CT Protocols
Frequently used policies (MCN links)
Head and neck protocols
| Position / Landmark | Level of Aortic Arch |
| Scan Start | Below Aortic Arch |
| Scan End | Above Skull |
| DFOV | 250mm |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 20G or larger, Antecubital |
| IV Contrast- Adult | 50ml OMNI 350 @ 5.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-4.0ml/sec. 50mL MAX |
| Contrast Delay | Bolus Tracked: Trigger Scan @ 120 HU |
| Reconstructions | |
|---|---|
| Axial Carotid/COW | 5mm x 2.5mm MIP |
| Axial COW | 5mm x 2.5mm MIP |
| Coronal COW | 5mm x 2.5mm MIP |
| Sagittal COW | 1mm x 1mm Avg |
| Coronal COW | 1mm x 1mm Avg |
| Sagittal COW | 1mm x 1mm Avg |
| Coronal Carotid | 5mm x 2.5mm MIP |
| Sagittal Carotid | 5mm x 2.5mm MIP |
| Coronal Carotid | 1mm x 1mm Avg |
| Sagittal Carotid | 1mm x 1mm Avg |
Notes
Scan a HEAD WO CONTRAST before CTA HEAD & NECK exam unless:
- Exam is ordered as Stereotactic for Surgery Planning
- Patient has had a Head WO Contrast within the last 6 hours.
- The ordering Provider or Radiologist does not want it
Philips notes: If Performed on Brilliance 16 Slice Scanners, use up to 80mL contrast.
| Position / Landmark | Level of Aortic Arch |
| Scan Start | Below base of nose |
| Scan End | Above head soft tissue |
| DFOV | 220mm (open FOV to include soft tissue anterior/posterior) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 20G or Larger, Antecubital |
| IV Contrast- Adult | 50ml OMNI 350 @ 5.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-4.0ml/sec. 50mL MAX |
| Contrast Delay | Bolus Tracked: Trigger Scan @ 120 HU |
| Reconstructions | |
|---|---|
| Axial Brain | 5mm x 2.5mm MIP |
| Coronal Brain | 5mm x 2.5mm MIP |
| Sagittal Brain | 5mm x 2.5mm MIP |
| Axial Brain | 1mm x 1mm Avg |
| Coronal Brain | 1mm x 1mm Avg |
| Sagittal Brain | 1mm x 1mm Avg |
Notes
Do not angle scan for any stereotactic or stealth exams. Position patient's head as straight as possible. Noncon head is not included in this exam unless requested by a provider.
| Position / Landmark | Center on patient's chin |
| Scan Start | Below base of nose |
| Scan End | Above Head Soft tissue |
| DFOV | 220mm (open FOV to include soft tissue soft tissue anterior/posterior) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | none |
| IV Contrast- Adults | none |
| IV Contrast- Pediatric | none |
| Contrast Delay | none |
| Reconstructions | |
|---|---|
| Axial Brain | 1mm x1mm |
Notes
Do not angle scan for any Stereotactic or Stealth exams. Position patient's head as straight as possible.
| Position / Landmark | Center on patient's chin |
| Scan Start | Below base of nose |
| Scan End | Above Head Soft tissue |
| DFOV | 220mm (OPEN FOV TO INCLUDE SOFT TISSUE ANTERIOR/POSTERIOR) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 22G or Larger, Antecubital |
| IV Contrast- Adult | 100ml OMNI 300 @ 2.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-2.0m/sec. 100mL MAX |
| Contrast Delay | Scan 5 minutes from Start of Injection |
| Reconstructions | |
|---|---|
| Axial Brain | 1mm x 1mm |
Notes
Do not angle scan for any Stereotactic or Stealth exams. Position patient's head as straight as possible.
| Position / Landmark | Center on patient's chin |
| Scan Start | Below base of skull |
| Scan End | Above skull |
| DFOV | 220mm |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 22G or Larger, Antecubital |
| IV Contrast- Adults | 100ml OMNI 300 @ 2.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-2.0m/sec. 100mL MAX |
| Contrast Delay | Scan 5 minutes from Start of Injection |
| Reconstructions | Adults |
|---|---|
| Axial Brain | 5mm x 5mm |
| Coronal Brain | 5mm x 5mm |
| Sagittal Brain | 5mm x 5mm |
| Axial Bone | 2mm x 2mm |
| Reconstructions | Pediatric |
|---|---|
| Axial Brain | 3mm x 3mm |
| Coronal Brain | 3mm x 3mm |
| Sagittal Brain | 3mm x 3mm |
| Axial Bone | 2mm x 2mm |
Notes
Toshiba notes: Angled Helical scan to avoid Orbits if possible. Volume Acquisition for repeats if motion artifacts present.
| Position / Landmark | Level of Aortic Arch |
| Scan Start | Below base of skull |
| Scan End | Above skull |
| DFOV | 220mm |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 20G or Larger, Antecubital |
| IV Contrast- Adult | 50ml OMNI 350 @ 5.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-4.0ml/sec. 50mL MAX |
| Contrast Delay | Bolus Tracked: Trigger Scan @ 120 HU |
| Reconstructions | |
|---|---|
| Axial Brain | 5mm x 2.5mm MIP |
| Coronal Brain | 5mm x 2.5mm MIP |
| Sagittal Brain | 5mm x 2.5mm MIP |
| Axial Brain | 1mm x 1mm Avg |
| Coronal Brain | 1mm x 1mm Avg |
| Sagittal Brain | 1mm x 1mm Avg |
Notes
Scan a HEAD WO CONTRAST before CTA HEAD exam unless:
- Exam is ordered as Stereotactic for Surgery Planning
- Patient has had a Head WO Contrast within the last 6 hours.
- The ordering Provider or Radiologist does not want it
Toshiba notes: Volume Acquisition for repeats if motion artifacts present.
| Position / Landmark | Center on Patient's Chin |
| Scan Start | Below base of skull |
| Scan End | Above skull |
| DFOV | 220mm |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 20G or Larger, Antecubital |
| IV Contrast- Adult | Adults: 100ml OMNI 300 @ 4.0-5.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-4.0ml/sec. 100mL MAX |
| Contrast Delay | Adults: Scan 45 seconds after start of injection |
| Reconstructions | Adults & Peds |
|---|---|
| Axial Brain | 5mm x 2.5mm MIP |
| Coronal Brain | 5mm x 2.5mm MIP |
| Sagittal Brain | 5mm x 2.5mm MIP |
| Axial Brain | 1mm x 1mm Avg |
| Coronal Brain | 1mm x 1mm Avg |
| Sagittal Brain | 1mm x 1mm Avg |
Notes
Scan a HEAD WO CONTRAST before CTA HEAD exam unless:
- Exam is ordered as Stereotactic for Surgery Planning
- Patient has had a Head WO Contrast within the last 6 hours.
- The ordering Provider or Radiologist does not want it
Toshiba notes: Volume Acquisition for repeats if motion artifacts present.
| Position / Landmark | Center on patient's chin |
| Scan Start | Above skull |
| Scan End | Above skull |
| DFOV | 220mm |
| Breath Hold | none |
| PO Prep | none |
| IV Access | none |
| IV Contrast | none |
| Contrast Delay | none |
| Reconstructions | Adult |
|---|---|
| Axial Brain | 5mm x 5mm |
| Coronal Brain | 5mm x 5mm |
| Sagittal Brain | 5mm x 5mm |
| Axial Bone | 2mm x 2mm |
| Reconstructions | Pediatric |
|---|---|
| Axial Brain | 3mm x 3mm |
| Coronal Brain | 3mm x 3mm |
| Sagittal Brain | 3mm x 3mm |
| Axial Bone | 2mm x 2mm |
Notes
Toshiba notes: Angled Helical scan to avoid Orbits if possible. Volume Acquisition for repeats if Motion Artifacts are present.
Spine protocols
| Position / Landmark | Level of Axillary |
| Scan Start | Base of skull (to include C1) |
| Scan End | Apices of lung (to include T1) |
| DFOV | 200mm (Larger if necessary to include entire Cervical spine anatomy.) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 22G or larger, antecubital |
| IV Contrast- Adult | 100mL OMNI 300 @ 2.0mL/sec |
| IV Contrast- Pediatric | 2ml/kg OMNI 300 @ 1.0-2.0mL/sec, 100mL MAX |
| Contrast Delay | 70 Seconds after injection start |
| Reconstructions | |
|---|---|
| Axial Bone | 1mm x 1mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
| Position / Landmark | Level of Axillary |
| Scan Start | Base of skull (to include C1) |
| Scan End | Apices of lungs (to include T1) |
| DFOV | 200mm (Larger if necessary to include entire Cervical spine anatomy.) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | none |
| IV Contrast | none |
| Contrast Delay | N/A |
| Reconstructions | |
|---|---|
| Axial Bone | 1mm x 1mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
| Position / Landmark | Level of Hips |
| Scan Start | Level of T12 (include T12) |
| Scan End | Level of S1 (include S1), include entire sacrum if requested by provider |
| DFOV | 200mm (Larger if necessary to include entire Lumbar spine anatomy.) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 22G or larger, antecubital |
| IV Contrast- Adult | 100mL OMNI 300 @ 2.0mL/sec |
| IV Contrast- Pediatric | 2mL/kg OMNI 300 @ 1.0-2.0mL/sec,100mL MAX |
| Contrast Delay | 70 seconds from start of injection |
| Reconstructions | |
|---|---|
| Axial Bone | 2mm x 2mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
| Position / Landmark | Level of Hips |
| Scan Start | Level of T12 (includeT12) |
| Scan End | Level of S1 (include S1), include entire sacrum if requested by provider |
| DFOV | 200mm (Larger if necessary to include entire Lumbar spine anatomy.) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | none |
| IV Contrast | none |
| Contrast Delay | N/A |
| Reconstructions | |
|---|---|
| Axial Bone | 2mm x 2mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
| Position / Landmark | Aortic arch |
| Scan Start | Just above External Acoustic Meatus (EAM) |
| Scan End | T1 |
| DFOV | As close to anatomy as possible without excluding relevant information |
| Breath Hold | - |
| PO Prep | None |
| IV Access | - |
| IV Contrast | - |
| Contrast Delay | - |
| Reconstructions | |
|---|---|
| Axial Bone | 1mm x 1mm |
| Coronal Bone | 3mm x 3mm |
| Sagittal Bone | 3mm x 3mm |
| Axial Soft Tissue | 1mm x 1mm |
| Position / Landmark | Level of Umbilicus |
| Scan Start | Level of C12 (include C12) |
| Scan End | Level of L1 (include L1) |
| DFOV | 200mm (Larger if necessary to include entire Thoracic spine anatomy.) |
| Breath Hold | none |
| PO Prep | none |
| IV Access | 22G or larger, antecubital |
| IV Contrast- Adult | 100mL OMNI 300 @ 2.0mL/sec |
| IV Contrast- Pediatric | 2mL/kg OMNI 300 @ 1.0-2.0mL/sec,100mL MAX |
| Contrast Delay | 70 seconds from start of injection |
| Reconstructions | |
|---|---|
| Axial Bone | 2mm x 2mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
| Position / Landmark | Level of Umbilicus |
| Scan Start | Level of C12 (include C12) |
| Scan End | Level of L1 (include L1) |
| DFOV | 200mm (Larger if necessary to include entire Thoracic spine anatomy.) |
| Breath Hold | None |
| PO Prep | None |
| IV Access | None |
| IV Contrast | None |
| Contrast Delay | N/A |
| Reconstructions | |
|---|---|
| Axial Bone | 2mm x 2mm |
| Coronal Bone | 2mm x 2mm |
| Sagittal Bone | 2mm x 2mm |
| Axial Soft Tissue | 3mm x 3mm |
Chest protocols
Chest through Liver with Contrast
Chest Venogram
Chest with Contrast
Chest WO
CTA PE Chest with Contrast
Esophogram WO
HRCT (Expiratory)
Lung Screening
Chest Navigational Bronchoscopy WO
Body protocols
| Position / Landmark | Supine (Diaphragm - pubis) |
| Topogram Direction | Top Down, Dual Scout (with arms up for correct dose modulation) |
| Respiratory Phase | Inspiration |
| Scan Type | Helical |
| Kv / mA / Rotation time (sec) | 120kVp |
| Pitch / Speed (mm/rotation) | 0.4 rotation |
| Noise Index | Dose right index 15 |
| Detector width x Rows = Beam Collimation | |
| Average Tube Output |
| First Helical Set | Non-Contrast Scan 5 x 2.5 |
|---|---|
| Slice Thickness / Spacing | 3 x 3 |
| Algorithm | STD (B) IDose 3 |
| Recon Destination | Coronal and Sagittal 5 x 2.5 |
| Second Helical Set | Hepatic Arterial 5 x 2.5 (**Diaphragm to the iliac crest**) 30 Sec delay |
|---|---|
| Slice Thickness / Spacing | 3 x 3 |
| Algorithm | STD (B) IDose 3 |
| Recon Destination | Coronal and Sagittal 5 x 2.5 |
| Third Helical Set | Portal Venous phase 5 x 2.5 (Diaphragm through the pubis) 90 sec delay |
|---|---|
| Slice Thickness / Spacing | 3 x 3 |
| Algorithm | STD (B) IDose 3 |
| Recon Destination | Coronal and Sagittal 5 x 2.5 |
| Scan Start / End Locations | See each phase above |
| DFOV | Accurate per the patient habitus |
| IV Contrast Volume / Type / Rate | Omnipaque 350 / 100mL @ 5-6 mL/sec |
| Scan Delay | Noncontrast / 30 sec / 90 sec |
| 2D / 3D Technique Used | 2D = Coronal and Sagittal, 3D = Hepatic arterial anatomy to include the celiac and all branches and the proximal SMA and any hepatic arterial variants. |
Notes
ROI in the aorta at the level of the hepatic artery on the wo images.