CT GUIDED SPINAL INJECTION PROCEDURES

PROCEDURE: Spinal steroid injection procedures performed by the Radiologist using CT guidance. Epidural steroid injections, nerve root blocks, facet

injections.

INDICATIONS: Back pain, radiculopathy

PATIENT PREP: None

IV CONTRAST: None

ORAL CONTRAST: None

POSITIONING: Feet First Prone, Arms above head, Pillow under abdomen to reduce lumbar lordosis.

TOPOGRAMS: Lateral. Range: Through the region of interest according to performing Radiologist guidance. 35 mA, 120 kV.

SCAN TYPE: Spiral/Helical

NOTES: Under Radiologist guidance perform a Control Scan at the level of interest. If necessary perform a short scan range with just a few slices above and

below the level of interest. Using sterile technique assist the Radiologist with equipment and patient preparation. Once the procedure has begun,

under guidance from the Radiologist perform short scan ranges through the region to check needle placement

ALARA – Keep radiation dose As Low As Reasonably Achievable.

CONTROL SCAN

Scan
Range / Scan Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / kV / Detector Configuration
Slices Per Tube Rotation / Table
Feed / Cycle
Time
(Seconds) / Scan
Time
(Seconds) / SFOV
(cm)
Single slice at
Level of Interest / Craniocaudal
Sequential / Suspended
Inspiration / 5
Seconds / ON / 50 / OFF / 120 / Detectors: 1 x 5.0 mm
Slices Per Tube Rotation: 1 / 0.0 mm / 1.5
Seconds / Full
1.0 Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL BONE
LEFT/RIGHT MIRRORING ON / Axial / 5.0 mm / 0.0 mm / B40s
Medium / Osteo
1500/450 / FOV include vertebral bodies, discs
And skin surface

SPINAL INJECTION PROCEDURES

Scan
Range / Scan Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Short Scan Range
Few Slices
Above And Below
Level of Interest / Craniocaudal
Spiral/Helical / Suspended
Inspiration / 5
Seconds / ON / 50 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 1.0
Seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL BONE
LEFT/RIGHT MIRRORING ON / Axial / ON
2 / 3.0 mm / 3.0 mm / I40s
Medium / Osteo
1500/450 / FOV include vertebral bodies, discs
And skin surface

*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:0.5 mGy – 60 mGy

XR29 Dose Notification Value (CTDIvol):60 mGy

NETWORK:Exam to PACS

12/2017