CT Protocols
Frequently used policies (MCN links)
Head and neck protocols
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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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
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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.