Optimizing Head Image Quality

Optmizing Head Image Quality: Positioning, Protocol, and Patient Computed Tomography Image quality is a highly subjective concept that varies around the world, across the country, and even within a department. Fundamentally, CT images should be diagnostic and ideally acquired using only that dose necessary to achieve that goal. The following guidelines are intended to help optimize image quality using the most appropriate radiation exposure when performing CT examinations of the head. 1. Positioning:  Isocenter - the physics of computed tomography necessitates that the object being scanned be placed directly in the rotational intersection of the x-ray beam.  Use the Siemens-supplied head holder and avoid table top scanning. If head holder cannot be used, scan head on foot extension and not table top  Assess each patient position using the available laser lights  Adjust the patient up, down, right, left, and symmetrically so that the head is positioned directly in the X and Y center of the gantry  Do not use presets or dedicated table heights  Use Siemens-supplied sponges and accessories to align the infraorbitomeatal line parallel to the x-ray beam and to reduce the possibility of patient motion  On many scanners, angling the gantry is sometimes preferred to match a particular radiographic baseline or to avoid excess exposure to the eyes; however, tilting the gantry should not take priority over placing the head at isocenter 2. Protocol:  Use only default or customized protocols intended for imaging of the head  Avoid changing parameters "on the fly" unless indicated by the situation or the radiologist  Avoid changing pitch values as default settings have been optimized for image quality and dose  When available, WorkStream 4D can be used to reconstruct axial images with a virtual tilt in lieu of physically tilting the gantry  Additional reconstruction jobs can be added to change parameters such as slice SIEMENS siemens.com/healthineers Healthineers Job Aid | Optimizing Head Image Quality Effective Date: 12/12/2016 | Quality HOOD05162002531999 thickness, incrementation, kernel, iterative reconstruction (if available), etc ., without the need to rescan the patient  Perform appropriate system maintenance - tube warm ups - when necessary prior to scanning 3. Patient: Explain the examination to the patient to increase their understanding and enlist  their cooperation Remember that it is the patient's right to receive a quality, dose-appropriate  examination  It is the technologist's responsibility to utilize their skills and experience to perform a quality dose- appropriate examination and to mitigate artifacts and repeats to the best of their ability The Siemens Customer Care Center is available to answer questions and provide further guidance to help you improve image quality and reduce patient radiation exposure: 1-800- 888-SIEM (7436) Siemens Healthineers Services Page 2 of 3 Job Aid | Optimizing Head Image Quality Effective Date: 12/12/2016 | Quality HOOD05162002531999 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively "Operator Manual") issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively "Functionality") may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright @ Siemens Healthcare GmbH ...... ........... Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 siemens.com/healthineers Siemens Healthineers Services Page 3 of 3