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1.  Challenges to Protocol Optimization Due to Unexpected Variation of CT Contrast Dose Amount and Flow 
Journal of Digital Imaging  2012;26(3):402-405.
High-quality computed tomography (CT) exams are critical to maximizing radiologist’s interpretive ability. Exam quality in part depends on proper contrast administration. We examined injector data from consecutive abdominal and pelvic CT exams to analyze variation in contrast administration. Discrepancies between intended IV contrast dose and flow rate with the actual administered contrast dose and measured flow rate were common. In particular, delivered contrast dose discrepancies of at least 10% occurred in 13% of exams while discrepancies in flow rate of at least 10% occurred in 42% of exams. Injector logs are useful for assessing and tracking this type of variability which may confound contrast administration optimization and standardization efforts.
PMCID: PMC3649061  PMID: 23143417
Computed tomography; Computer communication networks; Computer hardware; Contrast media; Diagnostic image quality
2.  Implementation of the ACR Dose Index Registry at a Large Academic Institution: Early Experience 
Journal of Digital Imaging  2012;26(2):309-315.
A rising conciousness within both the medical community and in the public has been created by the current levels of radiation exposure from increased use of computed tomography. The concern has prompted the need for more data collection and analysis of hospital and imaging center exam doses. This has spurred the American College of Radiology (ACR) to develop the Dose Index Registry (DIR), which will allow participating insitutions to compare the radiation dose from their CT exams to aggregate national CT dose data based on exam type and body part. We outline the steps involved in the process of enrolling in the DIR, the technical requirements, the challenges we encountered, and our solutions to those challenges. A sample of the quaterly report released by the ACR is presented and discussed. Enrolling in the ACR dose registry is a team effort with participation from IT, a site physicist, and a site radiologist. Participation in this registry is a great starting point to initiate a QA process for monitoring CT dose if none has been established at an institution. The ACR has developed an excellent platform for gathering, analyzing, and reporting CT dose data. Even so, each insititutions will have its own unique issues in joining the project.
PMCID: PMC3597962  PMID: 23152117
Computed tomography; Radiation dose; Quality assurance
3.  Creation and Storage of Standards-based Pre-scanning Patient Questionnaires in PACS as DICOM Objects 
Journal of Digital Imaging  2010;24(5):823-827.
Radiology departments around the country have completed the first evolution to digital imaging by becoming filmless. The next step in this evolution is to become truly paperless. Both patient and non-patient paperwork has to be eliminated in order for this transition to occur. A paper-based set of patient pre-scanning questionnaires were replaced with web-based forms for use in an outpatient imaging center. We discuss this process by which questionnaire elements are converted into SNOMED-CT terminology concepts, stored for future use, and sent to PACS in Digital Imaging and Communications in Medicine (DICOM) format to be permanently stored with the relevant study in the DICOM image database.
PMCID: PMC3180552  PMID: 20976611
Paperless; Pseudo paperless; Filmless; SNOMED-CT; Data mining; Clinical workflow; Data collection
4.  Creation and Usability Testing of a Web-Based Pre-Scanning Radiology Patient Safety and History Questionnaire Set 
Recent advances in technology have significantly changed radiology workflow. The main focus of these changes has been the transition from hard copy film to digital imaging. The next transition will be a “paperless” transformation. Web-based versions of the current paper-based patient safety and history questionnaires were created using PHP and MySQL. Two rounds of usability testing using volunteers were completed using tablet PCs. Volunteers were comprised of ten individuals. Ages of volunteers ranged from 27 to 60 years, and there were eight males and two females. The majority of users had at least a Master’s degree and was considered to have a computer experience level of a programmer. Eighty percent of the users agreed that the web-based questionnaires and tablet PCs were easy to use. Text input through the writing recognition window and scrolling proved to be the least usable sections of the questionnaires. The new web-based system was found to be a very usable system by our participants. The questionnaires were easy to use, easy to navigate, and easy to read. Individual elements such as radio buttons and checkboxes did not fair as well but were due to their small size. Difficulty with the writing recognition interface is an inherent issue with the Windows XP Tablet Edition operating system.
PMCID: PMC3043732  PMID: 18716839
Usability; paperless; filmless; tablet PC; workflow

Results 1-4 (4)