Updated & Modified Technique Charts

Updated & Modified Technique Charts

All of my CR and DR technique charts (with the exception of the CR Konica charts) have been updated and modified. It was a HUGE job that I have been dreading and putting off for at least 6 months, so I can honestly say I am amazingly satisfied and relieved to have this project completed.
As you may recall, last summer I was hired by Merrill’s first author Bruce Long to create the first ever digital technique charts for the 14th edition of Merrill’s due out in 2015. There will be just over 250 techniques, half CR and half DR. As Bruce looked over my original technique charts he noticed that some of the kVs were different between CR and DR. Also there were times when either the CR or DR seemed to have too much or too little mAs. My goal was to have the CR techniques be 50% more mAs than the DR techniques with the exact same kV.
So I spent the next 4 months working on creating the charts needed for Merrill’s. These techniques were set up for an average shaped male weighing 180 lbs. My charts, on the other hand, have 3 columns of patient sizes (small, medium and large) with the Merrill’s techniques being a medium.
Three months ago I began an amazing project with Ron Reed of Dev App Central, LLC and the company Supertech having to do with techniques. As it hasn’t been introduced yet, I won’t go into any of the details other than to say I once again had to create technique charts.
During the 3 months of creating technique charts for this new project I ended up with 11 different manufacturers. This was necessary as almost all of them use a different Exposure Index number. As I was finishing this project I knew it was finally time to begin updating my charts. It was at this time I had an epiphany. Up till this time I have always had 4 different CR charts. These are the Least mAs, 33% More mAs, 66% More mAs and the 100% More mAs. With my Cesium DR charts I have always only had one chart. Although I never thought about it, it really was a Least mAs chart. The epiphany was that I needed to create the 33% More mAs, 66% More mAs and the 100% More mAs charts for DR Cesium also.
So after a month of endless mistakes, oversights and blunders I finished it all 2 weeks ago. So that you can easily see where the Cesium and Gadolinium DR fits in with the CR charts, here is a graph (Chart #40  Difference Between Tech Charts in mAs) that shows it all in percentages and mAs.  Sorry it’s not super sharp.  When I make it larger it also gets blurrier.
You can now go to the All Charts section of the website and download all of these newly updated and modified technique charts.
Diff in Tech Charts Resized


First I want to say I absolutly love the CR and DR technique charts, I started using them after the webinar you gave a few weeks ago, and a few of my co workers are starting to use them also, we just went digital in 2012 and our old charts were useless (as were the people that came from GE and Fuji to ‘teach’ us), so instead of having dose creep we had a dose leap.
Now to my question. About 45% of our patients would be considered XL (240-280), XXL (280-320) and a smaller percent being in the 350-450 pound range . I know in CT when our patients are 250 pounds or more we up the kV to 140 to reduce mottel (140 kV is where the tube maxes out and it always does a “smart mA” setting). I’m sure in DR and CR there comes a point for when we need to do more than just keep bumping up the mAs for a larger patient, would you have any guesses at what patient size that kV bump should start at and by how much? I wasn’t sure if you had a magic math formula for bariatric kV ranges.

Hi Alaina,

Sorry this has taken me so long to reply to you. I totally forgot to check this page in my website. I’m so used to emails just coming in to my drs@redshift.com and not having to open up my website. My fault completely though.

I’m so glad you enjoyed the Webinar and how exciting that a few of your co-workers are willing to use these new techniques.

I would say that for bariatric patients you can easily bump up the another 10kV (maybe even 15). Also make sure you always are always on the large focal spot so that you can get your mA station as high as it can go too. This will get you the fastest exposure time, which is crucial when you end up using a large mAs.

I would love to have another cart made up for this size patient, but am so busy with other projects I don’t see it coming any time soon.

Please keep me updated on how things work out for you and your co-workers.

All the Best,


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