ASRT Standards of Practice for Medical Imaging and Radiation Therapy (2023)

preface

These standards of practice serve as a guide for the profession of medical imaging and radiotherapy. These standards define the practice and establish general criteria for determining compliance. Standards of practice are authoritative statements produced by the profession through supporting documentation to assess the quality of practice, service, and training provided by individuals within the profession.

Practice standards can be used by individual institutions to develop job descriptions and practical parameters. Non-professionals can use the standards as a general description of the roles and responsibilities of individuals within the profession.

The imaging and radiotherapy professional and any person legally authorized to perform medical imaging or radiotherapy must have an educational background and be clinically competent as a prerequisite for practicing the profession. Subject to any applicable legal requirements and limitations, the individual must use individual thought, judgment and discretion in conducting the process. Federal and state laws, regulations, accreditation standards, and institutional guidelines may prescribe practice parameters and override these standards.

Format

The ASRT standards of practice for radiotherapy and medical imaging are divided into five sections:

• introduction– defines the practice and minimum qualifications for training and certifying individuals and an overview of the specific practice.
• Scope of Radiotherapy and Medical Imaging Practice– describes the parameters of the specific practice.
• Standards– Incorporation of patient assessment and treatment into the analysis, implementation and evaluation of the procedure. The norms define the activities of the person responsible for patient care and for carrying out radiotherapy and imaging procedures; in areas of technical performance, e.g. B. Evaluation of equipment and materials, safety standards and comprehensive quality management; and in the areas of education, interpersonal relationships, self-assessment and ethical conduct.
• Advisory Opinion Statements– provide explanations of standards of practice and serve to clarify and guide specific practice issues.
• glossary– defines the terms used in the standard document.

Patterns are numbered, followed by a term or set of terms that describe the patterns. The following statement is the person's expected performance in performing the procedure or treatment. A logic follows that explains why an individual must meet a certain performance standard.

• criterion– Used to evaluate a person's performance. Each standard is divided into two parts: general criteria and specific criteria. Both should be used when evaluating performance.
• General Criteria- Written in a style applicable to radiotherapy and medical imaging professionals and intended for use in the appropriate area of ​​practice.
• Specific Criteria– Satisfaction of the needs of people in the various areas of professional activity. While many areas of practice in medical imaging and radiation therapy are similar, others are not. Specific criteria were developed taking these differences into account.

In this document, all organizations are identified by their abbreviations and described in detail in the glossary.

introduction

Definition

The profession of medical imaging and radiation therapy consists of healthcare professionals known as bone densitometry technologist, interventional cardiac and vascular technologist, computed tomography technologist, restricted X-ray machine operator, MRI technologist, mammography technician, medical dosimetrist , nuclear medicine technologist and quality management technologist , Radiotherapists, X-ray assistants, radiologist assistants or sonographers pedagogically prepared and clinically competent in accordance with these standards.

In addition, these standards apply to healthcare professionals who are legally authorized to perform radiation therapy or medical imaging and who are prepared educationally and clinically competent in accordance with these standards.

The complex nature of pathological processes implies multiple imaging modalities. Radiotherapy and medical imaging professionals are key members of a multidisciplinary team that forms a core of highly qualified medical professionals, each bringing experience in the field of patient care. They play a crucial role in the delivery of healthcare as new modalities emerge and the need for medical imaging and radiotherapy procedures increases.

Medical imaging and radiotherapy integrate scientific knowledge, technical experience and patient interaction skills to provide safe and accurate procedures with the utmost attention to all aspects of patient care. A specialist in medical imaging and radiotherapy recognizes each patient's unique elements, which is essential for the successful completion of the procedure.

Radiotherapy and medical imaging professionals are the primary link between patients, licensed physicians, and other support team members. These professionals must remain sensitive to the patient's needs through good communication, patient assessment, patient follow-up, and patient care skills. As members of the healthcare team, radiotherapy and medical imaging professionals participate in quality improvement processes and continuously evaluate their professional performance.

Radiotherapy and medical imaging professionals think critically and use independent, professional and ethical judgment in all aspects of their work. They participate in continuing education to include their field to improve patient care, safety, public education, knowledge and technical competence.

Advisory Opinion Statements

Opinions on advisory opinions contain explanations of standards of practice.

ASRT issues advisory opinions to clarify what constitutes good practice and provides guidance on specific practice issues.

The profession holds medical imaging and radiation therapy professionals accountable for providing safe and effective clinical services to patients and for the judgments and actions taken in the course of providing such services. Advisory opinion statements help radiation oncologists and medical imaging professionals use it safely.

The performance of the radiotherapy and medical imaging professional must be evidence-based and consistent with laws, regulations, established standards of practice, and federal and state policies and procedures.

ASRT recognizes the use of GRADE to measure the quality of evidence and the strength of recommendations for developing opinion.

Each radiotherapy and medical imaging professional must make a prudent decision as to whether the performance of a particular act is within the scope of practice for which the individual is licensed, where appropriate, within the jurisdiction in which the individual is employed, educated, and medically competent.

Guide for Communicating Clinical and Imaging Observations and Details of Procedures by Radiologist Assistants to Assistant Radiologists

After reviewing the supporting documentation, ASRT has issued the views contained in this document.

Advisory Opinion

It is ASRT's opinion, based on supporting documentation and to the fullest extent permitted by federal or state law and/or institutional policy, that:

1. The transmission of clinical and imaging observations and details of the procedure from the assistant radiologist to the supervising radiologist is an integral part of the assistant radiologist's practice. Without clear, consistent, and adequate communication between members of the radiology team, there is a risk of inadequate patient care, incomplete reporting, and reduced unit productivity. To create a safe and productive radiology environment, communication between the radiologist assistant and the assistant radiologist must be smooth, consistent, and relevant to the patient's exam or procedure. This communication can take many forms, including oral, written and electronic correspondence. These messages can be recorded and taken into account by the radiologist when preparing a final report. However, the initial clinical and imaging observations and details of the procedure that the radiologist communicates to the radiologist are for the radiologist only and do not replace the final report prepared by the radiologist. These communications should be considered and documented as "initial images and clinical observations or procedure details".
2. When assisting radiologists in performing imaging procedures or performing procedures under the radiologist's supervision, the radiologist's assistant must be able to communicate and document procedural notes, observations, patient responses, and other types of information relevant to interpretation. and production of relevant information for the radiologist. final report. Radiologists do not independently “report” findings and “interpret” them by dictation or otherwise; and to avoid confusion, these terms should not be used to refer to the activities of the radiologist's assistant. However, radiologist assistants may add items to the patient's record (in accordance with the institution's policies and procedures) in a similar manner to any other dependent non-medical professional. Radiologic assistants authorized to transmit the initial observations to the assistant radiologist through a voice recognition dictation system or other electronic means must adhere to institutional protocols that ensure that only the assistant radiologist can view or access the initial observations. Initial clinical or imaging observations or procedure details made by the attending radiologist as a result of the attending radiologist's involvement in performing the procedure and included in the final report should be carefully reviewed by the attending radiologist and added at the discretion of the attending radiologist.

DEGREE: Strong

The definition

See glossary.

supporting documentation

current literature
Not applicable

study plans

• Curriculum for Radiologist Assistants (ASRT, 2020)

EVIDENCE QUALITY: High

Entry level certification body clinical activities

• Registered Radiologist Assistant Entry Level Clinical Activities (ARRT, 2018)

  The document states that radiologist assistants “can review imaging procedures, make initial observations, and share observationsONLY[emphasis added] to the radiologist; recording the initial observations of the imaging procedures, upon approval by the radiologist; Submission of the radiologist's report to the appropriate health care provider, in accordance with the ACR practice parameter, for submission of diagnostic imaging results”.

Certificate Authority Content Specifications
Not applicable

EVIDENCE QUALITY: High

Application areas and practical reference standards

• Industry (radiology assistant only)
  • Submit the primary radiologist's report to the appropriate healthcare professional in accordance with ACR's practice guidelines for submission of diagnostic imaging reports.
  • Rate images for completeness and diagnostic quality and recommend additional images.
  • Obtaining the images necessary for the diagnosis and transmitting the first observations to the responsible radiologist. The radiologist's assistant does not offer image interpretation in the sense of ACR.
  • Perform a follow-up examination of the patient.
• ASRT standards of practice for radiotherapy and medical imaging
  • Performs and documents a radiology-focused physical exam, analyzes data, and reports results to the responsible radiologist. (Pattern One, radiologist assistant only)
  • Performs a follow-up examination of the patient and communicates the results to the responsible radiologist. (Pattern Seven, Radiologist Assistant Only)
  • Documents diagnosis, treatment, and patient information in the medical record in a timely, accurate, and complete manner. (Standard Eight, General Criteria)
  • Maintains documentation of quality assurance activities, procedures, and results. (Standard Eight, General Criteria)
  • Communicates and documents a radiologist's request to other healthcare professionals. (Pattern Eight, Assistant Radiologist only)
  • Documents and assists the radiologist in quality reporting activities to improve patient care. (Pattern Eight, Assistant Radiologist only)
  • Report clinical and imaging observations and procedure details to the responsible radiologist. (Pattern Eight, Assistant Radiologist only)

EVIDENCE QUALITY: High

References to federal and state laws
Not applicable

Several
Not applicable

Drug delivery into peripherally inserted central line lines or ports with an electrical injector*†

After reviewing the supporting documentation, ASRT has issued the views contained in this document.

Advisory Opinion

It is ASRT's opinion, based on supporting documentation and to the fullest extent permitted by federal or state law and/or institutional policy, that:

Radiotherapy and medical imaging professionals can access and/or use an FDA-approved certificate:

1. Peripherally Inserted Central Catheter (PICC) inserting an approved connector device. The PICC line must be rated for use with electrical injectors. Manufacturer's guidelines for infusion rate and pressure should be followed.
2. Open by inserting an approved non-punctureable needle. The connector is for use with power injectors. Manufacturer's guidelines for infusion rate and pressure should be followed.

DEGREE: Strong

The definition

See glossary.

supporting documentation

current literature
Not applicable

study plans

• Computed Tomography Curriculum (ASRT, 2018)
• MRI Curriculum (ASRT, 2020)
• Competency-Based Curriculum Guide in Nuclear Medicine Technology (SNMMI, 2015, beginning April 2020)
• Radiography Curriculum (ASRT, 2017)
• Curriculum for Radiologist Assistants (ASRT, 2020)

EVIDENCE QUALITY: High

Certificate Authority Content Specifications

• Preparation Components (NMTCB, 2020)
• Computed tomography (ARRT, 2017)
• Positron Emission Tomography (PET) Special Exam Content Summary (NMTCB, 2021)
• Interventional Vascular Radiography (ARRT, 2017)

EVIDENCE QUALITY: High

Application areas and practical reference standards

• scope of practice
  • Administer medications enterally, parenterally, through new or existing vascular lines, or by other routes prescribed by a licensed physician.*†
  • Administer medication with an infusion pump or electric injector as directed by a licensed physician.*†
  • Identify, calculate, combine, prepare and/or administer medications prescribed by a licensed physician.*†

EVIDENCE QUALITY: High

References to federal and state laws
Not applicable

Several
Not applicable

*Excluding restricted X-ray operator†
†Excluding medical dosimetry

Drug delivery through new or existing vascular access*†

After reviewing the supporting documentation, ASRT has issued the views contained in this document.

Advisory Opinion

It is ASRT's opinion, based on supporting documentation and to the fullest extent permitted by federal or state law and/or institutional policy, that:

1. It is part of the practice of radiotherapy and medical imaging professionals to access and administer medication through a new or existing vascular access using an approved method of administration (eg, a licensed physician).

DEGREE: Strong

The definition

• Access – The process of inserting an approved connector device through the access point of an existing vascular access device to administer intravenous (IV) fluids or medications.
• Existing Vascular Access: Implanted central or peripheral vascular devices or external access lines, including but not limited to peripherally inserted central catheter lines, intravenous lines, central lines, and ports.

supporting documentation

current literature

• ACR Committee of Contrast Agents.Manual two ACR Contrast Agents🇧🇷 American College of Radiology; 2021. Accessed September 4, 2021.
• American College of Radiology. Practical ACR reference for performing and interpreting diagnostic computed tomography (CT) exams. Revised 2017. Accessed November 30, 2018.
• American College of Radiology. Parameters of the ACR exercise to perform and interpret magnetic resonance imaging (MRI). Revised 2017. Accessed November 30, 2018.
• American College of Radiology. Practical ACR-SPR parameters for the use of intravascular contrast agents. Revised 2017. Accessed November 30, 2018.
• Rockwell D. A competition for the use of central signaling pathways in radiology.J Radiol Nurses.2008;27(2):84. doi:10.1016/j.jradnu.2008.04.016

EVIDENCE QUALITY: High

study plans

• Cardiac and Vascular Intervention Curriculum (ASRT, 2019)
• Computed Tomography Curriculum (ASRT, 2018)
• MRI Curriculum (ASRT, 2020)
• Mammography Curriculum (ASRT, 2018)
• National Sonography Curriculum (JRC-DMS, 2016)
• Competency-Based Curriculum Guide in Nuclear Medicine Technology (SNMMI, 2015, beginning April 2020)
• Curricular Radiotherapy (ASRT, 2019)
• Radiography Curriculum (ASRT, 2017)
• Curriculum for Radiologist Assistants (ASRT, 2020)

EVIDENCE QUALITY: High

Certificate Authority Content Specifications

• Preparation Components (NMTCB, 2020)
• Computed tomography (ARRT, 2017)
• Exam Summary: Registered Invasive Cardiovascular Disease Specialist (CCI, 2019)
• Magnetic Resonance (ARRT, 2020)
• Nuclear Medicine Technology (ARRT, 2022)
• Radiography (ARRT, 2022)
• Registered Radiologist Assistant (ARRT, 2018)
• Interventional Vascular Radiography (ARRT, 2017)

EVIDENCE QUALITY: High

Application areas and practical reference standards

• scope of practice
  • Administer medications enterally, parenterally, through new or existing vascular lines, or by other routes prescribed by a licensed physician.*†
  • Identify, calculate, combine, prepare and/or administer medications prescribed by a licensed physician.*†
  • Perform a venipuncture as directed by a licensed physician.*†
  • Initiate, maintain, and/or remove IV line as directed by a licensed physician.*†

EVIDENCE QUALITY: High

References to federal and state laws
Not applicable

Several
Not applicable

*Excluding restricted X-ray operators
† Excluding medical dosimetry

Placement of radiation monitors for staff

After reviewing the supporting documentation, ASRT has issued the views contained in this document.

Advisory Opinion

It is ASRT's opinion, based on supporting documentation and to the fullest extent permitted by federal or state law and/or institutional policy, that:

1. Radiation workers wear a personal radiation monitor outside of protective clothing, which is labeled with the radiation source at collar level.
2. In certain cases, a full-body monitor may be indicated. This monitor must be worn inside protective clothing around the waist with the label facing the radiation source.
3. In some cases, a ring monitor may be displayed. This monitor is intended to be used in the hand that is likely to be exposed to the highest levels of radiation, with the label facing the source of radiation.

DEGREE: Strong

The definition

See glossary.

supporting documentation

current literature

• Bushong S. Management of radiation dose in the workplace. At the:Radiological Science for Technologists: Physics, Biology, and Protection.12th edition. Elsevier; 2020: 547 - 549.
• By number of standards: 1910.1096(d)(3)(i) - Ionizing radiation. Occupational Health and Safety Authority website. Accessed on November 30, 2018.
• Gilmore D, Watersham-Rich K. Radiation safety in nuclear medicine. At the:Nuclear Medicine and PET/CT: Technology and Engineering.8th edition. Elsevier; 2016:116.
• Statkiewicz-Sherer MA, Visconti PJ, Ritenour ER, Welch-Haynes K. Radiation monitoring. At the:Radiation protection in medical radiographs.9ª ed. Elsevier; 2022: 72-87.

EVIDENCE QUALITY: High

study plans

• Bone Densitometry Curriculum (ASRT, 2019)
• Restricted Curriculum for X-Ray Operator (ASRT, 2020)
• Competency-Based Curriculum Guide in Nuclear Medicine Technology (SNMMI, 2015, beginning April 2020)
• Curricular Radiotherapy (ASRT, 2019)
• Radiography Curriculum (ASRT, 2017)
• Curriculum for Radiologist Assistants (ASRT, 2020)

EVIDENCE QUALITY: High

Certificate Authority Content Specifications

• Interventional cardiac radiography (ARRT, 2017)
• Preparation Components (NMTCB, 2020)
• Restricted scope in radiography (ARRT, 2018)
• Nuclear Medicine Technology (ARRT, 2022)
• Radiotherapy (ARRT, 2022)
• Radiography (ARRT, 2022)
• Registered Radiologist Assistant (ARRT, 2018)
• Interventional Vascular Radiography (ARRT, 2017)

EVIDENCE QUALITY: High

Application areas and practical reference standards

• Uses personal radiation monitoring equipment as appropriate, as directed by RSO or designee (Standard 4, General Criteria)

References to federal and state laws

• § 19.12 Training for Workers (NRC, 2021)
• § 20.1208 Embryo/fetal dose equivalent (NRC, 2021)
• § 20.1502 Conditions requiring individual external and internal occupational dose control (NRC, 2021)
• Regulatory Guide 8.34: Monitoring criteria and methods for estimating occupational radiation dose (NRC, 1992)
• Regulatory Guideline 8.36: Radiation dose to the embryo/fetus (NRC, 2018)
• Regulatory Guideline 8.7: Instructions for Recording and Reporting Occupational Radiation Exposure Data (NRC, 2016)

EVIDENCE QUALITY: High

Several

• AAPM Report #58: Managing Fluoroscopy Use in Medical Facilities. Appendix A: Quality Assurance/Radiation Protection Program

EVIDENCE QUALITY: High

Use of formwork, clipping, and post-exposure electronic masking in radiography

After reviewing the supporting documentation, ASRT has issued the views contained in this document.

Advisory Opinion

It is ASRT's opinion, based on supporting documentation and to the fullest extent permitted by federal or state law and/or institutional policy, that:

1. It is within the practice of a radiologic technologist to determine and apply the proper pre-exposure collimation for individual exam projections in order to comply with the ALARA principle. Post-exposure shuttering, cropping, electronic collimation, or electronic masking to remove visibility from large areas of glare are acceptable when automatic processing is not possible.
2. It is outside the scope of practice of a radiologic technologist to use post-exposure shuttering, clipping, electronic collimation, or electronic masking to remove anatomical information. This information forms part of the patient's permanent medical record and therefore must be presented to the licensed physician to determine whether the exposed anatomy obtained in an imaging session is significant or of diagnostic value.
3. It is beyond the reach of a radiologic technologist to use shuttering, clipping, electronic collimation, or post-exposure electronic masking to duplicate and use each acquired image for more than one prescribed view or projection in an exam. Institutions acquiring digital images are required by law to retain information in the DICOM of each image that identifies the view or projection selected at the time of image acquisition. Using the same captured image to present two different prescribed views or projections is a falsification of information in the patient record and examination images provided to the licensed physician.

DEGREE: Strong

The definition

See glossary.

supporting documentation

current literature

• American College of Radiology. Practical parameters ACR-AAPM-SIIM-SPR for digital radiography. Revised 2017.
• Bomer J, Wiersma-Deijl L, Holscher HC. Electronic collimation and radiation protection in pediatric digital radiography: resurgence of the silver lining.The perspective of the image.2013;4(5):723-727. doi:10.1007/s13244-013-0281-5
• Carol QB.Radiography in the digital age.3ra ed. Carlos C. Thomas; 2018.
• Carter C, Veale B.Digital radiography and PACS.3ra ed. Elsevier; 2019.
• Chalazonitis AN, Koumarianos D, Tzovara J, Chronopoulos P. How to optimize radiological images from digital cameras using Adobe Photoshop 6.0.J digits images.2003;16(2):216-229.
• DeMaio DN, Herrmann T, Noble LB, et al; American Society of Radiologic Technologists. Good practices in digital radiography. Launched in 2019.
• Don S, Macdougall R, Strauss K et al. Image Gentle Back to Basics Campaign Initiative: 10 Steps to Control Radiation Dose in Pediatric Digital Radiography.AJR Am J Roentgenol.2013;200(5):W431-W436. 2:10.2214/AJR.12.9895
• Fauber TL, Dempsey MC. X-ray field size and patient dosimetry.radio technology.2013;85(2):155-161.
• Faber TL.X-rays and exposure.6th Elsevier Edition; 2021: 120 and 176.
• Goske MJ, Charkot E, Herrmann T, et al. Image Gently: Challenges faced by radiologic technologists in performing digital radiographs in children.Pediatr Radiol.2011;41(5):611-619. doi:10.1007/s00247-010-1957-3
• Lo WY, Puchalski SM. digital image processing.Ultrassom Vet Radiol.2008;49(1 Suplemento 1):S42-S47. doi:10.1111/j.1740-8261.2007.00333.x
• Russell J, Burbridge BE, Duncan MD, Tynan J. Adult fingers visualized on NICU chest radiographs: what can't be seen.Can Assoc Radiol J.2013;64(3):236-239. doi:10.1016/j.carj.2012.04.004
• Seeram E.Digital radiography: an introduction.engaging learning; 2011
• Uffmann M, Schaefer-Prokop C. Digital radiography: The balance between image quality and the required radiation dose.Eur J Radiol.2009;72(2):202-208. doi:10.1016/j.ejrad.2009.05.060
• Willis EC. Optimization of digital radiography of children.Eur J Radiol.2009;72(2):266-273. doi:10.1016/j.ejrad.2009.03.003
• Zetterberg LG, Espeland A. Lumbar spine radiography: poor collimation practices after the introduction of digital technology.Br J Radiol.2011;84(1002):566-9. doi:10.1259/bjr/74571469

EVIDENCE QUALITY: High

study plans

• Restricted Curriculum for X-Ray Operator (ASRT, 2020)
• Radiography Curriculum (ASRT, 2017)

Certificate Authority Content Specifications

• Restricted scope in radiography (ARRT, 2018)
• Radiography (ARRT, 2022)

Application areas and practical reference standards

• scope of practice
  • Apply ALARA principles to minimize exposure to the patient, self, and others.
  • Choose the appropriate protocol and optimize technical factors while maximizing patient safety.
• ASRT standards of practice for radiotherapy and medical imaging
  • Involved in ALARA activities, patient and staff safety, risk management and quality assurance. (Standard One, General Criteria)
  • Uses professional judgment to adjust procedures to improve diagnostic quality or therapeutic outcomes. (Standard 2, general criteria)
  • Complies with radiation protection regulations and standards. (Standard Four, General Criteria)
  • Positions the patient to the anatomical area of ​​interest considering the patient's ability and comfort. (Standard Four, General Criteria)
  • Use pre-exposure collimation and proper field of view selection. (only four standard, restricted X-ray machine operator and radiography)
  • Evaluates images for optimal representation of the anatomy of interest. (Standard 5, General Criteria)
  • Evaluates images to determine the use of appropriate image parameters. (Pattern Five, restricted X-ray and radiography machine operators only)
  • Verifies that exposure indicator data for digital X-ray systems has not been altered or modified and is included in the DICOM header and images exported to media. (Pattern Five, restricted X-ray and radiography machine operators only)
  • Adheres to established standards of professional practice. (Standard Twelve, General Criteria)

EVIDENCE QUALITY: High

References to federal and state laws
Not applicable

Several
Not applicable

glossary

The Glossary is an alphabetical listing of defined terms or words found specifically in the ASRTP Standards of Practice for Radiotherapy and Medical Imaging. The terms or words have a meaning that may not be commonly known. Definitions are formulated using supporting documentation and implemented after thorough review and subsequent approval. The glossary is not complete. As time and technology advance, new terms and new uses of existing terms will emerge.

AAPM– American Association of Physicists in Medicine

ACR– American College of Radiology

advanced radiologist– A registered technologist who has gained additional knowledge and skills through successful completion of an organized radiology technology or apprenticeship program that prepares radiologic technologists for advanced practice roles and recognized by the national certification organization for participation in radiology technology advanced practice.

undesirable event– Any adverse experience related to the use of a medical device on a patient.

HEALTHY– Acronym for “as low as (is) reasonably attainable”, meaning that every reasonable effort is made to keep radiation exposure below the dose limits as possible, consistent with the purpose for which the authorized activity is carried out, taking into account consideration the state of technology, economics of improvements relative to the state of the art, economics of improvements relative to public health and safety benefits, and other social and socioeconomic considerations and in relation to the use of nuclear energy and permitted materials in the public interest. ASRT recognizes that the ALARA concept includes energies used for MRI and ultrasound imaging.

anatomical landmarks (anatomical)– Bones or other identifiable points that are visible or palpable and indicate the position of the internal anatomy.

Data– Data storage in hard (film) or soft (digital) format.

ARMAS– American Registry of Diagnostic Medical Ultrasound

TO RELAX– American Registry of Radiologic Technologists

Artifact– Superfluous information in the image that disturbs or distracts from the quality of the image.

ASRT– American Society of Radiologic Technologists

authorized user– A physician, dentist or podiatrist who meets the requirements of the US Nuclear Regulatory Commission.

beam modification devices– Devices that change the shape of the treatment field or the distribution of radiation in depth (tissue).

brachytherapy– A method of treatment in which sources of radiation (isotope or electron) are temporarily or permanently placed in or immediately adjacent to a region where a tumor is located.

ICC– International cardiovascular accreditation

change the management– Systematic approach to preparing, implementing and maintaining a process change.

clinical– Refers to or is based on actual patient observations and treatments.

clinically competent– The ability to perform a clinical procedure to meet the needs of a situation, assessed and documented by a qualified person.

compound drugs- Combining, mixing, grouping or otherwise altering a conventionally manufactured drug in response to or in anticipation of a drug prescription.

radiopharmaceutical compound- Combining, mixing, pooling or otherwise altering a conventionally manufactured radiopharmaceutical or synthesizing/formulating a radiopharmaceutical from bulk drugs and radionuclides.

contrast medium- A substance administered during a medical imaging procedure to increase the contrast between an internal structure or fluid and the surrounding tissue.

cut out– The process of selecting and removing part of the image.

custom blocks- Devices to model the radiation field.

DICOM– Acronym for “Digital Imaging and Communications in Medicine”. DICOM standards are a complex set of instructions for exchanging and presenting medical image information.

dose distribution– Spatial representation of the magnitude of the dose produced by a radiation source. Describes dose variation with position within an irradiated volume.

dosed combination- Combining unit doses of a radiopharmaceutical to meet the dosing requirements of an individual patient.

dosimetric calculations– – Calculation of treatment unit configuration, monitoring units, treatment times and radiation dose in areas of anatomical interest.

Electrocardiogram– – Electrocardiogram

pedagogically prepared– Successful completion of the didactic and clinical training necessary to correctly perform a procedure in accordance with accepted standards of practice.

electronic masking– Electronic collimation or cropping of the digital X-ray image, which occurs during post-processing of the captured image and does not change the size of the irradiated field.

FDA– US Food and Drug Administration

reference marks– Fixed reference points that can be used to measure other objects. They can be applied internally, on the surface of the skin, or externally to the patient.

QUALIFICATION– Assessment of recommendation classification, elaboration and evaluation

CCCC– Health Quality Certification Commission

hybrid images– – The combination of imaging technologies that allows information from different modalities to be presented as a single set of images.

image guided radiotherapy– A process that uses various imaging technologies to locate target and critical tissues and, if necessary, reposition the patient immediately before or during radiotherapy.

imaging technologies– Technologies that use ionizing and non-ionizing radiation to visualize physiological processes, internal structures, and anatomical and non-anatomical landmarks.

immediate use- Preparation of the dose, including reasonable and necessary variation, and/or administration of a specific sterile radiopharmaceutical for an individual patient.

immobilization deviceDevice that helps maintain or reproduce the position while restricting the patient's movement.

initial observation– Assessment of technical image quality with pathophysiological correlation communicated to a radiologist.

interpretation– The process of examining and analyzing all images in a given procedure and integrating the image data with relevant clinical data to form an impression or conclusion, which is recorded in a formal written report signed by a licensed physician.

interventional procedures– – Invasive medical imaging methods for the diagnosis and/or treatment of certain diseases.

ISCD– International Society of Clinical Densitometry

CCI-DMS– Joint review committee on diagnostic medical ultrasound education

less significant change- The smallest change in bone mineral densitometry that can be considered statistically significant.

approved practitioner– A physician or osteopath, chiropractor, podiatrist or dentist who has specialized education and training in the medical or dental use of radiation and is deemed competent by the applicable state licensing board to independently administer or supervise radiation therapy or medical imaging procedures

MDCB– Certification body for medical dosimetrists

medical physicist– A person capable of independently practicing the safe use of X-rays, gamma rays, electrons and other beams of charged particles, neutrons, radionuclides, sealed sources of radionuclides, ultrasonic radiation, radiofrequency radiation and magnetic fields for diagnostic and therapeutic purposes . A person is considered competent to practice in the field of medical physics when certified by the appropriate recognized certification organization.

medicine– Any chemical substance intended for the medical diagnosis, cure, treatment or prevention of disease.

minimal sedation (anxiolysis)– A drug-induced condition in which patients respond normally to verbal commands. While cognitive functions and coordination may be affected, respiratory and cardiovascular functions are not affected.

moderate sedation- A drug-induced depression of consciousness in which patients intentionally respond to verbal commands, either alone or accompanied by light tactile stimulation. No intervention is needed to maintain a patent airway, and spontaneous ventilation is sufficient. Cardiovascular function is generally preserved.

molecular imaging– A non-invasive diagnostic imaging technology that allows the visualization, characterization and measurement of biological processes at the molecular and cellular level. Molecular imaging techniques can be applied to computed tomography, magnetic resonance imaging, nuclear medicine, optical imaging, PET-CT, ultrasonography, and spectroscopy. 🇧🇷

monitor units- Unit of measure for the output of linear accelerators, sometimes denoted by the abbreviation MU. Accelerators are calibrated so that 1 MU provides 1 cGy for a standard reference field size at a standard reference depth in a standard source up to the calibration point.

MQSA– Mammography Quality Standards Act

REQUIRED– National Sonography Curriculum

NMTCB– Certifying Body for Nuclear Medicine Technology

non-interpretive fluoroscopic procedures– Use of fluoroscopic images under the direction of a licensed physician for purposes other than interpretation.

normal fabric compatibility– Radiation tolerance levels of healthy organs near or within radiation fields.

NRC– US Nuclear Regulatory Commission

Panorama- Movement of the treatment table during imaging to maintain visualization of an anatomical region of interest.

personal radiation monitors– Devices intended to be worn or used by a person to measure the radiation dose received.

physical research– Conduct device tests, evaluate test results, and prepare a formal written report of results. The written investigation report, validated by a medical physicist, contains sufficient information to document that each test was performed in accordance with local, state, or federal requirements and includes an assessment of corrective actions and recommendations for improvement.

post processing– Computer-aided processing of datasets after acquisition to create a diagnostic or therapeutic image.

process- Specific procedure intended to result in an imaging study, treatment, or other outcome.

Processing– Handling of raw data immediately after collection.

Protocol– The plan to conduct a procedure, scientific study, or treatment plan for a patient.

Quality warranty– Activities and programs aimed at achieving a desired level or level of care in a defined medical, nursing, or health setting or program. It is sometimes indicated by the abbreviation QA.

Quality warranty– The routine performance of techniques used in the monitoring or testing and maintenance of radiotherapy and medical imaging equipment components. This includes interpreting data related to device operation and confirming that corrective action has been taken. It is sometimes indicated by the abbreviation QC.

radiation oncologist– A doctor who specializes in using radiation to treat cancer.

protection against radioactivity– Prevention of injuries caused by ionizing radiation. The only effective preventive measures are to protect the operator, staff and patients from the radiation source; maintain a reasonable distance from the source; and limit the time and amount of exposure.

Radioactive Material– Substance composed of unstable atoms that decompose with spontaneous emission of radioactivity. It includes radiopharmaceuticals, unsealed sources (open, often in liquid or gaseous form) and sealed sources (permanently encapsulated, often in solid form).

radiation biology– The study of the effects of radiation on living organisms.

bone scan– The process of taking an image for diagnostic examination using X-rays.

radiotherapy– The use of radionuclides for paired imaging and therapeutic agents.

RS– Radiological Protection Officer

Attitude– Arrangement of treatment parameters in preparation for radiotherapy; includes patient positioning data, field guidance information, and device settings.

formwork– A post-processing technique that can be used to remove ambient light around an image for the sole purpose of improving the quality of the displayed image. It should not be used as a substitute for insufficient collimation of the radiated field.

Simulation– A process that uses imaging technologies to plan radiation therapy to precisely locate and mark the target area; Mockup procedure to treat a patient with documentation of medical images from treatment portals.

SNMMI– Society for Nuclear Medicine and Molecular Imaging

static– Any medical image with time locked or frozen.

assistant radiologist– A board-certified or board-approved radiologist who oversees the duties of the assistant radiologist and has appropriate clinical privileges for the procedure performed by the assistant radiologist.

theranostic– Systematic integration of specific diagnoses and treatments.

The time is over– Pre-procedure pause for final evaluation to identify the correct patient, site and procedure.

Tolerance limits (doses)– The maximum dose of radiation that can be delivered to a given biological tissue at a given dose rate and in a given volume without causing an unacceptable change in the tissue.

treatment calculations–See dosimetric calculations.

Treatment field (portal)- Volume of tissue exposed to radiation from a single beam.

treatment planning– The process by which dose administration is optimized for a specific patient and clinical situation. Covers procedures for planning a course of radiation treatment, including simulation, through completion of the treatment summary.

treatment protocol– – Documents administering treatments, recording partial and full doses, device setup, image review, and ordering and implementing prescribed changes.

valor T– Number of standard deviations between subject's bone mineral density and mean bone mineral density for same-sex youth with normal peak bone mass.

USP– United States Pharmacopoeia

vascular access device– Device inserted into the peripheral or central vasculature for diagnostic or therapeutic purposes.

vascular occlusion device‒ Active or passive medical devices for hemostasis after cardiovascular or endovascular procedures requiring catheterization.

venous puncture- Transcutaneous puncture of a vein with a sharp rigid stylet or cannula connected to a flexible plastic catheter, or through a steel needle connected to a syringe or catheter.

verification photos– – Images created to confirm accurate positioning of treatments and portals.

z-Score– Number of standard deviations between the subject's bone mineral density and the mean bone mineral density for the age- and sex-adjusted reference group.