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Protocols for Imaging Studies in the Oncologic Patient


Well–thought-out protocols for imaging are critical to ensure that the resultant images have the best possible chance to answer the clinical question. In the case of oncologic patients, this usually hinges on whether disease is stable, has regressed, or has progressed and whether there are new sites of disease. Beyond these fundamental questions, our patients may have unexpected findings, as well as complications from therapy. The ability to answer such questions relies on high-quality images and, in the case of computed tomography (CT), the best quality titrated with the least radiation exposure, because patients generally go into a lifetime of surveillance. This is a significant challenge. In patients undergoing imaging for surgical intervention, especially for cure, these studies need to be directly targeted to the most likely sites of metastases (e.g., high-quality liver imaging for metastases in patients with orbital, choroidal melanoma) and have optimal image quality to detect metastatic disease. Imaging with multidetector computed tomography (MDCT) can be performed in multiple phases, and developing protocols to detect hyper- as well as hypovascular metastases is critical in evaluating patients with tumors such as carcinoid, islet cell tumors of the pancreas, and a number of other primaries. Timing of the contrast bolus and subsequent imaging is critical in magnetic resonance imaging (MRI) as well as current MDCT scanning.

The charts provide a selection of common protocols developed by authors of this textbook and used in their daily practice. The protocols were prepared January 2010. They are grouped together in one chapter rather than being individually recorded for the reader’s convenience. They are simply provided for a reference within the context of this textbook, and scanning protocols should be developed and tailored to each individual physician’s practice.

Multidetector Computed Tomography: Computed Tomography Imaging

Chest Protocols (MDCT 64 Slice)

  • Aorta (Gated Study)

  • Cardiac Tumor (Gated Study)

  • Chest with Contrast

  • Chest without Contrast

  • Coronary Artery Screening (Gated Study)

  • Esophageal Leak Protocol

  • Low-Dose Surveillance Chest with Contrast (Nodule or Lung Cancer)

  • Perfusion Chest without and with Contrast

  • Pulmonary Embolism Protocol

  • Superior Vena Cava Venogram

  • Chest with Contrast (Virtual Bronchoscopy)

  • Chest without Contrast (Virtual Bronchoscopy)

Abdomen/Pelvis Protocols (MDCT 64 Slice)

  • Abdomen with Contrast

  • Abdomen without Contrast

  • Abdomen without and with Contrast

  • Abdomen and Pelvis with Contrast

  • Abdomen and Pelvis without Contrast

  • Abdomen and Pelvis without and with Contrast

  • Adrenals: Abdomen with Contrast

  • Adrenals: Abdomen without and with Contrast

  • Adrenals: Abdomen and Pelvis with Contrast

  • Adrenals: Abdomen and Pelvis without and with Contrast

  • Adrenals: Chest and Abdomen with Contrast

  • Adrenals: Chest and Abdomen without and with Contrast

  • Adrenals: Chest, Abdomen, and Pelvis with Contrast

  • Adrenals: Chest, Abdomen, and Pelvis without and with Contrast

  • Angiogram/Venogram: Abdomen

  • Angiogram/Venogram: Abdomen and Pelvis

  • Appendiceal/Peritoneal: Abdomen and Pelvis without and with Contrast

  • Appendiceal/Peritoneal: Chest, Abdomen, and Pelvis without and with Contrast

  • Bowel Carcinoid: Abdomen and Pelvis without and with Contrast

  • Chest and Abdomen with Contrast

  • Chest and Abdomen without Contrast

  • Chest and Abdomen without and with Contrast

  • Chest, Abdomen, and Pelvis with Contrast

  • Chest, Abdomen, and Pelvis without Contrast

  • Chest, Abdomen, and Pelvis without and with Contrast

  • CT Colonography

  • CT Cystogram

  • Gastric: Abdomen and Pelvis without and with Contrast

  • Kidney Stone

  • Kidneys, Ureters, and Bladder for Barium

  • Liver: Abdomen without and with Contrast

  • Liver: Abdomen and Pelvis without and with Contrast

  • Liver: Chest and Abdomen without and with Contrast

  • Liver: Chest, Abdomen, and Pelvis without and with Contrast

  • Lymphoma with Contrast

  • Lymphoma without Contrast

  • Lymphoma without and with Contrast

  • Pancreas: Abdomen without and with Contrast

  • Pancreas: Abdomen and Pelvis without and with Contrast

  • Pancreas: Chest, Abdomen, and Pelvis without and with Contrast

  • Pancreatic Islet Cell: Abdomen without and with Contrast

  • Postcystectomy: Abdomen and Pelvis with Contrast

  • Postcystectomy: Chest, Abdomen, and Pelvis with Contrast

  • Postcystectomy: Chest, Abdomen, and Pelvis without and with Contrast

  • Renal: Abdomen with Contrast

  • Renal: Chest and Abdomen without and with Contrast

  • Renal: Chest, Abdomen, and Pelvis without and with Contrast

  • Renal + 3D: Abdomen without and with Contrast

  • Renal + 3D: Abdomen and Pelvis without and with Contrast

  • Renal + 3D: Chest and Abdomen without and with Contrast

  • Renal + 3D: Chest, Abdomen, and Pelvis without and with Contrast

  • CT Runoff

  • CT Runoff (Fast)

  • Enterography (Small Bowel): Abdomen and Pelvis with Contrast

  • Enterography (Small Bowel): Abdomen and Pelvis without and with Contrast

  • Enterography (Small Bowel): Chest, Abdomen, and Pelvis with Contrast

  • Enterography (Small Bowel): Chest, Abdomen, and Pelvis without and with Contrast

  • Urogram: Abdomen and Pelvis without and with Contrast

  • Urogram: Chest, Abdomen, and Pelvis without and with Contrast

Musculoskeletal (MSK) Protocols (MDCT 64 Slice)

  • MSK (Bridging Protocol) with Contrast

  • MSK (Bridging Protocol) without Contrast

  • MSK (Metal Protocol) with Contrast

  • MSK (Metal Protocol) without Contrast

  • MSK Operating Room Hi-Res Protocol (64 Slice)

  • Operating Room High-Res Protocol with Contrast

  • Operating Room High-Res Protocol without Contrast

  • Operating Room Standard Protocol (64 Slice)

  • Operating Room Standard Protocol with Contrast

  • Operating Room Standard Protocol without Contrast

  • MSK (Soft Tissue Protocol) with Contrast

  • MSK (Soft Tissue Protocol) without Contrast

  • MSK (Standard Protocol) with Contrast

  • MSK (Standard Protocol) without Contrast

Magnetic Resonance Imaging Protocols

Chest Protocols (1.5 T)

  • Parathyroid

  • Heart/Cardiac

  • Superior Sulcus

  • Delayed Enhancement (Option)

Body Protocols (1.5 T)

  • Abdomen Single Phase with Liver Acquisition with Volume Acceleration (LAVA)

  • Abdomen for Large Patient

  • Pelvis

  • Abdomen Options

  • Triphasic Abdomen with LAVA

  • Triphasic Abdomen with LAVA and Eovist

  • Fast Dynamic Abdomen

  • Cholangiogram (magnetic resonance cholangiopancreato­graphy [MRCP])

  • Kidneys with LAVA

  • Pancreas

  • Pancreas Options

  • Magnetic Resonance Angiography (MRA): Abdomen Fluoro Triggering

  • Tandem Ovoid-Gyn Brachytherapy

  • Pelvis-Cervical Cancer with Gel

  • Rectum Staging

  • Pelvis with Dynamic

  • Routine Pelvis

  • Prostate with Torso Posteroanterior (PA)

  • Prostate with Torso PA

  • Prostate with Endorectal Coil

  • Testis

  • Pelvic Bone Tumor

  • Prostate with Endorectal Coil (Prostatectomy)

  • Lower Extremity Runoff

  • Abdomen Multiple Echo Recombined Gradient Echo (MERGE)

  • Active Surveillance Prostate

  • Options: Active Surveillance Prostate

Musculoskeletal Protocols (1.5 T)

  • Thigh

  • Thigh for Metal Artifact

  • Thigh (Optional Sequences)

  • Pelvis

  • Pelvis for Metal Artifact

  • Shoulder to Include Scapula

  • Shoulder to Include Scapula

  • Shoulder to Include Scapula for Metal Artifact

  • Shoulder to Include Scapula for Metal Artifact

  • T-Spine

  • L-Spine

Visit ExpertConsult.com to view the protocols .

References

  • 1. Einhorn LH, Burgess MA, Gottlieb JA: Metastatic patterns of choro­idal melanoma. Cancer 1974; 34: pp. 1001-1004.
  • 2. Zakka KA, Foos RY, Omphroy CA, et. al.: Malignant melanoma: analysis of an autopsy population. Ophthalmology 1980; 87: pp. 549-556.
  • 3. Rajpal S, Moore R, Karakousis CP: Survival in metastatic ocular melanoma. Cancer 1983; 52: pp. 334-336.
  • 4. Bedikian AY, Legha SS, Mavligit G, et. al.: Treatment of uveal melanoma metastatic to the liver. Cancer 1995; 76: pp. 1665-1670.
  • 5. Collaborative Ocular Melanoma Study Group : Assessment of meta­static disease status at death in 435 patients with large choroidal melanoma in the Collaborative Ocular Melanoma Study (COMS). COMS Report No. 15. Arch Ophthalmol 2001; 119: pp. 670-676.
  • 6. Silverman PM: Liver metastases: optimizing detection with multi­slice CT (MSCT). Cancer Imaging 2004; 4: pp. S108-S113.
  • 7. Silverman PM, Roberts S, Tefft MC, et. al.: Helical CT of the liver: clinical application of an automated computer technique, SmartPrep, for obtaining images with optimal contrast enhancement. AJR Am J Roentgenol 1995; 165: pp. 73-78.
  • 8. Silverman P: 2002.Lippincott Williams & WilkinsPhiladelphia

Multidetector Computed Tomography: Computed Tomography Imaging

Computed Tomography Imaging

Chest Protocols (MDCT 64 Slice)

Aorta (Gated Study)

  • Scanner Type: 64 slice

  • Gastrointestinal (GI) Contrast: None

  • Intravenous (IV) Contrast: Isoosmolar and saline

  • Volume: 125 mL Isoosmolar and 50 mL saline

  • Injection Rate

ISOOSMOLAR (mL/sec) SALINE (mL/sec) SCAN DELAY (sec)
5 5 30

Electrocardiogram (ECG) Monitor: Yes

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL DFOV kVp mA DELAY RECON 1 RECON 2
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 36 120 320 5.2 Standard 2.5 mm Lung
Postcontrast
3 Contrast Cine segment 0.35 sec Aortic arch through heart 1.25 mm/6.40/0.16:1 1.25 mm 18 Center on heart to include all aorta 120 320 30

  • Reconstruction: Postcontrast: Phase recon of 1.25 mL @ 1.25 mm @ 18 DFOV, with phase setting of 75% at 0% interval.

  • Reformat

  • Precontrast

    • Coronal: 2.5 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 2.5 mm @ 0.8 mm or default—lung algorithm

  • Postcontrast

    • Oblique-sagittal: 0.8 mm @ 2.5 mm default—standard algorithm (candy cane view)

  • Comments

    • Scanning direction from superior to inferior.

    • Check heart rate on arrival. Call radiologist for heart rate >70 beats per minute (bpm).

    • Select postcontrast pitch and field of view (FOV) based on heart rate and patient size.

Cardiac Tumor (Gated Study)

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: Isoosmolar and saline

  • Volume: 125 mL Isoosmolar and 50 mL saline

  • Injection Rate

VISIPAQUE (mL/sec) SALINE (mL/sec) SCAN DELAY (sec)
5 5 30

ECG Monitor: Yes

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL DFOV kVp mA DELAY RECON 1 RECON 2
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 36 120 320 5.2 Standard 2.5 mm Lung
Postcontrast
3 Contrast Cine segment 0.35 sec Carina through heart 1.25 mm/6.40/0.16:1 1.25 mm 18 Center on heart 120 320 30

Reconstruction: Postcontrast: Phase recon of 1.25 mL @ 1.25 @ 18 DFOV, with phase setting of 5%–95% at 10% intervals.

  • Reformat

  • Postcontrast

    • Coronal: 0.8 mm @ 2.5 mm or default—standard algorithm

    • Sagittal: 0.8 mm @ 2.5 mm or default—lung algorithm

  • Comments

    • Scanning direction from superior to inferior.

    • Check heart rate on arrival. Call radiologist for heart rate >70 bpm.

    • Select postcontrast pitch and FOV based on heart rate and patient size.

Chest with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: Contrast 320 mgI/mL

  • Volume: 100 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
3 30
2.5 35
2 40

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midabdomen 120 10
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 120 570 30 Standard 2.5 mm Lung

  • Reformat

    • Coronal: 2.5 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 2.5 mm @ 0.8 mm or default—lung algorithm

  • Comments: Scanning direction from superior to inferior.

Chest without Contrast

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: None

  • Volume: None

  • Injection Rate: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 120 570 5.2 Standard 2.5 mm Lung

  • Reformat

    • Coronal: 2.5 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 2.5 mm @ 0.8 mm or default—lung algorithm

  • Comments: Scanning direction from superior to inferior.

Coronary Artery Screening (Gated Study)

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: Isoosmolar and saline

  • Volume: 125 mL Isoosmolar and 50 mL saline

  • Injection Rate

ISOOSMOLAR (mL/sec) SALINE (mL/sec) SCAN DELAY (sec)
5 5 30

ECG Monitor: Yes

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL DFOV kVp mA DELAY RECON 1 RECON 2
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Cine smart score Apex through adrenals 2.5 mm/8i/0.05 2.5 mm 36 120 320 5.2 Standard 2.5 mm Lung
Postcontrast
3 Contrast Cine segment 0.35 sec Carina to below the heart 1.25 mm/6.40/0.16:1 1.25 mm 18 Center on heart 120 320 30

  • Reconstruction: Postcontrast: Phase recon of 1.25 mL @ 1.25 mm @ 18 DFOV, with phase setting of 5%–95% at 10% intervals.

  • Reformat : Postcontrast

    • Coronal 0.8 mm @ 2.5 mm or default—standard algorithm

    • Sagittal 0.8 mm @ 2.5 mm or default—lung algorithm

  • Comments

    • Scanning direction from superior to inferior.

    • Check heart rate on arrival. Call radiologist for heart rate >70 bpm.

    • Select postcontrast pitch and FOV based on heart rate and patient size.

Esophageal Leak Protocol

  • Scanner Type: 64 slice

  • GI Contrast

    • None for precontrast

    • 16 oz 2% barium sulfate or Gastroview for postcontrast chest

  • IV Contrast: Contrast 320 mgI/mL

  • Volume: 100 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
3 35

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Helical Full 0.8 Lung apices to adrenals 2.5 mm/39.37/0.984:1/ 64 2.5 mm 120 320 5.2 Standard 1.25 mm Lung
Postcontrast (Give 1 Cup Oral before Giving IV Contrast)
3 Contrast Helical Full 0.8 Lung apices to adrenals 2.5 mm/ 39.37/0.984:1/64 2.5 mm 120 360 35 Standard 1.25 mm Lung

  • Reformat

    • Coronal: 1.25 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 1.25 mm @ 0.8 mm or default—lung algorithm

  • Comments

    • Scanning direction from superior to inferior.

    • Cannot be combined with abdominal CT.

Low-Dose Surveillance Chest with Contrast (Nodule or Lung Cancer)

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: Contrast 320 mgI/mL

  • Volume: 100 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
3 30
2.5 35
2 40

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DFOV DELAY RECON 1 RECON 2
1 Scout AP & lateral C3 to midabdomen 120 10
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.0 mm 120 50 ≤38 30 Standard 2.5 mm Lung
Contrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.0 mm 120 100 ≥40 30 Standard 2.5 mm Lung

  • Reformat : None

  • Comments: Scanning direction from superior to inferior.

Perfusion Chest without and with Contrast

  • Scanner Type: 64 slice

  • IV Contrast: 320 mgI/mL

  • Volume:

    • <100 lb    100 mL

    • 100–200 lb  125 mL

    • >200 lb    150 mL

  • Injection Rate:2 mL/sec

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midab­domen 120 10
Precontrast
2 Precontrast Helical Full 0.5 Apex through adrenals 2.5 mm/20.62/0.516:1/64 1.5 mm 120 200 5.2 Standard 2.5 mm Lung
Postcontrast
3 Contrast Helical Full 0.5 Cover mass 1.25 mm/20.62/0.516:1/64 0.625 mm 120 200 0 Standard 0.625 mm Lung
Contrast Helical Full 0.5 Cover mass 1.25 mm/20.62/0.516:1/64 0.625 mm 120 200 5 Standard 0.625 mm Lung
Contrast Helical Full 0.5 Cover mass 1.25 mm/20.62/0.516:1/64 0.625 mm 120 200 90 Standard 0.625 mm Lung
Contrast Helical Full 0.5 Cover mass 1.25 mm/20.62/0.516:1/64 0.625 mm 120 200 180 Standard 0.625 mm Lung
Contrast Helical Full 0.5 Cover mass 1.25 mm/20.62/0.516:1/64 0.625 mm 120 200 300 Standard 0.625 mm Lung

  • Comments

    • Scanning direction from superior to inferior.

    • Schedule patient in rose and green zones ONLY and before 5:00 pm .

PE Protocol

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: Contrast 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
4.2 20

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to midabdomen 120 10
Postcontrast
2 Contrast Helical Full 0.8 Diaphragm to apex 1.25 mm/39.37/0.984:1/64 1.25 mm 120 360 25 Standard 1.25 mm Lung

  • Reformat

    • Coronal: 1.25 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 1.25 mm @ 0.8 mm or default—lung algorithm

  • Comments

    • Scanning direction from inferior to superior.

    • MD check.

Superior Vena Cava Venogram

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: 320 mgI/mL

  • Volume: 100 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
3 35

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midabdomen 120 10
Postcontrast
2 Contrast Helical Full 0.8 Lung apices to adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 120 320 35 Standard 1.25 mm Lung
Delayed Images
3 Delayed contrast Helical Full 0.8 Lung apices to adrenals 1.25 mm/39.37/0.984:1/64 1.25 mm 120 360 20 Standard 1.25 mm Lung

  • Reformat

    • Postcontrast Images

      • Coronal: 0.8 mm @ 2.5 mm or default—standard algorithm

      • Sagittal: 0.8 mm @ 2.5 mm or default—lung algorithm

    • Delayed Contrast Images

      • Coronal: 0.8 mm @ 2.5 mm or default—standard algorithm

      • Sagittal: 0.8 mm @ 2.5 mm or default—lung algorithm

  • Comments

    • Scanning direction from superior to inferior.

    • Start IV on affected side.

    • Bilateral arm injection will be determined by the radiologist.

Chest with Contrast (Virtual Bronchoscopy)

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: 320 mgI/mL

  • Volume: 100 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
3 30
2.5 35
2 40

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to midabdomen 120 10
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 120 320 30 Standard 2.5 mm lung

  • 1.25 mm @ 0.625 mmStandard

  • Reformat

    • Coronal: 2.5 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 2.5 mm @ 0.8 mm or default—lung algorithm

  • Comments: Scanning direction from superior to inferior.

Chest without Contrast (Virtual Bronchoscopy)

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: None

  • Volume: None

  • Injection Rate: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to midabdomen 120 10
Precontrast
2 Precontrast Helical Full 0.8 Apex through adrenals 2.5 mm/39.37/0.984:1/64 2.5 mm 120 320 5.2 Standard 2.5 mm lung

  • 1.25 mm @ 0.625 mm Standard

  • Reformat

    • Coronal: 2.5 mm @ 0.8 mm or default—standard algorithm

    • Sagittal: 2.5 mm @ 0.8 mm or default—lung algorithm

  • Comments: Scanning direction from superior to inferior.

Abdomen/Pelvis Protocols (MDCT 64 Slice)

Abdomen with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to midpelvis 120
Postcontrast
2 Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard
Delayed Images
3 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 120 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Abdomen without Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: None

  • Volume: None

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to midpelvis 120
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of crest 5 mm/39.37/0.984:1/64 5 mm 120 400 11 5.6 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Abdomen without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to midpelvis 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 120 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Abdomen and Pelvis with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120 10
Postcontrast
2 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard
Delayed Images
3 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 120 Standard 2.5 mm Standard
4 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 400 11 180 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Abdomen and Pelvis without Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: None

  • Volume: None

  • Injection Rate: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Abdomen and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard
Delayed Images
Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 120 Standard 2.5 mm Standard
Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 400 11 180 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Abdomen with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to midpelvis 120
Postcontrast
2 Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 60 Standard 2.5 mm Standard
15 Min Delayed
3 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Abdomen without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to trochanter 120
Precontrast
2 Precontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 315 5.2
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 60 Standard 2.5 mm Standard
15 Min Delayed
4 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Abdomen and Pelvis with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: Contrast 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120
Postcontrast
2 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 60 Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 180 Standard 2.5 mm Standard
15 Min Delayed
5 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Abdomen and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to trochanter 120
Precontrast
2 Precontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 315 5.2
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 60 Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 180 Standard 2.5 mm Standard
15 Min Delayed
5 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments : Scanning direction from superior to inferior.

Adrenals

Chest and Abdomen with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to midpelvis 120
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 500 35 Standard 2.5 mm Standard 2.5 mm Lung
Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 20 Standard 2.5 mm Standard
15 Min Delayed
4 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Chest and Abdomen without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to trochanter 120
Precontrast
2 Precontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 315 5.2
Postcontrast
3 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 500 35 Standard 2.5 mm Standard 2.5 mm Lung
Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 20 Standard 2.5 mm Standard
15 Min Delayed
4 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Chest, Abdomen, and Pelvis with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to trochanter 120
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 500 35 Standard 2.5 mm Standard 2.5 mm Lung
Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 20 Standard 2.5 mm Standard
Delayed Images
3 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 180 Standard 2.5 mm Standard
15 Min Delayed
4 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Adrenals

Chest, Abdomen, and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

MANUAL
INJECTION RATE (mL/sec) SCAN DELAY (sec)
5 60

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral C3 to trochanter 120
Precontrast
2 Precontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 315 5.2
Postcontrast
3 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 500 35 Standard 2.5 mm Standard 2.5 mm Lung
Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 20 Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 180 Standard 2.5 mm Standard
15 Min Delayed
5 Delayed contrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 120 650 11.5 15 min Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Angiogram/Venogram

A bdomen

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY
Aorta at celiac region 5 10 100 6
Aorta at celiac region 4 10 100 6

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA Max NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to midpelvis 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 140 400 13 5.2 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Liver through crest 2.5 mm/39.37/0.984:1/64 2.5 mm 140 770 10 SP Standard 0.625 mm Standard
Contrast Helical Full 0.8 Liver through crest 2.5 mm/39.37/0.984:1/64 2.5 mm 140 770 10 29 Standard 0.625 mm Standard
Contrast Helical Full 0.8 Liver through crest 2.5 mm/39.37/0.984:1/64 5 mm 140 400 12 90 Standard 2.5 mm Standard

  • Comments

    • Scanning direction from superior to inferior.

    • Do coronal and sagittal reformat postcontrast 1 and 2.

Angiogram/Venogram

Abdomen and Pelvis

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY
Aorta at celiac region 5 10 100 6
Aorta at celiac region 4 10 100 6

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA Max NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to midpelvis 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Liver and kidneys 5 mm/39.37/0.984:1/64 5 mm 140 400 13 5.2 Standard 2.5 mmStandard
Postcontrast
3 Contrast Helical Full 0.8 Liver through symphysis 2.5 mm/39.37/0.984:1/64 2.5 mm 140 770 10 SP Standard 0.625 mm Standard
Contrast Helical Full 0.8 Liver through symphysis 2.5 mm/39.37/0.984:1/64 2.5 mm 140 770 10 29 Standard 0.625 mm Standard
Contrast Helical Full 0.8 Liver through symphysis 2.5 mm/39.37/0.984:1/64 5 mm 140 400 12 90 Standard 2.5 mm Standard
Contrast Helical Full 0.8 Bladder 2.5 mm/39.37/0.984:1/64 5 mm 140 400 12 180 Standard 2.5 mm Standard

  • Comments

    • Scanning direction from superior to inferior.

    • Do coronal and sagittal reformat postcontrast 1 and 2.

Appendiceal/Peritoneal

Abdomen and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: Gastroview 15 mL/400 mL (oral & rectal)

  • IV Contrast: 350 mgI/mL or Iso-osmolar 320 mgI/mL

  • Volume: 150 mL contrast @ 4 mL/sec followed by 100 mL normal saline @ 3 mL/sec

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 4 10 100 10 4 (120 mL) 25
Aorta at celiac region 3 10 100 15 3 (150 mL) 35
Aorta at celiac region 2.5 10 100 20 2.5 (150 mL) 45

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of bladder 5 mm/39.37/0.984:1/64 5 mm 120 375 5.2 Standard 2.5 mm Standard
Postcontrast (Arterial)
3 Contrast Helical Full 0.8 Top of liver to bottom of kidneys 5 mm/39.37/0.984:1/64 5 mm 120 500 SP Standard 2.5 mm Standard 0.625 mm @ 0.312 mm
Postcontrast (Portal)
4 Contrast Helical Full 0.8 Top of liver to bottom of bladder 5 mm/39.37/0.984:1/64 5 mm 120 625 9.5 Standard 2.5 mm Standard 0.625 mm @ 0.312 mm
Delayed Images
5 Delayed contrast Helical Full 0.8 Top of liver through bladder 2.5 mm/39.37/0.984:1/64 2.5 mm 120 375 210 Standard 2.5 mm Standard 0.625 mm @ 0.312 mm

  • Comments

    • Scanning direction from superior to inferior.

    • Do coronal and sagittal reformat on all phases of the postcontrast images .

Appendiceal/Peritoneal

Chest, Abdomen, and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: Gastroview 15 mL/400 mL (oral & rectal)

  • IV Contrast: 350 mgI/mL or Isoosmolar 320 mgI/mL

  • Volume: 150 mL contrast @ 4 mL/sec followed by 100 mL normal saline @ 3 mL/sec

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 4 10 100 15 4 (120 mL) 25
Aorta at celiac region 3 10 100 20 3 (150 mL) 35
Aorta at celiac region 2.5 10 100 25 2.5 (150 mL) 45

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of bladder 5 mm/39.37/0.984:1/64 5 mm 120 375 5.2 Standard 2.5 mm Standard
Postcontrast (Arterial)
3 Contrast Helical Full 0.8 Top of liver to bottom of kidneys 5 mm/39.37/0.984:1/64 5 mm 120 500 SP Standard 2.5 mm Standard 0.625 mm @ 0.312 mm
Postcontrast (Portal)
4 Contrast Helical Full 0.8 Top of liver to bottom of bladder 5 mm/39.37/0.984:1/64 5 mm 120 625 9.5 Standard 2.5 mm Standard 0.625 mm @ 0.312 mm
Postcontrast
5 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 9.5 Standard 2.5 mm Standard 2.5 mm Lung
Delayed Images
6 Delayed contrast Helical Full 0.8 Top of liver through bladder 2.5 mm/39.37/0.984:1/64 2.5 mm 120 375 210 Standard 2.5 mm Standard 0.625 mm @ 0.312 mm

  • Comments

    • Scanning direction from superior to inferior.

    • Do coronal and sagittal reformat on all phases of the postcontrast images .

Bowel Carcinoid

Abdomen and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast

  • Volume

    • 1st Dose: 1 bottle (450 mL) 60 min before scan

    • 2nd Dose: 1 bottle (450 mL) 40 min before scan Rectal Contrast:Water

    • 3rd Dose: ½ bottle (225 mL) 20 min before scan

    • 4th Dose: ½ bottle (225 mL) on table

  • IV Contrast: 350 mgI/mL

  • Volume: 150 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 5 10 100 10 5 (150 mL) 30
Aorta at celiac region 4 10 100 10 4 (125 mL) 30

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA MAX NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to trochanter 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of symphysis pubis 5 mm/39.37/0.984:1/64 5 mm 140 400 12 5.2 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to bottom of symphysis pubis 2.5 mm/39.37/0.984:1/64 2.5 mm 140 715 18 SP Standard 0.625 mm Standard
Contrast Helical Full 0.8 Top of liver to bottom of symphysis pubis 2.5 mm/39.37/0.984:1/64 2.5 mm 140 715 18 24 Standard 0.625 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Top of liver to bottom of symphysis pubis 5 mm/39.37/0.984:1/64 5 mm 140 400 12 90 Standard 2.5 mm Standard
Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 140 400 12 180 Standard 2.5 mm Standard

  • Reformat

    • Coronal: 0.625 mm @ 0.625 mm (all series 3).

    • Sagittal: 0.625 mm @ 0.625 mm (all series 3).

Chest and Abdomen with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midpelvis 120 10
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard 2.5 mm Lung
3 Contrast Helical Full 0.8 Top of liver to crest 5 mm/39.37/0.984:1/64 5 mm 120 400 11 25 Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 150 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Chest and Abdomen without Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: None

  • Volume: None

  • Injection Rate: None

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midpelvis 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard 2.5 mm Lung
3 Noncontrast Helical Full 0.8 Top of liver to midpelvis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Chest and Abdomen without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to midpelvis 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 120 400 11 5.6 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard 2.5 mm Lung
4 Contrast Helical Full 0.8 Top of liver to midpelvis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 25 Standard 2.5 mm Standard
Delayed Images
5 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 150 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Chest, Abdomen, and Pelvis with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to trochanter 120 10
Postcontrast
2 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard 2.5 mm Lung
3 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 25 Standard 2.5 mm Standard
Delayed Images
4 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 150 Standard 2.5 mm Standard
5 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 400 11 180 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Chest, Abdomen, and Pelvis without Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: None

  • Volume: None

  • Injection Rate: None

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to trochanter 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard 2.5 mm Lung
3 Noncontrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Chest, Abdomen, and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: 2% barium sulfate or Gastrografin or water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 3 10 100 40 3 60
Aorta at celiac region 2.5 10 100 45 2.5 65
Aorta at celiac region 2 10 100 50 2 70

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral C3 to trochanter 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 120 400 11 5.6 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Apex through adrenals 5 mm/39.37/0.984:1/64 5 mm 120 400 11 SP Standard 2.5 mm Standard 2.5 mm Lung
4 Contrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 25 Standard 2.5 mm Standard
Delayed Images
5 Delayed contrast Helical Full 0.8 Kidneys 5 mm/39.37/0.984:1/64 5 mm 120 400 11 150 Standard 2.5 mm Standard
6 Delayed contrast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 120 400 11 180 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

CT Colonography

  • Scanner Type: 64 slice

  • GI Contrast: CO 2 (see insufflator instructions)

  • IV Contrast: None

  • Volume: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
Scout Supine
1 Scout AP & lateral Midsternum to trochanter 120 10
SUPINE
2 Noncontrast Helical Full 0.5 Diaphragm to symphysis 1.25 mm/39.37/0.984:1/64 0.8 mm 120 100 0 Standard
Scout Prone
3 Scout AP & lateral Midsternum to trochanter 120 10
Prone
4 Noncontrast Helical Full 0.5 Diaphragm to symphysis 1.25 mm/39.37/0.984:1/64 0.8 mm 120 100 0 Standard

  • Comments: Scanning direction from superior to inferior.

Computed Tomography Cystogram

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: 320 mgI/mL

  • Instructions: Prepare contrast by injecting 75 mL of Optiray 320 into a 500-mL bag of normal saline.

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA NI DELAY RECON 1 RECON 2
1 Scout AP & lateral Midsternum to trochanter 120 10
Instill 200 mL prepared contrast via Foley catheter into the urinary bladder .
2 Contrast Helical Full 0.8 Top of crest to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard
MD Check!!! If no extravasation detected, instill remainder of contrast .
3 Contrast Helical Full 0.8 Top of crest to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Soft 2.5 mm Standard
Optional Series Prone (If Radiologist Orders)
4 Scout Prone AP & lateral Midabdomen to trochanter 120 10
5 Contrast Prone Helical Full 0.8 Top of crest to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 400 11 0 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Gastric

Abdomen and Pelvis without and with Contrast

  • Scanner Type: 64 slice

  • GI Contrast: Water (oral & rectal)

  • IV Contrast: 350 mgI/mL

  • Volume: 125 mL

  • Injection Rate

BOLUS-TRACKING MANUAL
MONITORING LOCATION INJECTION RATE (mL/sec) MONITORING DELAY ENHANCEMENT THRESHOLD DIAGNOSTIC DELAY INJECTION RATE (mL/sec) SCAN DELAY (sec)
Aorta at celiac region 5 10 100 13 5 (150 mL) 33
Aorta at celiac region 4 10 100 13 4 (125 mL) 33

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA Max NI DELAY RECON 1 RECON 2 RECON 3
1 Scout AP & lateral Midsternum to trochanter 140 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 140 400 13 5.2 Standard 2.5 mm Standard
Postcontrast
3 Contrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 140 715 10 SP Standard 2.5 mm Standard
Contrast Helical Full 0.8 Top of liver to bottom of liver 5 mm/39.37/0.984:1/64 5 mm 140 715 10 22 Standard 2.5 mm Standard
Contrast Helical Full 0.8 Continue to symphysis 5 mm/39.37/0.984:1/64 5 mm 140 400 12 15 Standard 2.5 mm Standard
Delayed Images
4 Delayed con­trast Helical Full 0.8 Liver & kidneys 5 mm/39.37/0.984:1/64 5 mm 140 400 12 90 Standard 2.5 mm Standard
Delayed con­trast Helical Full 0.8 Bladder 5 mm/39.37/0.984:1/64 5 mm 140 400 12 120 Standard 2.5 mm Standard

  • Comments: Scanning direction from superior to inferior.

Kidney Stone

  • Scanner Type: 64 slice

  • GI Contrast: None

  • IV Contrast: None

  • Volume: None

  • Injection Rate: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120 10
Precontrast
2 Noncontrast Helical Full 0.8 Top of liver to symphysis 5 mm/39.37/0.984:1/64 5 mm 120 630 5.2 Standard 2.5 mm Standard

  • Comments

    • Scanning direction from superior to inferior.

    • MD check!!!

Kidney, Ureter, and Bladder for Barium

  • Scanner Type: 64 slice

  • IV Contrast: None

  • Volume: None

  • Injection Rate: N/A

SERIES DESCRIP SCAN TYPE AREA THICK/SPEED/PITCH/CHAN INTERVAL kVp mA DELAY RECON 1 RECON 2 RECON 3 RETRO RECON
1 Scout AP & lateral Midsternum to trochanter 120 10
Precontrast
2 Precontrast Axial Full 0.4 1st concentration of barium 5.0/L 10 mm 120 630 5.2 Standard
Precontrast Axial Full 0.4 2nd concentration of barium 5.0/L 10 mm 120 630 5.2 Standard
Precontrast Axial Full 0.4 3rd concentration of barium 5.0/L 10 mm 120 630 5.2 Standard

  • Comments

    • Scanning direction from superior to inferior.

    • MD check to see if patient can continue with the preparation.

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