CHEST - HIGH RESOLUTION (HRCT WEST)
INDICATIONS:
PATIENT PREP:
IV CONTRAST:
ORAL CONTRAST:
POSITIONING:
TOPOGRAMS:
SCAN TYPE:
NOTES:
Interstitial lung disease.
“Ideally for assessment of ILD.” “Asbestosis, UIP, NSIP, HP.”
“Sarcoid – may want to ask for thin section inspiration 1mm (not always necessary to do HRCT unless ordered by
Pulmonologist)”
“If history of scleroderma ask the radiologist if HRCT is warranted”
“NB: Can always get retro recon thin sections.”
“Use HRCT questionnaire if you feel unsure”
None
None
None
Feet First Supine and Feet First Prone
Supine: AP & Lateral. Prone: AP
Supine Inspiration: Spiral/Helical. Supine Expiration and Prone Inspiration: Sequential
ALARA – Keep radiation dose As Low As Reasonably Achievable.
Packs Per Day X Number of Years Smoking = Pack-Years
*If the patient has a prior HRCT or CT Chest use Low Dose Protocol on the Supine Inspiration Chest scan.
BMI<30: Care Dose On
Reference mAs: 50
kV: 110
BMI>30: Care Dose Off
mAs: 70
kV: 110
BMI Calculator Website: www.nhlbisupport.com/bmi/
LOW DOSE SUPINE INSPIRATION CHEST
Scan
Range
Scan
Direction
Scan Type
Respiration
Scan
Delay
(Seconds)
CARE
DOSE
4D
Quality
Reference
mAs
kV
Above Lung Apices
through Adrenals
Craniocaudal
Spiral/Helical
Suspended
Inspiration
4
Seconds
BMI<30: ON
BMI>30: OFF
BMI<30: 50
BMI>30: 70
110
Plane
Collimator (mm)
Pitch
Slices Per Tube Rotation
Collimator: 0.6 mm
Slices Per Tube Rotation: 16
RECON
Axial
Slice
Thickness
3.0 mm
RECON
Axial
1.0 mm
1.0 mm
RECON
Axial
3.0 mm
3.0 mm
Axial MIPS
Recon Card 3D Axial
Coronals Angled in Plane to Body part
Recon Card 3D Coronal
Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal
10.0 mm
2.0 mm
1.0 mm
1.0 mm
1.0 mm
1.0 mm
RECON
Axial MIPS
RECON
Coronals Angled in Plane to Body Part
RECON
Sagittals Angled in Plane to Body Part
SFOV
(cm)
Table Increment/Speed: (mm/rotation)
Rotation
Time
(Seconds)
Pitch: 1.5
Table Increment/Speed: 14.4 mm/rotation
0.6
Seconds
50
cm
Interval
Kernal
3.0 mm
B35s
HeartView Medium
B60s
Sharp
B60s
Sharp
B60s
Sharp
B60s
Sharp
B60s
Sharp
Window
Width/Level
Mediastinum
450/50
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
DFOV
(cm)
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
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SUPINE INSPIRATION CHEST
Scan
Range
Scan
Direction
Scan Type
Respiration
Scan
Delay
(Seconds)
CARE
DOSE
4D
Quality
Reference
mAs
kV
Above Lung Apices
through Adrenals
Craniocaudal
Spiral/Helical
Suspended
Inspiration
4
Seconds
On
100
110
Plane
Collimator (mm)
Pitch
Slices Per Tube Rotation
Collimator: 0.6 mm
Slices Per Tube Rotation: 16
RECON
Axial
Slice
Thickness
3.0 mm
RECON
Axial
1.0 mm
1.0 mm
RECON
Axial
3.0 mm
3.0 mm
Axial MIPS
Recon Card 3D Axial
Coronals Angled in Plane to Body part
Recon Card 3D Coronal
Sagittals Angled in Plane to Body Part
Recon Card 3D Sagittal
10.0 mm
2.0 mm
1.0 mm
1.0 mm
1.0 mm
1.0 mm
RECON
Axial MIPS
RECON
Coronals Angled in Plane to Body Part
RECON
Sagittals Angled in Plane to Body Part
SFOV
(cm)
Table Increment/Speed: (mm/rotation)
Rotation
Time
(Seconds)
Pitch: 1.5
Table Increment/Speed: 14.4 mm/rotation
0.6
Seconds
50
cm
Interval
Kernal
3.0 mm
B35s
HeartView Medium
B60s
Sharp
B60s
Sharp
B60s
Sharp
B60s
Sharp
B60s
Sharp
Window
Width/Level
Mediastinum
450/50
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
Lung
1500/-700
DFOV
(cm)
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
FOV just beyond
patient’s LUNGS
SUPINE EXPIRATION CHEST
Scan
Range
Scan Direction/
Scan Type
Respiration
Scan
Delay
(Seconds)
Just Into Lung Apices
Through Lung Bases
Craniocaudal
Sequential
Suspended
Expiration
4
Seconds
RECON
CARE
DOSE
4D
On
Quality
Reference
mAs
100
kV
Collimator (mm)
110
Slices Per Acquisition
Collimator: 0.6 mm
Slices Per Acquisition: 4
Table
Feed
20.0 mm
Cycle
Time
(Seconds)
3.0
Seconds
Scan
Time
(Seconds)
1.0
Seconds
Plane
Slice
Thickness
Interval/
Table Feed
Kernal
Window
Width/Level
DFOV
(cm)
Axial
1.2 mm
20.0 mm
B60s
Sharp
Lung
1500/-700
FOV just beyond
patient’s LUNGS
SFOV
(cm)
50
cm
CHANGE PATIENT POSITION TO:
FEET FIRST PRONE
PRONE INSPIRATION CHEST
Scan
Range
Scan Direction/
Scan Type
Respiration
Scan
Delay
(Seconds)
CARE
DOSE
4D
Quality
Reference
mAs
kV
Just Into Lung Apices
Through Lung Bases
Craniocaudal
Sequential
Suspended
Inspiration
4
Seconds
On
100
110
Plane
RECON
MIRRORING ON:
BOTH RT/LT & UP/DOWN
CHARGES:
NETWORK:
11/2015
Axial
MIRRORING ON:
BOTH RT/LT & UP/DOWN
Slice
Thickness
1.2 mm
Collimator (mm)
Table
Feed
Cycle
Time
(Seconds)
Scan
Time
(Seconds)
SFOV
(cm)
20.0 mm
3.0
Seconds
1.0
Seconds
50
cm
Slices Per Acquisition
Collimator: 0.6 mm
Slices Per Acquisition: 4
Interval/
Table Feed
20.0 mm
Kernal
B60s
Sharp
Window
Width/Level
Lung
1500/-700
DFOV
(cm)
FOV just beyond
patient’s LUNGS
CCHHR
Exam to PACS
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