Ct Ivu/Ivp/Urography

CT IVU/IVP/UROGRAPHY

WITH LOW DOSE KUB

INDICATIONS: PAINLESS hematuria, recurrent UTI, bladder cancer

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

IV CONTRAST: 125mL Isovue 370 @ 3.0mL/second.

Split Dose: Inject 50 mL, Wait 6 Minutes, Inject 75 mL with 100 Second Delay.

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 ischial tuberosities. 35 mA, 120 kV.

SCAN TYPE: Spiral/Helical

NOTES: If stones seen on KUB, consult radiologist before proceeding.

If stones seen in bladder or right at UVJ on KUB, consult radiologist about possible Low Dose Prone scan through bladder.

If ureters not seen in their entirety, consult radiologist about possible Low Dose Prone or Delay scans through region

ALARA – Keep radiation dose As Low As Reasonably Achievable.

NONCONTRAST KUB – LOW DOSE

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PYELOGRAPHIC PHASE

Scan
Range / ScanDirection
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)
Dome of Diaphragm
Through
Ischial Tuberosities / Craniocaudal
Spiral/Helical / Suspended
Inspiration / 100
Seconds / ON / 120 / ON / 120 / Detectors: 64 x0.6 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
3 / 3.0 mm / 3.0 mm / I40f
Medium / Abdomen
300/40 / 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 – 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 / I40f
Medium / Abdomen
300/40 / 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 / I40f
Medium / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – RPO OBLIQUE SOFT TISSUE MPR
RPO Angled Oblique Plane to Body Part / RPO Angled Oblique 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
RECON – LPO OBLIQUE SOFT TISSUE MPR
LPO Angled Oblique Plane to Body Part / LPO Angled Oblique 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

*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.

Low Dose KUB Allowed CTDIvol Dose Ranges:2 mGy – 50 mGy

IVP Allowed CTDIvol Dose Ranges:3 mGy – 50 mGy

XR29 Dose Notification Value (CTDIvol):50 mGy

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

*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: Exam to PACS

5/2018Page 2 of 2