CT NECKSOFT TISSUE

INDICATIONS: Neck mass/lump, abscess, submandibular gland stone, vocal cord paralysis

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

IV CONTRAST: Perform as directed by the supervising radiologist.

With:80mL Isovue 370 – SPLIT DOSE PROTOCOL – SEE BELOW

WithOut:Possible additional Noncontrast scans for vocal cord paralysis. Check with radiologist.

ORAL CONTRAST: None

POSITIONING: Head First Supine, Arms by sides

TOPOGRAMS: AP. Range: Above superior orbits through aortic arch. 35 mA, 120 kV.

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

SCAN TYPE: Spiral/Helical. If necessary: Sequential Axials angled behind dental work.

NOTES: Mark site of mass/lump with MRI Marker/Vitamin E Capsule.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

SUBMANDIBULAR GLAND STONE: Do NOT need to perform a NonContrast scan for submandibular stone unless specifically requested.

VOCAL CORD PARALYSIS: Do NOT need to perform additional scans for vocal cord paralysis unless specifically requested. If requested perform additional Noncontrast

scans from Tip of Epiglottis through Cricoid during “Phonation E” and “BreathHold/Valsalva”. 1x1mm Axials with 1x1mm Coronal

reformats. Be sure to annotate these on I-Site.

SPLIT DOSE PROTOCOL

Inject 50mL Contrast at 1.0mL per second (Simultaneouslystart scan with delay of 90 seconds)

25 second Delay between Contrast Injections

Inject 30mL Contrast at 2.0mL per second

Scan Immediately after second contrast injection: 90 seconds Total Delay from start of injections

SOFT TISSUE NECK

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / 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 / Suspended
Inspiration / 90
Seconds / ON / 130 / 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 / B40s
Medium / Mediastinum
400/40 / 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 / 2.0 mm / 2.0 mm / B40s
Medium / Mediastinum
400/40 / 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 / 2.0 mm / 2.0 mm / B40s
Medium / Mediastinum
400/40 / FOV just beyond
patient’s neck

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SEQUENTIAL AXIALS ANGLED FOR DENTAL WORK

Scan
Range / Scan Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Effective
mAs / kV / Detector Configuration
Slices Per Acquisition / Table Feed
(mm) / Scan
Time
(Seconds) / Cycle
Time
(Seconds) / SFOV
(cm)
Top slice in Amalgam with
3 slices Caudally, Angled
Cephalic behind dental work. / Craniocaudal
Sequential / Quiet
Respiration / 30 Seconds
To allow
Gantry Tilt / OFF / 150 / 110 / Detectors: 16 x 1.2 mm
Slices Per Acquisition: 16 / 20.5 mm / Full
1.5
Seconds / 3.75
Seconds / 50
cm
Plane/
Gantry Tilt / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON / Axials Angled Cephalic
behind dental work / 2.4 mm / 2.4 mm / B40s
Medium / Mediastinum
450/50 / FOV just beyond
patient’s neck

VOCAL CORD PARALYSIS – PHONATION E

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Tip of Epiglottis
Through Cricoid / Craniocaudal
Spiral/Helical / Phonation E / 3
Seconds / ON / 130 / 110 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 16 / Pitch: 0.8
Table Increment/Speed: 7.68 mm/rotation / 0.6
Seconds / 50
cm
Plane / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / 1.0 mm / 1.0 mm / B40s
Medium / Mediastinum
400/40 / 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 / 1.0 mm / 1.0 mm / B40s
Medium / Mediastinum
400/40 / FOV just beyond
patient’s neck

VOCAL CORD PARALYSIS – BREATHHOLD/VALSALVA

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Tip of Epiglottis
Through Cricoid / Craniocaudal
Spiral/Helical / Suspended Inspiration/Valsalva / 6
Seconds / ON / 130 / 110 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 16 / Pitch: 0.8
Table Increment/Speed: 7.68 mm/rotation / 0.6
Seconds / 50
cm
Plane / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / 1.0 mm / 1.0 mm / B40s
Medium / Mediastinum
400/40 / 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 / 1.0 mm / 1.0 mm / B40s
Medium / Mediastinum
400/40 / 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.

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

XR29 Dose Notification Value (CTDIvol):60 mGy

NETWORK:Exam to PACS

6/2018Page 2 of 2