CT CHEST LOW DOSE – LUNG CANCER SCREENING - CANYON PARK

CRITERIA: 1. Age 55-79

2. >29 pack-years of smoking

3. Currently smoking or quit within 15 years

4. Stop screening when quit 15 years

5. No co-morbidities that would significantly limit life expectancy

6. Willing and able to have curative surgery

PATIENT PREP: No Prep

IV CONTRAST: None

ORAL CONTRAST: None

POSITIONING: Feet First Supine, Arms above head.

TOPOGRAMS: AP. Range: Above lung apices through lung bases/costophrenic angles. 25 mA, 110 kV

Lateral: Range: Above lung apices through lung bases/costophrenic angles. 25 mA, 110 kV

SCAN TYPE: Spiral/Helical

SCAN RANGE: Above Lung Apices through Lung Bases/Costophrenic Angles (CPA)

DISPLAY FIELD OF VIEW: DFOV: 1cm beyond the rib cage. Does not need to include entire chest wall thickness.

NOTES: ALARA – Keep radiation dose As Low As Reasonably Achievable.

Packs Per Day X Number of Years Smoking = Pack-Years

CARE DOSE OFF

kV: 110

Adjust mAs According to BMI

BMI <30: 25 mAs

BMI 30-34.9: 30 mAs

BMI >35: 40 mAs

BMI Calculator Website: www.nhlbisupport.com/bmi/

CHEST LOW DOSE – LUNG CANCER SCREENING

Scan
Range / Scan Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / mAs / kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
-Above Lung Apices Thru Bases/CPA / Craniocaudal
Spiral/Helical / Suspended
Inspiration / 6
Seconds / OFF / BMI <30: 25 mAs
BMI 30-34.9: 30 mAs
BMI >35: 40 mAs / 110 / Detectors: 16 x 1.2 mm
Slices Per Tube Rotation: 16 / Pitch: 0.8
Table Increment/Speed: 15.36mm/rotation / 0.6
Seconds / 50
cm
Plane / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / 2.0 mm / 2.0 mm / B35s
HeartView Medium / Mediastinum
400/40 / 1cm beyond
rib cage
RECON – AXIAL LUNG / Axial / 2.0 mm / 2.0 mm / B70s
Sharp / Lung
1200/-600 / 1cm beyond
rib cage
RECON – AXIAL MIPS
Axial MIPS / Axial MIPS
Recon Card 3D Axial MIP Thin / 10.0 mm / 2.0 mm / B70s
Sharp / Lung
1200/-600 / 1cm beyond
rib cage
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / 2.0 mm / 2.0 mm / B35s
HeartView Medium / Mediastinum
400/40 / 1cm beyond
rib cage
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / 2.0 mm / 2.0 mm / B35s
HeartView Medium / Mediastinum
400/40 / 1cm beyond
rib cage

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*The operator must check the CTDIvol before and after the scan to ensure it is within the allowed dose range. Scans performed outside of the allowed range must be

documented and reviewed by the designated radiologist and/or physicist.

Allowed CTDIvol Dose Ranges: 0.25 mGy – 8 mGy

XR29 Dose Notification Value (CTDIvol): 8 mGy

Approximate Values for CTDIvol
Patient Size / Weight (kg) / Weight (lbs) / CTDIvol (mGy)
Small / 50-70 / 110-155 / 0.25-2.8
Average / 70-90 / 155-200 / 0.5-4.3
Large / 90-120 / 200-265 / 1.0-5.6
Reference: AAPM

Allowed CTDIvol Dose Ranges: 0.25 mGy – 8 mGy

XR29 Dose Notification Value (CTDIvol): 8 mGy

The allowed CTDIvol is for a *standard size patient. Individual patients may have higher or lower values to reflect adjustment for patient size.

*The ACR Reference Dose for a "standard size patient" (by definition, is approximately 5' 7" and 155 lbs or 170 cm and 70kg, with a BMI of about 24) is a CTDIvol of less than 3 mGy.

**There is no AAPM recommended NEMA XR29 Dose Notification Value for lung screening scans. In general, lung screening exams should not have a CTDIvol greater than 7 mGy. Exams with CTDIvol values less than the minimum allowed range should not be performed unless approved by a radiologist.

NETWORK: Exam to PACS

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