CT Protocols

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:

  1. Exam is ordered as Stereotactic for Surgery Planning
  2. Patient has had a Head WO Contrast within the last 6 hours.
  3. 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.

CT Head with contrast positioning image for scanning protocol
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:

  1. Exam is ordered as Stereotactic for Surgery Planning
  2. Patient has had a Head WO Contrast within the last 6 hours.
  3. 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:

  1. Exam is ordered as Stereotactic for Surgery Planning
  2. Patient has had a Head WO Contrast within the last 6 hours.
  3. 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 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

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine centered above the lung apices
Scout Start Lung apices
Scout End Through lung bases
DFOV Based on body habitus. Include skin surface if possible.
Breath Hold Inspiration
PO Prep none
IV Access none
IV Contrast none
Contrast Delay N/A
Reconstructions
Mediastinal 1.0 mm x 0.5 mm
Lung Axial 1.0 mm x 0.5 mm
Coronal Lung 1.0 mm x 1.5 mm
Lung Axial MIP 10 mm x 5 mm
Cor Lung MIP 10 mm x 5 mm
Sag Bone 3 mm x 1.5 mm

Indications: cancer, pain, staging

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image

Indications:  pain, cancer, trauma, mass

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine centered above the lung apices
Scout Start Above lung apices
Scout End Adrenals/upper kidneys
DFOV Based on body habitus. Include skin surface if possible.
Breath Hold Inspiration
PO Prep none
IV Access 18g -22g, Location: No lower than 2" below the AC crease of the elbow, pressure approved TLC, PICC lines, (NOTE: For PV IV flush with the arm in the position it will be for the scan)
IV Contrast- Adult OMNI 350, <150 lbs. = 80mL @ 3ml/sec, 150-250 lbs. = 100mL @ 3ml/sec, >250 lbs. = 125mL @ 3ml/sec
IV Contrast- Pediatric OMNI 350, 1ml/kg Omni 300 @ 1.5-2ml/sec (maximum dose 125mL)
Contrast Delay 35 sec
Reconstructions
Mediastinal 3 mm x 1.5 mm
Lung Axial 3 mm x 1.5 mm
Coronal Lung 3 mm x 1.5 mm
Coronal ST 3 mm x 1.5 mm

Indications:  nodule, PNA, cough

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine centered above the lung apices
Scout Start Above apices
Scout End Adrenals/upper kidneys
DFOV Based on body habitus. Include skin surface if possible.
Breath Hold Inspiration
PO Prep none
IV Access none
IV Contrast none
Contrast Delay N/A
Reconstructions
Mediastinal 3mm x 1.5mm
Lung Axial 3mm x 1.5mm
Coronal Lung 3mm x 1.5mm
Sag Bone 3mm x 1.5mm
CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine centered above the lung apices
Scout Start Above apices
Scan End Below lung bases
DFOV Based on patient size- lungs only
Breath Hold Dynamic Expiration
PO Prep None
IV Access N/A
IV Contrast None
Contrast Delay N/A
Reconstructions
Lung 3.0mm x 1.5mm

Notes

CT expiration chest includes a routine chest wo contrast unless otherwise stated in the protocol by Radiologist.

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine, centered above the lung apices, Arms down
Scout Start Above apices
Scout End Below lung bases
DFOV Based on patient size- chest only
Breath Hold Maximum inspiration
PO Prep none
IV Access N/A
IV Contrast none
Contrast Delay N/A
Reconstructions
Mediastinal 3 mm x 1.5 mm
Thin ST 1 mm x 0.8 mm (512x512 matrix)
Lung 3 mm x 1.5 mm
Coronal Lung 3 mm x 1.5 mm
Sag Bone 3 mm x 1.5 mm

Notes

Thin data set must be at 512 matrix with a maximum image count of 690 (or less) to load into the Super D system.

CT Protocol Mediastinal Lung Image
CT protocol mediastinal lung image
Position / Landmark Supine, centered above the lung apices
Scout Start Lung apices
Scout End Below lung bases
DFOV Based on patient body habitus- chest only
Breath Hold Stop Breathing
PO Prep none
IV Access 18g -20g or larger, Location: No lower than 2" below the AC (crease of the elbow, pressure approved TLC, PICC lines, (NOTE: For PV IV flush with the arm in the position it will be for the scan)
IV Contrast OMNI 350, <299 lbs. = 80mL, >300 lbs. = 100mL
IV Contrast- Pediatric Peds < or = 17 yrs., 2mL/kg with a max of 120mL OMNI 300
Bolus Tracker Location/HU Trigger Pulmonary Artery/ 150 HU
Contrast Delay 6 sec. post threshold delay
Reconstructions:
Mediastinal 2 mm x 1 mm
Coronal ST 2 mm x 1 mm
Lung 3 mm x 1.5 mm
Coronal Lung 3 mm x 1.5 mm
MIP Obliques 12 mm x 3 mm

Notes

Coach patient on proper breathing instructions prior to starting scan.

Toshiba notes: Save a snapshot of your bolus tracker location by pressing F7 and send it to pacs.