INDICATIONS: for Workup of Liver Pathology with the Following Histories Or Clinical Concerns

CT LIVER

INDICATIONS: “For workup of liver pathology with the following histories or clinical concerns: cirrhosis, chronic Hepatitis B or C, uncharacterized liver mass, HCC

(hepatocellular carcinoma/hepatoma), other chronic liver disease (eg: Chiari syndrome, primary sclerosing cholangitis).” Neuroendocrine tumors.

*Not for abnormal LFT’s*. NonContrast scan usually not needed. Check with radiologist.

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

IV CONTRAST: Perform as directed by the supervising radiologist.

125mL Isovue 370 @ 4-5 mL/second

ORAL CONTRAST: 32 oz Water 30 Minutes Prior to Scan, and12 oz Water Immediately Prior to Scan.

POSITIONING: Feet First Supine, Arms above head

TOPOGRAMS: AP. Range: Above dome of diaphragm through iliac crest. 35 mA, 120 kV

SCAN TYPE: Spiral/Helical

NOTES: NonContrast scan usually not needed. Check with radiologist.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

CARE BOLUS triggered Arterial scan.

100 kV on Arterial scan unless extra-large, then 120 kV.

NONCONTRAST

MONITORING

ScanRange
CARE BOLUS
Monitoring Location / Scan Direction
Scan Type
Number of Scans / Respiration / Threshold / Scan
Delay
Seconds / CARE
DOSE
4D / mAs / CARE
kV / kV / Detector Configuration
Slices Per Tube Rotation / Table
Feed / InterScan
Delay
(CycleTime)
Seconds / Scan
Time
Seconds / SFOV
(cm)
Single Slice
Abdominal Aorta
First Slice of Arterial Scan / Craniocaudal
Sequential
30 scans / Quiet
Respiration / 150 HU / 15
Seconds / OFF / 40 / OFF / 120 / Detectors: 1 x10.0 mm
Slices Per Tube Rotation: 1 / 0.0 mm / 1.5
Seconds / Full
0.5 Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON / Axial / 10.0 mm / 0.0 mm / B30s
Medium / Abdomen
300/40 / Small FOV large enough to
Cover region of interest

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ARTERIAL

Scan
Range / Scan
Direction / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Dome of Diaphragm
to Iliac Crest/
Through Entire Liver / Craniocaudal / Suspended
Inspiration / CARE BOLUS Tracking
(Trigger 150 HU)
Plus 6 Second Delay / ON / 120 / Semi / 100 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 0.5
seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON / Axial / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – SAGITTAL MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 2.0 mm / 2.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body

VENOUS

Scan
Range / Scan
Direction / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed:
(mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Dome of Diaphragm
to Iliac Crest/
Through
Entire Liver / Craniocaudal / Suspended
Inspiration / 70 sec. From
Start of Injection.
(Approximately 20 sec
From End of Arterial) / ON / 120 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.8
Table Increment/Speed:
15.36 mm/rotation / 0.5
Seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON / Axial / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON / Axial / ON
2 / 3.0 mm / 3.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon Card 3D Coronal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body

5 MINUTE DELAY

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Approximate Values for CTDIvol
Patient Size / Weight (kg) / Weight (lbs) / CTDIvol (mGy)
Small / 50-70 / 110-155 / 10-17
Average / 70-90 / 155-200 / 15-25
Large / 90-120 / 200-265 / 22-35
Reference: AAPM

Allowed CTDIvol Dose Ranges:7 mGy – 50 mGy

XR29 Dose Notification Value (CTDIvol):50 mGy

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

CHARGES:WITH ONLY:CABDW

WITH&WITHOUT:CABDWWO

NETWORK:Exam to PACS

1/2017Page 3 of 3