effective dose
  7. Size specific dose estimate (SSDE)
  8. Effective dose
  9. Dose reporting
    1. Millisievert (mSv)
    2. Milligray (mGy)
2. Reducing radiation dose
  1. Methods
    1. Increased screening techniques
    2. Alternative diagnostic imaging
    3. Reduction in multi-phasic examinations
    4. Technical factor selection
      1. mA
      2. kVp
      3. Collimation
      4. Couch speed
      5. Pitch
      6. Gantry rotation time
    5. Scanning geometry (partial rotation)
    6. Z-axis filtering
    7. Scanning mode
    8. Scanning length
    9. Scanner dosimetry survey
    10. Filtration
    11. Automatic tube current modulation
    12. Anatomical parameter consideration
      1. Weight of the patient
      2. Cross-sectional dimension of the patient
    13. Dual source/dual energy scanners
  2. Shielding
    1. Bismuth shields
    2. Shield positioning
  3. Dose Awareness Systems
    1. Dose notification
    2. Dose Alert
  4. Dose reduction software
    1. Adaptive filtration
    2. Iterative reconstruction
    3. Dedicated pediatric protocols
  5. Hardware design
    1. Off-focus radiation suppression (tube)
    2. Filtration – bowtie filters
    3. Collimation to prevent helical over-ranging or over-scanning
    4. Data acquisition system (DAS) – detector system efficiency
3. Pediatric patients
  1. Image Gently
  2. Radiation dose reduction parameters
    1. Weight categories (thorax and abdomen)
    2. Age categories (skull and brain)
    3. kVp and mA reduction
4. Ethical considerations in overuse of CT imaging
  1. Need for education
  2. Lack of awareness
  3. Image Gently
  4. Image Wisely
  5. Pediatrics
Helical/Spiral Computed Tomography
1. Definition
2. Differences between axial/sequential and helical/spiral CT
  1. Operation
  2. Advantages
  3. Disadvantages
3. Multidetector row computed tomography (MDCT)
  1. Detector configurations
  2. Pitch ratio
  3. Couch speed
  4. Interpolation algorithms
4. Scanner designs
  1. High-voltage and low-voltage scanners
  2. Slip-ring cylinders and slip-ring disk
Additional CT Procedures
Computed Tomography Angiography (CTA)
1. Equipment requirements
  1. Hardware
  2. Software
    1. Automated injection triggering
    2. ECG gating
    3. Postprocessing
2. Image quality
  1. Temporal resolution
  2. Spatial resolution
  3. Contrast resolution
3. Patient dose
4. Common artifacts in CTA
  1. Motion
  2. Beam hardening
  3. Stair-step
Computed Tomography Radiation Therapy Simulation
1. Replication of geometry
2. Scanning considerations
  1. DFOV
  2. Slice thickness
Positron Emission Tomography/Computed Tomography (PET/CT)
1. PET imaging
  1. Isotope
    1. Synthesis of isotope
    2. Uptake
  2. Patient preparation
  3. Detection
  4. Radiation protection measures
  5. Radionuclide contamination
2. CT imaging
  1. Attenuation correction
  2. Oncology
  3. Neurology
  4. Cardiac
3. Fusion
  1. Assessment
    1. Standardized uptake value (SUV)
    2. Glucose metabolic rate calculation
4. Clinical application
5. Advantages/disadvantages
6. Common artifacts in PET/CT
  1. Metallic
  2. Motion
  3. Truncation
Virtual CT
1. CT colonography
2. Cystography
3. Hardware requirements
4. Software requirements
5. Postprocessing
High-Resolution Computed Tomography
1. Hardware requirements
2. Software requirements
3. Postprocessing
Technological Advances
1. Dual source scanning
2. Photon counting
3. Inverse geometry scanning
4. Detector number
5. Artificial intelligence (AI)
6. 4-D
7. 5-D
8. Photon-counting detector
9. Dark-field CT

Planar and Volumetric Postprocessing

Objectives

Discuss image postprocessing and 2-D techniques in CT.
Describe 3-D imaging and display techniques in CT.
Recognize image quality concerns and CT artifacts.

Content

Image Postprocessing
1. Definition and benefits
2. Data acquisition requirements
  1. 2-D generation
    1. Axial
    2. Coronal
    3. Sagittal
    4. Orthogonal (oblique)
  2. 3-D generation
    1. Data acquisition, creation of 3-D space
      1. Coordinate systems to create 3-D (scene) space
        
        Scanner coordinate system
        
        Display coordinate system
        
        Object coordinate system
        
        Scene coordinate system
      2. 3-D space
        
        Image space
        
        Object space
        
        Parameter space
        
        View space
    2. Postprocessing
3. Image display
3-D Imaging System
1. Input – communication with configured DICOM devices to query and retrieve study
2. Workstation – identify proper series for postprocessing, manipulation and analysis
3. Output – exporting/recording DICOM images
3-D Terminology
3-D Image Transformation
1. Modeling
2. Shading and lighting
3. Rendering
Postprocessing Techniques in 2-D and 3-D Imaging
1. Slice imaging
  1. MPR
    1. Planes and image reformation (axial, coronal, sagittal, oblique)
    2. Thickness of reformatted images/sliding thin slabs (STS)
  2. Intensity projection renderings
    1. Average intensity projection (AIP or AVE)
    2. Maximum intensity projection (MIP)
    3. Minimum intensity projection (MinIP)
  3. Application of MPR and intensity projection renderings
    1. Anatomically corrected datasets
    2. Noise reduction
    3. Improve spatial resolution
  4. Curved multiplanar reformation (cMPR)
    1. Visualization of tubular structures-straightened
    2. Manual and automatic tracking
    3. Application
      1. Vessels
      2. Ducts
2. Projective imaging
  1. Surface rendering (SR) or shaded surface display (SSD)
    1. Surface formation and rendering
    2. Selection of threshold and size
    3. Shading (shadowing effect)
    4. Lighting (virtual light source)
    5. Image rotation and viewing angle
  2. SSD Applications
    1. Visualization of complex 3-D relationships
    2. Virtual endoscopy
  3. Volume rendering (VR)
    1. Preprocessing
    2. Rendering or ray tracing
    3. Opacity/transparency curve-surface display
  4. VR Applications
    1. CT angiography (CTA)
    2. Skeletal images
    3. Volume measurements
    4. Articular surface viewing
    5. Extremity images
3. Volume imaging
  1. Virtual reality images – volume rendering with transparency
  2. Virtual CT endoscopy (VE)
    1. Perspective volume rendering (pVR) – rendering along a path
    2. Alternative viewing angles
    3. Applications
      1. Angiography
      2. Bronchoscopy
      3. Colonoscopy
    4. Cystoscopy
4. Segmentation
  1. Threshold techniques
  2. Automated techniques
3-D Image Display
1. 2-D screen captures – proper window/level (W/L) display
2. Cine
3. Advanced 3-D display
  1. Fusion (PET/CT)
  2. Tissue perfusion (functional) imaging
  3. Artificial intelligence (AI)
    1. Computer -aided diagnosis (CAD)
CT Measurements
1. 2-D measurements
  1. Angle
  2. Centerline length
  3. Area
  4. Circumference
  5. Diameter
  6. Histogram
  7. Profile
  8. Calcium scoring
2. 3-D volume measurements
Image Quality
1. Acquisition errors
  1. Source image errors
    1. Slice thickness
    2. Image overlap
    3. Reconstruction algorithm
    4. Timing
      1. Bolus tracking
      2. Delayed images
  2. Positioning/technical errors
    1. Segmentation
    2. Curved planar centerline error
    3. Volume rendering settings
    4. Annotation errors
    5. Improper 3-D imaging protocol
2. Improving image quality
  1. Protocol selection (injection, scan timing)
  2. Patient motion
  3. Image data manipulation
3-D Artifacts
1. CT artifacts in 3-D image postprocessing
  1. Noise
  2. Segmentation misrepresentation
  3. Beam hardening
  4. Motion
  5. Patient size
2. Multiplanar reconstruction (MPR) and curved multiplanar reconstruction (cMPR) artifacts
  1. Partial volume
  2. False stenosis
  3. Mirror artifacts (cMPR)
3. Maximum intensity projection (MIP) and minimum intensity projection (MinIP) artifacts
  1. Depth perception
  2. Superimposition of structures
  3. Vessel calcification
4. Surface rendering (SR) and shaded surface display (SSD) artifacts
  1. Raising threshold selection
  2. Lowering threshold selection
5. Volume rendering (VR) artifacts
  1. Venetian blind
  2. Opacity setting error

Sectional Anatomy

Objectives

Explain the anatomical nomenclature used to describe anatomy and body locations.
Describe the anatomy and landmarks of the:
- Head and brain
- Neck
- Chest and mediastinum
- Abdomen
- Pelvis
- Spine
- Musculoskeletal system

Content

Anatomical Nomenclature
1. Directional references
2. Body planes
  1. Sagittal/midsagittal
  2. Coronal/midcoronal
  3. Axial/transverse
  4. Longitudinal
3. Body cavities
  1. Dorsal
    1. Cranial
    2. Vertebral
  2. Ventral
    1. Thoracic
    2. Abdominal
    3. Pelvic
Head and Brain
1. Sutures and fontanelles
2. Cranial bones
  1. Frontal
  2. Ethmoid
  3. Parietal
  4. Sphenoid
  5. Occipital
  6. Temporal
3. Surface anatomy of the brain
  1. Fissures (sulci)
  2. Convolutions (gyri)
4. Lobes of the brain and midline structures
  1. Forebrain
  2. Midbrain
  3. Hindbrain
5. Meninges
  1. Dura mater
  2. Arachnoid
  3. Pia mater
6. Cranial nerves
  1. Olfactory
  2. Optic
  3. Oculomotor
  4. Trochlear
  5. Trigeminal
  6. Abducens
  7. Facial
  8. Vestibulocochlear
  9. Glossopharyngeal
  10. Vagus
  11. Accessory
  12. Hypoglossal
7. Ventricular system
  1. Ventricles
  2. Choroid plexus
  3. Cerebrospinal fluid
8. Basal ganglia
9. Circle of Willis
10. Dural sinuses
11. Facial bones
  1. Mandible
  2. Maxillae
  3. Zygomas
  4. Nasal bones
  5. Lacrimal bones
  6. Palatine bones
  7. Vomer
  8. Inferior nasal conchae
12. Sinuses
  1. Frontal
  2. Maxillary
  3. Ethmoidal
  4. Sphenoidal
13. Orbit
  1. Bony orbit
  2. Orbital fissures
  3. Globe
  4. Lens
  5. Optic nerve
  6. Lacrimal gland
  7. Orbital muscles
14. Lines of angulation (imaging baselines)
  1. Orbitomeatal line (OML)
  2. Infraorbitomeatal line (IOML)
  3. Interpupillary line (IPL)
15. Anatomical landmarks
  1. Glabella
  2. Nasion
  3. Acanthion
  4. Mental point
  5. External auditory meatus (EAM)
Neck
1. Structures
  1. Hyoid bone
  2. Esophagus
  3. Trachea
  4. Glands
  5. Lymph nodes
2. Neurovasculature
3. Musculature
Chest and Mediastinum
1. Bony thorax
2. Pulmonary
  1. Lungs
  2. Diaphragm
  3. Bronchi
  4. Pleural lining
3. Mediastinum
  1. Thymus gland
  2. Heart
  3. Vasculature
  4. Esophagus
  5. Trachea
  6. Thoracic duct
  7. Lymph nodes
4. Breasts
Abdomen
1. Diaphragm
2. Quadrants and regions
  1. Abdominal cavity
    1. Peritoneum
    2. Peritoneal spaces
    3. Retroperitoneum
    4. Retroperitoneal spaces
3. Vasculature
  1. Abdominal aorta
  2. Inferior vena cava
  3. Portal venous system
4. Abdominal organs and systems
  1. Liver
  2. Gallbladder and biliary system
  3. Pancreas and pancreatic ducts
  4. Spleen
  5. Adrenal glands
  6. Urinary system and tract
  7. Stomach
  8. Small intestine
  9. Colon
5. Musculature
Pelvis
1. Bony structures
2. Vasculature
3. Pelvic organs
  1. Urinary bladder
    1. Ureter
    2. Urethra
  2. Small intestine
  3. Colon
  4. Reproductive organs
Spine
1. Cervical vertebrae
2. Thoracic vertebrae
3. Lumbar vertebrae
4. Sacrum/coccyx
Musculoskeletal System
1. Upper extremities
  1. Shoulder
    1. Bony anatomy
    2. Muscles and tendons
    3. Labrum and ligaments
    4. Vasculature
  2. Elbow
    1. Bony anatomy
    2. Muscles and tendons
    3. Ligaments
    4. Vasculature
  3. Hand and wrist
    1. Bony anatomy
    2. Tendons
    3. Vasculature
2. Lower Extremities
  1. Hip
    1. Bony anatomy
    2. Muscles and tendons
    3. Labrum and ligaments
    4. Vasculature
  2. Knee
    1. Bony anatomy
    2. Muscles and tendons
    3. Menisci and ligaments
    4. Vasculature
  3. Foot and ankle
    1. Bony anatomy
    2. Muscles and tendons
    3. Ligaments
    4. Vasculature

Artificial Intelligence

Objectives

Define terminology associated with artificial intelligence.
Explain the principles of machine learning, deep learning, natural language processing, and neural networks.
List applications of AI in health care, medical imaging, and CT specifically.
Recognize the standards and ethics applicable to artificial intelligence in medical imaging.
Describe artificial intelligence regulation and workflow integration.

Content

Terminology and concepts
1. Algorithm
2. Automation
3. Artificial intelligence (AI)
  1. Artificial narrow intelligence
  2. Artificial general intelligence
  3. Artificial super intelligence
4. AI-enabled
5. AI-bias
6. Machine learning (ML)
  1. Supervised
  2. Unsupervised
  3. Deep learning (DL)
7. Neural network models
  1. Artificial neural networks (ANN)
  2. Convolutional neural networks (CNN)
  3. Recurrent neural networks (RNN)
8. Software as a medical device (SaMD)
9. Recursion
10. Natural language processing (NLP)
  1. Pattern recognition
  2. Visual perception
  3. Decision making
Data and Data Sets
AI Applications in Healthcare
1. Diagnosis and treatment recommendation
2. Patient engagement
3. Administrative activities
AI Applications in Medical Imaging
1. Order scheduling and patient screening
2. Exam protocoling
3. Image acquisition
4. Image analysis
  1. Automated detection of findings
  2. Automated interpretation of findings
5. Automated clinical decision support (CDS)
Additional AI Applications in CT
1. Deep learning image reconstruction
2. Image segmentation
Ethics, Legality and Liability
Regulation and Workflow Integration
Precision Medicine

Optional Content

PET/CT Hybrid Imaging
1. Radiation safety
  1. Handling and disposal of radioisotopes
  2. Contamination and decontamination procedures

Resources

This list of resources will assist educators in sampling the pool of references and study materials that pertain to medical imaging. The resources list should be viewed as a snapshot of available materials. Omission of any one title is not intentional. Because the creation of literature and media related to the field is dynamic, educators are encouraged to search additional sources for recent updates, revisions and additions to this collection of titles.

Abramson S. The Complete Guide to Cardiac CT. New York, NY: McGraw-Hill Medical; 2012. ISBN 0071664416.

Adler A, Carlton R, Stewart K. Introduction to Radiologic & Imaging Sciences and & Patient Care. 8th ed. St. Louis, MO: Saunders/Elsevier; 2022.

Aehlert B. Pocket Reference Guide for ECG’s Made Easy. 6th ed. St. Louis, MO: Mosby/JEMS; 2018. ISBN-13: 9780323653596.

Aichinger H, Dierker J, Joite-Barfuß S, Säbel M. Radiation Exposure and Image Quality in X-Ray Diagnostic Radiology. Physical Principles and Clinical Applications. 2nd ed. New York, NY: Springer-Verlag; 2017. ISBN-10: 366251754X.

American Registry of Radiologic Technologists. ARRT Rules and Regulations. ARRT website. www.arrt.org/pdfs/Governing-Documents/Rules-and-Regulations.pdf.

American Registry of Radiologic Technologists. Computed Tomography Clinical Experience Requirements. ARRT website.https://www.arrt.org/arrt-reference-documents/by-document-type/clinical-experience-requirements

American Registry of Radiologic Technologists. Content Specifications for the Computed Tomography Examination. ARRT website. https://www.arrt.org/arrt-reference-documents/by-document-type/examination-content-specifications

American Registry of Radiologic Technologists. Post-Primary Discipline Handbook. ARRT website. https://www.arrt.org/arrt-reference-documents/handbooks.

Anderson M, Fox M. Sectional Anatomy by MRI and CT. 4th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2016.

Applegate E. The Sectional Anatomy Learning System. 3rd ed. St Louis, MO: Saunders/Elsevier; 2010. ISBN 1416050132.

Applegate E. The Anatomy and Physiology Learning System. 4th ed. St Louis, MO: Saunders/Elsevier; 2011. ISBN 143770395X.

Baliga RR. Introductory Guide to Cardiac CT Imaging. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. ISBN 1582559384.

Bankier AA, ed. Imaging in Transplantation. New York, NY: Springer-Verlag; 2010. ISBN 3642072976.

Barkovich AJ, Raybaud C. Pediatric Neuroimaging. 6th ed. Philadelphia, PA: Wolters Kluwer; 2019. ISBN-10: 1605477141.

Barrett KE, Barman SM, Brooks H, Yuan J. Ganong’s Review of Medical Physiology. 26th ed. New York, NY: McGraw-Hill Medical Education; 2019.

Blankenbaker DG, Davis KW, Sonin A, Crim J, Tuite MJ, Andrews CL. Diagnostic Imaging: Musculoskeletal: Trauma. 3rd ed. Elsevier; 2022.

Budoff MJ, Achenbach SS, Hecht HS, Narula J, eds. Atlas of Cardiovascular Computed Tomography. 2nd ed. New York, NY: Springer-Verlag; 2018.

Budoff MJ, Shinbane JS, eds. Cardiac CT Imaging. Diagnosis of Cardiovascular Disease. 3rd ed. New York, NY: Springer-Verlag;

Burgener FA, Herzog C, Meyers SP, Zaunbauer W. Differential Diagnosis in Computed Tomography. 2nd ed. New York, NY: Thieme; 2012. ISBN: 3131025425.

Busby C, Bertell R, Schmitz Feuerhake I, Yablokov AV, Cato MS. ECRR 2010 Recommendations of the European Committee on Radiation Risk: The Health Effects of Exposure to Low Doses of Ionizing Radiation. Green Audit Books; 2010. ISBN: 1897761163.

Bushberg JT, Seibert JA, Leidholdt EM, Boone JM. The Essential Physics of Medical Imaging. 4th ed. Baltimore, MD: Wolters Kluwer; 2021.

Bushong S. Radiologic Science for Technologists: Physics, Biology, and Protection. 12th ed. St Louis, MO: Elsevier; 2021.

Buzug TM. Computed Tomography: From Photon Statistics to Modern Cone Beam CT. Heidelberg, Germany: Springer-Verlag; 2010. ISBN: 3642072577.

Cademartiri F, Hoffmann U, Mollet NR. CT Coronary Angiography: An Atlas of Investigation and Diagnosis. Osford: Clinical Publishing; 2011. ISBN: 1846920108.

Chavhan G, Jensen SC, Peppers MP. Pharmacology and Drug Administration for Imaging Technologists. 2nd ed. St Louis, MO: Mosby; 2006. ISBN 0323030750.

Christian PE, Waterstram-Rich KM, Gilmore D. Nuclear Medicine and PET/CT: Technology and Techniques. 8th ed. St Louis, MO: Mosby; 2017.

Chung DYF, Mondal D, Erskine J, Holmes EJ, Misra R. Emergency Cross-sectional Radiology. Cambridge, UK: Cambridge University Press; 2012. ISBN: 0521279534.

Dachman AH, ed. Fundamentals of Virtual Colonoscopy. New York, NY: Springer Science+Business Media; 2010. ISBN-13: 9781931884846.

Daffner RH, ed. Imaging of Vertebral Trauma. Cambridge, UK: Cambridge University Press; 2011. ISBN-13: 9781931884846.

Davis, C. (2022). Kidney angiomyolipoma. MedicineNet website. https://www.medicinenet.com/angiomyolipoma/article.htm

Davies AM, Johnson KJ, Whitehouse RW, eds. Imaging of the Hip & Bony Pelvis: Techniques and Applications. New York, NY: Springer; 2010. ISBN-13: 9783642058400.

De Asís Bravo-Rodríquez F, Díaz-Aguilera R, Hygino da Cruz LC Jr. Learning Neuroimaging: 100 Essential Cases. New York, NY: Springer-Verlag; 2012. ISBN-13: 9783642229985.

DeMaio D. Exam Review in Computed Tomography. 3rd ed. St Louis, MO: Mosby; 2018.

Desai S, Lynch D, Elicker BM, Devaraj A, Sverzellati N. Webb WR, Muller NL, Naidich DP. Webb, Muller, and Naidich’s High-Resolution CT of the Lung. 6th ed. Philadelphia, PA: Lippincott, Williams & Wilkins; 2021.

Dewey M. Cardiac CT. 2nd ed. Heidelberg, Germany: Springer-Verlag; 2014.

Dudek RW, Thomas LM. High-Yield Gross Anatomy. 5th ed. Baltimore, MD: Wolters Kluwer; 2015.

Ehrlich RA, Coakes DM. Patient Care in Radiography: With an Introduction to Medical Imaging. 10th ed. St Louis, MO: Mosby; 2020.

Eisenberg RL, Johnson NM. Comprehensive Radiographic Pathology. 7th ed. St Louis, MO: Mosby; 2020.

Ellis H, Logan B, Dixon A, Bowden D. Human Sectional Anatomy Pocket Atlas of Body Sections, CT and MRI Images. 4th ed. Boca Raton, FL: CRC Press; 2017.

Emory Healthcare. Pituitary gland disorders and tumors. https://www.emoryhealthcare.org/conditions/pituitary/index.html

Federle MP, Brooke JR, Woodward PJ, Borhani A. Diagnostic Imaging: Abdomen. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2015. ISBN: 0323377556.

Fielding JR, Brown DL, Thurmond AS. Gynecologic Imaging: Expert Radiology Series. Philadelphia, PA: Elsevier/Saunders; 2011. ISBN-13: 9781437715750.

Folio LR. Chest Imaging: An Algorithmic Approach to Learning. New York, NY: Springer; 2011. ISBN-13: 9781461413165.

Fremgen BF. Medical Law and Ethics. 6th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2022.

Gould B, Van Meter KC, Hubert RJ. Gould’s Pathophysiology for the Health Professional. 7th ed. St Louis, MO: Saunders; 2022

Grey ML, Ailnani J. CT and MRI Pathology: A Pocket Atlas. 3rd ed. New York, NY: McGraw-Hill Medical; 2018.

Halpern EJ. Clinical Cardiac CT: Anatomy and Function. 2nd ed. New York, NY: Thieme Medical Publishers; 2010. ISBN-13: 9781604063752.

Hammer GD, McPhee SJ. Pathophysiology of Disease: An Introduction to Clinical Medicine. 8th ed. New York, NY: McGraw-Hill; 2019.

Hermans R, ed. Head and Neck Cancer Imaging. 3rd ed. Heidelberg, Germany: Springer-Verlag Nature; 2021.

Hsieh J. Computed Tomography: Principles, Design, Artifacts, and Recent Advances. 3rd ed. SPIE Digital Library; 2015. ISBN: 9781628416640.

Jhaveri MD, Salzman KL, Osborn. Diagnostic Imaging: Brain. 4th ed. Philadelphia, PA: Elsevier; 2020. ISBN-10: 0323756204.

Johns Hopkins Medicine. Salivary gland infection (sialadenitis). https://www.hopkinsmedicine.org/health/conditions-and-diseases/salivary-gland-infection-sialadenitis

Joiner M, Van der Kogel A. Basic Clinical Radiobiology. 5th ed. London: CRC Press; 2018. Kalendar WA. Computed Tomography: Fundamentals, System Technology, Image Quality, Applications. 4th ed. Munich: Wiley-VCH; 2021.

Karthikeyan D. Cross-Sectional Anatomy: Step by Step. New Delhi, India: Jaypee Brothers Medical Publishers; 2011. ISBN 9380704887.

Kau CH, Abramovitch K, Kamel SG, Bozic M. Cone Beam CT of the Head and Neck: An Anatomical Atlas. Berlin: Springer-Verlag; 2011. ISBN 3642127037.

Kitapci M. Atlas of Sectional Radiological Anatomy for PET/CT. New York, NY: Springer; 2012. ISBN 1461415268.

Koch BL, Vattoth S, Chapman P. Diagnostic Imaging: Head and Neck. 4th ed. Philadelphia, PA: Elsevier; 2021.

Kowalczyk N, Mace JD. Radiographic Pathology for the Technologist. 8th ed. Mosby Elsevier; 2021.

Kelley LL, Peterson CM. Sectional Anatomy for Imaging Professionals. 4th ed. St Louis, MO: Mosby; 2018. ISBN-13: 9780323414876.

Laghi A, ed. MDCT Protocols: Whole Body and Emergencies. New York, NY: Springer; 2012. ISBN: 8847024021.

Lee EY, Hunsaker A, Siewert B. Computed Body Tomography with MRI Correlation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2020.

Tamparo CD. Medical Law, Ethics, & Bioethics for the Health Professions. 8th ed. Philadelphia, PA: F.A. Davis Company; 2021.

Lipson SA. MDCT and 3D Workstations: A Practical How-To Guide and Teaching File. New York, NY: Springer; 2010. ISBN: 1441920668.

Mahesh M. MDCT Physics: The Basics: Technology, Image Quality and Radiation Dose. Philadelphia, PA: Lippincott, Williams & Wilkins; 2009. ISBN: 078176811X.

Mancall EL, Brock DG. Gray's Clinical Neuroanatomy: The Anatomic Basis for Clinical Neuroscience. Philadelphia, PA: Saunders; 2011. ISBN: 1416047050.

McConnell J. Index of Medical Imaging. Chichester, England: Blackwell Publishing; 2011. ISBN: 1405185449.

Merrow C, Aquino M, Linscott L, Koch B, Donnelly LF, Jones BV, O’Hara SM. Diagnostic Imaging: Pediatrics. 4th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2022.

Miller BF, Miller-Keane. Encyclopedia and Dictionary of Medicine, Nursing and Allied Health. 7th ed. Philadelphia, PA: Saunders Co; 2005. ISBN: 1416026045.

Moller TB. Pocket Atlas of Cross-Sectional Anatomy: CT and MRI: Thorax, Heart, Abdomen and Pelvis. 4th ed. New York, NY: Thieme Medical Publishers Inc; 2014. ISBN: 3131256044.

Nadgir, R, Yousem DM. Neuroradiology: The Requisites. 4th ed. Philadelphia, PA: Mosby Elsevier; 2017. ISBN: 1455775681.

Najarian K. Splinter R. Biomedical Signal and Image Processing. 2nd ed. Boca Raton: Taylor & Francis/CRC Press; 2012. ISBN: 1439870330.

Ohnesorge et al. Multi-slice and Dual-source CT in Cardiac Imaging: Principles - Protocols - Indications - Outlook. Heidelberg, Germany: Springer-Verlag; 2007. ISBN: 3540255230.

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Journal of Computer Assisted Tomography. 6 issues/year. Philadelphia, PA: Lippincott-Raven Publishers.

Journal of Invasive Cardiology. 12 issues/year. San Francisco, CA: HPM Communications.

Journal of Neuroimaging. 4 issues/year. Malen, MA: Blackwell Publishing.

Neuroradiology. New York, NY: Springer-Verlag.

Radiation Therapist. 2 issues/year. Albuquerque, NM: American Society of Radiologic Technologists.

RadioGraphics. 6 issues/year. Oakbrook, Ill: Radiological Society of North America.

Radiologic Technology. 6 issues/year. Albuquerque, NM: American Society of Radiologic Technologists.

Radiology. 12 issues/year. Oakbrook, IL: Radiological Society of North America.

Seminars in Ultrasound, CT and MRI. 6 issues/year. Philadelphia, PA: WB Saunders Publishing Co.

Appendix

Curriculum Revision Workgroup

We would like to extend special recognition to the outstanding professionals who volunteered their time as members of the curriculum revision project:

Sarah Barnes, M.B.A., R.T.(R)(CT)

Jennifer Little, Ed.D., R.T.(R)(MR)(CT), CRT

Kimberly Onstott, Ed.D., R.T.(R)(CT)(MR), MRSO

Christa Smith, B.S.R.S., R.T.(R)(CT)(QM)

Kendall Youngman, M.S.R.S., R.T.(R)(MR)(CT)

We also wish to express our sincere appreciation for the many contributions and suggestions from the professional community over the course of this project.

Computed Tomography Curriculum

Table of Contents

Core Content

CT Procedures

Objectives

Content

CT Equipment Overview

Patient Care, Education and Management Review

Safety, Radiation and Dose Review

Charting and Documentation Requirements

Anatomy Review

Procedure Elements

Procedures of the Head, Spine and Musculoskeletal System

Procedures for the Neck and Thorax

Procedures for the Abdomen and Pelvis

Additional Interventional Procedures

Pediatric Procedures

Bariatric Procedures

Radiation Therapy Simulation Procedures

Cardiac CT

Objectives

Content

Anatomy and Physiology of the Heart

Patient Screening and Preparation

Procedures

Image Reconstruction

Resolution

Viewing Formats

Image Assessment

Dose Reduction Methods

Artifacts

Physiology and Pathology Correlation in Computed Tomography

Objectives

Content

Autoimmune System

Cardiovascular System

Central Nervous System (CNS)

Head and Neck

Hematopoietic and Lymph System

Endocrine System

Respiratory System

Gastrointestinal (GI) System

Genitourinary (GU) System

Hepatobiliary System

Musculoskeletal System

Pediatric Pathologies

Physics – Instrumentation and Imaging

Objectives

Content

Historical Development of Computed Tomography

Computed Tomography Generations

CT Scanner Components and Operations

Digital Imaging

Computed Tomography Process

Image Quality in CT

Radiation Protection Practices for the CT Patient

Helical/Spiral Computed Tomography

Additional CT Procedures

Computed Tomography Angiography (CTA)

Computed Tomography Radiation Therapy Simulation

Positron Emission Tomography/Computed Tomography (PET/CT)

Virtual CT

High-Resolution Computed Tomography

Technological Advances

Planar and Volumetric Postprocessing

Objectives

Content

Image Postprocessing

3-D Imaging System

3-D Terminology

3-D Image Transformation

Postprocessing Techniques in 2-D and 3-D Imaging

3-D Image Display

CT Measurements

Image Quality

3-D Artifacts

Sectional Anatomy

Objectives

Content

Anatomical Nomenclature