Материал: part17

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AAAA Protocol Storage Examples and​ Concepts (informative)​

The following examples are provided to illustrate the usage of the CT Defined and Performed Procedure Protocol IODs. They do NOT​ represent recommended scanning practice. In some cases they have been influenced by published protocols, but the examples here​ may not fully encode those published protocols and no attempt has been made to keep them up-to-date.​

AAAA.1 Protocol Storage Concepts​

AAAA.1.1 Use Cases​

Theprimaryapplications(usecases)consideredduringthedevelopmentoftheCTProcedureProtocolStorageIODswerethefollowing:​

•​Managing protocols within a site for consistency and dose management (Using Defined Protocols)​

•​Recording protocol details for a performed study so the same or similar values can be used when performing followup or repeat​ studies, especially for oncology which does comparative measurements (Using Performed Protocols)​

•​Vendor troubleshooting image quality issues that may be due to poor protocol/technique (Using Performed Protocols, Defined​ Protocols)​

•​Distributing departmental, "best practice" or reference protocols (such as AAPM) to modality systems (Using Defined Protocols)​

•​Backing up protocols from a modality to PACS or removable media (e.g., during system upgrades or replacement); most vendors​ have a proprietary method for doing this which would essentially become redundant when Protocol Management is implemented​ (Using Defined Protocols)​

Figure AAAA.1.1-1. Protocol Storage Use Cases​

Additional potential applications include:​

•​Makingmoredetailedprotocolinformationavailabletorenderingorprocessingapplicationsthatwouldallowthemtoselectprocessing​ that corresponds to the acquisition protocol, to select parameters appropriate to the acquisition characteristics, and to select the​ right series to process/display (Using Performed Protocols)​

•​Improving imaging consistency in terms of repeatable technique, performance, quality and image charateristics; would benefit from​ associated image quality metrics and other physics work (Using Defined Protocols and Performed Protocols)​

•​Distributing clinical trial protocols (general purpose or scanner model specific) to participating sites (Using Defined Protocols)​

•​Recording protocol details for a performed study to submit with clinical trial images for technique validation (Using Performed Pro-​ tocols)​

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•​Tracking/extracting details of Performed Protocol such as timestamps, execution sequence and technique for QA, data mining, etc.​ (Using Performed Protocols)​

•​Making more detailed protocol information available to radiologists reviewing a study and priors, or comparing similar studies of​ different patients (Using Performed Protocols)​

AAAA.1.2 Workflow​

Using non-Patient-specific Protocols​

In most cases, the scanner uses any protocol details in the modality worklist item to present to the technologist a list of matching​ Defined Protocols on this scanner.​

Preparing and executing Patient-specific Protocols​

In the simplest form, this process could be driven with a combination of the Modality Worklist and Defined Protocols.​

Radiologist at the RIS:​

•​Selects a patient procedure on the upcoming Modality Worklist​

•​Adds tech notes to the Worklist entry (e.g., "Use Defined Protocol X; Decrease parameter Y…")​

Technologist at the modality:​

•​Selects the patient procedure on the upcoming Modality Worklist​

•​Reads the tech notes​

•​Selects the identified Defined Protocol and adjusts as described​

Modality​

•​Executes procedure​

•​Stores the Performed Protocol to study folder on PACS​

Radiologist​

•​(Optionally) Reviews the Performed Protocols​

In special cases, the radiologist might attend the scan and modify the protocol directly on the console.​

Note that the primary record of adjustments is the Performed Protocol object (which can be compared to the referenced Defined​ Protocol object).​

A new Defined Protocol is not typically saved unless the intent is to have a new Defined Protocol available in the Library.​

AAAA.2 Routine Adult Head Protocol​

The examples in this Annex are intended to illustrate the encoding mechanisms of the DICOM CT Protocol Storage IODs, not to​ suggest particular values for clinical use. Further, these examples do not contain the many detailed Attributes one would expect from​ a fully executable defined protocol generated by a CT scanner, but they do demonstrate the usage of many common Attributes.​

This section includes Defined Protocol examples of a Routine Adult Head Protocol for several different scanner models. The protocol​ is presented as adjusted by a fictitious Mercy Hospital from a reference protocol referenced in the Predecessor Protocol Sequence.​ AlthoughtheexamplesinthissectionwereoriginallyderivedfromprotocoldocumentspreviouslypublishedbytheAAPM,somevalues​ here were modified and are likely out of date. Parties interested in the current AAPM protocols are encouraged to visit ht-​ tp://www.aapm.org/pubs/CTProtocols/​

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