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CT BODY


BODY CT ROTATION

Faculty Representative: Dr. Stephen Zink

Hours: 8am – until attending dismissal (approximately 5:00 pm)

Location
    BI: 2 Linsky-07
    West: Varies with attending; please check Qgenda

Conferences
  • SLW: Hepatobiliary Conference, Tuesday at 5pm, in West 2nd floor conference room. 
*Inpatients/MBS 

Given the scheduling complexity for the fluoroscopy resident, Inpatient emergent fluoroscopy studies (r/o leak after bypass, etc) as well as any Modified Barium Swallow study can be performed by an onsite resident in place of the fluoroscopy resident.  However, if the fluoro resident happens to be on site when the study is requested, they should do it.

At SLW, the fluoroscopy coverage is: 1) Body CT, 2) Chest 3) Neuro. 
At BI, the fluoroscopy coverage is: 1) Body CT, 2) Chest 3) Neuro


* Regarding BIB (KH) studies
Shaun Honig is our IR attending at MSB and he is happy to help out with MSB body CT/US. While he doesn’t have defined, dedicated time, he can easily check his PS queue between IR cases and sign off resident preliminary reports. Because of his intermittent availability, these should not be ED exams. They should only be non-emergent IP exams performed there at Kings Highway.
 
Therefore, when the attending on the body CT South assignment needs help, first check QG to make sure Shaun is working—his IR assignment is not on QG, but we do put him in for his time off. Assuming he is working, you can ask the resident to pick up routine Kings Highway In Patient CTs and US, and assign them to Shaun. Its very important that the resident email or text Shaun to let him know they are assigning cases to him, and to give him their extension.
 
The radiology reception desk there is 718-951-2930 or 51-2930.

GOALS AND EXPECTATIONS

Goals:
TBD

Expectations
  • Protocoling: Please protocol all body CT cases at least 1 week ahead of time. On Friday, cases should be protocoled until the next Friday. Any protocoling questions, if any, can be directed to the attending. Protocol guidelines are attached below. Please check the protocol list as your first task when you come in at 8am for any added cases. Throughout the day, you should periodically check the protocol list for any added ED cases. 
  • Please use structured templates. Standardized dictation templates are available under "MSW" in Powerscribe. Make sure DLP radiation dosage is reported. 
  • Pre-dictate all studies as follows
    • West: St. Luke's, West, and Chelsea Cancer Center
    • BI: BI, Downtown Union Square, Brooklyn
  • All outpatient exams QC'ed and verified by 3:00pm should be dictated. 
  • All inpatient/ED exams verified by 3:45pm should be dictated. 

Note: CT colonographies are no longer scheduled at BI. Please email Dr. Zink if there is one scheduled at BI.



R1 TIPS

  • On your first day of CT: In the am, you should sit with the attending and learn to identify structures, ask questions when you can, and develop a brief foundation for being able to dictate a case on your own. In the afternoon, you can begin to dictate cases on your own, and ask questions as needed. Depending on your skill level, you can review each case as you dictate, or select a time to review a set number of cases at once. 
  • How many cases am I expected to dictate? During your first week, aim to dictate 4-6 CT cases per day. This number should naturally increase as you progress. Depending on the complexity of cases, the number of cases you dictate per day will vary. 
  • Towards the end of your first rotation, and during your 2nd block of CT as an R1, aim to dictate 10-20 cases per day depending on complexity. 
  • Towards the end of R1 year and primarily into R2 year, you should be preparing to build speed along with accuracy in preparation for call. You should aim to independently dictate the full day's CT list (10-30 cases), again depending on complexity. 
  • Please note that these numbers are only meant to guide you. Accuracy should always be prioritized over speed.
  • Try to focus on cases that you find difficult, and challenge yourself, as you will see similar cases on call. Ask the attending any questions you have. 
  • Please make sure to look at all imaging planes (axial, coronal, sagittal). 


RESOURCES

  1.  Organ Injury Scaling 
  2.  Adrenal Washout Calculator
  3. E-anatomy
  4. Cornfeld radiology (for identifying anatomy; common and basic cases with anatomy and pathology described in an easy to understand way). 
  5. http://radiology.cornfeld.org/http://radiology.cornfeld.org/
  6. Lieberman Radiology: "The Abdomen" lecture series (a good introduction lecture series)
  7. http://eradiology.bidmc.harvard.edu/interactivetutorials/
  8. Body CT basics lectures by ctisus. (a good introduction lecture series)
  9. https://www.youtube.com/playlist?list=PLzn03IJDMDgBeTME5eufrIKRfzC1Bfnlq
  10. CORE radiology
  11. Fundamentals of Body CT (available on H drive or Levy library) 
  12. Radprimer: Aim to be comfortable with basic objectives by the end of R1 year; intermediate objectives by the end of R2 year