Chest CT Protocols - Geisel School of Medicine...CHEST & NECK 16 SLICE – GE PARAMETER GROUP 1 (...

Chest CT Protocols

Standard CTA/CTV Cardiac

Chest With CTA Thorax Gated CTA Thoracic

Aorta

Chest Without Pectus Excavatum

CTV Chest CTA Cardiac

Chest Low Dose CTA Pulmonary Arteries CTA Coronary

Lung Screening Thoracic Outlet TAVR

High Res Chest Calcium Scoring

Chest & Neck Pulmonary Vein

Tracheobronchomalacia Left Atrial Appendage -

Watchman Protocol

Lead Extraction

CALCIUM SCORING

CALCIUM SCORING REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE

PT POSITION SUPINE / FEET FIRST

LANDMARK GE STERNAL NOTCH

SIEMENS ABOVE SHOULDERS

BREATHING INSPIRATION

SCOUTS AP AND LATERAL

PARAMETER SCAN START CARINA

END BELOW HEART

DFOV 25

PREP GROUP

GE

SIEMENS

INDICATION INTERMEDIATE CHD RISK

ORAL PREP None

SCAN I- CINE THROUGH HEART

RECON 2.5mm / 3.0mm AXIAL RECONS – STANDARD

ALGORITHM

REFORMAT

3D POST PROCESSING CALCIUM SCORING

CALCIUM SCORING

64 SLICE – GE VCT

PARAMETER SCAN*

SCAN TYPE CINE SEGMENT

ROTATION TIME 0.35 SEC

THICKNESS 2.5

PITCH

SPEED

INTERVAL 20.0

GANTRY TILT SCAN FOV LARGE BODY

kVp 120

mA 430

NOISE INDEX

DOSE REDUCTION 40%

ASIR/MODE 30% / SEGMENT

ALGORITHM

STANDARD

REFORMATS

Estimated CTDI 5.29

Estimated DLP 52.90

CALCIUM SCORING

196(2) – SIEMENS FORCE

PARAMETER CASC

SCAN TYPE


THICKNESS 3.0mm

PITCH 3.2

SPEED

INTERVAL 1.5mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 20

PREP GROUP

KERNEL CA Score

Qr36

ADMIRE

THICK/INCR.

KERNEL

ADMIRE

**** Send ECG strip to PACS****

Estimated CTDI 1.34

Estimated DLP

CHEST & NECK

CHEST & NECK REVISED: 5/1/20

IV SIZE

IV CONTRAST 110CC OMNIPAQUE 350

INJECTION RATE

PT POSITION SUPINE / FEET FIRST / ARMS UP (CHEST) / ARMS

DOWN (NECK)


SIEMENS ABOVE EARS


SCOUTS AP AND LATERAL (ARMS DOWN)

PARAMETER CHEST NECK

START ABOVE APICES TOP OF EAR

END BELOW ADRENALS BELOW CLAVICLES

DFOV <TO PATIENT> 20

PREP GROUP

GE 25 SEC 5 MINS

SIEMENS 25 SEC 5 MINS

INDICATION

ORAL PREP NONE

SCAN CHEST ~25 SECONDS AFTER START OF INJECTION WITH NECK SCAN TO IMMEDIATELY FOLLOW

RECON

5.0mm AXIAL RECON – DETAIL ALGORITHM (NOT SENT TO PACS)

3.0mm / 3.75mm AXIAL RECONS – STANDARD ALGORITHM (CHEST)

2.mm / 2.5mm AXIAL RECONS – STANDARD ALGORITHM (NECK)

0.625mm / 1.25mm / 1.5mm AXIAL RECONS – STANDARD ALGORITHM (CHEST)

0.625mm / 1.25MM AXIAL RECONS - DETAIL ALGORITHM (NECK) -- GE SCANNERS

0.6mm AXIAL RECONS – STANDARD ALGORITHM (NECK) – FORCE SCANNER

3.0mm / 3.75mm AXIAL RECONS – LUNG ALGORITHM

-REFORMAT 3mm CORONAL AND SAGITTAL (CHEST) 2mm CORONAL AND SAGITTAL (NECK)

3D POST PROCESSING NONE

CHEST & NECK

16 SLICE – GE

PARAMETER GROUP 1 ( CHEST) GROUP 2 ( NECK)

SCAN TYPE HELICAL FULL HELICAL FULL

ROTATION TIME 0.8 SEC 0.8 SEC

THICKNESS 3.75 5.0

PITCH 1.375:1 1.375:1

SPEED 27.50 27.50

INTERVAL 3.75 5.0

GANTRY TILT SCAN FOV LARGE LARGE

kVp 120 120

mA AUTO mA TO 440 W/

SMART mA AUTO mA TO 440 W/

SMART mA

NOISE INDEX 22.53 10.30

DOSE REDUCTION

ASiR/MODE 40% / PLUS 30% / PLUS

ALGORITHM STD Chest-Neck

STANDARD STD Chest-Neck

DETAIL

REFORMATS

THICK/INCR.

LUNG

3.75 q 3.75

ALGORITHM LUNG

REFORMATS

ASiR/MODE 40% / FULL

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD

REFORMATS COR 3 / SAG 3

40% / PLUS

THICK/INCR.

Detail THN

1.25 q 0.700

ALGORITHM DETAIL


ASiR/MODE 30% / PLUS

THICK/INCR. 2.5 q 2.5

ALGORITHM Detail Detail

REFORMATS


Estimated CTDI 17.94

Estimated DLP 635.27

CHEST & NECK

64 SLICE – GE VCT

PARAMETER GROUP 1 CHEST) GROUP 2 (NECK)



THICKNESS 3.75 5.0

PITCH 0.984:1 0.984:1

SPEED 39.37 39.37

INTERVAL 3.75 5.0

GANTRY TILT SCAN FOV LARGE BODY LARGE BODY

kVp 120 120


SMART mA AUTO mA TO 440 W/ SMART

mA


DOSE REDUCTION 40% 30%

ASIR/MODE 40% / PLUS 30% / PLUS

ALGORITHM STD Chest

STANDARD Detail THK Neck

DETAIL

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

0.625 q 0.625

Detail THN

0.625 q 0.625

ALGORITHM STANDARD DETAIL

REFORMATS COR 3 / SAG 3 COR 2 / SAG 2

ASiR/MODE 40% / PLUS-E 30% / PLUS-E

THICK/INCR.

STD 2

1.25 q 0.700

Detail

2.5 q 2.5

ALGORITHM STANDARD Detail

REFORMATS

ASiR/MODE 40% / PLUS 30% / PLUS



CHEST & NECK


PARAMETER TF CHEST DE NECK

SCAN TYPE


THICKNESS 3.0mm 2.0mm

PITCH 2.0 0.7

SPEED

INTERVAL 3.0mm 2.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV 90 / Sn150

mAs CARE Dose4D CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT> 20

PREP GROUP 25 SEC 45 SEC

KERNEL STD

Br40 STD

Br40

ADMIRE 3 1

THICK/INCR.

Lung

3.0 q 3.0 DE #PP STD THN

0.75 q 0.5

KERNEL Bl57 Qr40

ADMIRE 3 3

THICK/INCR.

COR 3

3.0 q 3.0

COR 2

2.0 q 2.0

KERNEL Br40 Br40

ADMIRE 3 3

THICK/INCR.

SAG 3

3.0 q 3.0

SAG 2

2.0 q 2.0

KERNEL Br40 Br40

ADMIRE 3 3

THICK/INCR. STD THN

1.5 q 1.0 STD THN

0.6 q 0.6

KERNEL Br40 Br40

ADMIRE 3 1

Estimated CTDI 6.16

Estimated DLP

CHEST LOW DOSE

CHEST LOW DOSE REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE






INDICATION EVAL OR F/U PULMONARY NODULE, BRONCHIECTASIS

ORAL PREP NONE

SCAN NON-CONTRAST

RECON

2.5mm / 3.0mm AXIAL RECON – STANDARD ALGORITHM

2.5mm / 3.0mm AXIAL RECON – LUNG ALGORITHM


REFORMAT 3mm CORONAL AND SAGITTAL

3D POST PROCESSING VOLUME DOUBLING TIME (PULMONARY NODULE)

PARAMETER SCAN

START ABOVE APICES -- UNLESS OTHERWISE SPECIFIED

END BELOW ADRENAL GLANDS –

UNLESS OTHERWISE SPECIFIED

DFOV <TO PATIENT>

PREP GROUP

GE

SIEMENS

CHEST LOW DOSE

16 SLICE – GE

PARAMETER SCAN

SCAN TYPE HELICAL FULL


THICKNESS 2.5

PITCH 1.375:1

SPEED 27.50

INTERVAL 2.5

GANTRY TILT

SCAN FOV LARGE

kVp 120

mA 100

NOISE INDEX DOSE REDUCTION

ASiR/MODE 0% / PLUS

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

2.5 q 2.5

ALGORITHM LUNG

REFORMATS

ASiR/MODE 0% / FULL

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


ASiR/MODE 0% / PLUS

Estimated CTDI 3.40


CHEST LOW DOSE

64 SLICE – GE VCT

PARAMETER SCAN



THICKNESS 2.5

PITCH 0.984:1

SPEED 39.37

INTERVAL 2.5


kVp 120


SMART mA

NOISE INDEX 12.75

DOSE REDUCTION

ASIR/MODE 0% / PLUS

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

2.5 q 2.5

ALGORITHM LUNG

REFORMATS

ASiR/MODE 0% / FULL

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


ASiR/MODE 0% / PLUS

Estimated CTDI 3.07

Estimated DLP 91.25

CHEST LOW DOSE


PARAMETER CHEST LOW DOSE

NO TF

SCAN TYPE


THICKNESS 3.0mm

PITCH 1.5

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp 120

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP

KERNEL STD

Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR. STD THN

1.5 q 1.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

Estimated CTDI 3.34

Estimated DLP

CHEST WITH

CHEST WITH REVISED: 5/1/20

IV SIZE

IV CONTRAST 60cc OMNIPAQUE 350

INJECTION RATE






PARAMETER SCAN START ABOVE APICES

END BELOW ADRENAL GLANDS

DFOV <TO PATIENT>

PREP GROUP

GE 25 SEC

SIEMENS 25 SEC

INDICATION

ORAL PREP NONE

SCAN 25 SEC AFTER INJECTION STARTS

RECON



1.25mm /1.5mm AXIAL RECON – STANDARD ALGORITHM


3D POST PROCESSING

CHEST WITH

16 SLICE – GE

PARAMETER SCAN



THICKNESS 3.75

PITCH 1.375:1

SPEED 27.50

INTERVAL 3.75

GANTRY TILT

SCAN FOV LARGE BODY

kVp 120


SMART mA

NOISE INDEX 19.51

DOSE REDUCTION ASiR/MODE 40% / PLUS

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD





CHEST WITH

64 SLICE – GE VCT

PARAMETER SCAN



THICKNESS 3.75

PITCH 0.984:1

SPEED 39.37

INTERVAL 3.75


kVp 120


SMART mA

NOISE INDEX 17.28

DOSE REDUCTION 40%

ASIR/MODE 40% / PLUS

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD



Estimated CTDI 7.15


CHEST WITH


PARAMETER TF CHEST WITH

SCAN TYPE


THICKNESS 3.0mm

PITCH 2.0

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP 25 SEC

KERNEL STD

Br40

ADMIRE 3

THICK/INCR. STD THN

1.5 q 1.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

***IF ANATOMY OF INTEREST EXCEEDS TURBO FLASH SFOV, USE SINGLE ENERGY SCAN (XXL PROTOCOL) ***

Estimated CTDI 4.81

Estimated DLP

CHEST WITH

PARAMETER XXL CHEST W/

SCAN TYPE


THICKNESS 3.0mm

PITCH 0.6

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP 25 SEC

KERNEL STD

Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR. STD THN

1.5 q 1.0

KERNEL Br40

ADMIRE 3

Estimated CTDI 3.14

Estimated DLP

CHEST WITHOUT

CHEST WITHOUT REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE








DFOV <TO PATIENT>

PREP GROUP

GE

SIEMENS

PECTUS EXCAVATUM: Start scan above Manubrium, extend below the tip of the Xyphoid (do not need apices or all of ribs), in bone 5.0mm q 5.0mm in a standard algorithm recons and thin bone recons. **Per Dr. Czum

CHEST CT MODIFICATIONS:

1. PLEURAL EFFUSION WORK-UP: To Look for underlying lung pathology in the setting of known or unknown

etiology. Prone (preferred) or decubitus (if prone not possible)

2. ESOPHAGEAL MASS WORK-UP: Oral Barium contrast administered on table immediately before scan.

3. ESOPHAGEAL POST-OP LEAK: Oral water soluble contrast administered on table immediately before scan.

4. SOLITARY PULMONARY NODULE: 12 cm FOV reconstruction covering known focal pathology 1.25mm thick by

1.25mm interval, limited to target lesion of interest.

INDICATION

ORAL PREP NONE

SCAN 25 SEC AFTER INJECTION STARTS

RECON



1.25mm /1.5mm AXIAL RECON – STANDARD ALGORITHM


3D POST PROCESSING

CHEST WITHOUT

16 SLICE – GE

PARAMETER SCAN



THICKNESS 3.75

PITCH 1.375:1

SPEED 27.50

INTERVAL 3.75

GANTRY TILT

SCAN FOV LARGE BODY

kVp 120


SMART mA

NOISE INDEX 19.51


ALGORITHM STD WO

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN WO

1.25 q 0.700

ALGORITHM STANDARD

REFORMATS COR 3 WO / SAG 3 WO




CHEST WITHOUT

64 SLICE – GE VCT

PARAMETER SCAN



THICKNESS 3.75

PITCH 0.984:1

SPEED 39.37

INTERVAL 3.75


kVp 120


SMART mA

NOISE INDEX 17.28

DOSE REDUCTION 40%


ALGORITHM STD WO

STANDARD

REFORMATS

THICK/INCR.

Lung WO

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN WO

1.25 q 0.700

ALGORITHM STANDARD

REFORMATS COR 3 WO / SAG 3 WO


Estimated CTDI 7.15


CHEST WITHOUT


PARAMETER TF CHEST WO

SCAN TYPE


THICKNESS 3.0mm

PITCH 2.0

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP

KERNEL STD WO

Br40

ADMIRE 3

THICK/INCR. STD THN WO

1.5 q 1.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR. COR 3

WO

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR. SAG 3 WO

3.0 q 3.0

KERNEL Br40

ADMIRE 3

Estimated CTDI 4.81

Estimated DLP

CHEST WITHOUT

PARAMETER XXL CHEST WO

SCAN TYPE


THICKNESS 3.0mm

PITCH 0.6

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP

KERNEL STD WO

Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR. SAG 3 WO

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR. COR 3

WO

3.0 q 3.0

KERNEL Br40

ADMIRE 3


1.5 q 1.0

KERNEL Br40

ADMIRE 3

Estimated CTDI 3.14

Estimated DLP

CTA CARDIAC

CTA CARDIAC REVISED: 5/1/20

IV SIZE 18g

IV CONTRAST WEIGHT BASED

INJECTION RATE 5cc/SEC


LANDMARK GE




PARAMETER CTA START CARINA

END BELOW HEART

DFOV

PREP GROUP

GE

SIEMENS MIROI + 14

INDICATION

1. AORTIC STENOSIS TAVR EVALUATION 2. CARDIAC VOLUMES/FUNCTION 3. CARDIAC MASS 4. CONGENITAL HEARD DISEASE PRE OR POST OP

EVALUATION

ORAL PREP NONE

SCAN 1. I+ CINE SCAN THROUGH HEART

RECON 3.0mm STANDARD ALGORITHM

0.6mm STANDARD ALGORITHM (0-95% PHASES)

REFORMAT

3D POST PROCESSING LV VOLUME RV VOLUME

CTA CARDIAC


PARAMETER TEST BOLUS RETROSPECTIVE

SCAN TYPE FULL



PITCH 0.15

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV

mAs 20 CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 20 20

PREP GROUP TEST BOLUS PEAK +

14

KERNEL

Bv40 STD

Br36

ADMIRE 2

THICK/INCR.

PHASES MATRIX

256 (5-95 q

10)

0.6 q 0.5

KERNEL Qr36

ADMIRE 2



Estimated DLP

CTA PULMONARY ARTERIES

CTA CORONARY REVISED: 5/1/20

IV SIZE 18g




LANDMARK GE




PARAMETER CALCIUM SCORING CTA START CARINA 2Omm ABOVE LAD

END BELOW HEART 20mm BELOW HEART

DFOV 25 20

PREP GROUP

GE

SIEMENS MIROI + 14

INDICATION

1. CORONARY ANOMALY 2. CORONARY ARTERY DISEASE 3. CHEST PAIN 4. ABNORMAL STRESS TEST

ORAL PREP NONE

SCAN 1. I- CINE THROUGH HEART 2. I+ CINE SCAN THROUGH HEART

RECON

2.5mm / 3.0mm AXIAL RECON - STANDARD ALGORITHM (CALCIUM SCORING)

0.625mm / 3.0mm AXIAL RECON - STANDARD ALGORITHM (CTA)

0.6mm / 0.625mm AXIAL RECON - STANDARD ALGORITHM (40-85% PHASES)

REFORMAT

3D POST PROCESSING

CALCIUM SCORING CURVED REFORMATS – EACH CORONARY 3D CORONARIES 3D CORONARIES W/ TRANSPARENT HEART X-SECTION CORONARY



PARAMETER CASC TEST BOLUS PROSPECTIVE RETROSPECTIVE

SCAN TYPE FULL FLEX

ROTATION TIME 0.25 SEC 0.25 SEC 0.25 SEC 0.25 SEC

THICKNESS 3.0mm 10.0mm 3.0mm 3.0mm

PITCH 3.2 0.15

SPEED

INTERVAL 1.5mm 0.0mm 3.0mm 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV 100 CARE kV CARE kV

mAs CARE Dose4D 20 CARE Dose4D CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 20 20 20 20

PREP GROUP 10 SEC TEST BOLUS PEAK +

14 SEC TEST BOLUS PEAK +

14 SEC

KERNEL CASC

Qr36

Bv40 STD

Qr36 STD

Qr36

ADMIRE 3 3

THICK/INCR.

PHASES

0.6 q 0.5

PHASES

0.6 q 0.5

KERNEL Qr36 Qr36

ADMIRE 3 3


Estimated CTDI 1.34 (CASC) / 7.77 (PROSPECTIVE) / 71.60

(RETROSPECTIVE)

Estimated DLP


CTA PULMONARY ARTERIES REVISED: 5/1/20

IV SIZE 18g OR 20g








PARAMETER CTA START ABOVE APICES

END BELOW DIAPHRAGM

DFOV <TO PATIENT>

PREP GROUP

GE MIROI + 4

SIEMENS SMART PREP @ PULMONARY ARTERY

INDICATION PULMONARY EMBOLISM, PULMONARY AVM

ORAL PREP NONE

SCAN FIRST PASS (ARTERIAL PHASE) SCAN TIMED OFF THE PULMONARY ARTERIES

RECON



1.25mm / 1.5mm AXIAL RECON – CHEST/STANDARD ALGORITHM

REFORMAT 3mm q 1.5mm MIP CORONAL AND SAGITTAL 3mm CORONAL AND SAGITTAL

3D POST PROCESSING


16 SLICE – GE

PARAMETER MIROI* CTA

SCAN TYPE AXIAL FULL HELICAL FULL


THICKNESS 5.0 2.5

PITCH 0.938:1

SPEED 18.75

INTERVAL 0.0 2.5

GANTRY TILT

SCAN FOV LARGE LARGE

kVp 120 100

mA 40 AUTO mA TO 420 W/ SMART mA

NOISE INDEX 18.26

DOSE REDUCTION ASiR/MODE 0% / FULL 40% / PLUS

ALGORITHM MIROI

STANDARD STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM CHEST

REFORMATS COR MIP / SAG MIP /

COR 3 / SAG 3





64 SLICE – GE VCT

PARAMETER MIROI CTA



THICKNESS 5.0 2.5

PITCH 0.984:1

SPEED 39.37

INTERVAL 0.0 2.5


kVp 100 100


NOISE INDEX 15.86


ASIR/MODE 20% / FULL 40% / PLUS

ALGORITHM MIROI

STANDARD STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM CHEST


COR 3 / SAG 3






PARAMETER PREMONITORING /

SMART PREP TF PE

SCAN TYPE FULL



PITCH 1.9

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV – Semi - 100

mAs 23 CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 30 <TO PATIENT>

PREP GROUP 6 SEC SMART PREP

KERNEL

Br36 STD

Bv36

ADMIRE 3

THICK/INCR.

STD THN

1.5 q 1.0

KERNEL Bv36

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3


Estimated DLP




SMART PREP XXL PE

SCAN TYPE FULL



PITCH 1.5

SPEED


GANTRY TILT

SCAN FOV

kVp 140 CARE kV – SEMI - 130

mAs 65 CARE Dose4D

NOISE INDEX

DOSE REDUCTION


KERNEL

Br36 STD

Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

STD THN

1.0 q 0.7

KERNEL Br40

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3


Estimated DLP

CTA THORACIC AORTA

CTA THORAX REVISED: 5/1/20

IV SIZE 18g OR 20g


INJECTION RATE 4-5cc/SEC







END BELOW DIAPHRAGM

DFOV <TO PATIENT>

PREP GROUP

GE SMART PREP

SIEMENS SMART PREP

SIEMENS FORCE: Turbo Flash protocols are to be used for all CTA Chest:

Acute Dissection: I- Turbo Flash I+ Turbo Flash

All Other Aortic Pathology I+ Turbo Flash ONLY

***DE CTA protocols are only to be used if specifically requested by MD***

INDICATION AORTIC PATHOLOGY

ORAL PREP NONE

SCAN I+ SMART PREP TIMED

RECON

2.5mm / 3.0mm AXIAL RECONS - STANDARD ALGORITHM

3.0mm / 3.75mm AXIAL RECONS LUNG ALGORITHM

0.6mm / 0.625mm / 1.25mm AXIAL RECONS – STANDARD ALGORITHM

REFORMAT 3mm q 1.5mm MIP CORONAL AND SAGITTAL

3D POST PROCESSING

3D ROTATION AORTA CURVED REFORMAT AORTA MAX VESSEL DIAMETER W/ 0* AND 90* VIEWS OF

AORTA

CTA THORACIC AORTA

16 SLICE – GE

PARAMETER SMART PREP CTA



THICKNESS 2.5

PITCH 1.375:1

SPEED 27.50

INTERVAL 2.5

GANTRY TILT

SCAN FOV LARGE

kVp 100

mA 10 AUTO mA TO 420 W/

SMART mA

NOISE INDEX 15.62


ALGORITHM

STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD

REFORMATS COR MIP / SAG MIP




CTA THORACIC AORTA

64 SLICE – GE VCT

PARAMETER SMART PREP* CTA



THICKNESS 2.5

PITCH 0.984:1

SPEED 39.37

INTERVAL 2.5


kVp 100

mA 10 AUTO mA TO 700 W/

SMART mA

NOISE INDEX 12.73

DOSE REDUCTION 50%


ALGORITHM

STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

0.625 q 0.625

ALGORITHM STANDARD

REFORMATS COR MIP / SAG

MIP

ASiR/MODE 50% / PLUS-E

*Dynamic Transition



CTA THORACIC AORTA


PARAMETER TF CHEST PREMONITORING /

SMART PREP TF AORTA DELAY

SCAN TYPE FULL

ROTATION TIME 0.28 SEC 0.25 SEC 0.25 SEC 0.5 SEC

THICKNESS 3.0mm 10.0mm 3.0mm 3.0mm

PITCH 2.0 1.9 1.0

SPEED

INTERVAL 3.0mm 0.0mm 3.0mm 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV 100 CARE kV CARE kV

mAs CARE Dose4D 23 CARE Dose4D CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT> 30 <TO PATIENT> <TO PATIENT>

PREP GROUP 10 SEC SMART PREP 3-5 MINS

KERNEL STD WO

Bv36

Br36 STD

Bv36 STD Delay

Bv36

ADMIRE 3 3 3


1.5 q 1.0

Lung

3.0 q 3.0

KERNEL Br40 Bl57

ADMIRE 3 3

THICK/INCR.

Lung

3.0 q 3.0

STD THN

0.6 q 0.6

KERNEL Bl57 Bv36

ADMIRE 3 3

THICK/INCR. COR MIP WO

3.0 q 1.5

COR MIP

3.0 q 1.5

KERNEL Bv36 BV36

ADMIRE 3 3

THICK/INCR. SAG MIP WO

3.0 q 1.5

SAG MIP

3.0 q 1.5

KERNEL Bv36 Bv36

ADMIRE 3 3


Estimated DLP

CTA THORACIC AORTA


SMART PREP TF CHEST DELAY

SCAN TYPE FULL

ROTATION TIME 0.25 SEC 0.25 SEC 0.5 SEC

THICKNESS 10.0mm 3.0mm 3.0mm

PITCH 1.9 1.0

SPEED

INTERVAL 0.0mm 3.0mm 3.0mm

GANTRY TILT

SCAN FOV

kVp 100 CARE kV CARE Kv

mAs 23 CARE Dose4D CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 30 <TO PATIENT> <TO PATIENT>

PREP GROUP 10 SEC SMART PREP 3-5 MINS

KERNEL

Br36 STD

Bv36 STD Delay

Br36

ADMIRE 3 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

STD THN

0.6 q 0.6

KERNEL Bv36

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Bv36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Bv36

ADMIRE 3


Estimated DLP

CTV CHEST

CTV CHEST REVISED: 5/1/20

IV SIZE 20g OR 18g








PARAMETER CTV START ABOVE APICES


DFOV <TO PATIENT>

PREP GROUP

GE 120 SEC

SIEMENS 120 SEC

INDICATION EVALUATE FOR ? SVC SYNDROME, VENA CAVA THROMBUS/TUMOR

ORAL PREP NONE

SCAN I+ 120 SEC DELAY

RECON

3.0mm / 3.75mm AXIAL RECONS – STANDARD ALGORITHM

3.0mm / 3.75mm AXIAL RECONS - LUNG ALGORITHM

1.25mm / 1.5mm AXIAL RECONS -STANDARD ALGORITHM


3D POST PROCESSING

CTV CHEST

16 SLICE – GE

PARAMETER SCAN



THICKNESS 3.75

PITCH 1.375:1

SPEED 27.50

INTERVAL 3.75

GANTRY TILT

SCAN FOV LARGE BODY

kVp 120

mA AUTO mA TO 440 W/ SMART

mA

NOISE INDEX 19.51

DOSE REDUCTION


ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


/ COR 3 / SAG 3




CTV CHEST

64 SLICE – GE VCT

PARAMETER SCAN



THICKNESS 3.75

PITCH 0.984:1

SPEED 39.37

INTERVAL 3.75

GANTRY TILT

SCAN FOV LARGE BODY

kVp 120

mA AUTO mA TO 440 W/ SMART

mA

NOISE INDEX 17.28

DOSE REDUCTION 40%


ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


/ COR 3 / SAG 3


Estimated CTDI 7.15


CTV CHEST


PARAMETER TF CTV CHEST W/

SCAN TYPE


THICKNESS 3.0mm

PITCH 2.0

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV – SEMI - 120

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP 120 SEC

KERNEL STD

Br40

ADMIRE 3

THICK/INCR. STD THN

1.5 q 1.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR. COR MIP

3.0 q 1.5

KERNEL Br40

ADMIRE 3

THICK/INCR. SAG MIP

3.0 q 1.5

KERNEL Br40

ADMIRE 3

Estimated CTDI 2.88

Estimated DLP

CTV CHEST


PARAMETER XXL CHEST CTV

SCAN TYPE


THICKNESS 3.0mm

PITCH 0.6

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV <TO PATIENT>

PREP GROUP 120 SEC

KERNEL STD

Br40

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR. SAG MIP

3.0 q 1.5

KERNEL Br40

ADMIRE 3

THICK/INCR. COR MIP

3.0 q 1.5

KERNEL Br40

ADMIRE 3

THICK/INCR. STD THN

1.5 q 1.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br40

ADMIRE 3

Estimated CTDI 3.14

Estimated DLP

GATED CTA THORACIC AORTA

GATED CTA THORACIC AORTA REVISED: 5/1/20

IV SIZE 18g OR 20g


INJECTION RATE 4-5cc/SEC

PT POSITION SUPINE / FEET FIRST / ECG MONITOR

ATTACHED






END BELOW DIAPHRAGM

DFOV <TO PATIENT>

PREP GROUP

GE SMART PREP @ ARCH

SIEMENS SMART PREP @ ARCH

INDICATION SINUS OF VALSALVA ANEURYSM; WHEN REQUESTED TO MINIMIZE AORTIC PULSATION ARTIFACT BY AORTIC ROOT

ORAL PREP NONE

SCAN I+ ARTERIAL PHASE CHEST

RECON 2.5mm AXIAL RECON – STANDARD ALGORITHM

2.5mm AXIAL RECON – LUNG ALGORITHM

1.25mm AXIAL RECON – STANDARD ALGORITHM


3D POST PROCESSING 3D ROTATION AORTA MIP ROTATION AORTA MAX VESSEL MEASUREMENT


64 SLICE – GE VCT

PARAMETER SMART PREP CTA

SCAN TYPE CARDIAC SEGMENT


THICKNESS 2.5

PITCH 0.16:1

SPEED 6.40

INTERVAL 2.5

GANTRY TILT SCAN FOV CARDIAC LARGE

kVp 100

mA 10 ECG MODULATED mA TO 700

NOISE INDEX DOSE REDUCTION 40%

ASiR/MODE 40% / SNAPSHOT SEGMENT

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

2.5 q 2.5

ALGORITHM LUNG

REFORMATS

ASiR/MODE 50% / SNAPSHOT

SEGMENT

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


ASiR/MODE 50% / SNAPSHOT

SEGMENT





USE TF AORTA PROTOCOL

HIGH RES CHEST

HIGH RES CHEST REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE

PT POSITION SUPINE / PRONE / FEET FIRST


SIEMENS N/A

BREATHING INSPIRATION / EXPIRATION / INSPIRATION


PARAMETER SUPINE INSPIRATION SUPINE

EXPIRATION PRONE

INSPIRATION START ABOVE APICES ABOVE APICES ABOVE APICES

END BELOW DIPAHRAGM BELOW DIAPHRAGM BELOW DIAPHRAGM

DFOV <TO PATIENT> <TO PATIENT> <TO PATIENT>

PREP GROUP

GE

SIEMENS

INDICATION INTERSTITIAL LUNG DISEASE

ORAL PREP NONE

SCAN 1. I- SUPINE INSPIRATION 2. I- SUPINE EXPIRATION 3. I- PRONE INSPIRATION

RECON

3.75mm AXIAL RECON – STANDARD ALGORITHM (SUPINE INSPIRATION

3.75mm AXIAL RECON – LUNG ALGORITHM ( SUPINE INSPIRATION)

1.25mm AXIAL RECON – CHEST ALGORITHM (SUPINE INSPIRATION)

1.25 q 10mm AXIAL RECON – BONE ALGORITHM (ALL)

REFORMAT 3mm CORONAL AND SAGITTAL (SUPINE

INSPIRATION)

3D POST PROCESSING

HIGH RES CHEST

16 SLICE – GE

PARAMETER SUPINE

INSPIRATION SUPINE

EXPIRATION PRONE

INSPIRATION

SCAN TYPE HELICAL FULL AXIAL FULL AXIAL FULL


THICKNESS 3.75 1.25 1.25

PITCH 1.375:1

SPEED 27.50

INTERVAL 3.75 10 10

GANTRY TILT

SCAN FOV LARGE LARGE LARGE

kVp 120 120 120




SMART mA

NOISE INDEX 15.43 25.39 25.39

DOSE REDUCTION

ASiR/MODE 30% / PLUS 30% / FULL 30% / FULL

ALGORITHM STD INSP

STANDARD Bone EXP

BONE Bone Prone INSP

BONE

REFORMATS

THICK/INCR.

Lung INSP

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN INSP

1.25 q 0.700

ALGORITHM CHEST

REFORMATS COR 3 INSP / SAG 3 INSP


THICK/INCR.

Bone INSP

1.25 q 10

ALGORITHM BONE

REFORMATS




HIGH RES CHEST

64 SLICE – GE VCT

PARAMETER SUPINE INSPIRATION SUPINE EXPIRATION PRONE INSPIRATION

SCAN TYPE HELICAL FULL AXIAL FULL AXIAL FULL


THICKNESS 3.75 1.25 1.25

PITCH 1.375:1

SPEED 27.50

INTERVAL 3.75 10.0 10.0

GANTRY TILT SCAN FOV LARGE BODY LARGE BODY LARGE BODY

kVp 120 120 120


SMART mA AUTO mA TO 100 W/ SMART


SMART mA

NOISE INDEX 13.58 23.59 23.59

DOSE REDUCTION 30% 30% 30%

ASIR/MODE 30% / PLUS 30% / FULL 30% / FULL

ALGORITHM STD INSP

STANDARD BONE EXP

BONE Bone Prone INSP

BONE

REFORMATS

THICK/INCR.

Lung INSP

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN INSP

1.25 q 0.700

ALGORITHM CHEST

REFORMATS COR 3 INSP / SAG 3 INSP


THICK/INCR.

Bone INSP

1.25 q 10.0

ALGORITHM BONE

REFORMATS


Estimated CTDI 6.93


LEAD EXTRACTION

LEAD EXTRACTION REVISED: 5/1/20

IV SIZE 20g

IV CONTRAST 150CC OMNIPAQUE 350



LANDMARK GE




INDICATION

ORAL PREP NONE

SCAN

RECON


0.6mm AXIAL RECON – STANDARD ALGORITHM - PHASES


REFORMAT

3D POST PROCESSING

3mm q 1.5mm MIP CORONAL AND SAGITTAL 3D ROTATION HEART AND PACEMAKER SAX, 2CH AND 4CH CARDIAC REFORMATS 3mm q 1.5mm MIP CORONAL AND SAGITTAL

REFORMATS

PARAMETER SCAN START ABOVE PACEMAKER

END BELOW HEART

DFOV 18.5

PREP GROUP

GE

SIEMENS 70 SEC

LEAD EXTRACTION


PARAMETER PROSPECTIVE

SCAN TYPE


THICKNESS 3.0mm

PITCH

SPEED

INTERVAL 3.0mm

GANTRY TILT

SCAN FOV

kVp CARE kV

mAs CAREDose4D

NOISE INDEX

DOSE REDUCTION

DFOV 18.5

PREP GROUP

KERNEL STD

Qr36

ADMIRE 3

THICK/INCR.

Phases

0.6 q 0.6

KERNEL Qr36

ADMIRE 3

THICK/INCR. STD THN

0.6 q 0.6

KERNEL Qr36

ADMIRE 3

Estimated CTDI 8.81

Estimated DLP

LEFT ATRIAL APPENDAGE – WATCHMAN PROTOCOL

LEFT ATRIAL APPENDAGE – WATCHMAN PROTOCOL REVISED: 5/1/20

IV SIZE 18g




LANDMARK GE




INDICATION LT ATRIAL APPENDAGE – WATCHMAN PLANNING

ORAL PREP NONE

SCAN PULMONARY VEIN PHASE TIMED OFF THE LEFT ATRIUM – TWO PHASES





3D POST PROCESSING

3D ROTATION PULMONARY VEIN CURVED REFORMAT LEFT ATRIAL APPENDAGE NECK AND MAX DIAMETER MEASUREMENTS LT

ATRIAL APPENDAGE WATCHMAN MEASUREMENTS

PARAMETER SCAN START 1CM ABOVE CARINA

END BELOW HEART

DFOV 20

PREP GROUP

GE

SIEMENS SMART PREP @ LEFT ATRIUM

LEFT ATRIAL APPENDAGE – WATCHMAN PROTOCOL



SMART PREP TF TF

SCAN TYPE FULL



PITCH 3.2 3.2

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV CARE kV

mAs 23 CAREDose4D CAREDose4D

NOISE INDEX

DOSE REDUCTION

DFOV 20 20 20

PREP GROUP SMART PREP 6 SEC

KERNEL

Br36 STD

Qr36 STD

Qr36

ADMIRE 3 3

THICK/INCR.

STD THN

0.6 q 0.3 STD THN

0.6 q 0.3

KERNEL Qr36 Qr36

ADMIRE 3 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3


Estimated DLP

LUNG SCREENING

LUNG SCREENING REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE



SIEMENS N/A




END BELOW DIAPHRAGM

DFOV <TO PATIENT>

PREP GROUP

GE

SIEMENS

INDICATION LUNG CANCER SCREENING. ASYMPTOMATIC BUT AT HIGH RISK FOR LUNG CANCER

ORAL PREP NONE

SCAN NON-CONTRAST




REFORMAT 3.0mm CORONAL AND SAGITTAL 6.0mm q 3.0mm AXIAL MIP

3D POST PROCESSING

LUNG SCREENING

16 SLICE – GE

PARAMETER SCAN



THICKNESS 2.5

PITCH 1.375:1

SPEED 27.50

INTERVAL 2.5

GANTRY TILT

SCAN FOV LARGE

kVp 120

mA

40mA (110-150 lbs) 80mA (150-200 lbs)

120mA (200-265 lbs)

NOISE INDEX

DOSE REDUCTION

ASiR/MODE 0% / FULL

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

2.5 q 2.5

ALGORITHM LUNG

REFORMATS

ASiR/MODE 0% / FULL

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


/ AX MIP 6

ASiR/MODE 0% / FULL

Estimated CTDI 1.36 / 2.72 / 4.08

Estimated DLP 38.01 / 76.01 / 114.02

LUNG SCREENING

64 SLICE – GE VCT

PARAMETER SCAN



THICKNESS 2.5

PITCH 1.375:1

SPEED 55.00

INTERVAL 2.5

GANTRY TILT

SCAN FOV LARGE BODY

kVp 120

mA

40mA (110-150 lbs) 100mA (150-200 lbs) 120mA (200-265 lbs)

NOISE INDEX DOSE REDUCTION

ASiR/MODE 0% / FULL

ALGORITHM STD

STANDARD

REFORMATS

THICK/INCR.

Lung

2.5 q 2.5

ALGORITHM LUNG

REFORMATS

ASiR/MODE 0% / FULL

THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM STANDARD


/ AX MIP 6

ASiR/MODE 0% / FULL

Estimated CTDI 1.54 / 2.74 / 4.61

Estimated DLP 45.63 / 93.23 / 136.88

PULMONARY VEIN

PULMONARY VEIN REVISED: 5/1/20

PARAMETER SCAN START JUST ABOVE SC NOTCH

END LUNG BASES

DFOV <TO PATIENT>

PREP GROUP

GE MIROI + 8 SEC

SIEMENS SMART PREP @ LEFT ATRIUM

INDICATION PULMONARY VEIN ISOLATION / PULMONARY VEIN MAPPING / ATRIAL FIBRILATION ABLATION PLANNING

ORAL PREP NONE

SCAN LATE ARTERIAL PHASE – TIMING OFF PULMONARY VEIN PLUS 8 SECONDS

RECON



1.25mm / 1.5mm AXIAL RECON – CHEST ALGORITHM


3D POST PROCESSING

3D ROTATION PULMONARY VEIN AXIAL/CORONAL NECK MEASUREMENTS RT/LT

SUPERIOR/INFERIOR VEIN, COMMON ORIGIN(S), AND AP/CC/RL LEFT ATRIUM

IV SIZE 18g








PULMONARY VEIN

16 SLICE – GE

PARAMETER *MIROI CTA



THICKNESS 5.0 1.25

PITCH 0.938:1

SPEED 18.75

INTERVAL 0.0 1.25

GANTRY TILT

SCAN FOV LARGE LARGE

kVp 120 100


NOISE INDEX 25.60

DOSE REDUCTION ASiR/MODE 0% / FULL 40% / PLUS

ALGORITHM MIROI

STANDARD STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 0.700

ALGORITHM CHEST


COR 3 / SAG 3




PULMONARY VEIN

64 SLICE – GE VCT

PARAMETER *MIROI CTA



THICKNESS 5.0 2.5

PITCH 0.984:1

SPEED 39.37

INTERVAL 0.0 2.5


kVp 120 100


NOISE INDEX 15.86

DOSE REDUCTION 40%

ASIR/MODE 0% / FULL 40% / PLUS

ALGORITHM MIROI

STANDARD STD

STANDARD

REFORMATS

THICK/INCR.

Lung

3.75 q 3.75

ALGORITHM LUNG

REFORMATS


THICK/INCR.

STD THN

1.25 q 1.25

ALGORITHM CHEST


COR 3 / SAG 3





PULMONARY VEIN


SMART PREP TF PV

SCAN TYPE FULL



PITCH 2.6

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV

mAs 23 CARE Dose4D

NOISE INDEX

DOSE REDUCTION



KERNEL

Br36 STD

Bv36

ADMIRE 3

THICK/INCR.

STD THN

1.5 q 1.0

KERNEL Bv36

ADMIRE 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG 3

3.0 q 3.0

KERNEL Br36

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Br36

ADMIRE 3


Estimated DLP

TAVR

TAVR REVISED: 5/1/20

IV SIZE 18g



PT POSITION SUPINE / FEET FIRST / ECG MONITOR

ATTACHED

LANDMARK GE




PARAMETER HEART C/A/P START ABOVE CARINA ABOVE APICES

END THROUGH HEART BELOW FEMORAL

BIFURCATION


PREP GROUP

GE MIROI + 12 SEC

SIEMENS SMART PREP @ CARINA (IN

DESCENDING AORTA)

INDICATION PRE TAVR

ORAL PREP NONE

SCAN 1. HEART 2. ARTERIAL PHASE CHEST/ABDOMEN/PELVIS

RECON

0.6mm AXIAL RECON – STANDARD ALGORITHM (HEART)

0.6mm AXIAL RECONS – STANDARD ALGORITHM 0-95% PHASES (HEART)

3.0mm AXIAL RECONS – STANDARD ALGORITHM (C/A/P)

1.5mm AXIAL RECONS – STANDARD ALGORITHM (C/A/P)

3.0mm AXIAL RECONS – LUNG ALGORITHM (C/A/P)

REFORMAT 3mm q 1.5mm MIP CORONAL AND SAGITTAL (C/A/P)

3D POST PROCESSING

VALVE MEASUREMENTS 3D ROTATION OF TAA/AAA CURVED REFORMATS AORTA/RT ILIAC/LT ILIAC THIN MIP DOUBLE OBLIQUE CELIAC/SMA/RENAL

ARTERIES/IMA ORIGINS ACCESS MEASUREMENTS

TAVR



SMART PREP GATED HEART TF TAVR

SCAN TYPE FULL



PITCH 0.15 3.0

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV – SEMI - 100 CARE kV


NOISE INDEX

DOSE REDUCTION

DFOV 20 20 <TO PATIENT>


KERNEL

Br36 STD Heart

Qr36 STD

Qr36

ADMIRE 2 3

THICK/INCR.

PHASES

0.6 q 0.5 STD THN

1.5 q 1.0

KERNEL Qr36 Qr36

ADMIRE 2 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Qr36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Qr36

ADMIRE 3

***IF PATIENT EXCEEDS 250LBS PLEASE USE XXL PROTOCOL ***


Estimated DLP

TAVR


SMART PREP

XXL GATED HEART

XXL TF TAVR

SCAN TYPE FULL



PITCH 0.18 1.2

SPEED


GANTRY TILT

SCAN FOV

kVp 100 CARE kV – SEMI - 120 CARE kV


NOISE INDEX

DOSE REDUCTION

DFOV 20 20 <TO PATIENT>


KERNEL

Br36 STD Heart

Qr36 STD

Qr36

ADMIRE 2 3

THICK/INCR.

PHASES

0.6 q 0.5 STD THN

1.5 q 1.0

KERNEL Qr36 Qr36

ADMIRE 2 3

THICK/INCR.

Lung

3.0 q 3.0

KERNEL Bl57

ADMIRE 3

THICK/INCR.

COR MIP

3.0 q 1.5

KERNEL Qr36

ADMIRE 3

THICK/INCR.

SAG MIP

3.0 q 1.5

KERNEL Qr36

ADMIRE 3


Estimated DLP

THORACIC OUTLET

THORACIC OUTLET REVISED: 5/1/20

PARAMETER SCAN START CARINA

END ABOVE SHOULDERS

DFOV <TO PATIENT> - INCLUDE ARMPITS

PREP GROUP

GE SMART PREP @ DESCENDING

AORTA

SIEMENS SMART PREP @ DESCENDING

AORTA

INDICATION THORACIC OUTLET SYNDROME

ORAL PREP NONE

SCAN ARTERIAL PHASE (ARMS UP) ARTERIAL PHASE (ARMS DOWN)

RECON




3D POST PROCESSING 3D ROTATION ARCH AND VESSELS SUBCLAVIAN CENTERLINE REFORMATS FOR EACH

ARM POSITION

IV SIZE 20g OR 18g








THORACIC OUTLET

64 SLICE – GE VCT

PARAMETER ARMS UP ARMS DOWN



THICKNESS 2.5 2.5

PITCH 0.984:1 0.984:1

SPEED 39.37 39.37

INTERVAL 2.5 2.5


kVp 100 100


SMART mA AUTO mA TO 600 W/ SMART mA



ASIR/MODE 50% / PLUS 50% / PLUS

ALGORITHM STD Arms UP

STANDARD STD Arms Down

STANDARD

REFORMATS

THICK/INCR.

STD THN Arms Up

1.25 q .700

STD THN Arms Down

1.25 q 0.700

ALGORITHM STD STD

REFORMATS

SAG MIP ARMS UP / COR MIP

ARMS UP / COR 3 Arms Up / SAG 3 Arms Up

SAG MIP ARMS DOWN / COR MIP

ARMS DOWN / COR 3 Arms Down / SAG 3

Arms Down

ASiR/MODE 50% / Plus 50% / Plus

THICK/INCR.

Lung Arms Up

3.75 q 3.75 Lung Arms Down

3.75 q 3.75

ALGORITHM Lung Lung

REFORMATS

ASiR/MODE 50% / Full 50% / Full

Estimated CTDI

Estimated DLP

THORACIC OUTLET


***SELECT THORACIC OUTLET ARMS UP PROTOCOL, SCAN AND THEN APPEND IN THE THORACIC

OUTLET ARMS UP PROTOCOL***

PARAMETER PREMONITORING TF ARMS UP PREMONITORING TF ARMS DOWN

SCAN TYPE FULL



PITCH 2.6 2.6

SPEED


GANTRY TILT

SCAN FOV

kVp CARE Kv – Semi - 120 100 CARE kV – Semi - 120

mAs CARE Dose4D 23 CARE Dose4D

NOISE INDEX

DOSE REDUCTION

DFOV 30 30 30 30

PREP GROUP SMART PREP 6 SEC SMART PREP

KERNEL

Br36 STD ARMS

UP

Bv40 Br36 STD ARMS DOWN

Bv40

ADMIRE 3

3

THICK/INCR.

STD THN

ARMS UP

1.5 q 1.0 STD THN

ARMS DOWN

1.5 q 1.0

KERNEL Bv40 Bv40

ADMIRE 3

3

THICK/INCR.

COR 3 ARMS

UP

3.0 q 3.0 COR 3 ARMS DOWN

3.0 q 3.0

KERNEL Br36 Br36

ADMIRE 3 3

THICK/INCR.

SAG 3 ARMS

UP

3.0 q 3.0 SAG 3 ARMS DOWN

3.0 q 3.0

KERNEL Br36 Br36

ADMIRE 3 3

THICK/INCR.

COR MIP

ARMS UP

3.0 q 1.5 COR MIP

ARMS DOWN

3.0 q 1.5

KERNEL Br36 Br36

ADMIRE 3

3

THICK/INCR.

SAG MIP

ARMS UP

3.0 q 1.5 SAG MIP

ARMS DOWN

3.0 q 1.5

KERNEL Br36 Br36

ADMIRE 3

3

THICK/INCR.

Lung Arms

Up

3.0 q 3.0 Lung Arms Down

3.0 q 3.0

KERNEL Bl57 Bl57

ADMIRE 3 3

THORACIC OUTLET


Estimated DLP

TRACHEOBRONCHOMALACIA

TRACHEOBRONCHOMALACIA REVISED: 5/1/20

IV SIZE

IV CONTRAST

INJECTION RATE

PT POSITION SUPINE / ARMS UP


SIEMENS N/A

BREATHING INSPIRATION / EXPIRATION / FREE

BREATHING***


PARAMETER INSPIRATION EXPIRATION DYNAMIC #1 DYNAMIC #2 DYNAMIC #3 START ABOVE APICES ABOVE APICES UPPER T0 MID

INTRATHORACIC TRACHEA

MID TO LOWER INTRATHORACIC

TRACHEA

JUST BELOW CARINA END

BELOW ADRENAL GLANDS

BELOW ADRENAL GLANDS

DFOV <TO PATIENT> <TO PATIENT> <TO PATIENT> <TO PATIENT> <TO PATIENT>

PREP GROUP

GE

SIEMENS

INDICATION TRACHEOBRONCHOMALACIA

ORAL PREP NONE

SCAN

1. INSPIRATORY – FULL COVERAGE 2. EXPIRATORY – FULL COVERAGE 3. DYNAMIC SERIES #1 4. DYNAMIC SERIES #2 5. DYNAMIC SERIES #3

RECON

3.75mm AXIAL RECON - STANDARD ALGORITHM (INSPIRATORY)

3.75mm AXIAL RECON - LUNG ALGORITHM (INSPIRATORY)

1.25mm AXIAL RECON - CHEST ALGORITHM (INSPIRATORY)

1.26 q 10mm AXIAL RECON - BONE ALGORITHM (INSPIRATORY)

2.5mm AXIAL RECON - STANDARD ALGORITHM (EXPIRATORY)

5.0mm AXIAL RECON - STANDARD ALGORITHM (EACH DYNAMIC SET)

REFORMAT 3MM SAGITTAL AND CORONAL (INSPIRATION)

3D POST PROCESSING NONE


*** FREE BREATHING: ASK PATIENT TO TAKE A BREATH IN, LET IT OUT, BREATH IN LET IT OUT (SLIGHTLY FASTER THAN INSTRUCTIONS FOR REGULAR CT) AND THEN BREATH IN AND OUT NORMALLY DURING THE SCAN

DYNAMIC #1: UPPER TO MID INTRATHORACIC TRACHEA. BETWEEN CLAVICLES AND AORTIC ARCH

DYNAMIC #2: MID TO LOWER INTRATHORACIC TRACHEA. JUST ABOVE CARINA


DYNAMIC #3: JUST BELOW CARINA


64 SLICE – GE VCT

PARAMETER INSPIRATION EXPIRATION DYNAMIC #1 DYNAMIC

#2 DYNAMIC

#3

SCAN TYPE HELICAL FULL HELICAL FULL AXIAL FULL AXIAL FULL AXIAL FULL

ROTATION TME 0.5 SEC 0.5 SEC 0.5 SEC 0.5 SEC 0.5 SEC

THICKNESS 3.75mm 2.5mm 5.0mm 5.0mm 5.0mm

PITCH 1.375:1 0.969:1

SPEED 27.50 19.37

INTERVAL 3.75mm 2.5mm 0.0mm 0.0mm 0.0mm

GANTRY TILT

SCAN FOV LARGE BODY LARGE BODY LARGE BODY LARGE BODY LARGE BODY

kVp 120 120 120 120 120

mA AUTO mA TO 440

W/ SMART mA AUTO mA TO 100

W/ SMART mA AUTO mA TO 100 W/

SMART mA

AUTO mA TO 100 W/ SMART

mA

AUTO mA TO 100 W/

SMART mA

NOISE INDEX 13.58 12.75 7.82 7.82 7.82

DOSE REDUCTION

30% 30% 30% 0% 0%

ASIR/MODE 0% / PLUS 0% / FULL 0% / FULL 0% / FULL 0% / FULL

ALGORITHM STD INSP

STD STD EXP

STD INSP Dynamic

1

STD INSP Dynamic

2

STD INSP Dynamic

2

STD

REFORMATS

THICK/INCR.

Lung INSP

3.75 q 3.75

ALGORITHM LUNG

REFORMATS

ASiR/MODE 0% / FULL

THICK/INCR.

STD THN INSP

1.25 q 0.700

ALGORITHM CHEST

REFORMATS

COR 3 INSP / SAG 3

INSP

ASiR/MODE 0% / PLUS

THICK/INCR.

Bone INSP

1.25 q 10

ALGORITHM BONE

REFORMATS

ASiR/MODE 0% / FULL





This study is not scanned on 196(2) Slice – Siemens Force

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