Chest, Abdomen and Pelvis CT Protocols

73 Pages·2015·1.24 MB·English

Chest, Abdomen and Pelvis CT Protocols
Oncology: Hypervascular Mets
Chest
ADRENAL MASS Protocol
Chest CT Low Dose Nodule Evaluation
ABDOMEN PELVIS: ROUTINE
Chest CT Lung Cancer Screening
ABDOMEN PELVIS: TRAUMA
Chest CT Routine With Contrast
Abdomen Pelvis: FAST ER Protocol: R/O Acute
Chest CT Without Routine
Appendicitis or Diverticulitis
Chest CTA- Pulmonary Embolism
Abdomen CTA- Aortic Aneurysm -Pre EVT
Chest CTA- Acute Aorta
Abdomen CTA- Aortic Aneurysm –Post EVT
Chest CTA- Aortic Aneurysm -Pre EVT
CT COLONOGRAPHY
Chest CTA Aortic Aneurysm- Post EVT
CT Enterography
Chest CTA- Acute Aorta- Trauma
CT UROGRAM
Chest CT High Resolution
CT UROGRAM LOW DOSE
Coronary CTA Screening History
Renal Mass
Chest, Abdomen and Pelvis Renal CTA
Retroperitoneal Hemorrhage
Chest Abdomen Pelvis: Acute Trauma
Oncology: Hepatoma: (Triphasic Liver CT)
Abdomen and Pelvis
Oncology: Cholangiocarcinoma
Pancreatic Mass CT
CT Cystogram
CT VENOGRAM PELVIS: Pelvic Venous
Oncology: Lymphoma
Congestion
Oncology: Hypovascular Mets
1
LOWER EXTREMITIES
CT VENOGRAM LOWER EXTREMITY
2
3
Chest
4
Chest CT Low Dose Nodule Evaluation
Typical Indications: Follow up pulmonary nodule(s). Normal or nearly normal radiograph
Acquisition Phase Scan Respiration Anatomical
Phase Included Delay Phase Coverage
Non Lower cervical spine
Contrast Y N/A Inspiration through both
costophrenic angles
Arterial
Phase N N/A N/A

Venous
Phase N N N/A

Delayed
Phase N N/A N/A

Scan Comments: Low dose: reduce mAs appropriate to patients size: consider
100 kVP/mAS modulation per scanner software. Nodules are lesions <3cm. For
pulmonary masses (>3cm) or hilar enlargement use Chest CT With Contrast
Routine protocol
Scan Comments: Low dose: reduce kVP appropriate to patients size: consider
100 kVP for patients less than 200 lbs/90 kgs. If exam is requested because of
an “abnormal CXR” please have outside CXR and report available for review.
Note: “pulmonary nodules” are lesions <3cm ; pulmonary masses are >3cm. If
scan is for pulmonary mass use Chest CT With Contrast Protocol.

5
Contrast Parameters Parameters
Contrast Type None
Contrast Volume N/A

Saline Flush N/A

Injection Rate N/A

Oral Contrast N/A

Oral Contrast Volume N/A

Reconstruction Soft Tissue Bone/ Thin Sag Cor
Parameters Lung Data
Slice Thickness x 5mm x 5mm x 2mm 3mm 3mm
Recon Spacing 5mm 5mm x x x
Phase #1 #1 1mm 3mm 3mm
#1) Noncontrast #1 #1 #1
Plane Axial Axial Axial Sag Cor
Reconstruction Soft Tissue Lung ST ST ST
Algorithm

Send to PACS PACS Hold PACS PACs

6
Chest CT Lung Cancer Screening (USPTF criteria)
1) Adults aged 55-80, with a >30 pack year history of
smoking and who currently smoke or have stopped
smoking in past 15 years
2) Screening should be discontinued once the
individual has not smoked for 15 years or develops a
health problem that significantly limits life
expectancy or the ability or willingness to have
curative lung surgery.
Acquisition Phase Scan Respiration Anatomical
Phase Included Delay Phase Coverage
Non Lower cervical spine
Contrast Y N/A Inspiration thru both costophrenic
angles
Arterial
Phase N N/A N/A

Venous
Phase N N/A N/A

Delayed
Phase N N/A N/A

Scan Comments:
Guidelines for techniques include:
For BMI < 30 use kVP of 100; mAS < 40; mA 80; goal CTDIvol < 3 mGy

For BMI > 30 use kVP of 120; mAS < 60; goal CTDIvol < 5 mGy

mAS software modulation with ADIR (Toshiba) or CareDose(Siemens) may alter these
parameters.
Additional reported risk factors: documented high radon exposure, occupational
exposures (silica,cadmium,asbestos,arsenic,beryllium,chromium,diesel
fumes,niockel,coal smoke,soot), personal cancer history ( lung cancer, lymphoma, head
and neck), COPD or pulmonary fibrosis, family history lung cancer.

7
Reconstruction Soft Bone/ Thin Sag Cor 3D/Special
Parameters Tissue Lung Data
Slice Thickness x 1 mm 1 mm 0.5 mm x 2 mm 2 mm NA
Recon Spacing 0.3 mm x 2 x 2
Phase mm mm
#1) Noncontrast
Plane Axial Axial Axial Sag Cor

Reconstruction Algorithm Soft LUNG LUNG LUNG LUNG N/A
Tissue

Send to PACS PACS Hold PACS PACs N/A

8
Chest CT Routine With Contrast
Typical Indications: Evaluate Infection, known or suspected lung cancer, empyema, evaluate
pulmonary mass, hilar enlargement
Acquisition Phase Scan Respiration Anatomical
Phase Included Delay Phase Coverage
Non N N/A N/A
Contrast
Arterial N Use Bolus Inspiration Lower cervical spine
Phase Tracking through adrenal glands
Venous N N N/A
Phase
Delayed N N/A N/A
Phase

Scan Comments: Nodules are lesions <3cm. For incidental nodules may be able to use
Noncontrast CT Nodule protocol. For pulmonary masses (>3cm) or hilar enlargement
use Chest CT With Contrast Routine protocol

Contrast Parameters Parameters
Contrast Type Per institution
Contrast Volume 75-80cc
Use 100 cc if combined with abdomen CT
Injection Rate 4-5cc/sec
Oral Contrast N/A
Oral Contrast Volume N/A
Contrast Comments: Scan delay: usual 25 seconds;
Use Bolus Tracking if available

Reconstruction Soft Bone/ Thin Sag Cor 3D/Special
Parameters Tissue Lung Data
Slice Thickness x 5mm x 5mm x 2mm x 3mm x 3mm x NA
Recon Spacing 5mm 5mm 1mm 3mm 3mm
Plane Axial Axial Axial Sag Cor NA
Reconstruction Algorithm Soft Tissue Lung ST ST ST NA

Send to PACS PACS Hold PACS PACS NA

9
Chest CT Without Routine
Typical Indications: Evaluate lung nodule(s)
Acquisition Phase Scan Respiration Anatomical
Phase Included Delay Phase Coverage
Non Lower cervical spine through both
Contrast Y N/A Inspiration costophrenic angles

Arterial
Phase N N/A N/A

Venous
Phase N N N/A

Delayed N N/A N/A
Phase

Scan Comments: Nodules are lesions <3cm. For pulmonary masses (>3cm) or hilar
enlargement use Chest CT With Contrast Routine protocol

Reconstruction Soft Bone/
Thin Data Sag Cor 3D/Special
Parameters Tissue Lung

Slice Thickness x 5mm x 5mm x 2mm x 3mm x 3mm x
NA
Recon Spacing 5mm 5mm 1mm 3mm 3mm
Plane Axial Axial Axial Sag Cor NA
Reconstruction Soft
Lung ST ST ST NA
Algorithm Tissue
Send to PACS PACS Hold PACS PACS NA

10