CT SINUSFUSION

CONTACT NUMBER:Technical Support: 1-800-595-9709

INDICATIONS:Pre-surgical. Referring physician MUST specify FUSION protocol.

PATIENT PREP:No prep

IV CONTRAST:None

ORAL CONTRAST:None

POSITIONING:Head First Supine. Position Glabelloalveolar Line horizontal/parallel to z-axis. No tilt or rotation.

Use standard head holder or table-top foam head holder.ENSURE THAT HEAD HOLDER OR SUPPORTS ARE NOT IN THE FIELD OF VIEW.

If necessary, place towels or cushions to stabilize patient’s head, BUT MAKE SURE THAT NOTHING IS PUSHING AGAINST THE PATIENT’S EARSAND THEY ARE IN NORMAL POSITION, ANDNOTHING IS TOUCHING THE PATIENT’S HEAD IN THE FIELD OF VIEW.

SCANRANGE:Superior aspect of horizontal portion of mandible completely through vertex of cranium. Include ears, maxillary teeth, tip of nose and vertex of cranium. If possible, avoid dental work to avoid artifact, a little artifact is acceptable if necessary.

FIELD OF VIEW:Smallest FOV to encompass the region of interest; just beyond patient’s anatomy. Include the EARS, maxillary teeth, TIP OF THE NOSE, and vertex.

Ensure that the tip of the nose is included in the scan and that it is the anterior point on the scan.ENSURE THAT HEAD HOLDER OR SUPPORTS ARE NOT IN THE FIELD OF VIEW.

TOPOGRAMS:Lateral. Range: Superior aspect of horizontal portion of mandible completely through vertex of cranium. 35 mA, 120 kV.

SCAN TYPE:Spiral/Helical. Use 256x256 or 512x512 matrix.

NOTES:Scan with the patient’s eyes closed.

No headgear or fiducials necessary.

Perform small field-of-view Coronal and Sagittal reformats in bone window to include all sinuses as we routinely do. Do not record to CD. PACS only.

*Record a CD with ONLYthe Axial Soft Tissue Reconstructions, No Topograms, etc... Record CDs from the scanner in uncompressed DICOM format

with NO VIEWER TOOL.

*Send CD to the referring physician (Dr.Zhou, Dr.Lamperti, Dr.Wolfe) at the PacMed Madison Clinic, or hand deliver to the Canyon Park Clinic.

ALARA – Keep radiation dose As Low As Reasonably Achievable.

CT SINUSFUSION

Scan
Range / ScanDirection
Scan Type / Respiration / Scan
Delay
(Seconds) / CARE
DOSE
4D / Effective
mAs / kV / Detector Configuration
Slices Per Tube Rotation / Pitch
Table Increment/Speed: (mm/rotation) / Rotation
Time
(Seconds) / SFOV
(cm)
Superior aspect of horizontal
Portionof mandible completely
throughvertex of cranium / Caudocranial
Spiral/Helical / Quiet
Respiration / 3
Seconds / OFF / 75 / 110 / Detectors: 16 x 0.6 mm
Slices Per Tube Rotation: 16 / Pitch: 1.0
Table Increment/Speed: 9.6 mm/rotation / 1.0
Seconds / 30
cm
Plane
Positioning and Reformat Angles / Slice
Thickness / Interval / Kernal / Window
Width/Level / DFOV
(cm)
RECON – AXIAL SOFT TISSUE
Axial – Send to Referring Physician & PACS / Axial: Position Glabelloalveolar Line
horizontal/parallel to z-axis / 1.0 mm / 1.0 mm / H30s
Medium Smooth / Mediastinum
400/40 / FOV just beyond patient’s anatomy (See Above)
RECON – CORONAL BONE MPR
Coronals Perpendicular to hard palette / Coronal Recon: Perpendicular to hard palette
Frontal Sinus Through Sphenoid Sinus
Recon Card 3D Coronal MPR / 1.0 mm / 1.0 mm / H70s
Sharp FR / Osteo
1500/450 / Small FOV to include all sinuses
RECON – SAGITTAL BONE MPR
Sagittals Parallel to Mid-Sagittal Plane / Sagittal Recon: Parallel to Mid-Sagittal Plane
Through All Sinuses
Recon Card 3D Sagittal MPR / 1.0 mm / 1.0 mm / H70s
Sharp FR / Osteo
1500/450 / Small FOV to include all sinuses

*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:4 mGy – 60 mGy

XR29 Dose Notification Value (CTDIvol):60 mGy

NETWORK:Exam to PACS2/2018