Protocol Library

February 2026 · 6 min

Overview

The Protocol Library standardizes imaging protocols across your radiology department, ensuring consistent image quality, patient safety, and dose optimization regardless of which technologist performs the study. Protocols define every technical parameter needed to execute a study correctly.

Standardized protocols are a core requirement for radiology accreditation (NABH, ACR) and are essential for meaningful dose tracking and quality benchmarking across equipment and operators.

Protocol Structure

Each protocol in the library includes:

Clinical Information:

• Study name and description.
• Approved clinical indications (maps to ordering workflow).
• Contraindications and precautions.

Patient Preparation:

• Fasting requirements (hours, specific instructions).
• Bowel preparation (for abdominal CT, barium studies).
• Hydration protocol (for contrast studies in patients with borderline renal function).
• Clothing and jewelry removal instructions.
• Sedation requirements (pediatric MRI, claustrophobic patients).

Technical Parameters:

• X-ray -- kV, mAs, SID, grid use, AEC settings, projection (PA, AP, lateral, oblique).
• CT -- kV, mAs (fixed or AEC), rotation time, pitch, slice thickness, reconstruction kernel, FOV, scan phases (non-contrast, arterial, venous, delayed).
• MRI -- Sequences (T1, T2, FLAIR, DWI, ADC, MRA), slice thickness, FOV, matrix, TR/TE, flip angle, fat suppression, contrast timing.
• Ultrasound -- Transducer type and frequency, patient position, survey approach, Doppler parameters.

Contrast Protocol (if applicable):

• Contrast agent type and concentration.
• Volume (weight-based or fixed).
• Injection rate and method (hand injection vs. power injector).
• Scan timing / bolus tracking parameters.
• Saline flush volume and rate.

Post-Processing:

• Reconstruction algorithms (MPR, MIP, VR, 3D).
• Window/level presets.
• Automated measurements (e.g., calcium scoring for cardiac CT).

Managing Protocols

Navigate to Radiology > Protocol Library:

• Create New -- Build a protocol from scratch or clone an existing one as a starting point.
• Edit -- Modify parameters. Edits create a new version; previous versions are archived for audit.
• Version History -- View all changes with who made them and when. Roll back to a previous version if needed.
• Assign to Studies -- Link protocols to study types. When a doctor orders 'CT Abdomen with contrast', the technologist automatically sees the assigned protocol.
• Equipment-Specific Variants -- The same study may have different technical parameters on different machines (e.g., 64-slice CT vs. 128-slice CT). Create equipment variants within the same protocol.
• Approval Workflow -- New or modified protocols require approval by the department head/chief radiologist before they become active.

Dose Reference Levels

Each protocol includes diagnostic reference levels (DRLs) for radiation dose:

• CT -- CTDIvol and DLP reference values per protocol.
• X-ray -- DAP (Dose Area Product) or entrance skin dose reference.
• Fluoroscopy -- Reference fluoroscopy time and DAP.

When a completed study's dose exceeds the protocol's DRL, the system flags it in the Dose Tracking module. This helps identify:

• Equipment needing calibration.
• Technologists who may need additional training.
• Protocols that need parameter optimization.

DRLs are benchmarked against AERB (Atomic Energy Regulatory Board) national reference levels and can be customized per institution.

Pediatric Protocols

Pediatric imaging requires special attention to dose reduction and age-appropriate parameters:

• Weight-based parameters -- kV and mAs automatically adjust based on the child's weight (entered at registration).
• Size-specific dose estimates (SSDE) -- For CT, the system calculates SSDE based on the child's effective diameter.
• Reduced scan range -- Protocols specify the minimum necessary scan coverage.
• Iterative reconstruction -- Protocols mandate iterative reconstruction (where available) to allow lower mAs while maintaining image quality.
• No routine multiphase -- Pediatric CT protocols default to single-phase unless explicitly overridden by the radiologist.
• Sedation checklist -- For MRI and CT requiring sedation, the protocol includes the sedation checklist and monitoring requirements.

Notes

Related topics