§ 175.55 Computed Tomography (CT) Equipment.
RCNY § 175.55
Except for dental registrants possessing cone beam computed tomography, each facility utilizing computed tomography equipment must comply with the requirements of this section.
(a)CT x-ray system equipment requirements.
(1)Each control panel and gantry of a CT x-ray system must include visual signals that indicate to the operator of the CT x-ray system whenever x-rays are being produced and when x-ray production is terminated, and, if applicable, whether the shutter is open or closed.
(2)Each CT x-ray system must be equipped with a control that allows the operator of the CT x-ray system to terminate the x-ray exposure at any time during a scan, or series of scans, when the exposure time is greater than one-half second duration.
(3)Each CT x- ray system must be designed such that the CT conditions of operation to be used during a scan or a scan sequence are indicated prior to the initiation of a scan or a scan sequence.
(4)Each CT x-ray system must include a clearly and conspicuously labeled emergency shutoff button or switch.
(5)Premature termination of the x-ray exposure by the operator must require resetting of the CT conditions of operation by the operator prior to the initiation of another scan.
(b)Patient communication and viewing requirements.
(c)Determination of the CT unit radiation output.
(iii)the requirements of subparagraphs (i) and (ii) of this paragraph can also be met by using an alternative method of radiation measurement and calculation published in the peer-reviewed scientific literature and acceptable to the Department.
(6)Records of radiation output determinations performed must be maintained for 3 years at the radiation installation where the CT is located.
(d)Quality assurance testing.
(ii)dose assessment for the most common CT examinations that are performed on the system for which reference levels have been published by the American College of Radiology (ACR), the American Association of Physicists in Medicine (AAPM) or the National Council on Radiation Protection and Measurements (NCRP) for pediatric head, pediatric abdomen, adult head and adult abdomen.
(iv)for each CT unit possessing dose adjustment software features for dose adjustment in clinical patient scans: (A) the facility must conduct measurements to determine that the dose adjustment software is functioning as the manufacturer specified to adjust the CT imaging techniques so as to maintain image quality. (B) this must be conducted at least annually or whenever there is a software upgrade or change to the dose adjustment software of the CT software. (C) for verification testing as required by clause (A) of this subparagraph (iv) of paragraph (6) of this subdivision, manufacturer test results with documentation and formal report shall be acceptable to verify compliance.
(7)For CT units used for treatment planning simulation, the registrant must conduct the following QA testing, in addition to daily QA tests mandated by the accreditation agency, if the site is accredited: (i) daily measurements to verify that image reconstruction dimensions or scaling accuracy are accurate to manufacturer's tolerances.
(e)Operating procedures and policies.
(i)Effective January 1, 2021, new registrants must be accredited but must demonstrate that they have initiated the accreditation process within 90 days of the start of operations.
(8)Effective July 1, 2020, each registrant performing CT scans on human beings must ensure that for each scan, the radiation dose delivered by the scanner to a reference phantom or the dose received by the patient or other dose metric is saved and recorded. The dose delivered must be recorded as Computed Tomography Dose Index volume (CTDIvol), dose length product (DLP) or other dosimetry metric published in the peer reviewed scientific literature and acceptable to the Department.
(9)The displayed dose must be verified on an annual basis by or under the supervision of a QMP to ensure that the equipment manufacturer's displayed dose is within 20percent of the measured dose. To accomplish the latter, a phantom must be used for this measurement.
(10)Each registrant that performs CT scans on human beings must establish and implement a policy and a procedure to ensure that a request for a CT scan originates from a licensed physician or other authorized professional practitioner familiar with the patient's clinical condition. The request must include sufficient information to demonstrate the medical indication for the CT examination and allow for the proper performance and interpretation of the CT scan.
(11)Each facility must maintain a patient logbook of all patients undergoing CT exams at the facility. The logbook must contain the following information: (i) patient identification information, (ii) CT scans performed along with the imaging parameters, (iii) the CT manufacturer's patient dose assessment, and (iv) whether the study was conducted with contrast media.
(v)The logbook can be in electronic format provided all information is readily available to the Department during periodic inspections.
(f)CT Radiation Protocol Committee (RPC).
(vi)provide an annual report to the radiation safety committee or radiation safety officer, in the absence of a radiation safety committee, (vii) At a minimum the RPC members must meet as often as necessary to conduct business but at intervals not to exceed 12 months.
(viii)A record of each RPC meeting must be maintained. The record must include the date, names of individuals in attendance, minutes of the meeting, and any action taken.
(g)PET CT and SPECT CT systems. Registrants of CT systems used solely to calculate attenuation coefficients in nuclear medicine studies are exempt from the accreditation and quality assurance requirements of subdivisions (c) through (f) of this section. The registrant must follow the manufacturer's recommendations for the quality assurance tests to be conducted at the manufacturer's recommended frequency.
(h)CT and CBCT units utilized in podiatry and veterinary offices. CT systems, including CBCT systems, solely used for podiatry imaging or non-human imaging must meet the requirements of radiation protection surveys as indicated in 24 RCNY Health Code § 175.16, and are otherwise exempt from the accreditation and quality assurance requirements of subdivisions (c) through (f) of this section. Facilities must follow the manufacturer recommended testing protocols and frequency as stated in the manufacturer's manual, and if any tests are shown to exceed manufacturer tolerances, the registrant must complete all required corrective actions within 30 days of such test. (Added City Record 4/24/2019, eff. 5/24/2019)
