The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines: •Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. •Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Purpose: Most clinical computed tomography (CT) protocols use helical scanning; however, the traditional method for CTDI vol measurement replaces the helical protocol with an axial scan, which is not easily accomplished on many scanners and may lead to unmatched collimation settings and bowtie filters. This study assesses whether CTDI vol can be accurately measured with a helical scan and determines the impact of pitch, collimation width, and excess scan length. Methods: CTDI vol was measured for 95 helical protocols on 31 CT scanners from all major manufacturers. CTDI vol was measured axially, then again helically, with the scan range set to the active area of the pencil chamber seen on the localizer image. CTDI vol measurements using each method were compared to each other and to the scanner-displayed CTDI vol. To test the impact of scan length, the study was repeated on four scanners, with the scan range set to the phantom borders seen on the localizer. Results: It was not possible to match the collimation width between the axial and helical modes for 12 of the 95 protocols tested. For helical and axial protocols with matched collimation, the difference between the two methods averaged below 1 mGy with a correlation of R 2 = 0.99. The difference between the methods was not statistically significant (P = 0.81). The traditional method produced four measurements that differed from the displayed CTDI vol by >20%; no helical measurements did. The accuracy of the helical CTDI vol was independent of protocol pitch (R 2 = 0.0) or collimation (R 2 = 0.0). Extending the scan range to the phantom borders increased the measured CTDI vol by 2.1%-9.7%. Conclusion: There was excellent agreement between the two measurement methods and to the displayed CTDI vol , without protocol or vendor dependence. The helical CTDI vol measurement can be accomplished more easily than the axial method on many scanners and is reasonable to use for QC purposes.

The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.

In general, the Veradius C-arm provided better low-contrast image quality during fluoroscopy, with lower ESAKR than the OEC 9900 Elite Vas 8. The differences were statistically significant only with PMMA phantoms. Funding support provided by Philips Healthcare (Bothell, WA).