B5401 - Tecniche di imaging TC, body e articolare (BO)

Learning outcomes

The student acquires the technical-practical and methodological knowledge necessary to perform a CT examination using appropriate protocols based on the patient's clinical question, pathology, and the type of equipment available.
They will also learn to recognize artifacts and apply image quality criteria.

Course contents

• Historical overview of computed tomography
• Main components of a CT scanner
• Structural and technological requirements of a CT room
• Basic principles of sequential CT and spiral CT
• Image formation in CT: acquisition – processing – visualization
• Physical principles of CT image formation
• Technological evolution of CT systems
• From spiral CT to multislice CT (MSCT)
• MSCT vs. spiral CT: advantages and disadvantages
• Basic characteristics and image acquisition methods in CT
• Reconstruction matrix, pixel, and voxel
• Image quality descriptors
• CT technical parameters (Scanning parameters, Reconstruction parameters, Display parameters)
• Scanning parameters (kilovoltage, milliamperes, scan time)
• Geometric parameters (FOV, slice thickness, slice increment, pitch factor, slice tilt)
• Reconstruction parameters (matrix)
• Display parameters
• Main CT image artifacts
• CT dose: descriptors and dose reduction techniques
• Optimization of CT techniques
• Factors influencing dose and image quality in CT
• Image processing techniques in MSCT: MPR, MIP, MinIP, SSD, VR
• CT Study Protocols
  • CT Study Protocols
    • Standard Brain CT Protocol with and without Contrast
    • Facial Bones CT Protocol with and without Contrast
    • Cervical, Thoracic, and Lumbosacral Spine CT Protocol with and without Contrast
    • Neck CT Protocol with and without Contrast
    • High-Resolution Chest CT (HRCT) Protocol
    • Baseline Chest CT Protocol with and without Contrast
    • Low-Dose Abdominal CT Protocol
    • Complete Abdominal CT Monophasic Protocol
    • Complete Abdominal CT Biphasic Protocol
    • Complete Abdominal CT Triphasic Protocol
    • Targeted Abdominal CT Protocol Based on Diagnostic Question
    • CT Urography Protocol
    • Pelvis and Hip Joint CT Protocol
    • Upper Limb CT Protocol with and without Contrast
    • Lower Limb CT Protocol with and without Contrast
    • CT Colonography Protocol
    • CT Enterography Protocol
      
    Angio-CT Study Protocols
    • General Angio-CT Protocols
    • Extracranial Angio-CT or Supra-Aortic Trunks (TSA) Protocol
    • Cerebral Veins Angio-CT Protocol
    • Thoracic Aorta Angio-CT Protocol
    • Thoracoabdominal Aorta Angio-CT Protocol
    • Abdominal Aorta and Iliac Vessels Angio-CT Protocol
    • Pulmonary Embolism Angio-CT Protocol
    • Lower Limb Angio-CT Protocol
    • Emergency Angio-CT Protocol

Readings/Bibliography

1. Elements of Computed Tomography
   (Edited by Lorenzo Faggioni, Fabio Paolicchi, Emanuele Neri)

2. Compendium of Computed Tomography and Spiral CT
   (By Giancarlo dal Pazzo)

3. Atlas of Human Anatomy
   (By Frank H. Netter, M.D.)

4. Spiral and Multislice Computed Tomography
   (By Mattias Prokop, Michael Galanski – Italian edition edited by Lorenzo Bonomo)

5. Computed Tomography and Magnetic Resonance Imaging Techniques in Diagnostic Imaging
   (By L. Cei)

6. CT Quality Guidelines – Regional Health Service of Emilia-Romagna

7. Multislice CT: Principles, Techniques, and Clinical Applications
   (By Elliot K. Fishman, R. Brooke Jeffrey, Jr.)

Teaching methods

1. Main Indications for the Examination

• Neurological conditions (head trauma, stroke, tumors, epilepsy)
• Thoracic-abdominal conditions (tumors, infections, trauma, vascular diseases)
• Oncological follow-up
• Emergencies (e.g., pulmonary embolism, organ rupture)

2. Patient Reception and Identification

• Verification of identity (name, date of birth, ID document)
• Explanation of the procedure
• Collection of informed consent
• Assessment of allergies, renal insufficiency, pregnancy

3. Verification of the Radiological Request

• Check for completeness and accuracy of the request
• Consistency between clinical question and type of exam requested
• Possible consultation with the radiologist

4. Patient Management and Preparation

• Fasting (if required)
• Removal of metallic objects
• Placement of venous access (if necessary)
• Administration of pre-exam medications (e.g., antiemetics, corticosteroids)

5. Use of Contrast Media

• Choice between iodinated contrast (IV or oral)
• Evaluation of renal function (eGFR)
• Administration protocol (dose, rate, timing)
• Management of possible adverse reactions

6. Positioning, Centering, and Protocol Selection

• Correct positioning on the table (e.g., supine, arms raised)
• Anatomical centering (e.g., orbitomeatal line for brain CT)
• Protocol selection based on pathology and anatomical region

7. Scanning Parameters

• Acquisition: slice thickness, pitch, kV, mAs
• Post-processing: MPR, MIP, 3D reconstructions
• Visualization: window settings (e.g., parenchymal, bone, vascular)

8. Image Quality Criteria

• Absence of artifacts
• Correct centering and anatomical coverage
• Good contrast and resolution
• Proper synchronization with contrast media (if used)

Assessment methods

Assessment of Learning

The learning assessment is conducted through a final oral exam that verifies the acquisition of the expected knowledge and skills related to CT room procedures. During the exam, the candidate is required to describe the CT methodology, from patient intake to the acquisition of the diagnostic study and the CT protocol used, evaluating the accuracy of the examination with critical and reflective thinking.

The student will be evaluated based on the following criteria:

• Cognitive and operational domain
  (Ability to apply theoretical knowledge to practical work; ability to justify actions based on Evidence-Based Practice principles)

• Knowledge, mastery, and depth of content

• Critical thinking and communication skills

• Accuracy in technical and scientific terminology

"Students with learning disabilities or temporary/permanent impairments

are encouraged to contact the dedicated office as soon as possible:
🔗 https://site.unibo.it/studenti-con-disabilita-e-dsa/en/for-students

Requests for accommodations must be submitted at least 15 days before the exam date to the instructor, who will evaluate the appropriateness of the measures in light of the course objectives.

Teaching tools

The teaching material presented during the lesson (PPT) will be made available to students in electronic format (PDF) on PC or OneDrive.

This material may be printed and brought to class or uploaded to a PC on the same day as the lessons.

Office hours

See the website of Antonella Mangione