Ct Runoff Angiography

CT RUNOFF ANGIOGRAPHY

INDICATIONS: Peripheral artery disease (PAD), claudication, bypass, deep venous thrombosis (DVT)

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

IV CONTRAST: 125mL Isovue 370 @ 4.0 mL/second. Push with 50mL Saline.

ORAL CONTRAST: None

POSITIONING: Feet First Supine, Arms above head.

TOPOGRAMS: AP. Range: RunOff Only: Above iliac crest through feet. 35 mA, 120 Kv

RunOff With Abdominal Angio: Above dome of diaphragm through feet. 35 ma, 120 kV

RunOff With Chest and Abdominal Angio: Above aortic arch through feet. 35 ma, 120 kV

SCAN TYPE: Spiral/Helical

NOTES: A second scan back up through the lower legs IS SET UP TO SCAN IF NECESSARY ONLY: IF NOT NEEDED: STOP SCAN

Send Recon-3D 0.6 x 0.3mm to Vital Workstation for 3D.

Bill for 3D in Charges section when ending exam: “3D POST PROCESSING CT”

CARE BOLUS triggered scan.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

MONITORING

Scan Range
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
(Cycle Time)
Seconds / Scan
Time
Seconds / SFOV
(cm)
Single Slice
RunOff Only: Just above
Aortic Bifurcation
RunOff/Abd Angio: Top slice
of Scan
RunOff/Chest/Abd Angio:
Above Celiac / Craniocaudal
Sequential
30 scans / Quiet
Respiration / 150 HU / 15
Seconds / OFF / 40 / OFF / 120 / Detectors: 1 x 10.0 mm
Slices Per Tube
Rotation: 1 / 0.0 mm / 1.16
Seconds / Full
0.33 Sec / 50
cm
Plane / Slice
Thickness / Interval/
Table Feed / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / 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
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)
RUNOFF ONLY:
Above Iliac Crest through Feet
RUNOFF WITH
ABDOMINAL ANGIO:
Above Celiac through Feet
RUNOFF WITH
CHEST/ABD ANGIO
Above Aortic Arch
through Feet / Craniocaudal
Spiral/Helical / Suspended
Inspiration
Through
Abd/Pelvis
Or
CAP / CARE BOLUS Tracking
(Trigger
150 HU)
Plus 6 Second Delay / ON / 84 / ON / 120 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.85
Table Increment/Speed:
16.32 mm/rotation / 033
seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – 3D AXIAL SOFT TISSUE
Send to Vital Workstation for 3D / Axial / ON
3 / 0.6 mm / 0.3 mm / I26f
Medium Smooth / Abdomen
300/40 / 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 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / 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 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL MIPS
Coronals Angled in Plane to Body Part / Coronal MIPS Angled in Plane to Body Part. Recon Card 3D Coronal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I30f
Medium Smooth / CT Angio
700/80 / FOV just beyond
patient’s body
RECON – SAGITTAL MIPS
Sagittals Angled in Plane to Body Part / Sagittal MIPS Angled in Plane to Body Part. Recon Card 3D Sagittal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I30f
Medium Smooth / CT Angio
700/80 / FOV just beyond
patient’s body

LATE ARTERIAL – IF NECESSARY ONLY

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)
RUNOFF #2:
Below Feet
Through Knees / Caudocranial
(Recon Craniocaudal)
Spiral/Helical / Quiet
Respiration / 10
Seconds / ON / 84 / ON / 100 / Detectors: 64 x 0.6 mm
Slices Per Tube Rotation: 32 / Pitch: 0.85
Table Increment/Speed:
16.32 mm/rotation / 033
seconds / 50
cm
Plane / SAFIRE
Strength / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE / Axial / ON
3 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – 3D AXIAL SOFT TISSUE
Send to Vital Workstation for 3D / Axial / ON
3 / 0.6 mm / 0.3 mm / I26f
Medium Smooth / Abdomen
300/40 / 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 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / 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 / 2.0 mm / 2.0 mm / I30f
Medium Smooth / Abdomen
300/40 / FOV just beyond
patient’s body
RECON – CORONAL MIPS
Coronals Angled in Plane to Body Part / Coronal MIPS Angled in Plane to Body Part. Recon Card 3D Coronal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I30f
Medium Smooth / CT Angio
700/80 / FOV just beyond
patient’s body
RECON – SAGITTAL MIPS
Sagittals Angled in Plane to Body Part / Sagittal MIPS Angled in Plane to Body Part. Recon Card 3D Sagittal MIP Thin / ON
3 / 10.0 mm / 2.0 mm / I30f
Medium Smooth / CT Angio
700/80 / FOV just beyond
patient’s body

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*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.

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.

CHARGES: Bill for 3D in Charges section when ending exam: “3D POST PROCESSING CT”

NETWORK: Exam to PACS

Send Recon-3D 0.6 x 0.3mm to Vital Workstation for 3D

12/2017 Page 3 of 3