neuroradiology ct protocols
TRANSCRIPT
1 Revised 7/22/09 (Gentry/Ranallo)
___________________ / ________________
_______________ / ______________ _____ Pediatric Brain
_________________________ _____ Pediatric Trauma (< 6 y/o) _____ add 3D CT
_________________________ _____ Adult Brain
________________ / ____________ _____ Pituitary & Cavernous Sinus
______________________________ _____ Stealth (Whole Brain Treatment Planning)
_____ Without _____ Without and Check _____ Face and Mandible (No 3D)
_____ With _____ With and Without _____ Face and Mandible (With 3D)
_____ Orbit Only (use only for blowout Fxs)
_____ Adult _____ (craniosynostosis, congenital facial anomaly)
_____ Pediatric (< 6 Y/O)
_____ Post-Myelogram
_____ Haughton Rotational _____ Pediatric Diagnostic ( < 6 y/o)
_____ Stealth: Stealth Levels ____________ _____ Adult Diagnostic
_____ Follow-up Adult ENT Sinus
___ Cervical ___ Thoracic ___ Lumbar ___ Sacral Stealth (Landmarks) Only (No Longer Done per Dr Gentry)
(non-traumatic)
_____ (Acute Stroke Workup) _____ Routine
Includes: CTA head/neck/arch, CT perfusion, CT head w/o & w/ _____ Vascular Mass or CC-Fistula
_____ (Stenosis, Trauma, Unknown Bleed) _____ With Valsalva
Includes: CTA head/neck/arch, CT perfusion, CT head w/o & w/ _____ Dynamic Multipositional
_____ (Cerebrovascular Disease, Unknown Bleed)
___ With Perfusion ___ Without Perfusion (adult or peds)Includes: CTA head, CT head w/o & w/, +/- perfusion ____ W/O ____ W/ ____ Both ____ Vascular Mass
_____ (Cerebrovascular Disease)
Includes: CTA neck and arch
_____ _____ Head _____ Head & Neck _____ Routine
Includes: CTV head +/- neck, CT head w/o & w/ _____ Salivary Gland Calculi (W/O & W/)
_____ (Nontraumatic SAH, Known Aneurysm) _____ Vascular Mass
Includes: CTA head, CT head w/o & w/, no perfusion _____ Parathyroid Adenoma
_____ _____ Brachial Plexus
CTA: _____ Head _____ Neck & Arch _____
Perfusion: _____ Yes _____ No _____ Puffed Cheek _____ Valsalva
_____ Vocalization _____ Perfusion CT
_____ Acute Stroke:
_____ Carotid Stenosis:
_____ Posterior Fossa: (Vertebrobasilar Insufficiency)
CT Protocols: (Brain, ENT, Spine, Vascular)
Name / MRN: Brain:DOB: Date of Scan:
Protocoled By: Dr.Monitored By: Dr.CT Tech Name & #:CT Scanner:
Contrast: Facial Trauma:
Spine: 3D CT
Sinuses:
Spine Levels - Coverage
Vascular Imaging: (CT/CTA/Perfusion) Orbit: Stroke Deluxe:
Total Cerebrovascular:
CTA Head Only:
Temporal Bone:
CTA Neck Only:
Neck – Nasopharynx – Larynx:CT Venography:
Aneurysm (Hi-Res COW):
Ala Carte Studies:
Add on Neck Options
CT Perfusion (Levels – Coverage)
Other Protocol:
2 Revised 7/22/09 (Gentry/Ranallo)
Table of Contents:Page # Protocol Exam
5 1.1 Adult Head – Routine Helical
8 1.2 Adult Head – Helical Scan with Angled Axial Reformations
11 1.3 Adult Head – Axial
13 11.1 & 11.2 Pediatric Head – Routine Helical
17 11.3 & 11.4 Pediatric Head – Helical Scan with Angled Axial Reformations
21 11.5 & 11.6 Pediatric Head – Axial
24 11.7 & 11.8 Pediatric Head – Trauma
27 2.1 Orbit – Routine
33 2.2 Orbit – With and Without Valsalva
34 2.3 Orbit – Vascular Mass or Carotid-Cavernous Fistula
36 2.4 Orbit – Dynamic – EOM Movements
27 12.1 &12.2 Pediatric Orbit – Routine
33 12.3 & 12.4 Pediatric Orbit – With and Without Valsalva
34 12.5 & 12.6 Pediatric Orbit – Vascular Mass or Carotid-Cavernous Fistula
36 12.7 & 12.8 Pediatric Orbit – Dynamic – EOM Movements
37 2.5a Maxillofacial Trauma – Routine
43 2.5b Maxillofacial Trauma – Routine plus 3D
37 12.9 & 12.10 Pediatric Maxillofacial Trauma – Routine
43 12.9 & 12.10 Pediatric Maxillofacial Trauma – Routine plus 3D
44 1.5 3D CT – Craniosynostosis, Congenital Facial Anomaly
44 11.9 & 11.10 Pediatric 3D CT – Craniosynostosis, Congenital Facial Anomaly
48 2.6 Pituitary Gland and Cavernous Sinus
48 12.11 & 12.12 Pediatric Pituitary Gland and Cavernous Sinus
52 1.10 Stealth – Stereotactic Head (Whole Brain Treatment Planning)
52 11.11 & 11.12 Pediatric Stealth – Stereotactic Head (Whole Brain Treatment Planning)
53 2.7 Sinuses – Diagnostic
53 12.13 & 12.14 Pediatric Sinuses – Diagnostic
59 2.8 Sinuses – Follow-up Adult ENT Sinus
61 2.9 Sinuses – Conbined Diagnostic and Landmark
61 12.16 & 12.17 Pediatric Sinuses – Conbined Diagnostic and Landmark
62 2.10 Temporal Bone and Posterior Fossa (W/O Contrast)
62 12.18 & 12.19 Pediatric Temporal Bone and Posterior Fossa (W/O Contrast)
66 2.11 Temporal Bone and Posterior Fossa (W/O and W Contrast)
66 12.20 & 12.21 Pediatric Temporal Bone and Posterior Fossa (W/O and W Contrast)
70 2.12 Temporal Bone – Vascular Mass
70 12.22 & 12.23 Pediatric Temporal Bone – Vascular Mass
75 3.1 Neck – Routine
75 3.2 Neck – Feet First
81 3.1 Neck – Salivary Gland
82 3.3 Neck – Vascular Mass
3 Revised 7/22/09 (Gentry/Ranallo)
Table of Contents (continued):Page # Protocol Exam
84 3.5 Neck – Add on Options
86 3.4 Neck – Parathyroid Adenoma
75 13.1 Pediatric Neck – Routine
75 13.2 Pediatric Neck – Feet First
81 13.1 Pediatric Neck – Salivary Gland
82 13.3 Pediatric Neck – Vascular Mass
86 3.4 Pediatric Neck – Parathyroid Adenoma
84 13.5 Pediatric Neck – Add on Options
90 3.1 Brachial Plexus – Adult
90 13.1 Brachial Plexus –Pediatric
91 3.5 Cervical Spine – Adult
93 7.5 Thoracic Spine – Feet First – Adult
94 7.6 Thoracic Spine – Head First – Adult
95 7.1 Lumbar Spine – Feet First – Adult
97 13.5 Cervical Spine – Pediatric
100 17.5 Thoracic Spine – Pediatric
103 17.1 Lumbar Spine – Pediatric
106 7.2 Stealth (Stereotactic) Spine
107 1.6 & 3.7 Vascular Imaging: Stroke Deluxe (Acute Stroke Workup)
111 1.6a Vascular Imaging: Total Cerebrovascular
112 1.7 Vascular Imaging: CTA Head Only (Stenosis, Unknown Bleed)
116 1.8 Vascular Imaging: Aneurysm (Hi-Res COW) (Non-traumatic SAH, Known Aneurysm)
120 3.8 Vascular Imaging: CTA Neck Only (Cerebrovascular Disease)
124 1.9 & 3.9 Vascular Imaging: CT Venography
107 11.16 & 11.17 Pediatric Vascular Imaging: Stroke Deluxe (Acute Stroke Workup)
111 11.16 & 11.17 Pediatric Vascular Imaging: Total Cerebrovascular
112 11.18 & 11.19 Pediatric Vascular Imaging: CTA Head Only (Stenosis, Unknown Bleed)
116 11.20 & 11.21 Pediatric Vascular Imaging: Aneurysm(Hi-Res COW)(Non-trauma SAH, Known Aneurysm)
120 11.22 & 11.23 Pediatric Vascular Imaging: CTA Neck Only (Cerebrovascular Disease)
124 11.24 & 11.25 Pediatric Vascular Imaging: CT Venography
128 Appendix #1 CTA Head: 2D Thin and Thick Slab Reformations
129 Appendix #2: CTA Neck: 2D-Reformations
130 Appendix #3: CT Perfusion Protocol
131 Appendix #4: CT Perfusion Coverage
132 Appendix #5: CT Perfusion Analysis Instructions
138 Appendix #6: Neck CT Contrast Timing for Routine Neck CT
139 Appendix #7: 64 Slice Scanner Prioity
140 Appendix #8: CT Scanner Type
141 Appendix #9: CT Scanner Limits
142 Appendix #10: Direction and Naming of 2D-Reformations
143 Appendix: #11 Combined Neuro and Body Contrast Studies
4 Revised 7/22/09 (Gentry/Ranallo)
CTI – 1 16 800 Lightspeed Xtra
CTI – 2 4 440 LightSpeed 16
CTI – 3 16 800 LightSpeed 16 Pro
CTI - 4 64 800 LightSpeed VCT 64
ER 64 800 LightSpeed VCT 64
CT-RP 8 440 LightSpeed 8
East 8 440 LightSpeed 8
Scanner Nomenclature:
Scanner -Location
# of Slices
Maximum mA at 120 kV
Scanner Name Naming Convention in this Protocol Book
LS Xtra
LS 16
LS 16 Pro
LS VCT 64
LS VCT 64
LS 8
LS 8
5 Revised 7/22/09 (Gentry/Ranallo)
Adult Head: Routine (Helical Mode) (Protocol # 1.1)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Supine, AP and lateral scouts, no gantry angle 2. Helical mode should be used routinely for adult head CT scans. Only use axial mode
when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck).
3. Patient Positioning: Tilt the patients head so that a line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). Use axial mode and angle the gantry if you cannot place the patient’s head within 15 degrees of the proper setup angle.
4. Start scans at the bottom of C1 and scan through the top of the head
DFOV: Preferred 20 cm (Range 18-22)
Contrast: 1. 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes)2. Begin scanning as soon as contrast injection is finished
Other Info:
6 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.6 0.4 0.4 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 200-660 130-440 200-660 190-620 130-440
Noise Index 2.8 2.8 2.8 2.8 2.8
(Manual mA) 530 350 530 500 340:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full Full
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Head: HelicalAdult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
7 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 230-750 130-420 230-750 210-700 130-420
Noise Index 3.3 3.3 3.3 3.3 3.3
(Manual mA) 620 330 600 570 340:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 90/30 90/30 90/30 90/30 90/30
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Full Full Full Full Full
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Head: HelicalAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
8 Revised 7/22/09 (Gentry/Ranallo)
Adult Head: Helical Scan with Angled Axial Reformations (Protocol # 1.2)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Use this protocol when the head cannot be properly positioned for a routine helical head scan. Example: when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck).
2. Supine, AP and lateral scouts, no gantry angle 3. Start the scans at C2 and scan through the top of the head4. Do not send the source images to PACS (Only send the 2D-reformations)5. Obtain 2D-reformations parallel to a line connecting the infraorbital rim with the
opisthion (see below). Use a sagittal view on Imageworks slightly off midline to choose proper angle of reconstruction. Start reformations at the bottom of C1 and go to the top of the head using a 20 cm DFOV.
6. Important: Be certain that dental filling artifact does not extend across the brain on the helical raw data. If it does, then use the axial mode head protocol instead.
DFOV: Preferred 20 cm (Range 18-22)
Contrast: 1. 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes)2. Begin scanning as soon as contrast injection is finished
Other Info: 1. 2D-Reformations
a. Axial Soft Tissue: 5 mm thick with an interval of 2.5 mm
b. Axial Bone: 2.5 mm thick with an interval of 1.25 mm
9 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.65 0.65 0.65 0.65 0.65
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 170-550 130-440 160-530 150-500 130-440
Noise Index 5.6 5.6 5.6 5.6 5.6
(Manual mA) 440 350 420 400 340:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Head: Helical Scan with Angled Axial Reformations - Adult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
10 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.65 0.65 0.65 0.65 0.65
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 240-750 130-420 230-750 210-700 130-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 630 330 600 570 340:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 90/30 90/30 90/30 90/30 90/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Head: Helical Scan with Angled Axial Reformations - Adult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
11 Revised 7/22/09 (Gentry/Ranallo)
Adult Head: (Axial Mode) (Protocol # 1.3)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Supine, AP and lateral scouts2. Helical mode should be used routinely `for adult head CT scans. Only use axial
mode when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck). This mode can also be used in unstable patients in the emergency department when the CT scan time must be expedited.
3. Patient Positioning: Using the lateral scout image, angle the gantry so that it is parallel to a line connecting the infraorbital rim with the opisthion (see below).
4. Start scans at the bottom of C1 and scan through the top of the head
DFOV: Preferred 20 cm (Range 18-22)
Contrast: 1. 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes)2. Begin scanning as soon as contrast injection is finished
Other Info:
12 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.7 0.9 0.6 0.6 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
2i 2i 2i 2i 2i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
mA 670 420 630 630 420:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 1.0 0.9 0.8 0.8 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
2i 2i 2i 2i 2i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Scan FOV Head Head Head Head Head
kV 100 120 100 100 120
mA 670 400 670 670 400:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 90/30 90/30 90/30 90/30 90/30:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Head: AxialAdult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Head: AxialAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 1
Recon 2
13 Revised 7/22/09 (Gentry/Ranallo)
Pediatric Head: Routine (Helical Mode) (< 6 years of age)
(Protocol # 11.1 & 11.2)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Supine, AP and lateral scouts, no gantry angle 2. Helical mode should be used routinely for pediatric head CT scans. Only use axial
mode when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck).
3. Patient Positioning: Tilt the patients head so that a line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). Use axial mode and angle the gantry if you cannot place the patient’s head within 15 degrees of the proper setup angle.
4. Start scans at the bottom of C1 and scan through the top of the head
Preferred: Preferred 16 cm (Range 14-18 cm)
Contrast: 1. 1 ml / pound (2 ml/kg) of 240 non-ionic contrast @ 0.6 ml/sec2. Begin scanning as soon as contrast injection is finished
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Other Info:
14 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.6 0.4 0.4 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 170-680 110-400 170-680 160-640 110-420
Noise Index 2.6 2.6 2.6 2.6 2.6
(Manual mA) 510 340 510 480 330:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full Full
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Head: Helical Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
15 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 190-675 110-400 180-675 170-675 100-400
Noise Index 3.0 3.0 3.0 3.0 3.0
(Manual mA) 560 340 540 510 310:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full Full
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Head: Helical Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
16 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.7 0.4 0.4 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.5 1.5 1.5 1.5 1.5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-675 80-390 140-675 130-640 80-390
Noise Index 3.3 3.3 3.3 3.3 3.3
(Manual mA) 460 260 460 430 260:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Plus Plus:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full Full
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Head: Helical Pediatric Infant (0– 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
17 Revised 7/22/09 (Gentry/Ranallo)
Pediatric Head: Helical Scan with Angled Axial Reformations (< 6 years of age)
(Protocol # 11.3 & 11.4)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Use this protocol when the head cannot be properly positioned for a routine helical head scan. Example: when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck)
2. Supine, AP and lateral scouts, no gantry angle 3. Start the scans at C2 and scan through the top of the head4. Do not send the source data to PACS (Only send the 2D-reformations)5. Obtain 2D-reformations parallel to a line connecting the infraorbital rim with the
opisthion (see below). Start reformations at the bottom of C1 and go to the top of the head using a 20 cm DFOV.
6. Important: Be certain that dental filling artifact does not extend across the brain on the helical raw data. If it does, then use the axial mode head protocol instead.
DFOV: Preferred 16 cm (Range 14-18 cm)
Contrast: 1. 1 ml / pound (2 ml/kg) of 240 non-ionic contrast @ 0.6 ml/sec2. Begin scanning as soon as contrast injection is finished
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Other Info: 1. 2D-Reformationsa. Axial Soft Tissue: 5 mm thick with an interval of 2.5 mmb. Axial Bone: 2.5 mm with an interval of 1.25 mm
18 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 130-560 110-420 130-540 120-510 110-420
Noise Index 5.2 5.2 5.2 5.2 5.2
(Manual mA) 420 340 400 380 330:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Head: Helical Scan with Angled Axial Reformations - Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
19 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 190-675 110-400 180-675 170-675 100-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 560 340 540 510 310:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Head: Helical Scan with Angled Axial Reformations - Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
20 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 370 260 360 340 260:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Head: Helical Scan with Angled Axial Reformations - Pediatric Infant (0– 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
21 Revised 7/22/09 (Gentry/Ranallo)
Pediatric Head: (Axial Mode) (Less than 6 years of age) (Protocol # 11.5 & 11.6)
Billing: 1. CT Head without, or with, or without and with2. Contrast if used
Setup: 1. Supine, AP and lateral scouts 2. Helical mode should be used routinely for pediatric head CT scans. Only use axial
mode when you cannot move the patient’s head into proper position (trauma, cervical collar, rigid neck). This mode can also be used in unstable patients in the emergency department when the CT scan time must be expedited.
3. Patient Positioning: Using the lateral scout image, angle the gantry so that it is parallel to a line connecting the infraorbital rim with the opisthion (see below).
4. Start scans at the bottom of C1 and scan through the top of the head
DFOV: Preferred 16 cm (Range 14-18 cm)
Contrast: 1. 1 ml / pound (2 ml/kg) of 240 non-ionic contrast @ 0.6 ml/sec2. Begin scanning as soon as contrast injection is finished
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Other Info:
22 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.7 0.8 0.6 0.6 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
2i 2i 2i 2i 2i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
mA 640 420 600 600 420:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.9 0.8 0.8 0.8 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
2i 2i 2i 2i 2i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Scan FOV Head Head Head Small Head Head
kV 80 100 80 80 100
mA 670 420 600 600 420:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Head: Axial Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Head: Axial Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 1
Recon 2
23 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
2i 2i 2i 2i 2i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
mA 660 400 640 640 400:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Head: Axial Pediatric Infant (0– 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
24 Revised 7/22/09 (Gentry/Ranallo)
Pediatric Head: (Trauma) (< 6 y/o) (with or without 3D CT) (Protocol # 11.7 & 11.8)
Billing: 1. CT Head without2. 3D CT Head if done
Setup: 1. Patient Supine, AP and lateral scouts, no gantry angle3. Remove all metallic and high-density objects from the scanning area3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). 4. Start scans at the bottom of C1 and scan completely through the top of the head5. Must be done with helical mode.
DFOV: Preferred 16 cm (Range 14-18 cm)
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Contrast: 1. None
Other Info: 1. See Maxillofacial Trauma Protocol for more information on 3D reconstructions.2. 3D Exam: Please perform three 3600 rotations at 100 intervals as follows
a. From a right lateral view = rotate the head horizontally for 3600
b. From an AP view = rotate vertically for 3600
c. From a Water’s type view = rotate horizontally for 3600 (note: to get a Water’s type projection rotate the patient’s nose upward about 200)
3. Networking 3D images to ALI Store 4. Place the 3D request in the 3D slot on the wall in the E3/3 control room!
25 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.6 0.4 0.4 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 170-680 110-420 170-680 160-640 110-420
Noise Index 2.6 2.6 2.6 2.6 2.6
(Manual mA) 510 340 510 480 330:
DFOV 22 22 22 22 22
Recon Type Soft Soft Soft Soft Soft
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Head Trauma: Helical Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
26 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.7 0.4 0.4 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.5 1.5 1.5 1.5 1.5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-680 80-390 140-680 130-640 80-390
Noise Index 3.3 3.3 3.3 3.3 3.3
(Manual mA) 460 260 460 430 260:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Plus Plus Plus Plus Plus:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Head Trauma: Helical Pediatric Infant (0 – 3 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
27 Revised 7/22/09 (Gentry/Ranallo)
1. CT Orbit without, or with, or with and without2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle.2. Extend the scouts to include aortic arch for smart prep.3. Patient Positioning: Tilt the patients head so that a line connecting the lateral canthus
of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). You may need to put a foam pad under the occiput to get the head in this position.
4. Ask the patient to look straight ahead and hold their eyes in a very still position.5. Start the scans at the infraorbital rim and scan through the top of the orbit
Preferred 14 cm (Range 14-16 cm)
1. Adults: 75 ml of 240 mg/ml nonionic contrast media (use 150ml of 240mg/ml if a CT of the head will also be obtained)
2. Pediatrics: 1 ml / pound (2 ml/kg) of 240 non-ionic contrast media3. Injection Rate: Adults: 3 ml/sec; Pediatric: 2 ml/sec4. Smart prep over the cavernous sinus (adults) or aortic arch (peds). Begin scanning
10 seconds (adults) or 6 seconds (pediatric) after arrival of contrast.
Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and bilateral oblique sagittal planes as shown in the image below.
2. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 3)
3. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the 1.25 mm standard algorithm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images from the non-contrast series (Recon 3).
4. Do not send the 0.625 mm (Recon 3) bone images to PACS.
Orbit: (Routine) (Protocol – Adult: # 2.1 – Pediatric: # 12.1 & 12.2)
Billing:
Setup:
DFOV:
Contrast:
Patient Age:
Recons & Reformats:
not
28 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 160-550 130-440 160-530 150-500 130-440
Noise Index 5.6 5.6 5.6 5.6 5.6
(Manual mA) 440 350 420 400 340:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Orbit: RoutineAdult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
29 Revised 7/22/09 (Gentry/Ranallo)
Cavernous Sinus 80 10.0 2.0 50 12.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 240-750 120-420 230-750 210-700 130-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 620 330 600 570 340:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20 350/20
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Orbit: Routine Adult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
30 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 140-560 100-390 130-540 120-510 100-380
Noise Index 5.2 5.2 5.2 5.2 5.2
(Manual mA) 420 290 400 380 290:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Orbit: RoutinePediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
31 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.0 50 6.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 0.8 0.6 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-650 110-400 150-610 170-675 110-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 510 340 460 510 340:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Orbit: RoutinePediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
32 Revised 7/22/09 (Gentry/Ranallo)
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Aortic Arch 40 10.0 2.0 50 6.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390
Noise Index 5.1 5.1 5.1 5.1 5.1
(Manual mA) 370 260 360 340 260:
DFOV 15 15 15 15 15
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 15 15 15 15 15
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 15 15 15 15
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Smart Prep
Orbit: Routine Pediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
33 Revised 7/22/09 (Gentry/Ranallo)
1. CT Orbit with or with and without2. Contrast
1. Monitored Exam: ENT attending or fellow2. Patient Supine, AP and lateral scouts, no gantry angle3. Extend the scouts to include aortic arch for smart prep.4. Patient Positioning: Tilt the patients head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). You may need to put a foam pad under the occiput to get the head in this position.
5. Ask the patient to look straight ahead and hold their eyes in a very still position.6. Start the scans at the infraorbital rim and scan through the top of the orbit 7. Always done following either a routine orbit CT with contrast or a vascular mass
CT of the orbit with and without contrast
Part 1: Routine Orbit CT with contrast or Orbit Vascular Mass CT without and with contrast
Part 2: Valsalva Protocol (as below) - Use routine orbit scan factors- To be monitored by ENT attending or ENT fellow if possible- If there is any indication of increased intra-orbital or intra-ocular pressure, the
radiologist should 1st clear this procedure with the ordering ophthalmologist- First rehearse the maneuver with the patient- Ask the patient to take a deep breath and Valsalva for 15 seconds (do not do
CT scans at this point)- Have the patient take another deep breath, then - Do Valsalva maneuver again. - Begin 1.25 mm helical scans through entire orbit 5 seconds after the start of
the 2nd Valsalva maneuver- Acquire 1.25 mm helical images in axial plane using just the standard
algorithm (no bone algorithm)
Preferred 14 cm (Range 14-16 cm)
1. Do the routine 2D orbital reformations for Part 1.
2. Do additional 2 x 2 mm 2D-reformations (soft tissue only) from the post Valsalva images in Part 2 in the coronal and bilateral oblique sagittal planes as shown below.
Orbit: (With and Without Valsalva) (Protocol – Adult: # 2.2 – Pediatric: # 12.3 & 12.4)
Billing:
Setup Info:
Exam:
(but only Recon 1 – No bone images)
DFOV:
Reformats:
34 Revised 7/22/09 (Gentry/Ranallo)
1. CT Orbit (with and without)2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include aortic arch and superior vena cava for smart prep.3. Always do exam with and without contrast4. Patient Positioning: Tilt the patients head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). You may need to put a foam pad under the occiput to get the head in this position.
5. Ask the patient to look straight ahead and hold their eyes in a very still position.6. Start the scans at the infraorbital rim and scan through the top of the orbit
14 cm (14-16 cm)
Part 1: Routine Orbit CT without contrast- Standard algorithm (Recon 1) only (no bone algorithm images & no reformats)
Part 2: Dynamic CT scans through lesion (as described below and on next page) - Choose eight 2.5 mm slices through the mass for dynamic scans- Smart prep over the superior vena cava- To be monitored by ENT attending or ENT fellow if possible- Adults: Inject 100 ml of 240mg/ml at 3.5 ml per sec (Injection time = 28.5 sec)
(note: use 150ml of 240mg/ml if a CT of the head will also be obtained)- Pediatrics: Inject 1 ml/lb (2 ml/kg) of 240 mg/ml contrast at 2 ml per sec - Begin scanning with the arrival of contrast in the superior vena cava- 1 image per sec X 5 (Using Cine Mode), then 1 image every 3 sec. X 3, then 1
image every 10 seconds X 2 (5 groups using Axial Mode with a Prep Group Delay of 2 sec and 9 sec respectively) (scan time = 34 sec).
- Use 100 kV; 300 mA for adults, 150 mA for peds less than 6 y/o.- Allow all of the contrast to be injected then do Part 3- no reformats or bone algorithm with Part 2, only axial standard 2.5 mm images
Part 3: Post-contrast Orbit CT - Scan as in routine orbit “with contrast” protocol performing all 3 Recons:
standard, bone and, thin bone
1. Only do 2D-Reconstructions from the Part 3 contrast-enhanced images 2. Do 2 mm x 2 mm 2D-reformations using both the standard 1.25 mm images
(Recon 1) AND the bone 0.625 mm images (Recon 3) in the coronal and bilateral oblique sagittal planes as outlined below.
3. Do not send the 0.625 mm (Recon 3) bone images to PACS
Orbit: (Vascular Mass or Carotid-Cavernous Fistula)
(Protocol – Adult: # 2.3 – Pediatric: # 12.5 & 12.6)
Billing:
Setup:
DFOV:
Exam:
Reformats:
35 Revised 7/22/09 (Gentry/Ranallo)
Superior Vena Cava
40 (Adult)20 (Peds)
10.0 2.0 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Cine then Axial Cine then Axial Cine then Axial Cine then Axial Cine then Axial
Rotation Time (sec) 1.0 1.0 1.0 1.0 1.0
Detector Coverage (mm) 20 20 20 20 20
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
mA Adults 380 300 300 300 300
mA Peds < 6 y/o 190 150 150 150 150:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20 350/20
Scan Factors for Part 2 only: (Adult and Pediatric)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Orbit: (Vascular Mass / Carotid-Cavernous Fistula)Adult and Pediatric
Contrast (Part 2 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
36 Revised 7/22/09 (Gentry/Ranallo)
1. CT Orbit without
1. Monitored Exam: (Only scheduled and done when an ENT attending is available)2. Always obtained following a Routine Orbit CT without contrast 3. Do only on 64 slice scanner 4. Patient Supine, AP and lateral scouts, no gantry angle5. Patient Positioning: Tilt the patients head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). You may need to put a foam pad under the occiput to get the head in this position.
6. Use a head restraint to help the patient hold their head still. 7. Ask the patient to look straight ahead and hold their eyes in a very still position.8. Start the scans at the infraorbital rim and scan through the top of the orbit
Part 1: Routine Orbit CT without contrast - The routine orbit protocol is performed as usual - The patient must be instructed to look straight ahead prior to the scan
Part 2: Dynamic Maneuver - Use the routine noncontrast orbit CT scan factors- Helical 1.25 mm scans will be obtained using standard algorithm only
(no bone algorithm) - Ask the patient to hold their head still and only move their eyes (practice this
with the patient ahead of time)- Do the following scans in these directions of gaze – IN THIS ORDER:
- Left gaze- Right gaze- Up gaze- Down gaze
Preferred 14 cm (Range 14-16 cm)
1. Do the standard 2 x 2 mm 2D-reformations for the routine orbit exam (Part 1)2. Do additional 2 x 2 mm 2D-reformations from Part 2 the as described below.
- Neutral gaze: coronal and bilateral oblique sagittal recons (Part 1)- Left gaze: No 2D recons- Right gaze: No 2D recons- Up gaze: coronal and bilateral oblique sagittal recons (Part 2)- Down gaze: coronal and bilateral oblique sagittal recons (Part 2)
Orbit: (Dynamic (EOM Movements) (Protocol – Adult: # 2.4 – Pediatric: # 12.7 & 12.8)
Billing:
Setup Info:
DFOV:
Reformats:
37 Revised 7/22/09 (Gentry/Ranallo)
1. CT Maxi-face without, or with, or with and without2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include aortic arch for smart prep.3. Remove all metallic and high-density objects from the scanning area.4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus and the EAC is perpendicular to the CT tabletop (see head CT protocol). 5. Scanning begins just below the genu of the mandible to the top of the frontal sinuses
1. Routine: w/o contrast. Use the following injection parameters if done w/ contrast.2. Adults: 100 ml of 240 mg/ml nonionic contrast (use 150ml of 240mg/ml if a CT head
will also be obtained); Pediatrics: 1 ml/lb (2 ml/kg) of 240 non-ionic contrast. 3. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 2 ml/sec 4. Smart prep over the aortic arch and begin scanning 15 seconds (adults) or 8
seconds (pediatrics) after arrival of contrast in the arch
: Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Preferred 17.2 cm (Range 15-18 cm)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats as shown in the image below
Oblique Sagittal: Through each orbit parallel to the optic nerves.Sagittal: Through both orbits. Be sure to include both TMJs.Coronal: From the anterior aspect of the superior orbital rim through the
sella. Be sure to include all of the TMJ.
2. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone images (Recon 2)
3. If this is a “with & without” contrast study: Do do Recon 2 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2mm x 2mm reformats using the bone images (Recon 2) from the non-contrast series.
Maxillofacial Trauma: (Routine)
(Protocol – Adult: # 2.5a – Pediatric: # 12.9 & 12.10)
Billing:
Setup:
Contrast:
Patient Age
DFOV:
Recons & Reformats:
not
38 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 170-550 130-440 160-530 150-500 130-440
Noise Index 5.6 5.6 5.6 5.6 5.6
(Manual mA) 440 350 420 400 340:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/50 400/50 400/50 400/50 400/50
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Maxillofacial TraumaAdult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
39 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 2.5 50 15.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 240-750 130-420 230-750 210-700 130-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 620 330 600 570 340:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/70 450/70 450/70 450/70 450/70
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Maxillofacial TraumaAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
40 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 130-560 100-390 130-540 120-510 100-380
Noise Index 5.2 5.2 5.2 5.2 5.2
(Manual mA) 420 290 400 380 290:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/50 400/50 400/50 400/50 400/50
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Maxillofacial Trauma: Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
41 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 0.8 0.6 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-650 110-400 150-610 170-680 110-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 490 340 460 510 340:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/50 400/50 400/50 400/50 400/50
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Maxillofacial Trauma: Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
42 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390
Noise Index 5.1 5.1 5.1 5.1 5.1
(Manual mA) 370 260 360 340 260:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/50 400/50 400/50 400/50 400/50
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 17.2 17.2 17.2 17.2 17.2
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Maxillofacial Trauma: Pediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
43 Revised 7/22/09 (Gentry/Ranallo)
1. CT Maxi-face without2. 3D CT charge
1. Patient Supine, AP and lateral scouts, no gantry angle2. Remove all metallic and high-density objects from the scanning area.3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus and the EAC is perpendicular to the CT tabletop (see head CT protocol). 4. Scanning begins just below the genu of the mandible to the top of the frontal sinuses
Part 1: Routine Maxiface Trauma Protocol
1. Do a routine maxillofacial trauma protocol 2. Scanning begins at the bottom of the mandible to the top of the frontal sinus (get
one air scan below chin to allow the 3D to show the entire mandible without artifacts)
Part 2: 3D Exam Post-Processing:
1. Cut away as much of the c-spine as possible2. Please perform three 360 degree rotations at 10 degree intervals as follows
a. From a right lateral view = rotate horizontally for 360 degreesb. From an AP view = rotate vertically for 360 degreesc. From a Water’s type view = rotate horizontally for 360 degrees (note: to get a
Water’s type projection rotate the patient’s nose upward about 20 degrees)
1. Do 2 mm x 2 mm 2D-Reformations as in the routine maxifacial protocol2. Network the 2D and 3D images to ALI Store 3. Place the 3D request in the 3D slot on the wall in the E3/3 control room!
Maxillofacial Trauma: (Routine plus 3D)
(Protocol – Adult: # 2.5b – Pediatric: # 12.9 & 12.10)
Billing:
Setup:
Exam:
Other Info:
44 Revised 7/22/09 (Gentry/Ranallo)
1. CT Head without contrast2. 3D CT Charge
1. Patient Supine, AP and lateral scouts, no gantry angle2. Use 64 slice scanners if possible3. Remove all metallic and high-density objects from the scanning area.4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus and the EAC is perpendicular to the CT tabletop. (see head CT protocol)5. Scanning begins below the genu of the mandible all the way through the top of the
head (Get 1-2 air scans above the head and below the chin to allow the 3D program to show the entire head and mandible without artifacts)
Preferred 20 cm (Range 18-22 cm) Must include the entire head, face, and mandible
1. Only done without contrast.
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. Send the following source images to PACS: Recon 1: 5 mm slice thickness standard images (2.5 mm Plus recon for infants), and Recon 2: 1.25 mm slice thickness bone images.
2. Do not send the 0.625 mm (Recon 3) bone images to PACS.
1. Do 3D Reconstructions only from the Recon 3 thin bone images
2. Cut away as much of the c-spine as possible
3. Please perform three 360 degree rotations at 10 degree intervals as followsa. From a right lateral view = rotate horizontally for 360 degrees b. From an AP view = rotate vertically for 360 degrees c. From a Water’s type view = rotate horizontally for 360 degrees (note: to get a
Water’s type projection rotate the patient’s nose upward about 20 degrees)
4. Networking all 3D images to ALI Store
5. Make sure the 3D request is placed in the 3D slot on the wall in the E3/3 control room!
3D CT: (Craniosynostosis, Congenital Facial Anomaly)
(Protocol – Adult: # 1.5 – Pediatric: # 11.9 & 11.10)
Billing:
Setup:
DFOV:
Contrast:
Patient Age:
Other Info:
3D Reconstructions:
45 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 170-550 130-440 160-530 150-500 130-440
Noise Index 2.8 2.8 2.8 2.8 2.8
(Manual mA) 440 350 420 400 340:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
3D CT: (Craniosynostosis, Congenital Facial Anomaly)
AdultNon-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
46 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 5 5 5 5 5
Interval (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 140-560 100-390 130-540 120-510 100-380
Noise Index 2.6 2.6 2.6 2.6 2.6
(Manual mA) 420 290 400 380 290:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
3D CT: (Craniosynostosis, Congenital Facial Anomaly)
Pediatric Child (3 – 6 yr)Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
47 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.5 1.5 1.5 1.5 1.5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 110-570 80-390 110-550 100-520 80-390
Noise Index 3.3 3.3 3.3 3.3 3.3
(Manual mA) 370 260 360 340 260:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 80/25 80/25 80/25 80/25 80/25
Recon Option Full Full Full Full Full:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
3D CT: (Craniosynostosis, Congenital Facial Anomaly)
Pediatric Infant (0 – 3 yr)Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
48 Revised 7/22/09 (Gentry/Ranallo)
1. CT Head with and without contrast; CT Sella with contrast2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include aortic arch for smart prep.3. Use 64 slice scanners if possible4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below).
Part 1: CT Head Without Contrast (do as in routine CT head)Part 2: Pituitary CT with Contrast (as outlined below)- Use a DFOV of approximately 14 cm (include the orbit and the sella- Perform helical axial scans between yellow lines as diagramed at bottom of page- Use a bolus contrast injection as listed below:
1. Adults: 150 ml of 240 mg/ml nonionic contrast at 3.5 ml/sec2. Pediatrics: 1 ml/lb (2 ml/kg) of 240 nonionic at 2.0 to 2.5 ml/sec
- Smart prep over the aortic arch and begin scanning 15 seconds (adults) or 8 seconds (pediatrics) after arrival of contrast in the arch
- Begin Part 3 when all of contrast is in.
Part 3: CT Head With Contrast (do as in routine CT head)
Head: Preferred 20 cm (Range 18-22 cm)Pituitary: 14 cm
For Part 2: 1. Only send the Standard 1.25 mm (Recon 1) images to PACS. Do not send the Recon 2 bone images to PACS.
2. Do 2 mm x 2 mm 2D-reformats using both the standard 1.25 mm (Recon 1) images AND the bone 0.625 mm (Recon 2) images as outlined below.
Pituitary Gland and Cavernous Sinus:(Protocol – Adult: # 2.6 – Pediatric: # 12.11 & 12.12)
Billing:
Setup:
Exam:
DFOV:
49 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 2.5 50 15.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 240-750 140-420 230-750 210-700 140-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 620 370 600 570 370:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20 350/20
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan Factors for Part 2 only:
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Pituitary Gland and Cavernous SinusAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
50 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 190-675 110-400 180-675 170-675 110-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 560 340 540 510 340:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan Factors for Part 2 only:
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Pituitary Gland and Cavernous SinusPediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
51 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.6 0.5 0.5 0.7Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 110-570 90-400 110-550 100-520 90-400
Noise Index 5.1 5.1 5.1 5.1 5.1
(Manual mA) 370 300 360 340 290:
DFOV 12 12 12 12 12
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/0 300/0 300/0 300/0 300/0
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 12 12 12 12 12
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Scan Factors for Part 2 only:
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Pituitary Gland and Cavernous SinusPediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
52 Revised 7/22/09 (Gentry/Ranallo)
1. CT Stereotactic2. Contrast if used
1. Patient Supine on table top2. AP and lateral scouts3. No gantry angle4. Using the lasers, line up patient so that the canthomeatal line is perpendicular to
the CT table. This may require you to tilt the patients head either up on down slightly.
5. Scan from the hard palate to the top of the head
1. Adult: 150 ml of 240 mg/dl non-ionic contrast @ 0.6 ml/sec (4.2 minutes)2. Peds: 1 ml / pound (2 ml/kg) of 240 non-ionic contrast @ 0.6 ml/sec 3. Begin scanning as soon as contrast injection is finished
Mode AxialTime 1 secMode 1.25 @ 8i - Interval 10.0KVP 120mA 250Algorithm StandardSFOV HeadDFOV 22 to 25
1. If there is ANY patient motion, start the scan over.2. All images should be networked to ALI Store.3. Archive only the axial images to the MOD that goes to the surgeon.4. Technical support is available 24 hours and day, 7 days a week at 800-595-9709.
Stealth - Stereotactic Head: (Whole Brain Treatment Planning)
(Protocol – Adult: # 1.10 – Pediatric: # 11.11 & 11.12)
Billing:
Setup:
Contrast:
Scan Factors:
General Notes:
53 Revised 7/22/09 (Gentry/Ranallo)
1. CT Sinus without, or with, or with and without2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include aortic arch for smart prep if the exam is to be done with
contrast.3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). The tip of the nose and the both zygomatic bones must be on the scan.
4. Scan from the bottom of maxillary teeth to the top of the frontal sinuses (see below)5. Note: If the scan is protocoled as a “with contrast” scan, start the scans at the genu
of mandible 6. Use axial CT scan factors if a coronal plane scan is ordered.
1. Adults: 100 ml of 240 mg/ml nonionic contrast media; Pediatrics: 1 ml/lb (2 ml/kg) of 240 nonionic contrast media.
2. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 0.6 to 2.5 ml/sec3. Smart prep over the aortic arch (use cavernous sinus if arch cannot be seen) and
begin scanning 15 seconds (adults) or 8 seconds (pediatrics) after arrival of contrast in the arch
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Preferred 14 cm (Range 14-16 cm)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats (see below)Sagittal: Through both orbits. Be sure to include both TMJs.Coronal: From the anterior aspect of the superior orbital rim through the sella. Be
sure to include all of the TMJ.
2. If this is an exam solely with contrast or solely without contrast: Do 2D reformats using both standard 1.25 mm images (Recon 1) and the bone images (Recon 2)
3. If this is a “with & without” contrast study: Do not do Recon 2 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series andalso do 2 mm x 2 mm reformats using bone images (Recon 2) from the non-contrast series.
Sinuses (Diagnostic): (Adult and Pediatric)
(Protocol – Adult: # 2.7 – Pediatric: # 12.13 &12.14)
Billing:
Setup:
Contrast:
Patient Age:
DFOV:
Recons & Reformats:
54 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 110-400 90-320 90-320 90-300 100-360
Noise Index 7.2 7.2 7.2 7.2 7.2
(Manual mA) 310 250 250 240 290:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/30 400/30 400/30 400/30 400/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Recon 2:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Sinuses (Diagnostic)Adult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
55 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 2.5 50 15.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 160-560 130-420 130-450 120-430 120-420
Noise Index 8.5 8.5 8.5 8.5 8.5
(Manual mA) 450 360 360 340 340:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/50 450/50 450/50 450/50 450/50
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Sinuses (Diagnostic)Adult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
56 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 100-410 80-330 80-330 80-310 90-370
Noise Index 6.8 6.8 6.8 6.8 6.8
(Manual mA) 300 240 240 230 280:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/30 400/30 400/30 400/30 400/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Sinuses (Diagnostic)Pediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
57 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-550 110-400 110-440 100-420 100-400
Noise Index 7.7 7.7 7.7 7.7 7.7
(Manual mA) 410 330 330 310 310:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/30 400/30 400/30 400/30 400/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Sinuses (Diagnostic)Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
58 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 8.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 90-410 70-330 70-330 60-310 70-370
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 280 220 220 210 250:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/30 400/30 400/30 400/30 400/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Sinuses (Diagnostic)Pediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
59 Revised 7/22/09 (Gentry/Ranallo)
1. CT Sinus without only (never use this protocol when giving contrast)
1. Patient Supine, AP and lateral scouts, no gantry angle2. Only use this protocol for ENT and allergy patients with multiple prior diagnostic
sinus CT scans3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see below). 4. Scan from the bottom of maxillary teeth to the top of the frontal sinuses (see below)
Preferred 14 cm (Range 14-16 cm)
1. Never give contrast with this protocol
1. Do 2 mm x 2 mm 2D-reformations using both the standard 1.25 mm images AND the bone 0.625 mm images as shown below.
Sinuses (Follow-up Adult ENT Sinus): (Protocol: # 2.7)
Billing:
Setup:
DFOV:
Contrast:
Reformats:
60 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.5 0.5 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 80-260 60-210 60-210 60-200 70-240
Noise Index 8.8 8.8 8.8 8.8 8.8
(Manual mA) 210 170 170 160 190:
DFOV 14 14 14 14 14
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/30 400/30 400/30 400/30 400/30
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 14 14 14 14 14
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.625 0.625 0.625 0.625 0.75
Sinuses: (Follow-up ENT)Adult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
61 Revised 7/22/09 (Gentry/Ranallo)
Sinuses: (Combined Diagnostic and Landmarx): (Adult and Pediatric)
(Protocol – Adult: # 2.9 – Pediatric: # 12.16 & 12.17)
This exam is no longer done! Do a Diagnostic Sinus CT instead. If there is any questions by referring doctors ask them to contact either Dr. Gentry or Dr. Hartman.
62 Revised 7/22/09 (Gentry/Ranallo)
1. Temporal Bone without
1. Patient Supine, AP and lateral scouts, no gantry angle2. Only use 16 and 64 slice scanners3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of the
eye and the EAC is perpendicular to the CT tabletop (see below). 4. Start scans at the mastoid tip and finish at the top of the petrous bone (see below)
1. Recon 1 and Retro Recons: Preferred 20 cm (Range 18-22 cm)2. Recon 2 and 3 of TB: 9.6 cm
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. Recon 1: 2.5 mm axial images using a bone algorithm. 2. Recon 2 & 3: Obtain left and right 0.625 mm temporal bone axial images with a DFOV of 9.6 cm.
3. Perform 1 additional Retro Recons to get the following axial images of the entire scan range:At 20 cm DFOV, standard algorithm, 2.5 mm slice thickness, 1.25 mm increment, (WW/WL: 400/30)
4. Do 1 mm by 1 mm 2D-reformats in the coronal, Stenver’s, and Pöschl planes of each temporal bone using Recon 2 & 3 as source images (below)
Temporal Bone: (W/O Contrast) (Protocol – Adult: # 2.10 – Pediatric: # 12.18 & 12.19)
Billing:
Setup:
DFOV:
Patient Age:
Recons & Reformats:
63 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25
Scan FOV Head Head Head Head
kV 120 120 120 120
Smart mA/ Auto mA Range 190-610 130-420 180-590 170-560
Noise Index 3.7 3.7 3.7 3.7
(Manual mA) 490 340 470 450:
DFOV 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full:
DFOV 9.6 9.6 9.6 9.6
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 9.6 9.6 9.6 9.6
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Temporal BoneAdult
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 3
64 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25
Scan FOV Head Head Head Small Head
kV 100 100 100 100
Smart mA/ Auto mA Range 160-630 110-420 150-610 140-570
Noise Index 3.5 3.5 3.5 3.5
(Manual mA) 480 330 460 430:
DFOV 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Full Full Full Full
Recon Option: 9.6 9.6 9.6 9.6
DFOV Bone Plus Bone Plus Bone Plus Bone Plus
Recon Type 3000/300 3000/300 3000/300 3000/300
WW/ WL Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 9.6 9.6 9.6 9.6Recon Type Bone Plus Bone Plus Bone Plus Bone PlusWW/ WL 3000/300 3000/300 3000/300 3000/300Recon Option Plus Plus Plus FullRecon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Temporal BonePediatric Child (3 – 6 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 3
65 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25
Scan FOV Head Head Head Small Head
kV 80 80 80 80
Smart mA/ Auto mA Range 120-630 90-400 120-610 120-580
Noise Index 3.4 3.4 3.4 3.4
(Manual mA) 430 290 410 380:
DFOV 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option
Recon 2: 9.6 9.6 9.6 9.6
DFOV Bone Plus Bone Plus Bone Plus Bone Plus
Recon Type 3000/300 3000/300 3000/300 3000/300
WW/ WL Full Full Full Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Recon 3:
DFOV 9.6 9.6 9.6 9.6
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Temporal BonePediatric Infant (0 – 3 yr)
Non-Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
66 Revised 7/22/09 (Gentry/Ranallo)
1. CT Temporal Bone (without and with) 2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle:2. Extend the scouts to include aortic arch for smart prep.3. Only use 16 and 64 slice scanners4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).
1. Posterior Fossa: Preferred 20 cm (Range 18-22 cm)2. TB: 9.6 cm
Part 1: Temporal Bone CT Without Contrast1. Use the same protocol as described in the Temporal Bone W/O Contrast protocol2. This includes axial Recon 1, 2 and 3; the additional Retro recons of soft tissue and of
bone; and all the reformatted 1 x 1 cm images of the temporal bones.
Part 2: Temporal Bone Examination With Contrast 1. Inject contrast and then obtain standard algorithm 1.25 mm scans with a 0.75 mm
interval from the bottom of C1 to 1 cm above the top of temporal bone. 2. Contrast Usage: Adults: 150 ml of 240 mg/ml nonionic contrast media; Pediatrics: 1 ml/lb
(2 ml/kg) of 240 nonionic contrast media.3. Injection Rate: Adults: 3.5 ml/sec; Pediatric: 2.0 to 2.5 ml/sec4. Smart prep over the aortic arch and begin scanning 30 seconds (adults) or 15 seconds
(pediatrics) after arrival of contrast in the arch. 5. Reconstruct the 1.25 mm axial slices into 2 mm x 2 mm images of the posterior fossa
(axial, coronal, and sagittal) using an 18-22 cm DFOV with standard algorithm only.
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. Part 1: Do 1 mm by 1 mm 2D-reformats in the coronal, Stenver’s, and Pöschl planes 2. Part 2: Do 2 mm by 2 mm 2D-reformats in the axial, coronal, and sagittal planes
Temporal Bone CT With Contrast Only1. Use the same technique as above except do Part 2 first then do Part 1 following the
contrast study.
Temporal Bone: (W/O & W/ Contrast) or (W/ Contrast Only):
(Protocol – Adult: # 2.11 – Pediatric: # 12.20 & 12.21)
Billing:
Setup:
DFOV:
Exam:
Patient Age:
Reformats:
Exam:
67 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 30.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 0.9 0.6 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Head
kV 100 100 100 100
Smart mA/ Auto mA Range 230-750 140-420 210-700 200-660
Noise Index 8.8 8.8 8.8 8.8
(Manual mA) 600 370 560 530:
DFOV 20 20 20 20
Recon Type Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Scan Factors: (For Part 2 Only - With Contrast)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Temporal Bone: (W/O & W/ Contrast)Adult
Contrast (Part 2 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
68 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.0 50 15.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 0.9 0.6 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Small Head
kV 80 80 80 80
Smart mA/ Auto mA Range 180-675 110-400 170-675 160-640
Noise Index 7.9 7.9 7.9 7.9
(Manual mA) 550 340 510 480:
DFOV 20 20 20 20Recon Type Standard Standard Standard StandardWW/ WL 400/40 400/40 400/40 400/40Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Scan Factors: (For Part 2 Only - With Contrast)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Temporal Bone: (W/O & W/ Contrast)Pediatric Child (3 – 6 yr)
Contrast (Part 2 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
69 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 2.5 50 15.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Small Head
kV 80 80 80 80
Smart mA/ Auto mA Range 130-630 90-400 120-610 120-580
Noise Index 6.8 6.8 6.8 6.8
(Manual mA) 430 290 410 380:
DFOV 20 20 20 20
Recon Type Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Scan Factors: (For Part 2 Only - With Contrast)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Temporal Bone: (W/O & W/ Contrast)Pediatric Infant (0 – 3 yr)
Contrast (Part 2 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
70 Revised 7/22/09 (Gentry/Ranallo)
1. CT Temporal Bone (without and with) 2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include aortic arch for smart prep.3. Only use 16 and 64 slice scanners4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). 5. The dynamic portion is a monitored exam by an ENT radiologist or ENT Fellow.
1. Posterior Fossa: Preferred 20 cm (Range 18-22 cm)2 TB: 9.6 cm
: Part 1: Temporal Bone CT Without Contrast1. Use the same protocol as described in the Temporal Bone W/O Contrast protocol2. This includes axial Recon 1, 2 and 3; the additional Retro recons of soft tissue and of
bone; and all the reformatted 1 x 1 cm images of the temporal bones.
Part 2: Dynamic Contrast Enhanced Exam Through the Vascular Mass (as described below)
1. Select eight 2.5 mm scans through the vascular mass of posterior fossa (per radiologist)2. 1 image per sec X 5 (Using Cine Mode), then 1 image every 3 sec. X 3, then 1 image
every 10 seconds X 2 (5 groups using Axial Mode with a Prep Group Delay of 2 sec and 9 sec respectively) (scan time = 34 sec).
3. Use 100 kV; 300 mA for adults, 150 mA for peds less than 6 y/o.4. Standard algorithm only5. Inject Contrast: Adults: Inject 150 ml of 240mg/ml at 4.0 ml per sec (Injection time = 37.5
sec). Pediatrics: Inject 1 ml/lb (2 ml/kg) of 240 mg/ml contrast at 2 ml per sec 6. Smart prep over superior vena cava; begin scanning with arrival of contrast in the
superior vena cava7. As soon as all contrast has been injected immediately start Part 3
Part 3: Temporal Bone Examination With Contrast 1. Inject contrast and then obtain standard algorithm 1.25 mm scans with a 0.75 mm
interval from the bottom of C1 to 1 cm above the top of temporal bone. 2. Reconstruct the 1.25 mm axial slices into 2 mm x 2 mm images of the posterior fossa
(axial, coronal, and sagittal) using an 18-22 cm DFOV with standard algorithm only.
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. Part 1: Do 1 mm by 1 mm 2D-reformations in the coronal, Stenver’s, and Pöschl planes
2. Part 3: Do 2 mm by 2 mm 2D-reformations in the axial, coronal, and sagittal planes
Temporal Bone: (Vascular Mass): (Protocol – Adult: # 2.11 – Pediatric: #12.20 & 12.21)
Billing:
Setup:
DFOV:
Exam
Patient Age:
2D Reformats:
71 Revised 7/22/09 (Gentry/Ranallo)
Superior Vena Cava 40 10.0 2.0 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Cine then Axial Cine then Axial Cine then Axial Cine then Axial Cine then Axial
Rotation Time (sec) 1.0 1.0 1.0 1.0
Detector Coverage (mm) 20 20 20 20
Slice Thickness (mm) 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head
kV 100 100 100 100
mA Adults 380 300 300 300
mA Peds < 6 y/o 190 150 150 150:
DFOV 20 20 20 20
Recon Type Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20
Scan Factors for Part 2 only: (Dynamic Contrast Enhanced Exam)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Temporal Bone: (Vascular Mass)Adult & Pediatric
Contrast (Part 2 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
72 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 0.9 0.6 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Head
kV 100 100 100 100
Smart mA/ Auto mA Range 230-750 140-420 210-700 200-660
Noise Index 8.8 8.8 8.8 8.8
(Manual mA) 600 370 560 530:
DFOV 20 20 20 20
Recon Type Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Scan Factors for Part 3 only:
Temporal Bone: (Vascular Mass)Adult
Contrast (Part 3 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
73 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.6 0.6Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Small Head
kV 80 80 80 80
Smart mA/ Auto mA Range 180-675 110-400 170-675 160-640
Noise Index 7.9 7.9 7.9 7.9
(Manual mA) 550 340 510 480:
DFOV 20 20 20 20Recon Type Standard Standard Standard StandardWW/ WL 400/40 400/40 400/40 400/40Recon Option Plus Plus Plus FullRecon Option IQ Enhance
Scan Factors for Part 3 only:
Temporal Bone: (Vascular Mass) Pediatric Child (3 – 6 yr)
Contrast (Part 3 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
74 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.7 0.5 0.5Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20
Detector Rows 16 16 16 16
Pitch 0.562 0.562 0.562 0.531
Speed (mm/rot) 5.625 5.625 5.625 10.62
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625
Slice Thickness (mm) 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625
Scan FOV Head Head Head Small Head
kV 80 80 80 80
Smart mA/ Auto mA Range 130-630 90-400 120-610 120-580
Noise Index 6.8 6.8 6.8 6.8
(Manual mA) 430 290 410 380:
DFOV 20 20 20 20
Recon Type Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Scan Factors for Part 3 only:
Temporal Bone: (Vascular Mass) Pediatric Child (0 – 3yr)
Contrast (Part 3 Only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
75 Revised 7/22/09 (Gentry/Ranallo)
1. CT Neck without, or with, or without and with2. Contrast if used
1. Patient supine, AP and lateral scouts from sella to mid chest, no gantry angle2. Extend the scouts to include aortic arch for smart prep.3. Have the patient remove any dentures or removable teeth, please place the
shoulders as low possible4. Start the scan at the carina and scan to the top of the orbit5. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).
6. Do angled views at 2.5 mm 4i for 8 slices at 2 different angles if there is lots of artifact from dental fillings or metal hardware (see below)
7. Note: see page 138 for protocol modifications if done as combined study with body/chest/abdomen/pelvis CT)
Preferred 30 cm (Range 26-30 cm)
1. Adults: 100 ml of 300 mg/ml nonionic contrast media, Pediatrics: 1 ml/lb (2 ml/kg) of 300 non-ionic contrast media.
2. Use a 50 ml saline chaser in adults and a 10-25 ml saline chaser in pediatrics.3. Injection Rate: Adults: 3.0 ml/sec; Pediatric: 2.0-2.5 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in aortic arch:
Adult: 10 sec (4-8 slice scanner), 15 sec (16 slice scanner), 20 sec (64 slice scanner)Peds: 5 sec (4-8 slice scanner), 8 sec (16 slice scanner), and 10 sec (64 slice scanner)
1. For Adult scans: There is a soft tissue 2.5 mm slice thickness for Recon 1, a bone plus 1.25 mm slice thickness for Recon 2, and a soft tissue 1.25 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 3 for the soft tissue reformats. Use the 1.25 mm slices in Recon 2 for the bone reformats.
2. For Pediatric scans: There is a soft tissue 1.25 mm slice thickness for Recon 1, a bone plus 1.25 mm slice thickness for Recon 2, and a bone plus 0.625 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 1 for the soft tissue reformats. Use the 0.625 mm slices in Recon 3 for the bone reformats.
3. Do 2 mm by 2 mm 2D-Reformations in the coronal and sagittal planes
Neck: (Routine) (Protocol – Adult: # 3.1 – Pediatric: # 13.1)
(Feet First) (Protocol – Adult: # 3.2 – Pediatric: # 13.2)
Billing:
Setup:
DFOV:
Contrast:
Reformats and Recons:
76 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 10.0
LS 16 & 16 Pro: 15.0LS 4 & LS 8: 20.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.8 1.0 0.6 0.6 1.0Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Scan FOV Large Large Large Large Body Large
kV 140 140 140 140 140
Smart mA/ Auto mA Range 280-715 180-380 300-715 280-715 200-380
Noise Index 11.4 11.4 11.4 11.4 11.4
(Manual mA) 450 290 480 450 330:
DFOV 30 30 30 30 30
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35
Recon Option Full Full Full Full Full
Recon Option IQ Enhance:
DFOV 30 30 30 30 30
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 30 30 30 30 30
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
Neck: RoutineAdult
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
77 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 5.0
LS 16 & 16 Pro: 8.0LS 4 & LS 8: 10.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 1.0 0.6 0.6 1.0Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Interval (mm) 1.25 1.25 1.25 1.25 1.25
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 240-720 130-400 220-670 210-630 150-440
Noise Index 14.9 14.9 14.9 14.9 14.9
(Manual mA) 430 240 400 380 270:
DFOV 26 26 26 26 26
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 26 26 26 26 26
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 26 26 26 26 26
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625 1.25
Interval (mm) 0.375 0.375 0.375 0.312 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
Neck: RoutinePediatric Child (3 – 6 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
78 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 5.0
LS 16 & 16 Pro: 8.0LS 4 & LS 8: 10.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 180-690 110-410 170-660 160-620 110-410
Noise Index 14.5 14.5 14.5 14.5 14.5
(Manual mA) 360 220 350 330 220:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Recon 3:
DFOV 22 22 22 22
Recon Type Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
Neck: Routine Pediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
79 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.7 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
4i 4i 4i 4i 4i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
mA 640 440 720 720 440:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.7 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
4i 4i 4i 4i 4i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
mA 630 420 700 700 420:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Neck: Routine Adult – Angled Axials
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Neck: Routine Pediatric Child (3 – 6 yr) – Angled Axials
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 1
Recon 2
80 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Axial Axial Axial Axial Axial
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
10 10 10 10 10
Detector Rows 16 16 16 16 8Number of Images per Rotation
4i 4i 4i 4i 4i
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 16 x 0.625 8 x 1.25
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
mA 640 400 620 620 400:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 300/35 300/35 300/35 300/35 300/35:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 2500/250 2500/250 2500/250 2500/250 2500/250
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Neck: Routine Pediatric Infant (0 – 3 yr) – Angled Axials
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
81 Revised 7/22/09 (Gentry/Ranallo)
----
-
Neck: (Salivary Gland) (Protocol – Adult: # 3.3 – Pediatric: # 13.3)
Billing: 1. CT Neck (without and with)2. Contrast
Setup: 1. Patient Supine (AP and lateral scouts from sella to mid chest)2. Make sure the patient removes any dentures or removable teeth3. No gantry angle
Examination: Part 1: Limited Non-contrast CT of NeckScan from hyoid bone to EACAdd angled views if there are lots of dental fillingsNo 2D ReconstructionsUse same scan factors as in routine neck CT
Part 2: Do a routine Neck CT With Contrast Protocol Be sure to do angled views if there are lots of dental fillings
82 Revised 7/22/09 (Gentry/Ranallo)
1. CT Neck with and without2. Contrast
1. Monitored exam (ENT Attending or ENT Fellow)2. Extend the scouts to include the superior vena cava for smart prep. 3. Patient supine, AP and lateral scouts from sella to mid chest, no gantry angle4. Have the patient remove any dentures or removable teeth, please place the shoulders
as low possible5. Start the scan at the carina and scan to the top of the orbit6. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol). 7. Do angled views if lots of artifact from dental fillings or metal hardware
Preferred 30 cm (Range 26-30 cm)
: Part 1: Limited Non-contrast CT of Neck (scan area per radiologist)1. Standard algorithm only
Part 2: Dynamic Contrast Enhanced Exam -Through the Vascular Mass (as described below)1. Select eight 2.5 mm scans through the vascular mass (ROI per radiologist)2. Use 100 kV; 300 mA for adults, 150 mA for peds less than 6 y/o.3. 1 image per sec X 5 (Using Cine Mode), then 1 image every 3 sec. X 3, then 1 image
every 10 seconds X 2 (5 groups using Axial Mode with a Prep Group Delay of 2 sec and 9 sec respectively) (scan time = 34 sec).
4. Standard algorithm only5. Smart prep over the superior vena cava. Start scanning with the arrival of contrast6. Adults: Inject 50 ml of 300 mg/ml at 4.0 ml per sec (Injection time = 18.7 sec) 7. Pediatrics: Inject 0.5 ml/lb (1 ml/kg) of 300 mg/ml contrast at 2 ml per sec 8. As soon as all contrast has been injected immediately start Part 3
Part 3: Routine Neck CT with Contrast (with the following modifications)1. Perform a Routine Neck CT Protocol (Use the same scan factors as in that protocol)2. Adults: Begin an additional injection of 50 ml of 300 mg/ml at 3.0 ml per sec and
immediately start scanning (no smart prep) from the carina to the top of the orbit.3. Pediatrics: Begin an additional injection of 0.5 ml/lb (1 ml/kg) of 300 mg/ml contrast
at 2 ml per sec and immediately start scanning (no smart prep) from the carina to the top of the orbit.
4. Use a 50 ml saline chaser in adults and a 10-25 ml saline chaser in pediatrics.5. Do angled views if necessary
Part 1: No 2D recons or bone algorithm, only axial standard algorithm imagesPart 2: No 2D recons or bone algorithm, only axial standard algorithm images
Part 3: A. Adult scans: There is a soft tissue 2.5 mm slice thickness for Recon 1, a bone plus 1.25 mm slice thickness for Recon 2, and a soft tissue 1.25 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 3 for the soft tissue reformats. Use the 1.25 mm slices in Recon 2 for the bone reformats.
B. Pediatric scans: There is a soft tissue 1.25 mm slice thickness for Recon 1, a bone plus 1.25 mm slice thickness for Recon 2, and a bone plus 0.625 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 1 for the soft tissue reformats. Use the 0.625 mm slices in Recon 3 for the bone reformats.
C. Do 2 mm by 2 mm 2D-Reformations in the coronal and sagittal planes
Neck: (Vascular Mass) (Protocol – Adult: # 3.3 – Pediatric: # 13.3)
Billing:
Setup:
DFOV:
Exam
Recons & Reformats:
83 Revised 7/22/09 (Gentry/Ranallo)
40 (Adult)20 (Peds)
10.0 2.0 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Cine then Axial Cine then Axial Cine then Axial Cine then Axial Cine then Axial
Rotation Time (sec) 1.0 1.0 1.0 1.0 1.0
Detector Coverage (mm) 20 20 20 20 20
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
mA Adults 380 300 300 300 300
mA Peds < 6 y/o 190 150 150 150 150:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20 350/20
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Superior Vena Cava
Scan Factors for Part 2 only:
Neck: Vascular Mass (Part 2 Dynamic Scan)Adult and Peds
Contrast (Part 2 only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
84 Revised 7/22/09 (Gentry/Ranallo)
1. Puffed Cheek: - Do after a complete routine neck CT - Ask the patient to purse their lips and gently distend the cheeks with air. Practice this
before the patient gets on the table.- Scan from the genu of the mandible to the EAC during this maneuver using the same
helical scan parameters as in the routine neck CT scan.- No 2D-recons but use standard and bone plus algorithms- If there are a lot of dental fillings, also do the scans with angled views- Check these scans with the radiologist before the patient leaves the CT scanner
2. Valsalva:- Do after a complete routine neck CT - Ask the patient to take a deep breath and bear down for about 10 seconds as if they
were having a bowel movement. Practice this before the patient gets on the table.- Scan from upper trachea to the angle of the mandible using the same helical scan
parameters as in the routine neck CT scan.- No 2D-recons but use standard and bone plus algorithms- Check these scans with the radiologist before the patient leaves the CT scanner
3. Vocalization:- Do after a complete routine neck CT - Ask the patient to take a deep breath and vocalize the vowel “EEEEEEEE” for 10
seconds during the scans. Practice this before the patient gets on the table.- Scan from upper trachea to the hyoid bone using the same scan parameters as in the
routine neck CT scan.- No 2D-recons but use standard and bone plus algorithms- Check these scans with the radiologist before the patient leaves the CT scanner
4. Perfusion CT: (To be monitored by Dr Gentry or Dr Hartman)
Part 1: CT Neck without contrast - Use PET CT scanner unless otherwise instructed- Do a limited noncontrast localizing scan (ROI per radiologist)- Use helical mode and no gantry angle
Part 2: CT Perfusion Study: - Perfusion ROI to be selected by Dr Gentry or Dr Hartman- 8 x 2.5 mm slices through lesion (prescribed from scout and Part 1)- No gantry angle- Cine mode with 80 KVP, 200 MA, DFOV = 18 cm, 1 rotation/sec- Inject 40 ml of 370 mg/ml contrast at 4 ml per sec with a 30 ml saline push - Begin scanning 5 seconds after the start of contrast injection- Scan Phases:
- Phase 1: 1 rotation/sec at 1 sec intervals for 45 seconds- Phase 2: 1 rotation/sec at 15 sec intervals 7 times for 105 seconds
- Image Processing:- 1 sec images reformatted to 0.5 sec images
- Perfusion Processing:- Kari Pulfer to process- Arterial and venous input functions: ROI on the ICA and EJV- Measure 25-30 mm3 freehand volumes in solid part of tumor for BV, BF,
MTT, and CP
Part 3: CT Neck with contrast: (optional)- Inject an additional 40 ml of 370 mg/ml contrast at 4 ml/sec- Immediately do our routine post contrast helical neck CT scan
Neck: (Add on Options) (Protocol – Adult: # 3.5 – Pediatric: # 13.5)
Option:
85 Revised 7/22/09 (Gentry/Ranallo)
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Cine then Axial Cine then Axial Cine then Axial Cine then Axial Cine then Axial
Rotation Time (sec) 1.0 1.0 1.0 1.0 1.0
Detector Coverage (mm) 20 20 20 20 20
Slice Thickness (mm) 2.5 2.5 2.5 2.5 2.5
Scan FOV Head Head Head Head Head
kV 80 80 80 80 80
mA Adults 250 200 200 200 200
mA Peds < 6 y/o 130 100 100 100 100:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 350/20 350/20 350/20 350/20 350/20
Scan Factors for Part 2 only: CT Neck Perfusion Study
Neck: Perfusion CT (Part 2)Adult & Peds
Contrast (Part 2 only)
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
86 Revised 7/22/09 (Gentry/Ranallo)
1. CT Neck with 2. Contrast
1. Patient Supine, AP and lateral scouts from sella to mid chest, no gantry angle2. Only do on a 64 slice scanner3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).4. Remove any dentures or removable teeth; please place the shoulders as low possible
1. Part 1: 22 cm (adults), 20 cm (peds 3-6 y/o), 18 cm (peds 0-3 y/o)2. Part 2: (as in routine neck CT)
: Part 1: Arterial Phase of Lower Neck1. Standard only2. Start scans at the carina and scan to the bottom of the upper teeth3. Adult: 100 ml of Iohexol 300 with a 50 ml saline chase
Peds: 1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase4. Adult: 4 ml per sec
Peds: 2.0-2.5 ml/sec5. Over aortic arch (initiate scan at the entry of contrast in the aortic arch) 6. Do a routine Neck CT Protocol immediately following Part 1 with the
following modifications.
Part 2: Routine Neck CT with Contrast (with the following modifications)1. Perform a Routine Neck CT Protocol using the same scan factors as in that protocol2. Do not use any CT scan delay but start scanning the routine neck CT as soon as
Part 1 is finished.3. Do angled views if necessary
Part 1: A. Sagittal and coronal 2D reformations using standard algorithm images onlyPart 2: A. Adult scans: There is a soft tissue 2.5 mm slice thickness for Recon 1, a bone plus 1.25 mm slice
thickness for Recon 2, and a soft tissue 1.25 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 3 for the soft tissue reformats. Use the 1.25 mm slices in Recon 2 for the bone reformats.
B. Pediatric scans: There is a soft tissue 1.25 mm slice thickness for Recon 1, a bone plus 1.25 mm slice thickness for Recon 2, and a bone plus 0.625 mm slice thickness for Recon 3. Only send Recon 1 and 2 to PACS. Do not send Recon 3 to PACS. Use the 1.25 mm slices in Recon 1 for the soft tissue reformats. Use the 0.625 mm slices in Recon 3 for the bone reformats.
C. Do 2 mm by 2 mm 2D-Reformations in the coronal and sagittal planes
Neck: (Parathyroid Adenoma) (Protocol – Adult: # 3.4 – Pediatric: # 13.4)
Billing:
Setup:
DFOV:
ExamAlgorithm:Scan Area:Contrast:
Injection Rate:
Smart Prep:Begin Part 2:
Recons & Reformats:
87 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Head Large
kV 120 120 120 120 120
Smart mA/ Auto mA Range 200-800 120-440 190-800 180-800 130-440
Noise Index 11.1 11.1 11.1 11.1 11.1
(Manual mA) 530 320 510 480 360:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Neck: Parathyroid AdenomaAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
88 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 110
Smart mA/ Auto mA Range 170-800 100-420 160-770 150-740 100-420
Noise Index 10.6 10.6 10.6 10.6 10.6
(Manual mA) 490 290 470 440 330:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Neck: Parathyroid Adenoma Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
89 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-675 80-400 130-675 120-675 90-400
Noise Index 10.4 10.4 10.4 10.4 10.4
(Manual mA) 440 260 420 400 300:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
Neck: Parathyroid Adenoma Pediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
90 Revised 7/22/09 (Gentry/Ranallo)
1. CT Neck without, or with, or without and with2. Contrast if used
1. Inject the contralateral arm from the brachial plexus of interest.2. CT scan delay after arrival of contrast in aortic arch:
- Adult: 15 sec (all scanners), - Peds: 10 sec (all scanners),
3. DFOV: Range 26-32 cm.- Extend DFOV laterally to include bilateral humeral heads of the shoulders
4. 2D Reformations in addition to standard routine neck reformations (see below)
Brachial Plexus: (Routine) (Protocol – Adult: # 3.1 – Pediatric: # 13.1)
(Feet First) (Protocol – Adult: # 3.2 – Pediatric: # 13.2)
This protocol is the same as the routine neck CT with the following exceptions:
Billing:
Modifications:
91 Revised 7/22/09 (Gentry/Ranallo)
1. CT cervical spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used. 3. Patient Positioning:
- Warning: Do not flex or extend the neck if there has been recent spine trauma or if the patient is in a c-spine trauma collar.
- If no recent trauma, tilt the patient’s head so that a line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop.
- The shoulders should be pulled down as much as possible4. Scan from the top of the sella to the bottom of T2
Preferred 17 cm (Range 16-18 cm)
1. Injection parameters:2. Volume: 100 ml of 240 mg/ml nonionic contrast (use 150ml of 240mg/ml if a CT of the
head will also be obtained). 3. Injection Rate: Adults: 3.5 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in aortic arch: 10 sec (8 slice scanners),
15 sec (16 slice scanners), 20 sec (64 slice scanners)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
2. You must include the entire larynx and hyoid bone on the sagittal 2D reformats (see below)
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
4. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
5. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Cervical Spine: (Adult Routine) (Protocol: # 3.5)
Billing:
Setup:
DFOV:
Contrast:
Recons & Reformats:
not
92 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 20
LS Xtra, LS 16 & 16 Pro: LS 8: 10
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.8 1.0 0.6 0.6 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Large Body Large
kV 140 140 140 140 140
Smart mA/ Auto mA Range 280-715 180-380 300-715 280-715 200-380
Noise Index 16.2 16.2 16.2 16.2 16.2
(Manual mA) 450 290 480 450 330:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
.015.0
.0
Cervical Spine: RoutineAdult
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 3
93 Revised 7/22/09 (Gentry/Ranallo)
1. CT thoracic spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used.3. Non-contrast unless otherwise protocoled4. Scan from the top of C7 to the bottom of L1 5. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning to distribute the contrast evenly in the spinal canal.
Preferred 17 cm (Range 16-18 cm)
1. Injection parameters:2. Volume: 100 ml of 240 mg/ml nonionic contrast (use 150ml of 240mg/ml if a CT of the
head will also be obtained). 3. Injection Rate: Adults: 3.5 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in aortic arch: 10 sec (8 slice scanners),
15 sec (16 slice scanners), 20 sec (64 slice scanners)
Increase scan time to on CT1, CT3, CT4, and ER CT.Raise kV to on CT2, East & RP CT.For VERY large patients, increase scan time to increase kV to on CT1, CT3, CT4, and ER CT.
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
3. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
4. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Thoracic Spine: (Feet First) (Adult Routine) (Protocol: # 7.5)
Thoracic Spine: (Head First) (Adult Routine) (Protocol: # 7.6)
Billing:
Setup:
DFOV:
Contrast:
For Large Patients: 1.0 sec140 kV
1.0 sec 140 kV
Recons & Reformats:
not
and
94 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 2
LS Xtra, LS 16 & 16 Pro: LS 8: 1
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Large Body Large
kV 120 120 120 120 120
Smart mA/ Auto mA Range 170-760 90-440 160-760 150-750 90-440
Noise Index 14.4 14.4 14.4 14.4 14.4
(Manual mA) 330 180 320 300 180:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
0.015.0
0.0
Thoracic Spine: RoutineAdult
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
95 Revised 7/22/09 (Gentry/Ranallo)
1. CT lumbar spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used.3. Non-contrast unless otherwise protocoled4. Scan from the top of T12 to the top of S25. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning to distribute the contrast evenly in the spinal canal.
Preferred 17 cm (Range 16-18 cm)
1. Injection parameters:2. Volume: 100 ml of 240 mg/ml nonionic contrast (use 150 ml of 240 mg/ml if a CT of the
head will also be obtained). 3. Injection Rate: Adults: 3.5 ml/sec4. Smart prep over the aortic arch. 5. CT scan delay after arrival of contrast in aortic arch: 10 sec (8 slice scanners),
15 sec (16 slice scanners), 20 sec (64 slice scanners)
Increase scan time to on CT1, CT3, CT4, and ER CT.Raise kV to on CT2, East & RP CT.For VERY large patients, increase scan time to increase kV to on CT1, CT3, CT4, and ER CT.
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
3. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2mm x 2mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
4. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Lumbar Spine: (Adult Routine) (Protocol: # 7.1)
Billing:
Setup:
DFOV:
Contrast:
For Large Patients: 1.0 sec140 kV
1.0 sec 140 kV
Recons & Reformats:
not
and
96 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3.0 50LS VCT64: 2
LS Xtra, LS 16 & 16 Pro: LS 8: 1
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Large Body Large
kV 120 120 120 120 120
Smart mA/ Auto mA Range 170-760 90-440 160-760 150-750 90-440
Noise Index 14.4 14.4 14.4 14.4 14.4
(Manual mA) 330 180 320 300 180:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
0.015.0
0.0
Lumbar Spine: RoutineAdult
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
Recon 3
97 Revised 7/22/09 (Gentry/Ranallo)
1. CT cervical spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used.3. Patient Positioning:
- Warning: Do not flex or extend the neck if there has been recent spine trauma or if the patient is in a c-spine trauma collar.
- If no recent trauma, tilt the patient’s head so that a line connecting the lateral canthus of the eye and the EAC is perpendicular to the CT tabletop.
- The shoulders should be pulled down as much as possible4. Scan from the top of the sella to the bottom of T2 5. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning in order to distribute the contrast evenly in the spinal canal.
Preferred 15 cm (Range 14-18 cm)
1. Injection parameters:2. Volume: 1 ml/lb (2 ml/kg) of 240 non-ionic contrast. 3. Injection Rate: 2 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in the aortic arch: 5 sec (8 slice scanners),
8 sec (16 slice scanners), 10 sec (64 slice scanners)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
2. You must include the entire larynx and hyoid bone on the sagittal 2D reformats (see below)
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
4. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
5. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Cervical Spine: (Pediatric Routine) (Protocol: # 13.5)
Billing:
Setup:
DFOV:
Contrast:
Recons & Reformats:
not
98 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64:
LS Xtra, LS 16 & 16 Pro: LS 8: 5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.7 1.0 0.6 0.6 1.0Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 120 120 120 120 120
Smart mA/ Auto mA Range 230-700 130-400 220-670 210-630 150-440
Noise Index 14.9 14.9 14.9 14.9 14.9
(Manual mA) 420 240 400 380 270:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
10.08.0
.0
Cervical Spine: RoutinePediatric Child (3 – 6 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
99 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64:
LS Xtra, LS 16 & 16 Pro: LS 8: 5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 180-690 110-410 170-660 160-620 110-410
Noise Index 14.5 14.5 14.5 14.5 14.5
(Manual mA) 360 220 350 330 220:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
10.08.0
.0
Cervical Spine: RoutinePediatric Infant (0 – 3yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
100 Revised 7/22/09 (Gentry/Ranallo)
1. CT thoracic spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used.3. Non-contrast unless otherwise protocoled4. Scan from the top of C7 to the bottom of L1 5. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning to distribute the contrast evenly in the spinal canal.
Preferred 15 cm (Range 14-18 cm)
1. Injection parameters:2. Volume: 1 ml/lb (2 ml/kg) of 240 non-ionic contrast. 3. Injection Rate: 2 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in the aortic arch: 5 sec (8 slice scanners),
8 sec (16 slice scanners), 10 sec (64 slice scanners)
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
3. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
4. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Thoracic Spine: (Pediatric Routine) (Protocol: # 17.5)
Billing:
Setup:
DFOV:
Contrast:
Patient Age:
Recons & Reformats:
not
101 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64: 10
LS Xtra, LS 16 & 16 Pro: LS 8:
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Medium Body Large
kV 100 100 100 100 100
Smart mA/ Auto mA Range 170-750 100-420 160-750 150-700 100-420
Noise Index 12.8 12.8 12.8 12.8 12.8
(Manual mA) 310 190 300 280 190:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
.08.0
5.0
Thoracic Spine: RoutinePediatric Child (3 – 6 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
102 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64:
LS Xtra, LS 16 & 16 Pro: LS 8:
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Small Small Small Small Body Small
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-675 90-400 150-675 140-650 90-400
Noise Index 11.3 11.3 11.3 11.3 11.3
(Manual mA) 280 170 270 260 170:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years) 2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
10.08.0
5.0
Thoracic Spine: RoutinePediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
103 Revised 7/22/09 (Gentry/Ranallo)
1. CT lumbar spine without, or with, or without and with2. Contrast if used
1. Patient Supine, AP and lateral scouts, no gantry angle2. Extend the scouts to include the aortic arch for smart prep if IV contrast is to be used.3. Non-contrast unless otherwise protocoled4. Scan from the top of T12 to the top of S25. Post myelography patients: Please remember to roll the patient 360 degrees before
scanning to distribute the contrast evenly in the spinal canal.
Preferred 15 cm (Range 14-18 cm)
1. Injection parameters:2. Volume: 1 ml/lb (2 ml/kg) of 240 non-ionic contrast. 3. Injection Rate: 2 ml/sec4. Smart prep over the aortic arch.5. CT scan delay after arrival of contrast in the aortic arch: 5 sec (8 slice scanner),
8 sec (16 slice scanners), 10 sec (64 slice scanners)
Choose the CT scan factors on the scanner for the proper age range of the patient
1. Child: (3 – 6 years)2. Infant: (0 – 3 years)
1. All 2-D reformats described below are to be done as 2 mm x 2 mm reformats. Do them in the coronal and sagittal planes.
3. If this is an exam solely with contrast or solely without contrast: Do 2D-reformats using both the standard 1.25 mm images (Recon 1) AND the bone 0.625 mm images (Recon 2)
3. If this is a “with & without” contrast study: Do do Recons 2 and 3 on the contrast scan. Do 2D-reformats using the standard 1.25 mm images (Recon 1) only from the contrast series AND also do 2 mm x 2 mm reformats using the bone 0.625 mm images (Recon 2) from the non-contrast series.
4. Do not send the 0.625 mm (Recon 2) bone images to PACS.
Lumbar Spine: (Pediatric Routine) (Protocol: # 17.1)
Billing:
Setup:
DFOV:
Contrast:
Patient Age:
Recons & Reformats:
not
104 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64: 10
LS Xtra, LS 16 & 16 Pro: LS 8: 5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Medium Body Large
kV 100 100 100 100 100
Smart mA/ Auto mA Range 170-750 100-420 160-750 150-700 100-420
Noise Index 12.8 12.8 12.8 12.8 12.8
(Manual mA) 310 190 300 280 190:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years)2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
.08.0
.0
Lumbar Spine: RoutinePediatric Child (3 – 6 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
105 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3.0 50LS VCT64: 10
LS Xtra, LS 16 & 16 Pro: LS 8: 5
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
10 10 10 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 5.625 5.625 5.625 10.62 6.25
Detector Configuration 16 x 0.625 16 x 0.625 16 x 0.625 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Small Small Small Small Body Small
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-675 90-400 150-675 140-650 90-400
Noise Index 11.3 11.3 11.3 11.3 11.3
(Manual mA) 280 170 270 260 170:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
DFOV 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full
Recon Option IQ Enhance
Slice Thickness (mm) 0.625 0.625 0.625 0.625
Interval (mm) 0.375 0.375 0.375 0.312:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.625 0.75
Patient Age: Choose the CT scan factors on the scanner for the proper age range of the patient 1. Child: (3 – 6 years)2. Infant: (0 – 3 years)
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold Diagnostic Delay (sec)
.08.0
.0
Lumbar Spine: RoutinePediatric Infant (0 – 3 yr)
Non-Contrast or Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2:
Recon 3
106 Revised 7/22/09 (Gentry/Ranallo)
1. CT Stereotactic2. Contrast if used
1. Patient Supine, AP and lateral scouts2. No gantry angle3. Non-contrast unless otherwise protocoled4. Scan one vertebrae above and below the vertebrae of interest. The region of interest
should be noted on the CT request or CT protocol.5. Call ordering M.D. to verify levels if necessary.
14 cm (for average patient)
1. Mode = Axial2. Rotation = 1 sec3. Detector Config = 1.25 @ 8i 4. Interval = 10.05. KVP = 1206. MA = 2507. Algorithm = Standard8 Scan FOV = Large9. DFOV = 14 (for average patient)
1. If there is ANY patient motion, start the scan over.2. Do not change the DFOV, centering, or move the patient during the CT exam.3 Only the axial images are to be archived on the MOD that goes to the surgeon.4. When IV contrast is needed, wait until it is all injected before starting the scan.5. No bone windows are needed.6. No overlapping slices.7. Technical support is available 24 hours and day, 7 days a week at 800-595-9709.
Stealth (Stereotactic) Spine: (Protocol: # 7.2)
Billing:
Setup:
DFOV:
Scan Factors:
Notes:
107 Revised 7/22/09 (Gentry/Ranallo)
1. CT Head with and without2. CTA Head and Neck with contrast3. CT Brain Perfusion4. Contrast
1. Patient Supine, AP and lateral scouts, No Gantry Tilt2. Extend the scouts to include the aortic arch for smart prep.3. 16 or 64 slice scanners only4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).
Preferred 20 cm (Range 18-22 cm)
1. from the top of the head to the bottom of the carina (see below)
2. scan from top to bottom
3.100 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
150 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase
4. 4 ml per sec (26.6 sec contrast injection time) (43.3 sec contrast transit time)
2.0-2.5 ml/sec
5. over aortic arch (initiate the scan at the entry of contrast in the aortic arch)
1. Wait at least 5 min from start of CTA contrast injection before beginning Perfusion Injection.2. Contrast 40 ml of 370 nonionic contrast (14.8 g Iodine) with 30 ml saline chase 3. Injection Rate Adults: 5 ml per sec with a 5 sec prep delay
Pediatric: 3-5 ml per sec (Depends on size of needle and age of patient)4. Prep Delay 5 seconds
1. Perform immediately after Perfusion Imaging (Part 3). No need to wait 5 min.
(Appendices 1 and 2)
(Appendices 3 and 4)
(Do on Stent Cases)
Vascular Imaging: Stroke Deluxe: (Acute Stroke Workup)
(Protocol – Adult: # 1.6 & 3.7 – Pediatric: # 11.16 & 11.17)
Billing:
Setup:
DFOV:
Exam: Part 1: Routine Head CT without contrast (helical)
Part 2: CTA Head and Neck
Scan Area
Scan direction
Contrast Adult: On LS VCT 64 and LS 16 Pro:
Adult: On LS 16, LS 8 and LS 4:
Peds:
Injection Rate Adult:
Peds:
Smart Prep
Part 3: CT Perfusion (see perfusion page for details)
Part 4: Routine Head CT with contrast (helical)
Networking:
1. ALI store, CTAW2 and CTAW3
Post Processing:
1. 2-D Reformation Instructions
2. Perfusion Analysis (3D Lab)
3. 3D Intravascular Image Analysis on ADW workstation
108 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Head Large
kV 120 120 120 120 120
Smart mA/ Auto mA Range 200-800 120-440 190-800 180-800 130-440
Noise Index 11.1 11.1 11.1 11.1 11.1
(Manual mA) 530 320 510 480 360:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Stroke DeluxeAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
109 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 110
Smart mA/ Auto mA Range 170-800 100-420 160-770 150-740 100-420
Noise Index 10.6 10.6 10.6 10.6 10.6
(Manual mA) 490 290 470 440 330:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Stroke Deluxe: Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
110 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-675 80-400 130-675 120-675 90-400
Noise Index 10.4 10.4 10.4 10.4 10.4
(Manual mA) 440 260 420 400 300:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Stroke Deluxe: Pediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
111 Revised 7/22/09 (Gentry/Ranallo)
Vascular Imaging: Total Cerebrovascular: (Stenosis, Trauma, Unknown Bleed)
(Protocol – Adult: # 1.6a or 13.7a – Pediatric: # 11.16 or 11.17)
Note: This protocol is identical to the stroke deluxe protocol.
112 Revised 7/22/09 (Gentry/Ranallo)
Billing: 1. CT Head with and without2. CTA Head with contrast3. CT Brain Perfusion if done4. Contrast used if done
Setup: 1. Patient Supine, AP and lateral scouts, No Gantry Tilt2. Extend the scouts to include the aortic arch for smart prep.3. 16 or 64 slice scanners 4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see below).
DFOV: Preferred 20 cm (Range 18-22 cm)
1. from the top of the head to the bottom of C2 (see below)2. scan from top to bottom3. 80 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase4. 4 ml per sec (26.6 sec contrast injection time) (43.3 sec contrast transit time)
2.0-2.5 ml/sec5. over aortic arch (initiate the scan at the entry of contrast in the aortic arch)
1. Wait at least 5 min from start of CTA contrast inject before beginning Perfusion Injection.2. Contrast 40 ml of 370 nonionic contrast (14.8 g Iodine) with 30 ml saline chase 3. Injection Rate Adults: 5 ml per sec with a 5 sec prep delay
Pediatric: 3-5 ml per sec (Depends on size of needle and age of patient)4. Prep Delay 5 seconds
1. If Perfusion is done, perform immediately after the Perfusion Imaging - No need to wait 5 min.2. If Perfusion is not done, perform scan at least 5 min after start of CTA contrast injection
1. ALI store, CTAW2 and CTAW3
1. Thick Slab Reformat Instructions (See Appendix 1) 2. Perfusion Analysis (3D Lab) (See Appendices 3 and 4)3. 3D Intravascular Image Analysis on ADW workstation (Do on Stent Cases)
Vascular Imaging: CTA Head Only: (Stenosis, Unknown Bleed):
(Protocol – Adult: # 1.7 – Pediatric: # 11.18 & 11.19)
Exam: Part 1: Routine Head CT without contrast (helical)
Part 2: CTA Head OnlyScan AreaScan directionContrast Adult:
Peds:Injection Rate Adult:
Peds:Smart Prep
Part 3: CT Perfusion (see perfusion page for details)
Part 4: Routine Head CT with contrast (helical)
Networking:
Processing:
113 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 280-780 170-420 270-750 260-710 190-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 620 380 600 570 420:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Head OnlyAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
114 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 220-675 130-400 210-675 200-660 150-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 540 330 520 490 370:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Head Only: Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
115 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.6 0.4 0.4 0.6Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-660 110-400 160-660 150-620 120-400
Noise Index 5.2 5.2 5.2 5.2 5.2
(Manual mA) 440 290 440 410 330:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Head Only: Pediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
116 Revised 7/22/09 (Gentry/Ranallo)
1. CT Head with and without2. CTA Head with contrast3. Contrast
1. Patient Supine, AP and lateral scouts, No Gantry Tilt2. Extend the scouts to include the aortic arch for smart prep.3. 16 or 64 slice scanners 4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see below).
: 18 cm
1. From the top of the lateral ventricles to the bottom of the C2 vertebrae (use Part 1 to select the top slice, see below)
2. scan from top to bottom3. 150 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase4. 4 ml per sec (26.6 sec contrast injection time) (43.3 sec contrast transit time)
2.0-2.5 ml/sec5. Over aortic arch (initiate the scan at the entry of contrast in the aortic arch)
1. Wait at least 5 min from start of CTA contrast inject before beginning Perfusion Injection.2. Contrast 40 ml of 370 nonionic contrast (14.8 g Iodine) with 30 ml saline chase 3. Injection Rate Adults: 5 ml per sec with a 5 sec prep delay
Pediatric: 3-5 ml per sec (Depends on size of needle and age of patient)4. Prep Delay 5 seconds
1. If Perfusion is done, perform immediately after the Perfusion Imaging - No need to wait 5 min.2. If Perfusion is not done, perform scan at least 5 min after start of CTA contrast injection
1. ALI store, CTAW2 and CTAW3
1. Thick Slab Reformat Instructions (See Appendix 1) 2. Perfusion Analysis (3D Lab) (See Appendices 3 and 4)3. 3D Intravascular Image Analysis on ADW workstation (Do on Stent Cases)
Vascular Imaging: Aneurysm (Hi-Res COW): (Nontraumatic SAH, Known Aneurysm)
(Protocol – Adult: # 1.8 – Pediatric: # 11.20 & 11.21)
Billing:
Setup:
DFOV
Exam: Part 1: Routine Head CT without contrast (helical)
Part 2: CTA Head OnlyScan Area
Scan directionContrast Adult:
Peds:Injection Rate Adult:
Peds:Smart Prep
Option: CT Perfusion (see perfusion page for details)
Part 3: Routine Head CT with contrast (helical)
Networking:
Processing:
117 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 280-780 170-420 270-750 260-710 190-420
Noise Index 6.6 6.6 6.6 6.6 6.6
(Manual mA) 620 380 600 570 420:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 450/60 450/60 450/60 450/60 450/60
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Aneurysm (Hi-Res COW)Adult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
118 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 220-675 130-400 210-675 200-660 150-400
Noise Index 6.0 6.0 6.0 6.0 6.0
(Manual mA) 540 330 520 490 370:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Aneurysm (Hi-Res COW): Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
119 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.5 0.6 0.4 0.4 0.6Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Small Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 160-660 110-400 160-660 150-620 120-400
Noise Index 5.2 5.2 5.2 5.2 5.2
(Manual mA) 440 290 440 410 330:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Aneurysm (Hi-Res COW): Pediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
120 Revised 7/22/09 (Gentry/Ranallo)
1. CTA Neck/Arch (with contrast)2. Contrast
1. Patient Supine, AP and lateral scouts, no gantry tilt2. Extend the scouts to include the aortic arch for smart prep.3. 16 or 64 slice scanners 4. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral
canthus of the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).
1. Start scans at the carina and scan to the EAC (see below)2. Scan from bottom to top
3.80 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
120 ml of Iohexol 300 (24 g Iodine) with a 50 ml saline chase
1 ml/lb (2 ml/kg) of Iohexol 300 with a 10-25 ml saline chase4. 4 ml per sec
2.0-2.5 ml/sec5. Over aortic arch (initiate the scan at the entry of contrast in the aortic arch)
1. ALI store, CTAW2 and CTAW3
1. Thick Slab Reformat Instructions (See Appendix 1) 2. Perfusion Analysis (3D Lab) (See Appendices 3 and 4)3. 3D Intravascular Image Analysis on ADW workstation (Do on Stent Cases)
Vascular Imaging: CTA Neck Only: (Cerebrovascular Disease)
(Protocol – Adult: # 3.8 – Pediatric: # 11.22 & 11.23)
Billing:
Setup:
Examination: CTA Neck and Arch Scan AreaScan direction
Contrast Adult: On LS VCT 64 and LS 16 Pro:
Adult: On LS 16, LS 8 and LS 4:
Peds:Injection Rate Adult:
Peds:Smart Prep
Networking:
Processing:
121 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Large Large Large Head Large
kV 120 120 120 120 120
Smart mA/ Auto mA Range 200-800 120-440 190-800 180-800 130-440
Noise Index 11.1 11.1 11.1 11.1 11.1
(Manual mA) 530 320 510 480 360:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Neck OnlyAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
122 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 110
Smart mA/ Auto mA Range 170-800 100-420 160-770 150-740 100-420
Noise Index 10.6 10.6 10.6 10.6 10.6
(Manual mA) 490 290 470 440 330:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Neck OnlyPediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
123 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 3.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.8 0.5 0.5 0.8Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-675 80-400 130-675 120-675 90-400
Noise Index 10.4 10.4 10.4 10.4 10.4
(Manual mA) 440 260 420 400 300:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CTA: Neck OnlyPediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
124 Revised 7/22/09 (Gentry/Ranallo)
1. CT Head with and without2. CTA of Head +/- CTA of Neck with contrast3. Contrast
1. Patient Supine, AP and lateral scouts, no gantry tilt2. Extend the scouts to include the aortic arch for smart prep.3. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see below).
1. From the top of the head to the bottom of C2 (see below)2. Scan from top to bottom3. 150 ml of Iohexol 240 (36 g Iodine) with a 50 ml saline chase
1 ml/lb (2 ml/kg) of Iohexol 240 with a 10-25 ml saline chase4. 4 ml per sec (26.6 sec contrast injection time) (43.3 sec contrast
transit time) 2.0-2.5 ml/sec
5. Over aortic arch (initiate the scan 5 seconds after entry of contrast in the aortic arch)
1. Do as in Part 2 except:2. From the top of the head to the carina
1. Wait at least 5 min from start of CTV contrast injection before beginning scan.
Vascular Imaging: CT Venography:(Protocol – Adult: #1.9 & 3.9 – Pediatric: # 11.24 & 11.25)
Billing:
Setup:
Exam: Part 1: Routine Head CT without contrast (helical)
Part 2: CTV Head Scan AreaScan directionContrast Adult:
Peds:Injection Rate Adult:
Peds:Smart Prep
Part 2b: Option: CTV Head and Neck
Scan Area:
Part 3: Routine Head CT with contrast (helical)
125 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 80 10.0 3 50 5.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Medium Medium Medium Head Medium
kV 120 120 120 120 120
Smart mA/ Auto mA Range 200-800 110-440 190-800 180-800 120-440
Noise Index 11.1 11.1 11.1 11.1 11.1
(Manual mA) 530 280 510 480 320:
DFOV 22 22 22 22 22
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 22 22 22 22 22
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3500/350 3500/350 3500/350 3500/350 3500/350
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CT VenographyAdult
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
126 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 5.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 100 100 100 100 100
Smart mA/ Auto mA Range 170-800 90-420 160-770 150-740 100-420
Noise Index 10.6 10.6 10.6 10.6 10.6
(Manual mA) 490 260 470 440 290:
DFOV 20 20 20 20 20
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 20 20 20 20 20
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CT Venography: Pediatric Child (3 – 6 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
127 Revised 7/22/09 (Gentry/Ranallo)
Aortic Arch 40 10.0 3 50 5.0
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8
Scan Type Helical Helical Helical Helical Helical
Rotation Time (sec) 0.6 0.9 0.5 0.5 0.9Detector Coverage (mm)Beam Collimation (mm)
20 20 20 20 10
Detector Rows 16 16 16 16 8
Pitch 0.562 0.562 0.562 0.531 0.625
Speed (mm/rot) 11.25 11.25 11.25 10.62 6.25
Detector Configuration 16 x 1.25 16 x 1.25 16 x 1.25 64 x 0.625 8 x 1.25
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Scan FOV Head Head Head Head Head
kV 80 80 80 80 80
Smart mA/ Auto mA Range 140-675 70-400 130-675 120-675 80-400
Noise Index 10.4 10.4 10.4 10.4 10.4
(Manual mA) 440 230 420 400 260:
DFOV 18 18 18 18 18
Recon Type Standard Standard Standard Standard Standard
WW/ WL 400/40 400/40 400/40 400/40 400/40
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance:
DFOV 18 18 18 18 18
Recon Type Bone Plus Bone Plus Bone Plus Bone Plus Bone Plus
WW/ WL 3000/300 3000/300 3000/300 3000/300 3000/300
Recon Option Plus Plus Plus Full Plus
Recon Option IQ Enhance
Slice Thickness (mm) 1.25 1.25 1.25 1.25 1.25
Interval (mm) 0.75 0.75 0.75 0.625 0.75
Smart Prep
Prep Over mAMonitoring Delay
(sec)Monitoring ISD (sec)
Enhancement Threshold
Diagnostic Delay (sec)
CT Venography: Pediatric Infant (0 – 3 yr)
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
Recon 2
128 Revised 7/22/09 (Gentry/Ranallo)
1. 1 mm X 1 mm right oblique sagittal (see example below) (FOV = 12)2. 1 mm X 1 mm left oblique sagittal (mirror image of example below) (FOV = 12)
a. Make sure the reference line is parallel to the carotid canal (see image below)b. Use a window with and level of 800/200c. Axial images to use for obtaining the oblique sagittal 2-D Reformations
- CTA Head Protocol: Images from C2 to the top of the lateral ventricles- CTA Head and Neck: Images from C2 to the top of the lateral ventricles
d. Send to ALI Store
1. Choose the 1.25 mm slices2. Select Ref. Detail.3. Use a window width 600 and window level 2004. Choose batch. (You don’t need to change slice thickness & rendering mode on image 1st)5. Do axial, sagittal, and coronal thick-slab MIPs through the entire head. (See examples below)6. Change the slice thickness to 10 mm with an interval of 2.5 mm and change the rendering mode from
Average to MIP.7. Send to ALI Store. 8. Put the CT Angio request in the box on the wall in the E3/3 control room for the 3D to be done.9. All patients should have a duplicate request made, write duplicate on it, put the duplicate request in the 3D
box, all remaining requests go to the neuro reading room.
Appendix # 1
CTA Head: 2D Thin and Thick Slab ReformationsA. Do Thin 2D-Reformations through the vertebral and carotid arteries
B. 2D Thick-Slab MIP Reformats of Head:
129 Revised 7/22/09 (Gentry/Ranallo)
1. For each carotid bifurcation, calculate the percent stenosis (NACET) using Vitrea2. Do 1 mm by 1 mm curved reformations through any vessel that has been previously stented3. Send all images to ALI Store.
1. Use an axial image near the level of the hyoid bone at the carotid bifurcation to prescribe the correct oblique angles. Use an image that shows the external and internal carotid arteries.
2.3. Use a window width 800 and window level 2004. Bilateral oblique sagittal 2D reformations: Do 2 mm X 2 mm reformations thru each carotid bifurcation.
Angle so that the reformations go through both the external and internal carotid arteries. (See below)5. Coronal 2D reformations: Do 2 mm X 2 mm reformations thru both sides at the same time. Include both
the carotid and vertebral arteries (See example below)6. Send to 3D Lab for Intravascular Analysis of the carotid bifurcations (i.e. severity of carotid stenosis).7. Send all images to ALI Store. 8. All patients should have a duplicate request made, write duplicate on it, put the duplicate request in the 3D
box, all remaining requests go to the neuro reading room.
Appendix # 2
CTA Neck: 3D Vascular Analysis and 2D-ReformationsA. 3D Analysis through the vertebral and carotid arteries
B. Do 2D-Reformations through the vertebral and carotid arteries
Choose only the axial images from the aortic arch to the EAC.
Oblique Sagittal 2D-ReformatsThrough Carotid Bifurcations
Coronal 2D-Reformats
Through Carotid Bifurcations
130 Revised 7/22/09 (Gentry/Ranallo)
1. Perfusion and contrast used
1. Patient Supine, AP and lateral scouts, no gantry tilt2. Patient Positioning: Tilt the patient’s head so that a line connecting the lateral canthus of
the eye and the EAC is perpendicular to the CT tabletop (see head CT protocol).3. Usually done in conjunction with a CT/CTA of the Head or CT/CTA of Head/Neck
Cine45 seconds(next page)40 ml of 370 nonionic contrast with 30 ml saline chase Adult: 5 ml per sec Pediatric: 3-5 ml per sec (Depends on size of needle and age of
patient)5 secondsUse maximum number (4-8-16) of contiguous 5 mm slabs allowed by each specific CT scanner (use toggle/shuttle mode if possible)
Preferred 20 cm (Range 18-22 cm)
(See next Page)
(see Appendix 5 for further details):
1. Prospectively reconstruct the images to .5 seconds. This is found under thick/speed - (Go under show recon 2).
2. When you are in recon 2, enter the RAS coordinates manually. 3. Network raw perfusion images to CTAW3 & ALI Source – DO Not send the perfusion part to
ALI store
Scanner GE LS Xtra GE LS 16 GE LS 16 Pro GE LS VCT 64 GE LS 8Scan Type Cine Cine Cine Cine Cine Rotation Time (sec) 1.0 1.0 1.0 1.0 1.0Detector Coverage (mm) 20 20 20 40 20Slice Thickness (mm) 5 5 5 5 5Cine Time Between Images 0.5 sec 0.5 sec 0.5 sec 0.5 sec 0.5 secScan FOV Head Head Head Head HeadkV 80 80 80 80 80mA Adults 250 200 200 200 200mA Peds < 6 y/o 190 150 150 150 150Cine Duration (sec) 45 45 45 45 45
:DFOV 22 22 22 22 22Recon Type Standard Standard Standard Standard StandardWW/ WL 350/20 350/20 350/20 350/20 350/20
Appendix # 3CT Perfusion Protocol: (Specific Instructions):
Billing:
Setup:
Exam: CT Perfusion1. Scan Type2. Cine Duration3. Perfusion Area4. Contrast5. Injection Rate
6. Prep Delay7. Perfusion Slabs
DFOV:
Perfusion Locations:
Perfusion Post Processing:
CT Perfusion: Adult and Pediatric
Contrast
CT 1 CT 2 CT 3 CT 4 & ER CT East & RP CT
Recon 1
131 Revised 7/22/09 (Gentry/Ranallo)
Appendix # 4: CT Perfusion Coverage
A. 8-16 Channel CT Perfusion: (4 slice coverage)
B. 64 Channel CT Perfusion: Non-shuttle Mode(8 slice coverage)
C. 64 Channel CT Perfusion: Obtain 16 contiguous 5 mm slices from EAC UpwardShuttle/Toggle Mode: (16 slice coverage)
132 Revised 7/22/09 (Gentry/Ranallo)
Appendix # 5: CT Perfusion Analysis Instructions
Suggestions for ROI Placement
133 Revised 7/22/09 (Gentry/Ranallo)
Suggestions for ROI Placement
Continued on next page
134 Revised 7/22/09 (Gentry/Ranallo)
135 Revised 7/22/09 (Gentry/Ranallo)
a. Select Perfusion series from patient list
b. From Applications menu at right of screen choose CT PerfusionN (exam will load)
c. From list of protocols choose Brain Tumor
d. Using slide bar at bottom of upper left port, slide back and forth to look for motion. If there is motion click apply registration, then . If not, .
e. Now you will see a box called Processing Thresholds. Your object here is to get all little boxes/pixels out of the brain tissue and include as much brain parenchyma as you can. Your slide bar that you used to check for motion must be all the way to the left and rank should be 1/89. Slide air bar to left to remove boxes/pixels from ventricles and there are any diagonal lines with pieces missing, this air bar may fill them in. This is a very slight movement. Your average range should be (-27 to around -63). It can go higher and that is ok but usually doesn’t
f. Slide bone bar to right to bring circle out to edge of bone only. This is easiest when using a bone window. Middle mouse will change window/level. .
g. Using slide bar in upper left port again, move it left to right to find a slice where contrast is fairly bright.
. Click on ROI to the left of your screen
and place over an artery. . This should result in a small purple circle being placed in an artery with a label and arrow.
h. Now do the same for a vein. A good place to look is down in the sinus. . If you have gone up several levels to find your vein/artery, make sure you go back to the beginning to place your ROIs! The vein and artery do not have to be on the same slice!
i. Roam your image over to the right. Do this by grabbing the “ on the bottom of your upper left port (you will see a hand) and moving your head.
j. Now place your cursor in the upper right port and hit the space bar. This will bring up a graph with 2 lines (1) and (2). 1 is the artery you marked and 2 is the vein. On the line that says “Last pre-enhancement image” grab the number and a white line will appear in your graph. You want to move the line to the last spot before the contrast spikes. You do this on line 1 only. (If you are having trouble seeing the 2 lines separately, click on the word arteryin your upper left port. This will activate it and turn it green and you will be able to distinguish the two lines. When you are done click in the upper left port to de-activate the artery so it returns to purple.) .
k. Click compute. This will take a minute. .
l. In the lower left port there will be a drop down menu under DFOV called Blood Flow. to Mean Transit Time.
m. Click on Film/Save box and choose ROIs/Templates. Click on Neuro template for upper levels and Neuro-lower for lower levels (the only difference between these two is that Neuro-lower only has 2 ROIs to place instead of four. . This will bring up your ROIs and Axis line. You may need to adjust their placement depending on your centering.
.
n. Look for any obvious perfusion abnormality. This is where you will place your ROI. If there isn’t any obvious abnormality then you will place your ROIs in the standard places.
GE Advantage: CT Perfusion Post Processing Protocol
click next click next
Click next
Look on upper slices for anterior cerebrals, just above frontal horns. This is the best place to look for an artery You can move up levels by right-clicking on your image location in your upper left port.
Click next
Click next
P”
Click next
Close Final Settings box
Change this view
Hit Load
You can now close this box
136 Revised 7/22/09 (Gentry/Ranallo)
o. to split the brain into two equal hemispheres.
p. After you have done this, hold the control key down and click on all ROI’s and the axis line. This will turn them all green. Go back to the symmetry button and there is a little black tab, open that and click on that button. This will place the ROI’s on the left side. Now you are ready to film.
q. In the upper left port, .
r. In the upper right port go outside yellow box and . After doing that there are some numbers in red at the top and bottom left of the grid.
. This should move your 1 and 2 graph up and out of the yellow box and bring the ROI’s you just created up in view. If it doesn’t, you can also grab the numbers at the bottom and bring them up. Once they are in view right mouse click and click on multiple graphs. This will show them in a nice graph.
s. Go out of the yellow box again and .
t. Place your cursor in the lower right port and on your keyboard hit the key with the ( ). This will bring up all 4 views at once. Now you can film them in order without having to change each one. Mean Transit Time first, then Blood Flow, Blood Volume, andPermeability Surface.
u. Go Back up to your upper left port and hold down the control key and click on your ROI’s to turn them green. Hit CTRL-C to copy. Go to the image location and right mouse click to go to the next level. This will take a minute to process. Once it is done, Hit CTRL-V to paste or you can also use the right click menu.
v. Now all ROI’s will be in the same spot as before. You may need to move them just a hair if they get too close to bone or a big blood vessel but otherwise try to leave them in the same spot.
w. Now repeat all filming. Upper left port first, upper right port next, Mean Transit Time, Blood Flow, Blood Volume, Permeability Surface. This time when you finish you just click on the next level. You don’t need to copy again because you have already done it once. If you move them a lot you will need to make them green again and recopy. When you get to the third level, CTRL-V or right click to paste your ROI’s, adjust them if necessary, then film.
x. After you have done all four/eight levels, . Choose Functional Data and hit save. This will bring up a graph to the right called functional data. Click next until the button goes gray, and go back to the film/save box and click save again.
y. Now you can exit and go back to the patient list. Send to ALI-STORE.
1. CTRL-C copy
2. CTRL-V or right click menu to paste
3. CTRL-X cut
4. CTRL and click to make ROI’s green
You must straighten the Axis line by grabbing the boxes at either end
right mouse click and save view
right mouse click and save viewGrab the
numbers at the top and middle mouse scroll to the left
save view
?/
Film
click on film/save
137 Revised 7/22/09 (Gentry/Ranallo)
a. Go to PACS and choose perfusion series.
b. Right click 3D and choose “View selected series in Vitrea 3D”. This will launch Vitrea and may take a few minutes.
c. When perfusion comes up, it will be auto-selecting your artery and vein. The amount of time it takes will show on the task bar at the bottom of the screen. You need to check the placement of both vessels. Before you do this check for rotational motion. If there is motion click on motion correction. This should help unless the patient picked up their head completely. If no motion proceed with checking artery and vein placement. If you are happy with the vessels selected, click compute. If not scroll to your alternate location and left click to draw oval over the new artery. Click artery button. Do the same for the vein. These do not have to be on the same slice. After you have manually selected vessels click compute.
d. You will now have your 4 main images – grey scale, blood volume, blood flow and mean transit time. Scroll to first image and check axis line for centering. If it needs adjusting, do so.
e. Click on ROI Templates, choose the one that has square ROI’s all around periphery and 2 oval ROI’s in the center. Tight fit which is the box directly below this, should be checked. There is no need to adjust ROI’s. If you want to make them bigger, you can change the thickness. Default thickness is 15 mm and default count of ROI’s is 12.
f. You are done except for screen saving images.
g. Click on the camera (snap) or hit S on the keyboard. This activates the camera. Hold down the control key and left click in the grey-scale port (upper left hand box). Do this for all levels. On the bottom left task bar click back to HRS. Export all.
a. Wheel-roll the wheel in the middle of the mouse to go up and down levels.
b. Window/Level-Click on the window/level button in the upper left hand side of the machine and left click with your mouse to change w/l. you MUST change back to ellipse when done.
c. To delete something click on it to make it purple and hit delete on the keyboard.
d. To screen save images-click on camera (snap) or hit S on the keyboard, hold down ctrl and left-click. This will save all four images as long as you are in upper left hand port.
Vitrea: CT Perfusion Post Processing Protocol
Helpful hints:
138 Revised 7/22/09 (Gentry/Ranallo)
Scanner (Age)
InjectionRate
InjectionVolume
(300 mg/dl)
Volume
Saline
Chaser
TotalInjectionVolume
CT Scan Delay after
contrast arrival in arch on
Smart Prep
Contrast volume injected from detection by Smart Prep to Start of CT
Scan
Time available to
scan from the initiation of
the CT scans
64 Slice (Adult) 3.0 100 50 150 20 33.3 - 20 >13.3 sec
16 Slice (Adult) 3.0 100 50 150 15 33.3 - 15 >18.3 sec
8 Slice (Adult) 3.0 100 50 150 10 33.3 - 10 >23.3 sec
64 Slice (Peds) 2.0 1 ml/lb 10-25 ? 5 Volume
Dependant ?
16 Slice (Peds) 2.0 1 ml/lb 10-25 ? 7 Volume
Dependant ?
8 Slice (Peds) 2.0 1 ml/lb 10-25 ? 10 Volume
Dependant ?
Appendix: 6
Neck CT Contrast Timing Table For Routine Neck CT
139 Revised 7/22/09 (Gentry/Ranallo)
Appendix: 7
64 Slice Scanner Priorities
1. CTA (High-res COW)
2. CTA (Stroke Deluxe)
3. Temporal Bone CT
4. Any Pediatric CT
5. C-Spine CT
6. T-Spine CT
7. Orbit, Maxiface, Sinus CT
8. Neck-Nasopharynx CT
9. L-Spine CT
10. Brain CT
140 Revised 7/22/09 (Gentry/Ranallo)
CTI – 1 16 0.625 0.4 sec LightSpeed Xtra(LS Xtra)
500
CTI – 2 16 0.625 0.4 sec LightSpeed 16(LS 16)
400 - 450
CTI – 3 16 0.625 0.4 sec LightSpeed 16 Pro(LS 16 Pro)
400 - 450
CTI - 4 64 0.625 0.4 sec LightSpeed VCT 64(LS VCT 64)
500
ER 64 0.625 0.4 sec LightSpeed VCT 64(LS VCT 64)
500
CT-RP 8 1.25 0.5 sec LightSpeed 8(LS 8)
400 - 450
East 8 1.25 0.5 sec LightSpeed 8(LS 8)
400 - 450
Appendix: 8
CT Scanner Type
* When one number is given, that is the maximum allowed weight limit AND the table positioning accuracy at that weight limit is 0.25 mm. When two numbers are given the first indicates the weight limit that will provide 0.25 mm positional accuracy; the second number is the absolute maximum allowed weight limit and will provide a positional accuracy of 1.0 mm.
Scanner -Location
# of Slices
Thinnest Slice
Minimum Scan Time
Scanner Name Weight* Limits
141 Revised 7/22/09 (Gentry/Ranallo)
Scanner Name Scan FOV 140 kV 120 kV 100 kV 80 kV
All except Ped HeadLS VCT 64 & LS 16 Pro
Ped Head
All except Ped HeadLS 16, & LS 8,
Ped Head
Scanner Name Scan FOV Maximum Display FOV (cm)
Default Display FOV (cm)
Large Body
Medium Body
Small Body
Head
Small Head
Ped Body
LS VCT
Ped Head
Large
Small
Head
LS 16 Pro, LS 16, & LS 8,
Ped Head
Appendix: 9
CT Scanner Limits
mA Limits
Scan FOV
715 800 770 675
170 200 240 300
380 440 420 400
170 200 240 300
50 50
50 36
32 25
32 25
32 25
32 20
32 20
50 50
25 25
25 25
25 25
142 Revised 7/22/09 (Gentry/Ranallo)
Appendix: 10
Direction and Naming of 2D-Reformations
1. Always do Bone 2D-Reformations before Soft Tissue 2D Reformations
2. Always do 2D-Reformations in this order: a. Axialb. Coronalc. Sagittald. Oblique Sagittal
3. Always do 2D-Reformations in these directionsa. Axial = Bottom to Topb. Coronal = Front to Backc. Sagittal = Right to Leftd. Oblique Sagittal = Right to Left
4. Naming of 2D-Reconstructionsa. Axial Bone = AX BONEb. Coronal Bone = CO BONEc. Sagittal Bone = SA BONEd. Right Oblique Bone = RT BONEe. Left Oblique Bone = LT BONEf. Axial Soft Tissue = AX STg. Coronal Soft Tissue = CO STh. Sagittal Soft Tissue = SA STi. Right Oblique Soft Tissue = RT STj. Left Oblique Soft Tissue = LT STk. TB - Right Stenver’s = RT STENVl. TB - Right Pöschel = RT POSCHm. TB - Left Stenver’s = LT STENVn. TB - Left Pöschel = LT POSCHo. CTA - Right Carotid Bifurcation = RT Carp. CTA - Left Carotid Bifurcation = LT Carq. CTA - Right ICA Oblique = RT ICA
r. CTA - Left ICA Oblique = LT ICA
143 Revised 7/22/09 (Gentry/Ranallo)
Appendix: 11
Combined Neuro and Body Contrast Studies
1. Split the total contrast dose equally with Body/Chest/Abdomen so that neuro has a total of about 50 cc of 300 mg / ml of nonionic contrast unless otherwise indicated.
2. When the neuro CT study follows a body/chest/abdomen study, initiate the neuro CT scans immediately after detection of contrast on smart prep. Do not use a CT delay in these cases.
3. Modify the injection parameters of the following studies for the combined studies as follows: (Omnipaque 300 unless otherwise specified) (Note: CTA studies will require a total dose of contrast that exceeds 150 ml)
Volume (cc) Rate (cc/sec)
A. CTA Head Only: 50 4
B. CTA Head with Perfusion: (only 64 slice scanner)- CTA (Omnipaque 300) 40 3.3- Perfusion (Omnipaque 370) 40 5
C. CTA Head & Neck: (only 64 slice scanner) 80 2.8
D. CTA Neck Only: 50 4
E. CT Neck: 50 3
F. CT Orbit/Maxiface/Sinus/TB: 50 3
G. CT Spine (C-T-L): 50 3
H. CT Sella: 50 4
4. Do not do the following studies as combined studies with Body/Chest/Abdomenunless the studies are urgent and a total of 150 cc of 300 mg/dl nonionic contrast can be exceeded. Ideally, the most urgent study should be performed on one day and the other study done on a separate day. A MRI/MRA study is an alternative when the 150 ml total dose of contrast cannot be exceeded in a particular patient.
A. CTA Head & Neck with Perfusion:- CTA (Omnipaque 300) 80 2.8- Perfusion (Omnipaque 370) 40 5