CT NECK/CHEST/ABDOMEN/PELVIS

INDICATIONS: Cancer restaging

PATIENT PREP: NPO for solid foods, water only, for 4 hours prior to scan

IV CONTRAST: Perform as directed by the supervising radiologist.

With: 100mL Isovue 370 @ 2.0 mL/second

WithOut: None

ORAL CONTRAST: Perform as directed by the supervising radiologist.

Routine: 32 oz Water 30 Minutes Prior to Scan, and 12 oz Water Immediately Prior to Scan.

POSITIONING: Head First Supine. Arms above head for Chest/Abd/Pelvis scan, then arms by sides for the Neck scan

TOPOGRAMS: AP. Range: Above superior orbits through ischial tuberosities. 35 mA, 120 kV.

Lateral Neck. Range: Above superior orbits through aortic arch. 35 mA, 120 kV.

SCAN TYPE: Spiral/Helical

NOTES: Chest/Abdomen/Pelvis scan performed in a single acquisition.

Mark with MRI Marker/Vitamin E Capsule at any site of mass/lump.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

CHEST/ABDOMEN/PELVIS – ARMS OVERHEAD

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)
Above Lung Apices through
Ischial Tuberosities / Craniocaudal
Spiral/Helical / Suspended
Inspiration / Adjust to Scan Liver
At 70 Seconds
(Approximately 61-63 Second Scan Delay) / ON / 120 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 0.5
Seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – AXIAL LUNG / Axial / ON
2 / 3.0 mm / 3.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – AXIAL MIPS
Axial MIPS Through Chest / Axial MIPS
Recon Card 3D Axial MIP Thin / ON
2 / 10.0 mm / 2.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
HAVE PATIENT LOWER ARMS BY SIDES
15 Second Delay

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SOFT TISSUE NECK – ARMS BY SIDES

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)
Superior Orbit to
Below Aortic Arch. / Craniocaudal
Spiral/Helical / Don’t
Swallow / 15 Seconds
(Adjust in order to scan Neck at 90 seconds) / ON / 116 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 0.5
Seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
2 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon card 3D Coronal MPR / ON
3 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck

*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.

Torso Allowed CTDIvol Dose Ranges: 3 mGy – 50 mGy.

Torso XR29 Dose Notification Value (CTDIvol): 50 mGy.

Neck Allowed CTDIvol Dose Ranges: 4 mGy – 60 mGy, 32 cm CTDI Phantom

Neck XR29 Dose Notification Value (CTDIvol): 60 mGy.

Approximate Values for CTDIvol (Single Acq.) - TORSO
Patient Size / Weight (kg) / Weight (lbs) / CTDIvol (mGy)
Small / 50-70 / 110-155 / 7-16
Average / 70-90 / 155-200 / 11-24
Large / 90-120 / 200-265 / 14-34

Reference: AAPM

*The AAPM recommended NEMA XR29 Dose Notification Value for an adult torso is 50 mGy. Dose notification levels less than the AAPM recommended can be set. The maximum CTDIvol should match the dose notification value. Exams with CTDIvol values less than the minimum allowed range should not be performed unless approved by a radiologist.

NETWORK: Separate Neck and Chest/Abdomen/Pelvis Exams before sending to PACS

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