BODY CT

Locations & Lists

Body CT West

FACULTY REPRESENTATIVE: Dr. Barak Friedman
Phone: ALWAYS cover phone x23-6147 (at least 1 person on Body CT W).
Ensure you are added to the WHATSAPP group for protocol requests ("Chest/Body CT W Protocols")
Location: Depends on the site; Body CT W attending usually covers Fluoro "RF" (check QGenda for "RF" or "In-house Attending"; can also e-mail attending in advance).
- Morningside (3rd Floor - Clark Building) or
- West ballroom (4th Floor, Radiology Ballroom).
EPIC Worklist: Body CT West _BR/MSM/MSW_QG

Body CT South

FACULTY REPRESENTATIVE: Dr. Barak Friedman
Phone: ALWAYS cover and forward universal phone x 44-8723
Location: Downtown Union Square reading room 3rd floor (near CT Suite)
EPIC Worklist: Body CT South_BC/BI/KD/MSB/NY/PH_QG

HOURS:

8:00 am until dismissed by attending - 4:00pm.

Additional duties may require you to stay later than 4:00pm, patient care always comes first. Leave together with co-residents/don't abandon them. Confirm with attendings before leaving.

Responsibilities:

Outpatient studies until 3:00 pm
ER and Inpatient until 3:45 pm

CONFERENCES:

Mandatory conferences

Body ICC Conference, Thursdays 4 PM
Zoom link here ("Conference" page)
- 1st Thursday of Month:
  Systemwide, MSH / MSW presents (rotating)
- 2nd Thursday of Month:
  if MSH presented on 1st Thurs...
  then Internal MSW-only ICC here
- 3rd Thursday of Month:
  No Conference
- 4th Thursday of Month:
  if MSW presented on 1st Thurs...
  then Internal MSW-only ICC here

*Body MR + Body CT residents present.

Liver conference with GI fellows, 3rd Friday 8 AM
- All US + Fluoro + Body CT/MR residents attend

Optional conferences

Trauma Conference (Join Here) - Fridays 7 am
Colorectal/GI Tumor Board, every Monday from 5pm-6pm. Cases are presented by Body attendings, look for email + Zoom invite from Stephanie Diaz.

PROTOCOL TIPS

ORAL CONTRAST Guide for OUTPATIENTS

Oral contrast NOT needed:
- - Abdominal pain
  - Adrenal
  - All CT Angiograms
  - CT Cystogram
  - Gastric protocol
  - Hernia
  - Liver
  - Oncology follow up
  - Pancreas
  - Renal
  - Stonehunt (Kidney Stone)
  - Trauma
  - CT Urogram
  - CT Venogram

Water can be used instead of oral contrast and given 20 minutes prior to scan.

Oral Contrast can be helpful:
- - CT Enterography
  - Suspected appendicitis BMI < 25
  - No IV Contrast -- Give oral contrast on a case by case basis
  - Initial oncology study
  - Rule out GI leak studies

CT cystogram

If a CT cystogram is requested, make sure to ask who is coming with patient/make sure someone (i.e. patient's care team) administers the contrast into Foley. Or if you have time, you can also volunteer to do it.
- Guide here (Click this link)

GOALS AND EXPECTATIONS

CURRICULUM:

Refer to this website by Dr. Friedman
Refer to the R1 GU/GI checklist at the bottom of the webpage

RESPONSIBILTIES

Attend Body ICC Conference and monthly Liver Conference (see left column for schedule)
Phone coverage at each primary site (Morningside, West, and DUS), please see above.
R1s should pick up most/all phone calls and ask seniors for assistance as needed. (see below for more R1 tips)
R2-R4s are expected to teach junior residents and assist with phone/fluoro/protocol duties as needed.
Protocoling:
- Please protocol all non-ED (IP/OP) body CT cases at least 1 week ahead of time.
  - Monitor the protocol chat on whatsapp throughout the day.
  - On Friday, cases should be protocoled until the next Friday - especially to save phone calls for Weekend on-call residents. Ideally, if any protocoling questions, these can be directed to the weekday attending.
- Refer to Protocol Guidelines on Dr Friedman's body imaging website.
Site-specific duties as below:
- West pre-dictates studies from: Morningside, West, Urgent Care
  - Body CT W Resident will perform any M/W Fluoro studies, when Fluoro resident is not onsite
- South pre-dictates studies from: Downtown Union Square, Brooklyn, Chelsea Cancer Center, Urgent Care
  - Body CT S Resident will perform DUS Fluoro studies when needed

R1 TIPS

On your first day / first rotation of Body CT:
- First tasks
  - Forward phones - ideally message/check in with X-ray resident to make sure they know where you are.
  - Open the protocol list, and ask your senior about how to protocol the studies.
- 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.
Cases: Tips? And how many cases am I expected to dictate?
- 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).
- Please note that the below numbers are meant to guide you. Accuracy should always be prioritized over speed.
  - 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 10-15 cases per day depending on complexity & the # of co-residents on the rotation.
  - Towards the end of R1 year and primarily into R2-R4 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 (15-30 cases), again depending on complexity & the # of co-residents on the rotation.

RESOURCES

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

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