iCT Coronary CTA Workflow Version 3

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  • 8/6/2019 iCT Coronary CTA Workflow Version 3

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    2008 Koninklijke Philips Electronics N.V. All rights are reserved. Philips Medical Systems Nederland B.V. reserves the right to make changes in specifications

    and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.

    Printed in the USA. 453567525911 - Rev.3 des 11/2008

    iCT workflow for Coronary CTA

    Brilliance iCT v2.5

    This is an application guide for Brilliance iCT on version 2.5. For more detailed information, please refer tothe Philips operator or user guide.

    Patient Preparation

    Feet first scanning is recommended

    Position patient on couch, feet first supine (with cushion under knees)

    Ensure proper skin prep (see below)

    Place ECG electrodes on patient and connect ECG leads (see below)

    Hook patient up to the Patient Interface Module (PIM)

    Verify the ECG wave display on gantry (see below)

    Offset patient on the couch so the patients heart is in the middle of the field of view.

    Skin prep

    1. If body hair is present, shave the skin to ensure good electrode contract with the skin.2. Clean the contact site with alcohol to remove excess oils.3. Use ECG skin prep tape to abrade the skin and remove the outer layer of the dead skin

    cells.4. Use the wet-gel electrodes (not dry) for better skin contact.5. Connect the four leads to the electrodes.

    6. Make sure the electrodes are not in the field of view.7. Run the leads along the side of the patients body.8. Make sure the leads are straight and without loops.9. If necessary tape the electrodes to the leads for a better connection.

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    2Brilliance iCT v2.5

    453567525911 - Rev. 3 des 11/2008

    ECG Lead Placement

    International ElectrotechnicalCommission (IEC)Configuration

    Advancement of MedicalInstrumentation (AAMI)Configuration

    1. Have the patient assume the posture for the scan; raise the arms above the head.2. Connect the leads to the electrodes (best if done before placing on the chest)

    Verify the ECG Signal on the Gantry

    1. Ask the patient to simulate a breath hold with arms above their head.2. Observe the ECG signal during the breath hold.3. If a clear ECG signal does not display, make sure that the electrodes are properly

    connected.4. If ECG appears noisy or QRS tagging is incorrect, redo the skin prep and reposition

    electrodes.

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    3Brilliance iCT v2.5

    453567525911 - Rev. 3 des 11/2008

    Choose the correct protocol

    Heart rateRotation

    Time Pitch

    HR62 0.33 0.18

    62

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    4Brilliance iCT v2.5

    453567525911 - Rev. 3 des 11/2008

    8. Verify the Tracker scan parameters.9. Verify the Coronary CTA scan parameters.10. Use the contrast injection parameters per your sites requirements11. The default threshold for Bolus Tracking is 110 HU with a 7 8 second post

    threshold delay12. If desired, turn on Cardiac DoseRight under the Cardiac Tab13. If desired, define the coronaries and functional phases using the Edit phase

    option under the Cardiac tab14. Verify the patients heart rate on the ECG viewer15. If needed, adjust rotation time and pitch based on the patients heart rate under

    the advanced tab. See patient HR protocol table above.16. Perform the Locator scan17. Place the ROI in the descending Aorta, using the Auto ROI feature.

    18. Perform the Tracker scan19. Follow the on-screen instructions and perform and complete Coronary CTA scan

    with a short inspiration20. Adjust the images and edit the ECG as needed.

    1. Coronary

    Note: CTA start point is placed 1 to 2 cm above the first slice where a coronaryartery can be seen (slightly below the level of the carina). The end point is 1 to 2cm below the apex of the left ventricle.

    C

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