the 2004 CT
Multislice computed tomography (MSCT) has been the
major advance in the practice of computed tomography (CT) since this
modality began. It has made existing applications easier and has extended
the applications of CT into new areas, with significant impact on the
clinical management of disease.
This change has created educational and practice
challenges that are on going because the technological advance continues.
The last six years have seen the successive introduction of systems
capable of acquiring simultaneously 4, 8 or 16, 32 slices, and systems with
or more detector arrays are on the point of introduction. So rapid has
been the development that changes in examination technique have had
difficulty keeping pace with technological advance.
The new technology also has significant implications
to the radiation dose administered to the population from medical uses.
For more than ten years it has been recognised that CT represents a
progressively enlarging contribution to the dose to the population and
that in some departments the modality may represent the largest single
source of patient radiation in diagnostic radiology. The wider
applications of MSCT contribute to this trend, increasing the scope of
examinations and increasing the number of patients in whom CT becomes the
investigation of choice.
For these reasons MSCT represents a powerful
challenge to existing practice standards. Medical personnel using MSCT
must be conscientious in practicing to the highest possible standards and
adapting these standards as developments progress. It is mandatory that
practice concurs with national and international legislation and
guidelines in justifying examinations and optimising practice. However
MSCT continues to develop and it is essential that practice also takes
account of evidence continually emerging from clinical experience and
In 1999 the European Commission published the
European Guidelines on Quality Criteria for Computed Tomography (European
Commission, ISBN 92-828-7478-8). Since this publication MSCT has changed
practice in CT dramatically. It is timely, therefore, to re-examine the
guidelines to take account of this advance.
The present document sets out the key elements of
current MSCT, with particular regard to image quality, radiation dose and
dosimetry, and makes recommendations on good examination approach in key
areas. It is intended that these recommendations should inform good
practice and also serve as a base for future knowledge growth as MSCT
continues to develop.
These guidelines result from the cooperative effort
of the following European study group of radiologists and physicists
involved in diagnostic computed tomography:
- Prof.dr. G. Bongartz (Universitätsinstitut für
Radiologie, Kantonsspital Basel, Switzerland)
- Dr. S.J. Golding (John Radcliffe Hospital, Oxford
MRI Centre, Oxford, United Kingdom)
- Dr. A.G. Jurik (Aarhus University Hospital,
Department of Diagnostic Radiology, Aarhus, Denmark)
- Prof. M. Leonardi (Ospedale Bellaria, Bologna,
- Dr. E. van Persijn van Meerten (Leiden University
Medical Center, Leiden, The Netherlands)
- Dr R. Rodríguez (Hospital Universitario San
Carlos, Department of Diagnostic Radiology, Madrid, Spain)
- Dr. K. Schneider (Dr. von Haunersches
Kinderspital, Munich, Germany)
- Dr. A. Calzado (Complutense University,
Department of Radiology, Madrid, Spain)
- Dr. J. Geleijns (Coordinator of the concerted
action, Leiden University Medical Center, Department of Radiology,
Leiden, The Netherlands)
- Dr. K.A. Jessen (Aarhus University Hospital,
Department of Medical Physics, Aarhus, Denmark)
- Dr. W. Panzer (GSF, Neuherberg, Germany)
- Dr. P. C. Shrimpton (NRPB, Chilton,United
- Prof. G. Tosi (Istituto Europeo di Oncologia,
The present report has been supported in the
framework of the European Commission's radiation protection actions by Dr. D. Teunen,
Dr. C. Desaintes and Dr. G.N. Kelly.
The consortium, March 2004.
the 2004 CT Quality Criteria
Please refer to the quality
G. Bongartz, S.J. Golding, A.G.
Jurik, M. Leonardi, E. van Persijn van Meerten, R. Rodríguez, K.
Schneider, A. Calzado, J. Geleijns, K.A. Jessen, W. Panzer, P. C.
Shrimpton, G. Tosi
European Guidelines for
Multislice Computed Tomography
Funded by the European Commission
Introductions to the 2004 CT
Technical principles of MSCT
Clinical Principles of MSCT
The 2004 CT Quality Criteria
Clinical and associated
performance parameters for MSCT Quality Criteria
Clinical and performance
parameters: MSCT in paediatric patients
2004 MSCT Quality Criteria
2004 MSCT Paediatric Quality
Appendices to the 2004 CT Quality
Appendix A - MSCT Dosimetry
Appendix B - European field survey
Appendix C - Assessment of Patient
Dose in Paediatric MSCT
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