Establishing a Standard for Creating Angle-Corrected, Reformatted Brain CT Images

To establish a standardized method of reformatting axial images for computed tomography (CT) brain examinations.

An anatomic line between the superior orbital rim and the base of the occipital bone (SOR-BS line) was chosen as the standardized reference line. In June 2022, CT technologists at a tertiary care center received an educational presentation and a 1-page reference handout on making standardized CT reformats. This was the quality-of-care intervention. Subsequently, 100 CT brain examinations performed on July 1 to 10, 2020 (preintervention) were analyzed and compared with 100 CT brain examinations performed on July 1 to 10, 2022 (postintervention).

There were no significant differences in the mean angle differences measured between the preintervention (6.2 ± 5.8°) and the postintervention (5.8 ± 4.7°) groups (P = .67). However, the number of CT brain studies with an angle difference of more than 20° decreased from 4 studies to 1 study. In addition, the number of CT brain studies without reformatted images decreased from 5 to 2 studies.

The cause for the less-than-optimal adoption of the expected change in CT workflow might be complex and multifactorial. However, the institution in this study is a busy tertiary care center with a chronic shortage of CT technologists. The busy workflow might have contributed to lack of significance for the parameters assessed.

There was a slight but not significant improvement between preintervention and postintervention data.