For this reason users may notice that posts asking for second opinions tend to be downvoted, have fewer comments, and will end up being deleted. This protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Ct scans of this nature assess the arteries and veins for plaque, atherosclerosis, dissections, and aneurysms. Stanford cardiovascular ct scanning and injection protocols. Ct scan computed tomography cat scan centers and services. Functional treatment or case immobilization after minimally invasive repair of an acute achilles tendon rupture. Lp riccelli works closely with ohsu ct techs in the art of creating optimal images from current technology. Salient points in chest ct protocols lung nodule fu ct. Ct pet or mri neuroimaging showing a pattern of hypermetabolism or diffusion restriction not clinically explained by. Ct imaging increasingly relies on the integration of a variety of knowledge and skills.
A metaanalysis on the effectiveness of multidetector ct for the diagnosis of small bowel obstruction. Brain stents show big promise for certain stroke patients. Mgh adult diffusion data acquisition details hcp protocols. Ct protocols do not currently adhere to the acr appropriateness criteria. Richard duszak jr, md, is from the department of radiology, emory uni. Mass general imaging is one of the worlds premier medical imaging facilities. Dsmb login restricted access a phase ii study of parathyroid hormone following sequential unrelated cord blood transplantation. Table 3 shows the three main questions that need to be answered with ct protocol in patients with acute stroke and the specific procedures that will help answer each question. The massachusetts general hospital neuroradiology division employed an experience and evidence based approach to develop a neuroimaging algorithm to best select patients with severe ischemic strokes caused by anterior circulation occlusions acos for intravenous tissue plasminogen activator and endovascular treatment. Massachusetts general hospital sports medicine 2 palpable muscle contraction felt in scapular musculature pain massachusetts general hospital covid19 treatment guidance this document was prepared in marchapril, 2020 by and for mgh medical professionals a. The mghusc hcp team has acquired and shared diffusion imaging data from 35 healthy adults scanned on the customized siemens 3t connectom scanner. Rescue diagnostic testing protocol recommendations cardiac ct version 2. Do not give anything by mouth or allow the client to resume an upright position until feeling of weakness has passed.
Leyendecker, md ivan pedrosa, md, phd steve raman, md erick m. This forum is for education of those interested in radiology only, and not for personal advice. Image gently pediatric imaging image wisely adult imaging the purpose of these ct protocol pages is to provide a reference. Pdf use of multiphase ct protocols in 18 countries. Massachusetts general hospital mgh has several ct scan models from all the three major scan manufacturers ge, siemens and philips healthcare.
The research laboratory technician i is a fulltime position, and the primary responsibility is to assist in ongoing research studies under the supervision of a principal investigator in the endocrine unit at massachusetts general hospital. The ct scan of the abdomen using a liver protocol is typically used to evaluate abnormalities found within the liver and hepatic system. Focal spot at 120 kv, if the ma is less than 570, the machine will default to the small focal spot, providing greater detail on the images. Iv tpa administration mgh american heart association. Purpose to assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography ct protocols for routine chest and abdomenpelvis examinations in 18 countries. The sports physical therapy service is an integral part of the sports medicine center and the department of. Ct head 75 mgy ct adult abdomen 25 mgy ct adult chest 21 mgy ct paediatric abdomen 5 y old 20 mgy ct paediatric head 5 y old 34 mgy images courtesy of.
Acute stroke brain and carotids multiphase elvo brain helical adult brain venogram cta carotid and brain. In this paper we summarize approaches to reduce dose, as discussed in lectures comprising the first session of the 20 ucsf virtual symposium on radiation safety in computed tomography. Rehabilitation protocol for total shoulder arthroplasty. Advancing cancer therapy depends on a host of factors. Guidelines for use of medical protocols approved by the connecticut board of examiners for nursing february 4, 2004 history of the issue the use of medical protocols has been a topic of discussion and source of concern for sben and dph, and discussed at sben meetings for some time now. Diagnostic testing protocol recommendations cardiac ct. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. The staff at the mgh ctni have designed protocols for over 100 trials. How dose tracking affected protocol optimization in a. Neuroradiology protocols currently applied in our mri section. Mass general imaging massachusetts general hospital. Routine ct protocol % dose reduction routine abdomen 21. The wcc thanks the medical professionals who have spent and continue to spend many hours working with us to bring the most appropriate treatment, and the highest standard of care, to injured workers in connecticut.
Critical to invest efforts in lowering ct dose optimize ct protocols based on body size, age and clinical indications weight adapted ma and kvp reductions limit scan acquisition phases and scan length use thicker slices 5 mm and include multiplanar reconstructions mgh webster center for radiation dose research and education. Kalra, md webster center for quality and safety massachusetts general hospital harvard medical school financial disclosures research grants siemens healthcare. Mass general is home to the largest hospitalbased imaging research program in the country. Ct scanners differ in their capabilities and various indications require unique protocols, but there remains room for standardization and optimization. This page is for physicians, inside and outside this institution, and ct technologists. Steroids are not currently recommended for the treatment of viral pneumonia due to. September 18, 2009 a team of researchers led by massachusetts general hospital mgh radiologists has developed a computedtomography based protocol that identifies both narrowing of coronary arteries and areas of myocardial ischemia in a single examination, giving a better indication of clinically significant coronary artery disease, said a. Nurse protocols for registered professional nurses for 2012 emergency guidelines, policies, procedures and protocols 12.
Md, and mannudeep kalra, md, are from the department of radiology, massachusetts general hospital, harvard medical school, boston, massachusetts. Vendor specific dose reduction guidelines for ct siemens healthcare version 2. Most protocols include use of nonionic iv contrast material injected at a rate of 3 mlsec and a collimation of 7 mm. Silverman, md, cochair hersh chandarana, md ankur doshi, md gary m. Singh, mgh webster center for advanced research and education in radiation images courtesy of.
How dose tracking affected protocol optimization in a tertiary quaternary healthcare center mannudeep k. Salient points in kidney stone ct protocols kidney stone ct protocols should be done at reduced dose relative to routine abdomenpelvis scans. New mgh ct protocol identifies narrowing of coronary. Ct angiography of the head is typically used to evaluate abnormalities found within the blood vessels that run through the brain. We provide comprehensive diagnostic imaging services using the latest imaging technology and specialized expertise to care for mass general patients. The mgh neurology department placed 4th in us news neurology neurosurgery rankings for 2014. Asir benefits cta protocol % dose reduction ct aaa 3 phase 21. The imaging data is available to those who register and agree to the open access data use terms. Standardization and optimization of computed tomography. Protocol design mgh clinical trials network and institute. Find pdfs of our most common rehabilitation protocols.
Other similar protocols can be used with different ct equipment 15. Mass general physicianscientists seeking to assess the potential benefits and risks of new cancer. In preparation for this procedure the patient may be asked to remove any metal and change into a gown. Rehabilitation protocols massachusetts general hospital. Standard imaging protocols this document includes typical imaging protocols for diagnostic imaging.
At the martinos center, we use one of the most powerful brain scanners in the world to produce images for the human connectome project. Over 100 subspecialized radiologists together with imaging technologists, specially. The following cardiovascular ct scanning and injection protocols have been developed with the goal to derive theoretically sound and at the same time practicable scanning and injections protocols for the siemens sensation 64 multislice scanner at stanford. Our areas of expertise include the design of protocols for studies in all cns areas, including major depressive disorder, treatment resistant depression trd, posttraumatic stress disorder, schizophrenia, bipolar disorder and womens mental health. Protocol design and optimization mass general imaging. Massachusetts general hospital treatment guidance for. The protocols provided in this text provide complete information regarding i patient.
If phosphodiesterase inhibitors for 48 hours before the test, no nitrates to be given during ct scan acquisition 2. A new systematic approach for the imaging assessment of patients with chronic pancreatitis april 2020. Unless otherwise noted, protocols that include intravenous contrast enhancement use a 300 concentration, low osmolality agent. Above 9 years old use adult protocols, except for the newly added rapid swift for under 16 yrs old.
There is a wide range in the number of protocols used for helical ct in the abdomen and pelvis among the responding institutions. It outlines ct protocols for diagnostic imaging currently applied to ou ct scanners. Specifically, there was concern that medical protocols may. Ct angiography versus conventional angiography for the postoperative evaluation of clipped cerebral aneurysm april 2020. New concept in ct image reconstruction asir in the. Ct scans of this nature assess for liver tumors, bleeding, jaundice, and liver diseases. Radiologists work closely with ohsu mri techs in the art of creating optimal images from current technology. Especially followup exams for kidney stones 30% lower dose than routine abdomenpelvis scan is a good target. Shoulderaxialcoronal sagittalreformat 2 2bonesoft tissuereconstruct 1.