Computed Tomography: Advanced Clinical Applications

Foreword
Acknowledgements
Contents
Part I: Radiobiology and Patient Care
	Radiobiology and Radiation Protection
		1	 Radiobiology and Radiation Protection
			1.1	 Interactions Between Photons and Matter
				1.1.1	 Rayleigh Scattering
				1.1.2	 Compton Scattering
				1.1.3	 Photoelectric Absorption
				1.1.4	 Pair Productions
			1.2	 Effects of Ionizing Radiation
				1.2.1	 Deterministic Effects
				1.2.2	 Stochastic Effects
				1.2.3	 Evidence of Ionizing Radiation Effects
			1.3	 Linear No-Threshold Model
			1.4	 Radiation Protection
			1.5	 Image Quality Optimization and Dose Reduction
		2	 Radiation Dose in CT Examinations
			2.1	 Absorbed Dose
			2.2	 Effective Dose
			2.3	 Organ Dose
			2.4	 Exposure
			2.5	 Dose Distribution in SFOV
			2.6	 Dose Distribution Along Scan Length
			2.7	 CT Dose Index
			2.8	 CTDIFDA
			2.9	 CTDI100
			2.10	 CTDIW
			2.11	 CTDIvol
			2.12	 Dose-Length Product
		References
	Patient Care and Self-Care in CT
		1	 Introduction
		2	 Clinical Considerations for Patients Undergoing a CT Examination
			2.1	 Obtaining Informed Consent
				2.1.1	 Ionising Radiation
				2.1.2	 Iodinated Contrast Media
				2.1.3	 CT-Guided Interventional Procedures
			2.2	 Preparation and Safety for CT Scans Requiring IV Contrast
				2.2.1	 Dietary Restriction
				2.2.2	 Contrast-Induced Nephropathy (CIN)
				2.2.3	 Hypersensitivity to IV Contrast
					Some Key Points About Allergic Reactions (Cardarelli and Ulsh 2018)
					Premedication for Patients with Previous Allergic Reactions to Contrast
				2.2.4	 Extravasation of Contrast Media
				2.2.5	 Pregnancy and Breastfeeding in Relation to Iodine Contrast
					Pregnancy
					Breastfeeding
		3	 Patient Interaction and Communication
			3.1	 Values & Biases in Patient Interaction
				3.1.1	 Values & Biases of the Healthcare Professional
				3.1.2	 Values & Biases of the Patient
			3.2	 Language and Communication
				3.2.1	 Language Barriers
			3.3	 Patient Greeting
			3.4	 Patients with Specific Needs
				3.4.1	 Anxiety
					Causes
					Signs & Symptoms
				3.4.2	 Physical Limitations/Disabilities
				3.4.3	 Children
				3.4.4	 Aggressive & Intoxicated Patients
			3.5	 Medical History & Referral Review
				3.5.1	 Common Medical Questions for IV Contrast Administration Include
				3.5.2	 Common Medical Questions for Interventional Procedures
		4	 Navigating the CT Department as a Technologist
			4.1	 Alignment of Values between the Healthcare Professional and the Healthcare Institution
			4.2	 Roles, Responsibilities & Goals for CT Technologists
			4.3	 Balancing Workflow in a CT Department
				4.3.1	 Trilemma of CT Workflow
				4.3.2	 Empathy vs Sympathy
				4.3.3	 Patient-Centred Care
		5	 Self-Care as a CT Radiographer
			5.1	 Healthy Lifestyle and Work Habits
				5.1.1	 Scheduled Breaks
				5.1.2	 Breath and Body Awareness
				5.1.3	 Mindfulness and Other Self-Care Tools
					Journaling
					Physical Exercise
					Meditation and Breathwork
				5.1.4	 Managing Stressful or Traumatic Situations in a CT Department
		References
Part II: CT in an Emergency Setting
	CT in an Emergency Setting
		1	 Introduction
		2	 Traumatic brain injury
			2.1	 TBI imaging Protocols
				2.1.1	 General Protocol for NCCT
		3	 Stroke (nTBI)
			3.1	 Stroke (nTBI) imaging Protocols
				3.1.1	 Non-contrast CT (NCCT) for Stroke
				3.1.2	 Contrast Media (CM) Considerations
				3.1.3	 CT Perfusion (CTP)
				3.1.4	 CT Angiography (CTA)
		4	 General Considerations of Findings on CT Scan TBI and nTBI
		5	 Common Primary Findings for TBI and nTBI Explained
			5.1	 Epidural Hematoma
			5.2	 Subdural Hematoma
			5.3	 Subarachnoid/Intraventricular hematoma
			5.4	 Intra-Axial Hemorrhage
			5.5	 Intraparenchymal Hematoma (IPH)
			5.6	 Cortical Contusions
			5.7	 Skull Fractures
		6	 Common Secondary Findings in CT TBI and nTBI
			6.1	 Hemorrhagic Stroke
			6.2	 Transient Ischemic Attack (TIA)
			6.3	 Traumatic Brain Herniation
			6.4	 Ischemic Stroke
			6.5	 Infarction
		7	 Emerging Protocols: (MSCT)
		8	 Standardizing CT Protocols
		9	 Responses to Trauma, Stroke, and/or Intensive Care Patients
		References
	Trauma Imaging Protocols and Image Evaluations
		1	 Introduction
		2	 Head and Spine Injuries
		3	 Thorax, Abdomen & Pelvis
		4	 Penetrating and Vascular Injuries
		5	 Extremities
		6	 CT Imaging of Trauma
		References
	Stroke Imaging Protocols
		1	 Introduction
		References
	Responses to Trauma and Stroke
		1	 Introduction
		References
			Bibliography
	Whole-Body CT
		1	 Background & History
		2	 Time
		3	 Radiation Dose
		4	 Overdiagnosis and Incidental Findings
		5	 Cost
		6	 Tips for CT Radiographer When Resuscitation Room Calls
		7	 Protocols
			7.1	 Patient Preparation
			7.2	 Dual Intravenous Contrast Bolus
			7.3	 Single Intravenous Contrast Phase with Two Scan Ranges
			7.4	 Image Reconstruction (Table 1):
		8	 Conclusion
		References
Part III: CT Guided Interventions
	Indications, Technique and Pitfalls
		1	 Indications
			1.1	 Technique
			1.2	 Patient Preparation
			1.3	 Consent
			1.4	 Positioning the Patient
			1.5	 Pre-Planning CT Scan
			1.6	 Procedure
			1.7	 Acquisition Option 1: Injection/Biopsy Mode (I.E. Intermittent CT Fluoro)
			1.8	 Acquisition Option 2: Scanning a Range
			1.9	 Acquisition Option 3: CT Fluoroscopy
			1.10	 Summary of Technique for CT Radiographer
			1.11	 Lumbar Spine Injections
			1.12	 Cervical Spine Injections
			1.13	 Shoulder Hydrodilatation ± Injection ± Arthrogram
			1.14	 Hip Injection
			1.15	 Knee Injection
			1.16	 Lung Biopsy
		2	 Pitfalls
		References
	Tips, Tricks, Radiation Dose and Protection
		1	 Tips and Tricks
		2	 Radiation Dose and Radiation Protection
			2.1	 Clinical Example of Dose Reduction for CT-Guided Lumbar Spine Injections
			2.2	 Radiation Protection of Staff
			2.3	 Methods to Reduce Occupational Radiation Dose
		References
Part IV: CT Forensic Imaging
	CT Forensic Imaging
		1	 Introduction
		2	 History of Forensic Imaging
		3	 Future of Forensic Imaging
		4	 Living Versus Deceased Cases
		5	 Advantages and Disadvantages of Post-Mortem CT (PMCT)
			5.1	 Strengths of PMCT
			5.2	 Limitations of PMCT
		6	 PMCT Protocol Considerations
			6.1	 Equipment
			6.2	 Reconstruction Considerations
			6.3	 Scanning Approaches
				6.3.1	 General Considerations
				6.3.2	 Study Approaches
					Head, Neck and Torso
					Whole-Body Approach No 1
					Whole-Body Approach No 2 (Recommended)
				6.3.3	 Dental Acquisition
				6.3.4	 Choice of Scan Approach
		7	 Image Storage, Retrieval & Archiving
			7.1	 Discussion of Medico-Legal Concepts
		8	 Radiographer Review/Impressions in PMCT
			8.1	 Background
			8.2	 What Is a Radiographer Review/Impression?
			8.3	 The Structure and Approach for Radiographer Reviewing/Impressions
				8.3.1	 Head and Neck
				8.3.2	 Chest
				8.3.3	 Abdomen
				8.3.4	 Limbs
		9	 Education and Training
		10	 Conclusion
		References
Part V: CT Education
	Education in CT
		1	 Introduction
		2	 Andragogy: Adult Learning
		3	 Pedagogy: Method and Practice of Teaching
			3.1	 Interactional Practice
			3.2	 Dynamic Practice
			3.3	 Contextual Practice
		4	 Assessment of the Learning CT Radiographer
			4.1	 Competence and Capability
			4.2	 Assessment for Learning and Assessment of Learning
			4.3	 Professional Judgement
			4.4	 Application to Assessment of CT Capability
		5	 Conclusion
		References