CT NECK/CHEST

INDICATIONS: Cancer restaging

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

IV CONTRAST: Perform as directed by the supervising radiologist.

With:100mL Isovue 370 @ 2.0 mL/second

WithOut:None

ORAL CONTRAST: None

POSITIONING: Head First Supine. Arms above head for the Chest scan, then arms by sides for the Neck scan.

TOPOGRAMS: AP. Range: Above superior orbits through lung bases/costophrenic angles or adrenals if history of lung cancer. 35 mA, 120 kV.

Lateral. Range: Above superior orbits through lung bases/costophrenic angles or adrenals if history of lung cancer. 35 mA, 120 kV.

SCAN TYPE: Spiral/Helical

NOTES: *If History of Lung Cancer scan through Adrenals*

Mark with MRI Marker/Vitamin E Capsule at any site of mass/lump.

Adjust scan delay on Neck scan according to Chest scan time in order to scan Neck at 90 seconds

ALARA – Keep radiation dose As Low As Reasonably Achievable.

*XCARE ON CHEST SCAN*

CHEST – ARMS OVERHEAD

Scan
Range / Scan
Direction
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Quality
Reference
mAs / CARE
kV / Quality
Reference
kV / XCARE / DetectorConfiguration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
-Above Lung Apices
Thru Bases/CPA
-If H/O Lung CA
Scan thru Adrenals / Craniocaudal
Spiral/Helical / Suspended
Inspiration / 40
Seconds / ON / 66 / ON / 120 / ON / Detectors: 64x0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.6
Table Increment/Speed:
11.52 mm/rotation / 0.33
Seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 3.0 mm / 3.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s body
RECON – AXIAL LUNG / Axial / ON
2 / 1.0 mm / 1.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – AXIAL MIPS
Axial MIPS / Axial MIPS
Recon Card 3D Axial MIP Thin / ON
2 / 10.0 mm / 2.0 mm / I70f
Very Sharp ASA / Lung
1200/-600 / FOV just beyond
patient’s body
RECON – CORONAL SOFT TISSUE MPR
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 / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s body
RECON – SAGITTAL SOFT TISSUE MPR
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 / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s body
HAVE PATIENT LOWER ARMS BY SIDES

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SOFT TISSUE NECK – ARMS BY SIDES

Scan
Range / Scan Direction
Scan Type / 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)
Superior Orbit to
Below Aortic Arch. / Craniocaudal
Spiral/Helical / Don’t
Swallow / 40 Seconds
(Adjust in order to scan Neck at 90 seconds) / ON / 116 / 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 SOFT TISSUE / Axial / ON
2 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck
RECON – CORONAL SOFT TISSUE MPR
Coronals Angled in Plane to Body Part / Coronals Angled in Plane to Body Part
Recon card 3D Coronal MPR / ON
3 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck
RECON – SAGITTAL SOFT TISSUE MPR
Sagittals Angled in Plane to Body Part / Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal MPR / ON
3 / 2.0 mm / 2.0 mm / I31f
Medium Smooth / Mediastinum
350/50 / FOV just beyond
patient’s neck

*The operator must check the CTDIvol before and after the scan to ensure it is within the allowed dose range. Scans performed outside of the allowed range must be

documented and reviewed by the designated radiologist and/or physicist.

Torso Allowed CTDIvol Dose Ranges:1 mGy – 50 mGy.

Torso XR29 Dose Notification Value (CTDIvol):50 mGy.

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

Neck XR29 Dose Notification Value (CTDIvol):60 mGy.

Approximate Values for TORSO CTDIvol
Patient Size / Weight (kg) / Weight (lbs) / CTDIvol (mGy)
Small / 50-70 / 110-155 / 4-10
Average / 70-90 / 155-200 / 8-16
Large / 90-120 / 200-265 / 14-22
Reference: AAPM

*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.

NETWORK:Separate Neck and Chest Exams before sending to PACS

5/2018Page 2 of 2