Revision History
All physicians who supervise and/or interpret CT examinations must be licensed medical practitioners who meet the following minimum criteria:
Requirements for all Physicians Supervising and/or Interpreting CT Examinations | ||
Initial Qualifications | ||
Board-Certified Radiologist | Non-Board Certified Radiologist | Other Physician |
| All of these:
| All of these:
|
Continuing Experience | ||
Upon renewal, physicians reading CT examinations must demonstrate one of the following:
Additional information regarding continuing experience requirements | ||
Continuing Education | ||
Upon renewal must meet one of the following:
Additional information regarding continuing education requirements | ||
*Completion of an accredited radiology residency in the past 24 months will be presumed to be satisfactory for the reporting and interpreting requirements for both initial and continuing experience.
Occasional readers who are providing imaging services to and for the practice are not required to meet the interpreting physician initial qualifications or continuing experience requirements. However, the reads of all occasional readers combined should not exceed 5% of the total volume of reads per practice and per modality. There must be an active written review process in place at the institution for occasional readers based on each institution’s credentialing requirements. Validation of this process will take place during any site visit by the ACR.
Requirements for all Physicians Supervising and/or Interpreting Cardiac CT Examinations** | ||
Initial Qualifications | ||
Board-Certified Radiologist | Non-Board Certified Radiologist | Other Physician |
| All of these:
| Cardiologists - Cardiac ONLYCertification in cardiology by the American Board of Internal Medicine with completion of Level 2 training or higherLevel 2 Requirements (All of the following):
Level 3 Requirements (All of the following):
Nuclear Medicine Physicians - Cardiac ONLYAll of these:
In addition:
OR
|
Continuing Experience | ||
Additional information regarding continuing experience requirements | ||
Continuing Education | ||
Additional information regarding continuing education requirements | ||
**Note: Reading calcium scoring CT exams does not count toward certification to interpret CCTA exams and reading calcium scoring exams does not require the CCTA certification. However, calcium score readers should understand there are cardiac-specific anatomy, quality-control, interpretation, and recommendation considerations that make relevant cardiac education/training beneficial.
In addition, all physicians interpreting CT examinations must:
Have completed an accredited diagnostic radiology residency or 80 hours of documented, relevant classroom instruction including diagnostic radiology and radiation safety physics. Otherwise, physicians must demonstrate training in the principles of radiation protection, the hazards of radiation exposure to both patients and radiological personnel, and appropriate monitoring requirements.
Be thoroughly acquainted with the many morphologic and pathophysiologic manifestations and artifacts demonstrated on computed tomography. Additionally, supervising physicians should have appropriate knowledge of alternative imaging methods.
Be knowledgeable of patient preparation, and training in the recognition/treatment of adverse effects of contrast materials for these studies, as described in the ACR-SPR Practice Parameter for the Use of Intravascular Contrast Media.
Be responsible for reviewing all indications for the examination; specifying the use, dosage, and rate of administration of contrast agents (per the 2005 ACCF/AHA Clinical Competence Statement on Cardiac CT and MR, specifying the imaging technique, including appropriate windowing and leveling; interpreting images; generating written reports; and maintaining the quality of both the images and interpretations.
Be familiar with the meaning and importance to the practice of CT of: total radiation dose to the patient; exposure factors; conscious sedation principles that are performed in the practice; and post-processing techniques and image manipulation on work stations.
Intravascular Contrast Media
Onsite Personnel to Ensure Safety
On site, there must be a radiology or other physician OR qualified person who is acting under the general supervision of a physician. This individual must:
Have received training and meet institutional periodic competency guidelines at evaluating patients and diagnosing and differentiating different types of adverse reactions to contrast material.
Be able to recognize when medical intervention is required for hypersensitivity immediate reaction or physiology adverse event due to contrast administration.
Be trained and legally permitted to administer prescription medications (e.g. antihistamine, intravenous fluid, beta agonist inhalers, epinephrine) and other appropriate interventions independently or under a standing orders/algorithmic approach under state law or regulations, and under local, institutional, site and facility policies, guidelines and rules. These interventions are those indicated for urgent response to a contrast material adverse event as listed in the ACR Manual of Contrast Media or similar local policies or guidelines.
When qualified to act under general supervision of a physician, be able to consult with the supervising physician within an appropriate timeframe.
Has minimum BLS certification.
Understand when to call for assistance and how to activate emergency response systems.
If the general supervision by a physician is performed remotely, the process should comply with all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules related to telemedicine. This remote general supervision should be available whenever contrast material is administered and include the standard post administration monitoring as dictated by all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules.
Overall staffing should take into account the timeliness of available emergency response systems.
*Note: Other physicians include radiology residents and fellows
Radiologist Led Teams
In order to ensure quality in diagnostic imaging, it is essential that the supervising professional be able to assess the quality of an image relative to the capability of the equipment and diagnostic demands, ensure diagnostic quality, and minimize unnecessary radiation exposure to the patient and personnel. Onsite personnel should continue to be part of the radiologist led teams. To ensure that, APRNs and PAs should continue to work alongside physicians-led teams.
| Next: Radiologic Technologist: CT |  |