Computed Tomography (CT)

1 EXAMINATION CONTENT SPECIFICATIONS ARRT BOARD APPROVED: JANUARY 2017. IMPLEMENTATION DATE: JULY 1, 2017. Computed Tomography The purpose of the Computed Tomography examination is to assess the knowledge and cognitive skills underlying the intelligent performance of the tasks typically required of Computed Tomography technologists at entry into the profession. The tasks typically performed were determined by administering a comprehensive practice analysis survey to a nationwide sample of Computed Tomography The Task Inventory for Computed Tomography may be found on the ARRT's website ( ). The Examination Content Specifications for Computed Tomography identifies the knowledge areas underlying performance of the tasks on the Task Inventory for Computed Tomography . Every content category can be linked to one or more activities on the task inventory.

2 The table below presents the major content categories and subcategories covered on the examination. The number of test questions in each category are listed in bold and number of test questions in each subcategory in parentheses. Specific topics within each category are addressed in the content outline, which makes up the remaining pages of this document. Content Category Number of Scored Questions2. Patient Care 22. Patient Interactions and Management (22). Safety3 20. Radiation Safety and Dose (20). Image Production 55. Image Formation (30). Image Evaluation and Archiving (25). Procedures 68. Head, Spine, and Musculoskeletal (24). Neck and Chest (20). Abdomen and Pelvis (24). Total 165. 1. A special debt of gratitude is due to the hundreds of professionals participating in this project as committee members, survey respondents, and reviewers.

3 2. The exam includes an additional 20 unscored (pilot) questions. 3. SI units are the primary (principal) units of radiation measurement used on the Computed Tomography examination. 1 COPYRIGHT 2017 BY THE AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS ALL RIGHTS RESERVED. REPRODUCTION IN WHOLE OR PART IS NOT PERMITTED WITHOUT THE WRITTEN CONSENT OF THE ARRT. Computed Tomography ARRT BOARD APPROVED: JANUARY 2017. CONTENT OUTLINE IMPLEMENTATION DATE: JULY 1, 2017. Patient Care 1. Patient Interactions and Management A. Patient Assessment and Preparation 3. administration route and dose 1. clinical history calculations 2. scheduling and screening a. IV. 3. education b. oral 4. consent c. rectal 5. immobilization d. intrathecal 6. monitoring e. catheters ( , peripheral line, a. level of consciousness central line, PICC line). b. vital signs f.

4 Other ( , stoma, intra-articular). c. heart rhythm and cardiac cycle 4. venipuncture d. oximetry a. site selection 7. management of accessory medical b. aseptic and sterile technique devices c. documentation ( , site, amount, a. oxygen delivery systems gauge, concentration, rate, and b. chest tubes number of attempts). c. in-dwelling catheters 5. injection techniques 8. lab values a. safety a. renal function (* , BUN, eGFR, b. manual creatinine) c. power injector options b. other ( , d-dimer, LFT, INR) 1. single or dual head 9. medications and dosage 2. single phase a. current 3. multi-phase b. pre-procedure medications ( , 4. flow rate steroid, anti-anxiety) 5. timing bolus c. post-procedure instructions ( , 6. bolus tracking diabetic patient) 6. post-procedure care B. Contrast Administration a. treatment of contrast extravasation 1.

5 Contrast media b. documentation a. ionic, nonionic 7. adverse reactions b. osmolarity a. recognition and assessment c. barium sulfate b. treatment d. water soluble (iodinated) c. documentation e. air * The abbreviation , is used to indicate that examples f. water are listed in parenthesis, but that it is not a complete list of g. other all possibilities. 2. special contrast considerations a. contraindications b. indications c. pregnancy d. lactation e. dialysis patients 2. Computed Tomography ARRT BOARD APPROVED: JANUARY 2017. CONTENT OUTLINE IMPLEMENTATION DATE: JULY 1, 2017. Safety 1. Radiation Safety and Dose A. Radiation Physics 1. radiation interaction with matter 2. acquisition (geometry). 3. physical principles (attenuation). B. Radiation Protection 1. minimizing patient exposure a. kVp b. mAs c. pitch d. collimation/beam width e.

6 Multi-detector configuration f. gating 2. personnel protection a. controlled access b. education 3. shielding a. traditional ( , lead apron). b. non-traditional ( , bismuth). 4. dose measurement a. CT dose index (CTDI). b. dose length product (DLP). c. documentation 5. patient dose reduction and optimization a. pediatric b. adult c. dose modulation techniques ( , SMART mA, auto mA, CARE. dose, and SURE exposure). d. iterative reconstruction e. dose notification f. dose alert 3. Computed Tomography ARRT BOARD APPROVED: JANUARY 2017. CONTENT OUTLINE IMPLEMENTATION DATE: JULY 1, 2017. Image Production 1. Image Formation 2. Image Evaluation and Archiving A. CT System Principles, Operation, A. Image Display and Components 1. pixel, voxel 1. tube 2. matrix a. x-ray production 3. image magnification b. warm-up procedures 4. display field of view (DFOV).

7 2. collimation/beam width 5. window level, window width 3. generator 6. cine 4. detectors 7. geometric distance or region of a. detector configuration interest (ROI) ( , mean, b. detector collimation standard deviation [SD]). 5. data acquisition system (DAS) B. Image Quality 6. computer and array processor 1. spatial resolution B. Imaging Parameters and Data Acquisition 2. contrast resolution 1. parameters 3. temporal resolution a. kVp 4. noise and uniformity b. mAs 5. quality assurance and accreditation c. pitch 6. CT number (Hounsfield units). d. acquisition thickness 7. linearity e. x, y, z planes C. Artifact Recognition and Reduction f. scan field of view (SFOV) 1. beam hardening or cupping 2. acquisition 2. partial volume averaging a. axial/sequential 3. motion b. helical/spiral 4. metallic c. volumetric 5. edge gradient C. Image Processing 6.

8 Patient positioning (out-of-field). 1. reconstruction 7. equipment induced a. filtered backprojection a. rings reconstruction b. streaks b. iterative reconstruction c. tube arcing c. interpolation d. cone beam d. reconstruction algorithm e. capping e. raw data versus image data D. Informatics f. prospective/retrospective 1. hard/electronic copy ( , DICOM file reconstruction format). g. reconstruction thickness 2. archive h. reconstruction interval 3. PACS and electronic medical record 2. post-processing (EMR). a. multi-planar reformation (MPR) 4. security and confidentiality b. 3D rendering (MIP, SSD, VR) 5. networking c. quantitative analysis ( , distance, diameter, calcium scoring, ejection fraction). 4. Computed Tomography ARRT BOARD APPROVED: JANUARY 2017. CONTENT OUTLINE IMPLEMENTATION DATE: JULY 1, 2017. Procedures TYPE OF STUDY FOCUS OF QUESTIONS.

9 1. Head, Spine, and Musculoskeletal Questions about each of the studies listed on the left may focus on any of the following relevant A. Head factors: 1. temporal bones/internal auditory canal (IAC). Anatomy 2. pituitary fossa 3. orbits imaging planes 4. sinuses pathological considerations/recognition 5. maxillofacial and/or mandible protocol considerations 6. temporomandibular joint (TMJ) patient considerations 7. base of skull ( , pediatric, geriatric, bariatric). 8. brain post-processing presentations 9. cranium landmarks 10. brain perfusion B. Spine Contrast Media 1. cervical indications 2. thoracic scan/prep delay 3. lumbar effect on images 4. sacrum/coccyx 5. post myelography Additional Procedures 6. discography vascular (CTA, CTV). C. Musculoskeletal ( , PE, dissection, runoff, venogram). 1. upper extremity biopsies 2. lower extremity drainages 3.

10 Bony pelvis and/or hips aspirations 4. shoulder and/or scapula 5. sternum and/or ribs (Procedures continue on the following page.). 6. arthrography 5. Computed Tomography ARRT BOARD APPROVED: JANUARY 2017. CONTENT OUTLINE IMPLEMENTATION DATE: JULY 1, 2017. Procedures (continued). TYPE OF STUDY FOCUS OF QUESTIONS. 2. Neck and Chest Questions about each of the studies listed on the left may focus on any of the following relevant A. Neck factors: 1. larynx 2. soft tissue neck Anatomy B. Chest imaging planes 1. mediastinum pathological considerations/recognition 2. lung protocol considerations 3. heart patient considerations 4. airway ( , pediatric, geriatric, bariatric). 5. low dose lung screening post-processing presentations 3. Abdomen and Pelvis landmarks A. Abdomen 1. liver Contrast Media 2. biliary indications 3. spleen scan/prep delay 4.