This study evaluated the physical and clinical effects of off-scout CT imaging and assessed whether targeted technologist education could improve scout coverage and patient centering. Experiments showed that when scan ranges extended beyond the scout image, tube current modulation did not continue beyond the scout boundary, resulting in scanner- and direction-dependent changes in tube current behavior and CTDIvol. In a clinical analysis, off-scout imaging was associated with increased scan length beyond intended anatomical landmarks, increased thyroid inclusion, and, for inferior off-scout scans, significant increases in CTDIvol and DLP after controlling for patient size. Following a physics-guided education intervention, institutional on-scout and centering performance was improved.
