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Interpreting Physician: CT (Revised 9-23-2024)

Revision History


All physicians who supervise and/or interpret CT examinations must be licensed medical practitioners who meet the following minimum criteria:


Requirements for all Physicians Supervising and/or Interpreting CT Examinations

Initial Qualifications

Board-Certified Radiologist

Non-Board Certified Radiologist

Other Physician

  • Board-certification in radiology or diagnostic radiology by the American Board of Radiology (ABR), American Osteopathic Board of Radiology (AOBR), Royal College of Physicians and Surgeons of Canada (RCPSC) or College des Medecins du Quebec (CMQ)

  • If board-certified before 2008 must also document supervision, interpretation and reporting of 300 CT examinations in the past 36 months

  • Radiologists graduating from residency after 6/30/14 must be board-certified or eligible as defined by the ABR

All of these:

  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA) diagnostic radiology residency

  • Interpretation and reporting of 500 CT examinations in the past 36 months*

All of these:

  • Completion of an accredited specialty residency

  • 200 hours of category 1 CME in the interpretation of CT in the subspecialty where CT reading occurs

  • Interpretation and reporting of 500 supervised cases in the past 36 months

Continuing Experience

Upon renewal, physicians reading CT examinations must demonstrate one of the following:

  • Currently meets the Maintenance of Certification (MOC) requirements for the ABR or the Osteopathic Continuous Certification (OCC) for AOBR

  • Physicians reading CT examinations across multiple organ systems must have interpreted 200 CT exams over the prior 36 months

  • Physicians reading organ-system-specific exams (i.e. body, abdominal, musculoskeletal, head) across multiple modalities must interpret a minimum of 60 organ-system-specific CT exams in 36 months; however, they must interpret a total of 200 cross-sectional imaging (MRI, CT, PET/CT and ultrasound) studies over the prior 36 months (the 60 organ-system-specific exams are included in the 200 cross-sectional imaging studies)

Additional information regarding continuing experience requirements

Continuing Education

Upon renewal must meet one of the following:

Additional information regarding continuing education requirements


*Completion of an accredited radiology residency in the past 24 months will be presumed to be satisfactory for the reporting and interpreting requirements for both initial and continuing experience.


Occasional readers who are providing imaging services to and for the practice are not required to meet the interpreting physician initial qualifications or continuing experience requirements. However, the reads of all occasional readers combined should not exceed 5% of the total volume of reads per practice and per modality. There must be an active written review process in place at the institution for occasional readers based on each institution’s credentialing requirements. Validation of this process will take place during any site visit by the ACR.


Requirements for all Physicians Supervising and/or Interpreting Cardiac CT Examinations**

Initial Qualifications

Board-Certified Radiologist

Non-Board Certified Radiologist

Other Physician

  • Board-certification in radiology or diagnostic radiology by the American Board of Radiology (ABR), American Osteopathic Board of Radiology (AOBR), Royal College of Physicians and Surgeons of Canada (RSPSC) or College des Medecins du Quebec (CMQ)

  • If board-certified before 2008: supervision, interpretation and/or review and reporting of 75 Cardiac CT examinations within the last 36 months

  • Radiologists graduating from residency after 6/30/14 must be board-certified or eligible as defined by the ABR

  • Completion of at least 40 hours of category 1 Continuing Medical Education (CME) in cardiac imaging, including cardiac CT, anatomy, physiology and/or pathology, or documented equivalent supervised experience in a center actively performing cardiac CT

All of these:

  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA) approved diagnostic radiology residency program 

  • Have supervised interpretation of 75 cardiac CT cases in the past 36 months

  • Completion of at least 40 hours of category 1 Continuing Medical Education (CME) in cardiac imaging, including cardiac CT, anatomy, physiology and/or pathology, or documented equivalent supervised experience in a center actively performing cardiac CT

Cardiologists - Cardiac ONLY

Certification in cardiology by the American Board of Internal Medicine with completion of Level 2 training or higher


Level 2 Requirements (All of the following):

  • Board-certification or eligibility, valid medical license, and completion of a 3-month (cumulative) specialty residency or fellowship in Cardiac CT

  • 150 Cardiac CT examinations, including 50 where the candidate is physically present, involved in the acquisition and interpretation of the case 

  • Completion of 30 hours of courses related to CT in general and/or Cardiac CT in particular


Level 3 Requirements (All of the following):

  • Board-certification or eligibility, valid medical license, and completion of a 12-month (cumulative) specialty residency or fellowship in Cardiac CT

  • 300 Cardiac CT examinations, including 100 where the candidate is physically present, involved in the acquisition and interpretation of the case 

  • Completion of 60 hours of courses related to CT in general and/or Cardiac CT in particular


Nuclear Medicine Physicians - Cardiac ONLY


All of these:

  • Completion of an ACGME-approved training program in Nuclear Medicine

  • Interpretation and reporting under the supervision of a qualified physician of at least 75 cases of CT of the cardiovascular system during the past 36 months.

In addition:

  • Specific training in CT within an ACGME-accredited training program

OR

  • 160 hours of category 1 CME in CT, including, but not limited to: CT physics; recognition of artifacts; safety; instrumentation; and 40 hours specific to cardiovascular CT

Continuing Experience

  • Upon renewal, radiologists reading Cardiac CT examinations must have read 50 exams over the prior 24-month period. The cardiac exams interpreted will count toward the overall continuing experience for other CT modules.

  • Upon renewal, cardiologists reading Cardiac CT examinations must have continuing experience in accordance with level 2 requirements or higher - 50 examinations each year.

Additional information regarding continuing experience requirements

Continuing Education

  • Upon renewal, physicians must have earned at least 15 CME hours in CT (half of which must be category 1) in the prior 36 month period, and should include CME in Cardiac CT as is appropriate to the physician's practice needs.

  • Upon renewal, cardiologists must have completed at least 30 hours of coursework in the prior 36 month period, in accordance with Level 2 requirements.

Additional information regarding continuing education requirements


**Note: Reading calcium scoring CT exams does not count toward certification to interpret CCTA exams and reading calcium scoring exams does not require the CCTA certification. However, calcium score readers should understand there are cardiac-specific anatomy, quality-control, interpretation, and recommendation considerations that make relevant cardiac education/training beneficial.


In addition, all physicians interpreting CT examinations must:

  • Have completed an accredited diagnostic radiology residency or 80 hours of documented, relevant classroom instruction including diagnostic radiology and radiation safety physics. Otherwise, physicians must demonstrate training in the principles of radiation protection, the hazards of radiation exposure to both patients and radiological personnel, and appropriate monitoring requirements.

  • Be thoroughly acquainted with the many morphologic and pathophysiologic manifestations and artifacts demonstrated on computed tomography. Additionally, supervising physicians should have appropriate knowledge of alternative imaging methods.

  • Be knowledgeable of patient preparation, and training in the recognition/treatment of adverse effects of contrast materials for these studies, as described in the ACR-SPR Practice Parameter for the Use of Intravascular Contrast Media.  

  • Be responsible for reviewing all indications for the examination; specifying the use, dosage, and rate of administration of contrast agents (per the 2005 ACCF/AHA Clinical Competence Statement on Cardiac CT and MR, specifying the imaging technique, including appropriate windowing and leveling; interpreting images; generating written reports; and maintaining the quality of both the images and interpretations.

  • Be familiar with the meaning and importance to the practice of CT of: total radiation dose to the patient; exposure factors; conscious sedation principles that are performed in the practice; and post-processing techniques and image manipulation on work stations.


Intravascular Contrast Media

Onsite Personnel to Ensure Safety

On site, there must be a radiology or other physician OR qualified person who is acting under the general supervision of a physician. This individual must:

  1. Have received training and meet institutional periodic competency guidelines at evaluating patients and diagnosing and differentiating different types of adverse reactions to contrast material.

  2. Be able to recognize when medical intervention is required for hypersensitivity immediate reaction or physiology adverse event due to contrast administration.

  3. Be trained and legally permitted to administer prescription medications (e.g. antihistamine, intravenous fluid, beta agonist inhalers, epinephrine) and other appropriate interventions independently or under a standing orders/algorithmic approach under state law or regulations, and under local, institutional, site and facility policies, guidelines and rules. These interventions are those indicated for urgent response to a contrast material adverse event as listed in the ACR Manual of Contrast Media or similar local policies or guidelines.

  4. When qualified to act under general supervision of a physician, be able to consult with the supervising physician within an appropriate timeframe.

  5. Has minimum BLS certification.

  6. Understand when to call for assistance and how to activate emergency response systems.

  • If the general supervision by a physician is performed remotely, the process should comply with all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules related to telemedicine. This remote general supervision should be available whenever contrast material is administered and include the standard post administration monitoring as dictated by all federal/state law or regulations and local, institutional, site and facility policies, guidelines, or rules.

  • Overall staffing should take into account the timeliness of available emergency response systems.

*Note: Other physicians include radiology residents and fellows


Radiologist Led Teams

In order to ensure quality in diagnostic imaging, it is essential that the supervising professional be able to assess the quality of an image relative to the capability of the equipment and diagnostic demands, ensure diagnostic quality, and minimize unnecessary radiation exposure to the patient and personnel. Onsite personnel should continue to be part of the radiologist led teams.  To ensure that, APRNs and PAs should continue to work alongside physicians-led teams.


Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

4-6-2022

Requirements for all Physicians Supervising and/or Interpreting CT Examinations

Added or the Osteopathic Continuous Certification (OCC) for AOBR under Continuing Education and Experience

8-22-2022

Intravenous contrast media

Updated supervision of contrast administration requirement

12-16-2022

Intravenous contrast media

Updated supervision of contrast administration requirement

12-5-23


Corrected typo

7-19-2024

Radiologist Non Board-Certified

Added AOA to initial cardiac qualifications

9-23-2024

Intravenous Contrast Media

Updated supervision of contrast administration requirement



Next: Radiologic Technologist: CT

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