PPTS Portal Home
Revised 2020 (Resolution 44)
Document Navigator
All
PREAMBLE
I. INTRODUCTION
II. INDICATIONS
III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
IV. SPECIFICATIONS OF THE EXAMINATION
V. DOCUMENTATION
VI. EQUIPMENT SPECIFICATIONS
VII. RADIATION SAFETY IN IMAGING
VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION
ACKNOWLEDGEMENTS
REFERENCES
Document Navigator
ACR–ASNR–SPR PRACTICE PARAMETER FOR THE PERFORMANCE OF COMPUTED TOMOGRAPHY (CT) OF THE HEAD
PREAMBLE
I. INTRODUCTION
II. INDICATIONS
III. QUALIFICATIONS AND RESPONSIBILITIES OF PERSONNEL
IV. SPECIFICATIONS OF THE EXAMINATION
V. DOCUMENTATION
VI. EQUIPMENT SPECIFICATIONS
VII. RADIATION SAFETY IN IMAGING
VIII. QUALITY CONTROL AND IMPROVEMENT, SAFETY, INFECTION CONTROL, AND PATIENT EDUCATION
ACKNOWLEDGEMENTS
REFERENCES
1. [-3188535]
American College of Radiology. ACR Committee on Drugs and Contrast Media. Manual on Contrast Media. Available at: https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Contrast-Manual.
2. [17398264]
Harden SP, Dey C, Gawne-Cain ML. Cranial CT of the unconscious adult patient. Clin Radiol. 2007 May;62(5):404-15.
3. [21111131]
Hijaz TA, Cento EA, Walker MT. Imaging of head trauma. Radiol Clin North Am. 2011 Jan;49(1):81-103.
4. [21294647]
Jacobs B, Beems T, van der Vliet TM, Diaz-Arrastia RR, Borm GF, Vos PE. Computed tomography and outcome in moderate and severe traumatic brain injury: hematoma volume and midline shift revisited. J Neurotrauma. 2011 Feb;28(2):203-15.
5. [15179234]
Miller MT, Pasquale M, Kurek S, et al. Initial head computed tomographic scan characteristics have a linear relationship with initial intracranial pressure after trauma. J Trauma. 2004 May;56(5):967-72; discussion 972-3.
6. [21465153]
Schachar JL, Zampolin RL, Miller TS, Farinhas JM, Freeman K, Taragin BH. External validation of the New Orleans Criteria (NOC), the Canadian CT Head Rule (CCHR) and the National Emergency X-Radiography Utilization Study II (NEXUS II) for CT scanning in pediatric patients with minor head injury in a non-trauma center. Pediatr Radiol. 2011;41(8):971-979.
7. [23937824]
Mohan S, Rogan EA, Batty R, et al. CT of the neonatal head. [Review]. Clin Radiol. 68(11):1155-66, 2013 Nov.
8. [24065011]
Perry JJ, Stiell IG, Sivilotti ML, et al. Clinical decision rules to rule out subarachnoid hemorrhage for acute headache. JAMA. 310(12):1248-55, 2013 Sep 25.
9. [29133539]
Perry JJ, Sivilotti MLA, Sutherland J, et al. Validation of the Ottawa Subarachnoid Hemorrhage Rule in patients with acute headache. CMAJ. 2017 Nov 13;189(45):E1379-E1385.
10. [15128996]
Akpinar E. The tram-track sign: cortical calcifications. Radiology. 2004 May;231(2):515-6.
11. [22370691]
Jung JM, Lee JY, Phi JH, et al. Value of routine immediate postoperative brain computerized tomography in pediatric neurosurgical patients. Childs Nervous System. 28(5):673-9, 2012 May.
12. [22582355]
Tamrazi B, Almast J. Your brain on drugs: imaging of drug-related changes in the central nervous system. Radiographics. 2012;32(3):701-19.
13. [19627647]
Martín-Santos R, Fagundo AB, Crippa JA, et al. Neuroimaging in cannabis use: a systematic review of the literature. Psychol Med. 2010 Mar;40(3):383-98.
14. [19101105]
Taheri MS, Moghaddam HH, Moharamzad Y, Dadgari S, Nahvi V. The value of brain CT findings in acute methanol toxicity. Eur J Radiol. 2010 Feb;73(2):211-4.
15. [24599624]
Winklhofer S, Surer E, Ampanozi G, et al. Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy. Eur Radiol. 2014 Jun;24(6):1276-82.
16. [27282861]
Buethe J, Nazarian J, Kalisz K, Wintermark M. Neuroimaging Wisely. AJNR Am J Neuroradiol. 2016 Dec;37(12):2182-2188.
17. [27575483]
Patterson BW, Pang PS, AlKhawam L, et al. The Association Between Use of Brain CT for Atraumatic Headache and 30-Day Emergency Department Revisitation. AJR Am J Roentgenol. 207(6):W117-W124, 2016 Dec.
18. [23412380]
Kawano H, Hirano T, Nakajima M, Inatomi Y, Yonehara T. Diffusion-weighted magnetic resonance imaging may underestimate acute ischemic lesions: cautions on neglecting a computed tomography-diffusion-weighted imaging discrepancy. Stroke. 2013 Apr;44(4):1056-61.
19. [21960158]
Giesemann AM, Kontorinis G, Jan Z, Lenarz T, Lanfermann H, Goetz F. The vestibulocochlear nerve: aplasia and hypoplasia in combination with inner ear malformations. Eur Radiol. 2012 Mar;22(3):519-24.
20. [22582354]
Joshi VM, Navlekar SK, Kishore GR, Reddy KJ, Kumar EC. CT and MR imaging of the inner ear and brain in children with congenital sensorineural hearing loss. Radiographics. 32(3):683-98, 2012 May-Jun.
21. [20309536]
Miyasaka M, Nosaka S, Morimoto N, Taiji H, Masaki H. CT and MR imaging for pediatric cochlear implantation: emphasis on the relationship between the cochlear nerve canal and the cochlear nerve. Pediatr Radiol. 2010 Sep;40(9):1509-16.
22. [21937234]
Kaczmarczyk K, Wit A, Krawczyk M, Zaborski J, Gajewski J. Associations between gait patterns, brain lesion factors and functional recovery in stroke patients. Gait Posture. 2012 Feb;35(2):214-7.
23. [21111129]
Mullins ME.. Emergent neuroimaging of intracranial infection/inflammation. [Review]. Radiol Clin North Am. 49(1):47-62, 2011 Jan.
24. [23364506]
Bhalla A, Suri V, Singh P, Varma S, Khandelwal N. Imaging in adult patients with acute febrile encephalopathy: what is better computerized tomography or magnetic resonance imaging. Indian J Med Sci. 2011 May;65(5):193-202.
25. [19633907]
Dung NM, Turtle L, Chong WK, et al. An evaluation of the usefulness of neuroimaging for the diagnosis of Japanese encephalitis. J Neurol. 2009 Dec;256(12):2052-60.
26. [20713953]
García HH, Gonzalez AE, Rodriguez S, et al. Neurocysticercosis: unraveling the nature of the single cysticercal granuloma. Neurology. 2010 Aug 17;75(7):654-8.
27. [23122258]
Rath TJ, Hughes M, Arabi M, Shah GV. Imaging of cerebritis, encephalitis, and brain abscess. Neuroimaging Clin N Am. 2012 Nov;22(4):S1052-5149(12)00060-3.
28. [21221031]
Toma AK, Holl E, Kitchen ND, Watkins LD. Evans' index revisited: the need for an alternative in normal pressure hydrocephalus. Neurosurgery. 2011 Apr;68(4):939-44.
29. [22740019]
Sivaganesan A, Krishnamurthy R, Sahni D, Viswanathan C. Neuroimaging of ventriculoperitoneal shunt complications in children. Pediatr Radiol. 2012 Sep;42(9):1029-46.
30. [18925673]
Abdel-Salam GM, Zaki MS, Saleem SN, Gaber KR. Microcephaly, malformation of brain development and intracranial calcification in sibs: pseudo-TORCH or a new syndrome. Am J Med Genet A. 2008 Nov 15;146A(22):2929-36.
31. [22209524]
Rao P, Bekhit E, Ramanauskas F, Kumbla S. CT head in children. Eur J Radiol. 82(7):1050-8, 2013 Jul.
32. [22158928]
Chen Q, Chen XZ, Wang JM, Li SW, Jiang T, Dai JP. Intracranial meningeal hemangiopericytomas in children and adolescents: CT and MR imaging findings. AJNR Am J Neuroradiol. 2012 Jan;33(1):195-9.
33. [20386894]
Eran A, Ozturk A, Aygun N, Izbudak I. Medulloblastoma: atypical CT and MRI findings in children. Pediatr Radiol. 2010 Jul;40(7):1254-62.
34. [21051520]
Han L, Qiu Y, Xie C, et al. Atypical teratoid/rhabdoid tumors in adult patients: CT and MR imaging features. AJNR Am J Neuroradiol. 2011 Jan;32(1):103-8.
35. [17998738]
Prabhakar R, Haresh KP, Ganesh T, Joshi RC, Julka PK, Rath GK. Comparison of computed tomography and magnetic resonance based target volume in brain tumors. J Cancer Res Ther. 2007;3(2):121-3.
36. [23224678]
Skogen K, Ganeshan B, Good C, Critchley G, Miles K. Measurements of heterogeneity in gliomas on computed tomography relationship to tumour grade. J Neurooncol. 2013 Jan;111(2):213-9.
37. [20068383]
D'Haese PF, Pallavaram S, Konrad PE, Neimat J, Fitzpatrick JM, Dawant BM. Clinical accuracy of a customized stereotactic platform for deep brain stimulation after accounting for brain shift. Stereotact Funct Neurosurg. 2010;88(2):81-7.
38. [20036691]
Hebb AO, Miller KJ. Semi-automatic stereotactic coordinate identification algorithm for routine localization of Deep Brain Stimulation electrodes. J Neurosci Methods. 2010 Mar 15;187(1):114-9.
39. [22986604]
Holloway K, Docef A. A quantitative assessment of the accuracy and reliability of O-arm images for deep brain stimulation surgery. Neurosurgery. 2013 Mar;72(1 Suppl Operative):47-57.
40. [22814648]
Lefranc M, Le Gars D. Robotic implantation of deep brain stimulation leads, assisted by intra-operative, flat-panel CT. Acta Neurochir (Wien). 2012 Nov;154(11):2069-74.
41. [20718919]
Marsh JC, Gielda BT, Herskovic AM, Wendt JA, Turian JV. Sparing of the hippocampus and limbic circuit during whole brain radiation therapy: A dosimetric study using helical tomotherapy. J Med Imaging Radiat Oncol. 2010 Aug;54(4):375-82.
42. [21792519]
Meshkini A, Shahzadi S, Zali A, Parsa K, Afrough A, Hamdi A. Computed tomography-guided stereotactic biopsy of intracranial lesions in pediatric patients. Childs Nerv Syst. 2011 Dec;27(12):2145-8.
43. [20033503]
Pallavaram S, Dawant BM, Remple MS, et al. Effect of brain shift on the creation of functional atlases for deep brain stimulation surgery. Int J Comput Assist Radiol Surg. 2010 May;5(3):221-8.
44. [21799235]
Ruijters D, Homan R, Mielekamp P, van de Haar P, Babic D. Validation of 3D multimodality roadmapping in interventional neuroradiology. Phys Med Biol. 2011 Aug 21;56(16):5335-54.
45. [19404103]
Uhl E, Zausinger S, Morhard D, et al. Intraoperative computed tomography with integrated navigation system in a multidisciplinary operating suite. Neurosurgery. 2009 May;64(5 Suppl 2):231-9; discussion 239-40.
46. [21111136]
Barnes PD. Imaging of nonaccidental injury and the mimics: issues and controversies in the era of evidence-based medicine. Radiol Clin North Am. 2011 Jan;49(1):205-29.
47. [20010292]
Levy AD, Harcke HT, Mallak CT. Postmortem imaging: MDCT features of postmortem change and decomposition. Am J Forensic Med Pathol. 2010 Mar;31(1):12-7.
48. [22271006]
Tartaglione T, Filograna L, Roiati S, Guglielmi G, Colosimo C, Bonomo L. Importance of 3D-CT imaging in single-bullet cranioencephalic gunshot wounds. Radiol Med. 2012 Apr;117(3):461-70.
49. [33958108]
Shih RY, Burns J, Ajam AA, et al. ACR Appropriateness Criteria® Head Trauma: 2021 Update. J Am Coll Radiol 2021;18:S13-S36.
50. [19968701]
Gelfand JM, Wintermark M, Josephson SA. Cerebral perfusion-CT patterns following seizure. Eur J Neurol. 2010 Apr;17(4):594-601.
51. [20974379]
Hess CP, Barkovich AJ. Seizures: emergency neuroimaging. Neuroimaging Clin N Am. 2010 Nov;20(4):619-37.
52. [20065250]
Hsieh DT, Chang T, Tsuchida TN, et al. New-onset afebrile seizures in infants: role of neuroimaging. Neurology. 2010; 74(2):150-156.
53. [18359597]
Nair PP, Kalita J, Misra UK. Role of cranial imaging in epileptic status. Eur J Radiol. 2009 Jun;70(3):475-80.
54. [21647630]
Phuttharak W, Sawanyawisuth K, Kawiwungsanon A, Tiamkao S. The appropriate neuroimaging study in persons with epilepsy. Neurol Sci. 32(5):969-71, 2011 Oct.
55. [20430848]
Harder S, Gourgaris A, Frangou E, et al. Clinical and neuroimaging findings of Cree leukodystrophy: a retrospective case series. AJNR Am J Neuroradiol. 31(8):1418-23, 2010 Sep.
56. [20522568]
Koob M, Laugel V, Durand M, et al. Neuroimaging in Cockayne syndrome. AJNR Am J Neuroradiol. 2010 Oct;31(9):1623-30.
57. [22615483]
Tang Z, Pi X, Chen F, et al. Fifty percent reduced-dose cerebral CT perfusion imaging of Alzheimer's disease: regional blood flow abnormalities. Am J Alzheimers Dis Other Demen. 2012 Jun;27(4):267-74.
58. [21383324]
Olesen PJ, Guo X, Gustafson D, et al. A population-based study on the influence of brain atrophy on 20-year survival after age 85. Neurology. 76(10):879-86, 2011 Mar 08.
59. [12578916]
Shevell M, Ashwal S, Donley D, et al. Practice parameter: evaluation of the child with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and The Practice Committee of the Child Neurology Society. Neurology. 2003 Feb 11;60(3):367-80.
60. [22959259]
Khandanpour N, Hoggard N, Connolly DJ. The role of MRI and CT of the brain in first episodes of psychosis. Clin Radiol. 68(3):245-50, 2013 Mar.
61. [-3120926]
American College of Radiology. ACR-SPR Practice Parameter for Imaging Pregnant or Potentially Pregnant Patients with Ionizing Radiation. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=23+&releaseId=2.
62. [-3197742]
American College of Radiology. ACR–SPR Practice Parameter for Performing and Interpreting Diagnostic Computed Tomography (CT). Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=132+&releaseId=2
63. [29306371]
O'Hora L, Foley SJ. Iterative reconstruction and automatic tube voltage selection reduce clinical CT radiation doses and image noise. Radiography (Lond). 2018 Feb;24(1):S1078-8174(17)30138-4.
64. [22844033]
Brady Z, Ramanauskas F, Cain TM, Johnston PN. Assessment of paediatric CT dose indicators for the purpose of optimisation. Br J Radiol. 2012 Nov;85(1019):1488-98.
65. [20110373]
Diekmann S, Siebert E, Juran R, et al. Dose exposure of patients undergoing comprehensive stroke imaging by multidetector-row CT: comparison of 320-detector row and 64-detector row CT scanners. AJNR Am J Neuroradiol. 31(6):1003-9, 2010 Jun.
66. [24063388]
Hoang JK, Wang C, Frush DP, et al. Estimation of radiation exposure for brain perfusion CT: standard protocol compared with deviations in protocol. AJR Am J Roentgenol. 2013 Nov;201(5):W730-4.
67. [11717063]
Mahesh M, Scatarige JC, Cooper J, Fishman EK. Dose and pitch relationship for a particular multislice CT scanner. AJR Am J Roentgenol. 2001 Dec;177(6):1273-5.
68. [23298102]
Perisinakis K, Seimenis I, Tzedakis A, Papadakis AE, Damilakis J. The effect of head size/shape, miscentering, and bowtie filter on peak patient tissue doses from modern brain perfusion 256-slice CT: how can we minimize the risk for deterministic effects?. Med Phys. 2013 Jan;40(1):011911.
69. [22592620]
Reimann AJ, Davison C, Bjarnason T, et al. Organ-based computed tomographic (CT) radiation dose reduction to the lenses: impact on image quality for CT of the head. J Comput Assist Tomogr. 2012;36(3):334-8.
70. [22627796]
Vorona GA, Zuccoli G, Sutcavage T, Clayton BL, Ceschin RC, Panigrahy A. The use of adaptive statistical iterative reconstruction in pediatric head CT: a feasibility study. AJNR Am J Neuroradiol. 2013 Jan;34(1):205-11.
71. [21088088]
Yamauchi-Kawara C, Fujii K, Aoyama T, Yamauchi M, Koyama S. Radiation dose evaluation in multidetector-row CT imaging for acute stroke with an anthropomorphic phantom. Br J Radiol. 2010 Dec;83(996):1029-41.
72. [23674008]
Kilic K, Erbas G, Guryildirim M, et al. Quantitative and qualitative comparison of standard-dose and low-dose pediatric head computed tomography: a retrospective study assessing the effect of adaptive statistical iterative reconstruction. J Comput Assist Tomogr. 2013;37(3):377-81.
73. [18389247]
Ertl-Wagner B, Eftimov L, Blume J, et al. Cranial CT with 64-, 16-, 4- and single-slice CT systems-comparison of image quality and posterior fossa artifacts in routine brain imaging with standard protocols. Eur Radiol. 2008 Aug;18(8):1720-6.
74. [11376264]
Jones TR, Kaplan RT, Lane B, Atlas SW, Rubin GD. Single- versus multi-detector row CT of the brain: quality assessment. Radiology. 2001 Jun;219(3):750-5.
75. [-3197778]
American Association of Physicists in Medicine. Adult routine head CT protocols. Available at: https://www.aapm.org/pubs/ctprotocols/documents/adultroutineheadct.pdf.
76. [-3197748]
American College of Radiology. ACR–SPR Practice Parameter for the use of Intravascular Contrast Media. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=142+&releaseId=2
77. [-3180641]
American College of Radiology. American College of Radiology. ACR– ASNR– SPR Practice Parameter for the Performance of Myelography and Cisternography. Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=64+&releaseId=2
78. [23605637]
Adeshina AM, Hashim R, Khalid NE, Abidin SZ. Multimodal 3-D reconstruction of human anatomical structures using SurLens Visualization System. Interdiscip Sci. 2013 Mar;5(1):23-36.
79. [21980202]
Campbell BC, Christensen S, Levi CR, et al. Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core. Stroke. 2011 Dec;42(12):3435-40.
80. [23604268]
Chen W, Belle A, Cockrell C, Ward KR, Najarian K. Automated midline shift and intracranial pressure estimation based on brain CT images. J. vis. exp.. (74), 2013 Apr 13.
81. [12186469]
Friedman JA, Goerss SJ, Meyer FB, et al. Volumetric quantification of Fisher Grade 3 aneurysmal subarachnoid hemorrhage: a novel method to predict symptomatic vasospasm on admission computerized tomography scans. J Neurosurg. 2002 Aug;97(2):401-7.
82. [20634108]
Gupta V, Ambrosius W, Qian G, et al. Automatic segmentation of cerebrospinal fluid, white and gray matter in unenhanced computed tomography images. Acad Radiol. 2010 Nov;17(11):1350-8.
83. [23493210]
Hanson EH, Roach CJ, Day KJ, et al. Assessment of the tracer delay effect in whole-brain computed tomography perfusion: results in patients without known neuroanatomic abnormalities. J Comput Assist Tomogr. 37(2):212-21, 2013 Mar-Apr.
84. [11387149]
Hoeffner EG, Quint DJ, Peterson B, Rosenthal E, Goodsitt M. Development of a protocol for coronal reconstruction of the maxillofacial region from axial helical CT data. Br J Radiol. 2001 Apr;74(880):323-7.
85. [23408047]
Kamiya K, Kunimatsu A, Mori H, et al. Preliminary report on virtual monochromatic spectral imaging with fast kVp switching dual energy head CT: comparable image quality to that of 120-kVp CT without increasing the radiation dose. Jpn J Radiol. 2013 Apr;31(4):293-8.
86. [23556897]
Kim JH, Nuyts J, Kuncic Z, Fulton R. The feasibility of head motion tracking in helical CT: a step toward motion correction. Med Phys. 2013 Apr;40(4):041903.
87. [17296999]
Matsumoto M, Kodama N, Endo Y, et al. Dynamic 3D-CT angiography. AJNR Am J Neuroradiol. 2007 Feb;28(2):299-304.
88. [22968671]
Milchenko M, Marcus D. Obscuring surface anatomy in volumetric imaging data. Neuroinformatics. 2013 Jan;11(1):65-75.
89. [19092094]
Murayama K, Katada K, Nakane M, et al. Whole-brain perfusion CT performed with a prototype 256-detector row CT system: initial experience. Radiology. 2009 Jan;250(1):202-11.
90. [23321844]
Nowinski WL, Puspitasari F, Volkau I, Orrison WW, Knopp MV. Quantification of the human cerebrovasculature: a 7Tesla and 320-row CT in vivo study. J Comput Assist Tomogr. 2013;37(1):117-22.
91. [24007731]
Ono Y, Abe K, Suzuki K, et al. Usefulness of 4D-CTA in the detection of cerebral dural sinus occlusion or stenosis with collateral pathways. Neuroradiol J. 2013 Aug;26(4):428-38.
92. [22268092]
Phan CM, Yoo AJ, Hirsch JA, Nogueira RG, Gupta R. Differentiation of hemorrhage from iodinated contrast in different intracranial compartments using dual-energy head CT. AJNR Am J Neuroradiol. 2012 Jun;33(6):1088-94.
93. [23387759]
Qian X, Wang J, Guo S, Li Q. An active contour model for medical image segmentation with application to brain CT image. Med Phys. 2013 Feb;40(2):021911.
94. [22440645]
Rorden C, Bonilha L, Fridriksson J, Bender B, Karnath HO. Age-specific CT and MRI templates for spatial normalization. Neuroimage. 2012 Jul 16;61(4):957-65.
95. [-3197713]
American College of Radiology. ACR–ASNR–SPR Practice Parameter for the Performance of Computed Tomography (CT) Perfusion in Neuroradiologic Imaging. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=170+&releaseId=2
96. [-3097783]
American College of Radiology. ACR–NASCI–SIR–SPR Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (CTA). Available at: https://gravitas.acr.org/PPTS/GetDocumentView?docId=164+&releaseId=2.
97. [-3197621]
American College of Radiology. ACR Practice Parameter for Communication of Diagnostic Imaging Findings. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=74+&releaseId=2
98. [-3197634]
American College of Radiology. ACR–AAPM Technical Standard for Diagnostic Medical Physics Performance Monitoring of Computed Tomography (CT) Equipment. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=131+&releaseId=2
99. [21741870]
Habibzadeh MA, Ay MR, Asl AR, Ghadiri H, Zaidi H. Impact of miscentering on patient dose and image noise in x-ray CT imaging: phantom and clinical studies. Phys Med. 2012 Jul;28(3):191-9.
100. [24589403]
Trattner S, Pearson GDN, Chin C, et al. Standardization and optimization of CT protocols to achieve low dose. J Am Coll Radiol. 2014 Mar;11(3):271-278.
101. [28221093]
Kanal KM, Butler PF, Sengupta D, Bhargavan-Chatfield M, Coombs LP, Morin RL. U.S. Diagnostic Reference Levels and Achievable Doses for 10 Adult CT Examinations. Radiology. 2017 Jul;284(1):120-133.
102. [-3197655]
American College of Radiology. ACR–AAPM–SPR Practice Parameter for Diagnostic Reference Levels and Achievable Doses in Medical X-Ray Imaging. Available at https://gravitas.acr.org/PPTS/GetDocumentView?docId=16+&releaseId=2
103. [31052099]
Al Mahrooqi KMS, Ng CKC, Sun Z. Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review. J Med Imaging Radiat Sci. 2015 Jun;46(2):S1939-8654(15)00145-9.
104. [27072355]
Ryan ME, Jaju A, Ciolino JD, Alden T. Rapid MRI evaluation of acute intracranial hemorrhage in pediatric head trauma. Neuroradiology. 58(8):793-9, 2016 Aug.
105. [-3197779]
American Association of Physicists in Medicine. AAPM position statement on the use of bismuth shielding for the purpose of dose reduction in CT scanning. Available at: https://www.aapm.org/publicgeneral/BismuthShielding.pdf. .
106. [11566670]
Jhaveri KS, Saini S, Levine LA, et al. Effect of multislice CT technology on scanner productivity. AJR Am J Roentgenol. 2001 Oct;177(4):769-72.
107. [16916131]
Jordan MJ, Lightfoote JB, Jordan JE. Quality outcomes of reinterpretation of brain CT imaging studies by subspecialty experts in neuroradiology. J Natl Med Assoc. 2006 Aug;98(8):1326-8.
108. [23169731]
Jordan YJ, Jordan JE, Lightfoote JB, Ragland KD. Quality outcomes of reinterpretation of brain CT studies by subspecialty experts in stroke imaging. AJR Am J Roentgenol. 2012 Dec;199(6):1365-70.
109. [22033719]
Korn A, Fenchel M, Bender B, et al. Iterative reconstruction in head CT: image quality of routine and low-dose protocols in comparison with standard filtered back-projection. AJNR Am J Neuroradiol. 2012 Feb;33(2):218-24.
110. [19698072]
Nelson DW, Nyström H, MacCallum RM, et al. Extended analysis of early computed tomography scans of traumatic brain injured patients and relations to outcome. J Neurotrauma. 2010 Jan;27(1):51-64.
111. [22207302]
Rapalino O, Kamalian S, Kamalian S, Cranial CT with adaptive statistical iterative reconstruction: improved image quality with concomitant radiation dose reduction. AJNR Am J Neuroradiol. 2012 Apr;33(4):609-15.
112. [22304977]
Ren Q, Dewan SK, Li M, et al. Comparison of adaptive statistical iterative and filtered back projection reconstruction techniques in brain CT. Eur J Radiol. 2012 Oct;81(10):2597-601.
113. [18854441]
Tan JS, Tan KL, Lee JC, Wan CM, Leong JL, Chan LL. Comparison of eye lens dose on neuroimaging protocols between 16- and 64-section multidetector CT: achieving the lowest possible dose. AJNR Am J Neuroradiol. 2009 Feb;30(2):373-7.
114. [20961529]
You JJ, Gladstone J, Symons S, Rotstein D, Laupacis A, Bell CM. Patterns of care and outcomes after computed tomography scans for headache. Am J Med. 2011 Jan;124(1):58-63.e1.