Chest CT Protocols Standard CTA/CTV Cardiac Chest With CTA Thoracic Aorta Gated CTA Thoracic Aorta Chest Without CTV Chest CTA Cardiac Chest Low Dose CTA Pulmonary Arteries CTA Coronary Lung Screening TAVR High Res Chest Calcium Scoring Chest & Neck Pulmonary Vein Tracheobronchomalacia Left Atrial Appendage - Lariat Protocol Left Atrial Appendage - Watchman Protocol
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Chest CT Protocols...landmark ge sternal notch siemens above ears breathing inspiration scouts ap and lateral (arms down) parameter chest neck start above apices top of ear end below
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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 2.5
PITCH 1.375:1 1.375:1
SPEED 27.50 27.50
INTERVAL 3.75 2.5
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 14.56
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.
STD THN Neck
1.25 q 0.700
ALGORITHM DETAIL
REFORMATS COR 2 / SAG 2
ASiR/MODE 30% / PLUS
Estimated CTDI 28.10
Estimated DLP 850.80
CHEST & NECK
64 SLICE – GE VCT
PARAMETER GROUP 1 CHEST) GROUP 2 (NECK)
SCAN TYPE HELICAL FULL HELICAL FULL
ROTATION TIME 0.5 SEC 0.5 SEC
THICKNESS 3.75 2.5
PITCH 0.984:1 0.984:1
SPEED 39.37 39.37
INTERVAL 3.75 2.5
GANTRY TILT SCAN FOV LARGE BODY LARGE BODY
kVp 120 120
mA AUTO mA TO 440 W/
SMART mA AUTO mA TO 440 W/ SMART
mA
NOISE INDEX 13.88 13.20
DOSE REDUCTION 40% 30%
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
0.625 q 0.625
ALGORITHM STANDARD
REFORMATS COR 3 / SAG 3
ASiR/MODE 40% / PLUS-E
THICK/INCR.
STD THN Neck
0.625 q 0.625
ALGORITHM DETAIL
REFORMATS COR 2 / SAG 2
ASiR/MODE 30% / PLUS-E
THICK/INCR.
STD 2
1.25 q 0.700
ALGORITHM STANDARD
REFORMATS
ASiR/MODE 40% / PLUS
Estimated CTDI 34.94
Estimated DLP 890.38
CHEST & NECK
196(2) – SIEMENS FORCE
PARAMETER TF CHEST DE NECK
SCAN TYPE
ROTATION TIME 0.28 SEC 0.25 SEC
THICKNESS 3.0mm 2.0mm
PITCH 2.0 0.7
SPEED
INTERVAL 3.0mm 2.0mm
GANTRY TILT
SCAN FOV
kVp CARE kV – ON 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: 8/24/18
IV SIZE
IV CONTRAST
INJECTION RATE
PT POSITION SUPINE / FEET FIRST
LANDMARK GE STERNAL NOTCH
SIEMENS ABOVE SHOULDERS
BREATHING INSPIRATION
SCOUTS AP AND LATERAL
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
1.25mm / 1.5mm AXIAL RECON – STANDARD 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
ROTATION TIME 0.5 SEC
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
REFORMATS COR 3 / SAG 3
ASiR/MODE 0% / PLUS
Estimated CTDI 3.40
Estimated DLP 105.50
CHEST LOW DOSE
64 SLICE – GE VCT
PARAMETER SCAN
SCAN TYPE HELICAL FULL
ROTATION TIME 0.5 SEC
THICKNESS 2.5
PITCH 0.984:1
SPEED 39.37
INTERVAL 2.5
GANTRY TILT SCAN FOV LARGE BODY
kVp 120
mA AUTO mA TO 100 W/
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
REFORMATS COR 3 / SAG 3
ASiR/MODE 0% / PLUS
Estimated CTDI 3.07
Estimated DLP 91.25
CHEST LOW DOSE
196(2) – SIEMENS FORCE
PARAMETER CHEST LOW DOSE
NO TF
SCAN TYPE
ROTATION TIME 0.5 SEC
THICKNESS 3.0mm
PITCH 1.2
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
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 1.14
Estimated DLP
CHEST WITH
CHEST WITH REVISED: 8/24/18
IV SIZE
IV CONTRAST 60cc OMNIPAQUE 350
INJECTION RATE
PT POSITION SUPINE / FEET FIRST
LANDMARK GE STERNAL NOTCH
SIEMENS ABOVE SHOULDERS
BREATHING INSPIRATION
SCOUTS AP AND LATERAL
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
3.0mm / 3.75mm AXIAL RECON – STANDARD ALGORITHM
3.0mm / 3.75mm AXIAL RECON – LUNG ALGORITHM
1.25mm /1.5mm AXIAL RECON – STANDARD ALGORITHM
REFORMAT 3mm CORONAL AND SAGITTAL
3D POST PROCESSING
CHEST WITH
16 SLICE – GE
PARAMETER SCAN
SCAN TYPE HELICAL FULL
ROTATION TIME 0.5 SEC
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 ASiR/MODE 40% / PLUS
ALGORITHM STD
STANDARD
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
ASiR/MODE 40% / PLUS
Estimated CTDI 10.76
Estimated DLP 338.05
CHEST WITH
64 SLICE – GE VCT
PARAMETER SCAN
SCAN TYPE HELICAL FULL
ROTATION TIME 0.5 SEC
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%
ASIR/MODE 40% / PLUS
ALGORITHM STD
STANDARD
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
ASiR/MODE 40% / PLUS
Estimated CTDI 7.15
Estimated DLP 246.44
CHEST WITH
196(2) – SIEMENS FORCE
PARAMETER TF CHEST WITH
SCAN TYPE
ROTATION TIME 0.28 SEC
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
ROTATION TIME 0.25 SEC
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: 8/24/18
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 ABOVE APICES
END BELOW ADRENAL GLANDS
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
3.0mm / 3.75mm AXIAL RECON – STANDARD ALGORITHM
3.0mm / 3.75mm AXIAL RECON – LUNG ALGORITHM
1.25mm /1.5mm AXIAL RECON – STANDARD ALGORITHM
REFORMAT 3mm CORONAL AND SAGITTAL
3D POST PROCESSING
CHEST WITHOUT
16 SLICE – GE
PARAMETER SCAN
SCAN TYPE HELICAL FULL
ROTATION TIME 0.5 SEC
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 ASiR/MODE 40% / PLUS
ALGORITHM STD WO
STANDARD
REFORMATS
THICK/INCR.
Lung
3.75 q 3.75
ALGORITHM LUNG
REFORMATS
ASiR/MODE 40% / FULL
THICK/INCR.
STD THN WO
1.25 q 0.700
ALGORITHM STANDARD
REFORMATS COR 3 WO / SAG 3 WO
ASiR/MODE 40% / PLUS
Estimated CTDI 10.76
Estimated DLP 338.05
CHEST WITHOUT
64 SLICE – GE VCT
PARAMETER SCAN
SCAN TYPE HELICAL FULL
ROTATION TIME 0.5 SEC
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%
ASIR/MODE 40% / PLUS
ALGORITHM STD WO
STANDARD
REFORMATS
THICK/INCR.
Lung
3.75 q 3.75
ALGORITHM LUNG
REFORMATS
ASiR/MODE 40% / FULL
THICK/INCR.
STD THN WO
1.25 q 0.700
ALGORITHM STANDARD
REFORMATS COR 3 WO / SAG 3 WO
ASiR/MODE 40% / PLUS
Estimated CTDI 7.15
Estimated DLP 246.44
CHEST WITHOUT
PARAMETER TF CHEST WO
SCAN TYPE
ROTATION TIME 0.28 SEC
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
CTA CARDIAC
CTA CARDIAC REVISED: 8/24/18
IV SIZE 18g
IV CONTRAST WEIGHT BASED
INJECTION RATE 5cc/SEC
PT POSITION SUPINE / FEET FIRST
LANDMARK GE STERNAL NOTCH
SIEMENS ABOVE SHOULDERS
BREATHING INSPIRATION
SCOUTS AP AND LATERAL
PARAMETER CTA START CARINA
END BELOW HEART
DFOV
PREP GROUP
GE MIROI + 14
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 0.625mm / 3.0mm STANDARD ALGORITHM
0.6mm / 0.625mm STANDARD ALGORITHM (0-95% PHASES)
REFORMAT
3D POST PROCESSING LV VOLUME RV VOLUME
CTA CARDIAC
16 SLICE – GE
This study is not scanned on the 16 Slice - GE scanner
CTA CARDIAC
64 SLICE – GE VCT
PARAMETER MIROI **CTA (SNAPSHOT SEGMENT LARGE)
SCAN TYPE AXIAL FULL CARDIAC SEGMENT
ROTATION TIME 0.5 SEC 0.35 SEC
THICKNESS 5.0 0.625
PITCH 0.16:1
SPEED 6.40
INTERVAL 0.0 0.625
GANTRY TILT SCAN FOV SMALL BODY CARDIAC LARGE
kVp 120 100
mA 150 ECG MODULATED TO
770
NOISE INDEX DOSE REDUCTION 40% 10%
ASIR/MODE 40% / FULL 30% / SNAPSHOT
SEGMENT
ALGORITHM MIROI
STANDARD STD
STANDARD
REFORMATS
***PREP GROUP: (MIROI): Start breathing instructions (they take 20.6 seconds). Watch the scanner and start the injection with there is 5 seconds left before the scan. Pause the scan after the peak in the aorta. Place MIROI in the ascending aorta.
SCAN PITCH: Check chart and compare heart rate. Adjust pitch if necessary. To override heart rate turn override heart rate button to on, and click accept.
RETRO RECONS:
- Start Phase 5% - End Phase 95% - Increment of 10
GANTRY TILT SCAN FOV LARGE BODY SMALL BODY CARDIAC LARGE
kVp 120 120 100
mA 430 150 ECG MODULATED TO
770
NOISE INDEX DOSE REDUCTION 40% 40% 10%
ASIR/MODE 30% / SEGMENT 40% / FULL 30% / SNAPSHOT
SEGMENT
ALGORITHM CASC
STANDARD MIROI
STANDARD STD
STANDARD
REFORMATS
*NON-CONTRAST: Choose Smart Score – Gate 0.35 sec on protocol list under chest.
**SNAPSHOT SEGMENT LARGE: Protocol is found under the chest
***PREP GROUP: (MIROI): Start breathing instructions (they take 20.6 seconds). Watch the scanner and start the injection with there is 5 seconds left before the scan. Pause the scan after the peak in the aorta. Place MIROI in the ascending aorta.
SCAN PITCH: Check chart and compare heart rate. Adjust pitch if necessary. To override heart rate turn override heart rate button to on, and click accept.
RETRO RECONS:
o Start Phase 40% o End Phase 85% o Increment of 5
**** Send ECG strip to PACS****
Estimated CTDI 92.81
Estimated DLP 898.21
CTA CORONARY
196(2) – SIEMENS FORCE
PARAMETER CASC TEST BOLUS PROSPECTIVE RETROSPECTIVE
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
TRACHEOBRONCHOMALACIA
*** 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