Publications and Presentations

Overview of CT Protocol Development at UW

Szczykutowicz TP and Pozniak M. A team approach for CT protocol optimization. Radiology Management Nov/Dec Issue 2016

UW CT Protocol Project Background as presented 6/10/2015

Szczykutowicz TP, Bour R, Pozniak M, Ranallo F. Compliance with AAPM Practice guideline 1.a: “CT Protocol Management and Review” from the perspective of a University Hospital. Journal of Applied Clinical Medical Physics 16:2 2015.


General CT Protocol Development

Brunnquell CL, Avey GD, Szczykutowicz TP. Objective Evaluation of CT Time Efficiency in Acute Stroke Response. Journal of the American College of Radiology 2018 DOI:10.1016/j.jacr.2018.01.011

Szczykutowicz TP, et al. A General Framework for Monitoring Image Acquisition Workflow in the Radiology Environment: Timeliness for Acute Stroke CT Imaging. Journal of Digital Imaging 2018

Malkus A and Szczykutowicz TP. A method to extract image noise level from patient images in CT. Medical Physics 2017
DOI: 10.1002/mp.12240

Szczykutowicz TP. Why do I see Iodine signal coming from bones on dual energy CT images? American Journal of Roentgenology 2016
DOI: 10.2214/AJR.16.17308

Szczykutowicz TP, DuPlissis A, Pickhardt PJ. Variation in CT number and image noise uniformity according to patient positioning in MDCT. American Journal of Roentgenology 2016
DOI: 10.2214/AJR.16.17215

Szczykutowicz TP, Malkus A, Ciano A, Pozniak M. Tracking patterns of nonadherence to prescribed CT protocol parameters. Journal of the American College of Radiology 2016
DOI: 10.1016/j.jacr.2016.08.029

Szczykutowicz TP, et al. A wiki based solution to managing your institutions imaging protocols.Journal of the American College of Radiology, Accepted Fall 2015

Szczykutowicz TP, et al. A Wiki Based CT Protocol Management System. Radiology Management, Nov/Dec Issue 2015

Szczykutowicz TP and Siegelman J. On the Same Page: Physicist and Radiologist Perspectives on Protocol Management and Review. Journal of the American College of Radiology
12(8) 2015
DOI: 10.1016/j.jacr.2015.03.042

Szczykutowicz TP, et al. CT protocol management: simplifying the process by using a master protocol concept. Journal of Applied Clinical Medical Physics 16.4 (2015).
DOI: 10.1120/jacmp.v16i4.5412

Ranallo F and Szczykutowicz TP. The Correct Selection of Pitch for Optimal CT Scanning: Avoiding Common Misconceptions. Journal of the American College of Radiology Volume 12, Issue 4, Pages 423–424 April 2015
DOI: 10.1016/j.jacr.2014.12.017 OR PDF
See also: Poster presented at AAPM 2014

Guite KM, Hinshaw JL, Ranallo F, Lindstrom, Lee FT. Ionizing radiation in abdominal CT: unindicated multiphase scans are an important source of medically unnecessary exposure. Journal of the American College of Radiology 8, no. 11 (2011): 756-761.
DOI: 10.1016/j.jacr.2011.05.011

Bley TA, Chase PJ, Reeder SB, François CJ, Shinki K, Tefera G, Ranallo FN, Grist TM, Pozniak M. Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up.Radiology. 2009 Oct;253(1):253-62. Epub 2009 Jul 31.
DOI: 10.1148/radiol.2531082093


CT in Abdominal Imaging

Bley TA, Chase PJ, Reeder SB, Francois CJ, Shinki K, Tefera G, Ranallo FN, Grist TM, Pozniak MEndovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up. Radiology. 2009 Oct;253(1):253-62.
DOI: 10.1148/radiol.2531082093

Kim DH, Pickhardt PJ, Hinshaw JL, Taylor AJ, Mukherjee R, Pfau PR. Prospective blinded trial comparing 450mL and 90-mL doses of oral sodium phosphate for bowel preparation before computed tomographic colonography. JCAT 2007;31(1):53-58.

Kim DK, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, Gopal DV, Riechelderfer M, Pfau PR. CT colonography versus colonoscopy for the detection of advanced neoplasia. New Engl J Med2007;357(14):1403-12.
DOI: 10.1056/NEJMoa070543

Pickhardt PJ, Hanson ME, Vanness DJ, Lo JY, Kim DH, Taylor AJ, Winter TC, Hinshaw JL. Unsuspected extracolonic findings at screening CT colonography: Clinical and economic impact. Radiology, 2008 Oct;249(1):151-9.
DOI: 10.1148/radiol.2491072148

Boyce CJ, Pickhardt PJ, Kim DH, Taylor AJ, Winter TC, Bruce RJ, Lindstrom MJ, Hinshaw JL. Hepatic Steatosis (Fatty Liver Disease) in asymptomatic adults identified by unenhanced low-dose CT. AJR Am J Roentgenol. 2010 Mar;194(3):623-8.
DOI: 10.2214/AJR.09.2590

Dachman AH, Obuchowski NA, Hoffmeister JW, Hinshaw JL, Frew MI, Winter TC, Van Uitert RL, Periaswamy S, Summers RM, Hillman BJ. Effect of Computer Aided Detection for CT Colonography in a Multireader, Multicase Trial. Radiology. 2010 Sept;256:827-35.
DOI: 10.1148/radiol.10091890

Kim DH, Pickhardt PJ, Hanson ME, Hinshaw JL. CT Colonography performance and program outcome measures in an older screening population. Radiology. 2010 Feb;254(2):493-500.
DOI: 10.1148/radiol.09091478

Guite KM, Hinshaw JL, Lee FT. Author’s Reply: Letter to the Editor (Ionizing radiation in abdominal imaging: Unindicated multiphase scans are an important source of medically unnecessary exposure). Journal of the American College of Radiology. 2011 Nov;8(11):756-61
DOI: 10.1016/j.jacr.2011.05.011

Guite KM, Hinshaw JL, Ranallo FN, Lindstrom MJ, Lee FT. Ionizing radiation in abdominal CT: Unindicated multiphase scans are an important source of medically unnecessary exposure. J Am Coll Radiol. 2011 Nov;8(11):756-61.

Boyce CJ, Pickhardt PJ, Kim DH, Winter TC, Taylor AJ, Hinshaw JL. Should small sliding hiatal hernias be reported at CT Colonography? AJR. 2011 Apr;196(4):W400-4.

Koshkin V, Hinshaw JL, Wroblewski K, Dachman AH. CAD Associated Reader Error in CT Colonography. Academic Radiology, 2012 Jul;19(7):801-10.
DOI: 10.1016/j.acra.2012.03.008

Campbell C, Lubner MG, Hinshaw JL, Munoz del Rio A, Brace CL. Contrast media-doped hydrodissection during thermal ablation: Optimizing contrast media concentration for improved visibility on CT images. AJR Am J Reontgenol. 2012 Sep;199(3):677-82.
DOI: 10.2214/AJR.11.7999

Pickhardt PJ, Kim DH, Pooler BD, Hinshaw JL, Barlow D, Jensen D, Reichelderfer M, Cash BD. Assessment of volumetric growth rates of small colorectal polyps with CT colonography: a longitudinal study of natural history. The Lancet Oncology, 2013 Jul;14(18):711-20.
DOI: 10.1016/S1470-2045(13)70216-X

Kim DH, Hinshaw JL, Lubner ML, Munoz del Rio A, Pooler BD, Pickhardt PJ. Contrast coating of flat polyps at CT colonography: a marker of detection. Eur Radiol. 2014 Apr;24(4):940-6
DOI: 10.1007/s00330-014-3095-z

Guite KM, Hinshaw JL, Ranallo FN, Lee FT. Guidelines for Appropriate CT Imaging. Chapter 33, Radiation Dose from Adult and Pediatric Multidetector Computed Tomography, 2nd edition.

Guite KM, Hinshaw JL, Lee FT. Computed Tomography in Abdominal Imaging: How to Gain Maximum Diagnostic Information at the Lowest Radiation Dose. Computed Tomography. Intech. 2013.
DOI: 10.5772/55903


CT in Neuroradiology

Rymer MM, Anderson CS, Harada M, et al. Stroke service: how can we improve and measure outcomes? Consensus summary from a global stroke forum. Acta neurologica Scandinavica2014;130:73-80
DOI: 10.1111/ane.12256

Saver JL, Jovin TG, Smith WS, et al. Stroke treatment academic industry roundtable: research priorities in the assessment of neurothrombectomy devices. Stroke; a journal of cerebral circulation2013;44:3596-3601
DOI: 10.1161/STROKEAHA.113.002769

Wintermark M, Sanelli PC, Albers GW, et al. Imaging recommendations for acute stroke and transient ischemic attack patients: a joint statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery. Journal of the American College of Radiology : JACR 2013;10:828-832

Wintermark M, Albers GW, Broderick JP, et al. Acute Stroke Imaging Research Roadmap II. Stroke; a journal of cerebral circulation 2013;44:2628-2639
DOI: 10.1161/STROKEAHA.113.002015

Rowley HA. The alphabet of imaging in acute stroke: does it spell improved selection and outcome? Stroke; a journal of cerebral circulation 2013;44:S53-54
DOI: 10.1161/STROKEAHA.113.001939

Fiebach JB, Al-Rawi Y, Wintermark M, et al. Vascular occlusion enables selecting acute ischemic stroke patients for treatment with desmoteplase. Stroke; a journal of cerebral circulation2012;43:1561-1566
DOI: 10.1161/STROKEAHA.111.642322

Chen GH, Theriault-Lauzier P, Tang J, et al. Time-resolved interventional cardiac C-arm cone-beam CT: an application of the PICCS algorithm. IEEE transactions on medical imaging 2012;31:907-923
DOI: 10.1109/TMI.2011.2172951

Nett BE, Brauweiler R, Kalender W, et al. Perfusion measurements by micro-CT using prior image constrained compressed sensing (PICCS): initial phantom results. Physics in medicine and biology2010;55:2333-2350
DOI: 10.1088/0031-9155/55/8/014

Supanich M, Tao Y, Nett B, et al. Radiation dose reduction in time-resolved CT angiography using highly constrained back projection reconstruction. Physics in medicine and biology 2009;54:4575-4593
DOI: 10.1088/0031-9155/54/14/013

Wintermark M, Rowley HA, Lev MH. Acute stroke triage to intravenous thrombolysis and other therapies with advanced CT or MR imaging: pro CT. Radiology 2009;251:619-626
DOI: 10.1148/radiol.2513081073

Josephs SC, Rowley HA, Rubin GD, et al. Atherosclerotic Peripheral Vascular Disease Symposium II: vascular magnetic resonance and computed tomographic imaging. Circulation 2008;118:2837-2844
DOI: 10.1161/CIRCULATIONAHA.108.191173

Hacke W, Furlan AJ, Al-Rawi Y, et al. Intravenous desmoteplase in patients with acute ischaemic stroke selected by MRI perfusion-diffusion weighted imaging or perfusion CT (DIAS-2): a prospective, randomised, double-blind, placebo-controlled study. The Lancet Neurology2009;8:141-150
DOI: 10.1016/S1474-4422(08)70267-9
UW EZ-Proxy Link:!/content/journal/1-s2.0-S1474442208702679

Turk AS, Chaudry I, Haughton VM, et al. Effect of carotid artery stenting on cognitive function in patients with carotid artery stenosis: preliminary results. AJNR American journal of neuroradiology2008;29:265-268
DOI: 10.3174/ajnr.A0828

Turk AS, Rowley HA, Niemann DB, et al. CT angiographic appearance of in-stent restenosis of intracranial arteries treated with the Wingspan stent. AJNR American journal of neuroradiology2007;28:1752-1754
DOI: 10.3174/ajnr.A0713

Turk AS, Grayev A, Rowley HA, et al. Variability of clinical CT perfusion measurements in patients with carotid stenosis. Neuroradiology 2007;49:955-961
DOI: 10.1007/s00234-007-0276-3

Hsu DA, Stafstrom CE, Rowley HA, et al. Hemiplegic migraine: hyperperfusion and abortive therapy with intravenous verapamil. Brain & development 2008;30:86-90
DOI: 10.1016/j.braindev.2007.05.013

Moftakhar R, Rowley HA, Turk A, et al. Utility of computed tomography perfusion in detection of cerebral vasospasm in patients with subarachnoid hemorrhage. Neurosurgical focus 2006;21:E6
DOI: 10.3171/foc.2006.21.3.6

Hill MD, Kent DM, Hinchey J, et al. Sex-based differences in the effect of intra-arterial treatment of stroke: analysis of the PROACT-2 study. Stroke; a journal of cerebral circulation 2006;37:2322-2325
DOI: 10.1161/01.STR.0000237086.85164.92

Rowley HA. Extending the time window for thrombolysis: evidence from acute stroke trials. Neuroimaging clinics of North America 2005;15:575-587
DOI: 10.1016/j.nic.2005.08.002

Hill MD, Rowley HA, Adler F, et al. Selection of acute ischemic stroke patients for intra-arterial thrombolysis with pro-urokinase by using ASPECTS. Stroke; a journal of cerebral circulation2003;34:1925-1931
DOI: 10.1161/01.STR.0000082483.37127.D0

Wechsler LR, Roberts R, Furlan AJ, et al. Factors influencing outcome and treatment effect in PROACT II. Stroke; a journal of cerebral circulation 2003;34:1224-1229
DOI: 10.1161/01.STR.0000068782.15297.28

Roberts HC, Dillon WP, Furlan AJ, et al. Computed tomographic findings in patients undergoing intra-arterial thrombolysis for acute ischemic stroke due to middle cerebral artery occlusion: results from the PROACT II trial. Stroke; a journal of cerebral circulation 2002;33:1557-1565
DOI: 10.1161/01.STR.0000018011.66817.41

Kase CS, Furlan AJ, Wechsler LR, et al. Cerebral hemorrhage after intra-arterial thrombolysis for ischemic stroke: the PROACT II trial. Neurology 2001;57:1603-1610
DOI: 10.1212/WNL.57.9.1603

Rowley HA. The four Ps of acute stroke imaging: parenchyma, pipes, perfusion, and penumbra. AJNR American journal of neuroradiology 2001;22:599-601
DOI: n/a
UW EZ-Proxy Link:

Furlan A, Higashida R, Wechsler L, et al. Intra-arterial prourokinase for acute ischemic stroke. The PROACT II study: a randomized controlled trial. Prolyse in Acute Cerebral Thromboembolism. Jama 1999;282:2003-2011
DOI: 10.1001/jama.282.21.2003

del Zoppo GJ, Higashida RT, Furlan AJ, et al. PROACT: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. PROACT Investigators. Prolyse in Acute Cerebral Thromboembolism. Stroke; a journal of cerebral circulation1998;29:4-11
DOI: 10.1161/01.STR.29.1.4

Rowley HA. Noninvasive imaging of the ischemic penumbra. Annals of neurology 1997;42:539-541
DOI: 10.1002/ana.410420402

Freise CE, Rowley H, Lake J, et al. Similar clinical presentation of neurotoxicity following FK 506 and cyclosporine in a liver transplant recipient. Transplantation proceedings 1991;23:3173-3174
DOI: n/a

Aldape KD, Fox HS, Roberts JP, et al. Cladosporium trichoides cerebral phaeohyphomycosis in a liver transplant recipient. Report of a case. American journal of clinical pathology 1991;95:499-502
DOI: n/a

Rowley HA, Lowenstein DH, Rowbotham MC, et al. Thalamomesencephalic strokes after cocaine abuse. Neurology 1989;39:428-430
DOI: 10.1212/WNL.39.3.428



Conference Proceedings

Szczykutowicz TP, Pozniak M, Ranallo F. The master CT protocol concept in practice: how a small set of optimized protocols can be used to create parameters for a wide range of clinical indications. RSNA SSQ18-02 2014.

Szczykutowicz TP, Pozniak M, and Ranallo F. A comparison of three methods for measuring patient positioning from localizer imaging in CT: which correlates best with image quality? RSNA SSQ18-08 2014.

Szczykutowicz TP, and Ranallo F. A metric for measuring the noise non-uniformity in clinical CT images. RSNA PHS-191 2014.

Ranallo F, and Szczykutowicz TP. The correct selection of pitch and rotation time for optimal CT scanning-“The big misconception”; the effects of pitch on image quality and patient dose in both manual mA and AEC mA modulation scanning modes. RSNA SSG14-07 2014.
DOI: 10.1016/j.jacr.2014.12.017

Ranallo FR, Schreibman KL, Szczykutowicz TP. A degradation of diagnostic image quality in musculoskeletal CT imaging: Loss of image sharpness in CT bone imaging due to positioning within the scan field of view – causes and several possible solutions. RSNA PHS-166 2014.

Ranallo FR, Szczykutowicz TP. Loss of Image Sharpness in CT Bone Imaging Due to Positioning Within the Scan Field of View – Possible Solutions Medical Physics 41 (6) Presented at the 2014 AAPM Summer Meeting. 2014. SU-F-18C-3.

Ranallo FR, Szczykutowicz TP. The Correct Selection of Pitch and Rotation Time for Optimal CT Scanning: The Big Misconception Medical Physics 41 (6) Presented at the 2014 AAPM Summer Meeting. 2014. SU-E-I-60.
DOI: 10.1016/j.jacr.2014.12.017

Kennedy TA, Szczykutowicz TP, Royalty K, et all. C-Arm CT Imaging of the Temporal Bone: Image Quality and 3D Radiation Dose Distribution. ASNR 2014.

Kennedy TA, Szczykutowicz TP, Nace SR, et all. Comparative cadaver study of MDCT and c-arm CT imaging of the temporal bone before and after cochlear electrode implantation: image quality and dose distribution. RSNA SSA06-12 2014.

Connell N, Kennedy TA, Szczykutowicz TP, et all. Flat Panel Computed Tomography Imaging of the Temporal Bone: Comparison of Image Quality and Radiation Exposure to Conventional MultiDetector Compute Tomography. Educational Exhibit. 14th Symposium on Cochlear Implants in Children. Nashville, TN. December 2014.

Szczykutowicz TP, Schafer S, Royalty K, Nace SR, Kennedy TA. Understanding the differences in radiation dose distribution between multi detector CT and C-arm CT for high contrast imaging(Educational exhibit) (Presentation won cum laude honors and was invited for submission to Radiographics). RSNA PHE-117 2014.

Connell N, Kennedy TA, Szczykutowicz TP, et all. Can the Scalar Location of Cochlear Implant Electrodes be Determined Using Computed Tomography? A Comparison of Conventional Multidetector Computed Tomography and Flat Panel Computed Tomography. Educational Exhibit (Won Best Poster Award). 14th Symposium on Cochlear Implants in Children. Nashville, TN. December 2014.

Szczykutowicz TP, Ranallo F, Peppler W, Bruce R, Pozniak MDCT. M protocol optimization using an automated IT solution provided size specifc patient doses, automatic tube current modulation information, and radiologist feedback. RSNA 2013 S405AB-08.

Szczykutowicz TP, Ranallo F, Gill K, Pozniak M. The influence of kV and patient positioning on CT image quality and dose: why low kV CT scans have a higher sensitivity to patient positioning. RSNA 2013 S403B-07.

Ranallo F, Szczykutowicz TP. The optimization of CT protocols using plots of CTDIvol and of max and min mA versus patient size for actual clinical scans using automatic exposure control (AEC). Medical Physics. 40 (6) 2013. WE-C-103-4.
DOI: 10.1118/1.4815553

Bevins N, Szczykutowicz TP, Supanich MP. A simple method for simulating reduced-dose images for evaluation of clinical CT protocols. Medical Physics. 40 (6) 2013. TU-C-103-6.

Ranallo F, Szczykutowicz TP, Pozniak M, Bruce R. An overview of a CT protocol optimization process at a major university hospital medical center; including details on physics support, IT support, and a radiologist based quality assurance program. Medical Physics. 40 (6) 2013. SU-E-I-56.
DOI: 10.1118/1.4814166

Szczykutowicz TP, Ranallo F. Guidance for CT departments desiring to optimize protocols for multiple scanner architectures. Medical Physics. 40 (6) 2013. SU-C-134-6.
DOI: 10.1118/1.4813981