SOMATOM Emotion 6/16-slice configuration Application Guide Protocols Principles Helpful Hints Software Version syngo CT 2007E
The information presented in this application guide is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Solutions Inc., to be used for any purpose in that regard.
Overview User Documentation 16 Scan and Reconstruction 18 Dose Information 42 Workflow Information 64 Contrast Medium 122 Application Information 136 Head 162 Neck 204 Shoulder 218 Thorax 226 Abdomen 262 Spine 294 Pelvis 314 Upper Extremities 332 Lower Extremities 346 Vascular 360 Specials 416 Radiation Therapy 462 3
Overview 4 Respiratory Gating 484 Children 508
Overview 5
Contents User Documentation 16 Scan and Reconstruction 18 • • • • • • • • • • • • • • • • Concept of Scan Protocols 18 Scan Set Up 19 Feed in/Feed out 19 Topo Length 20 Scan Modes 21 - Sequential Scanning 21 - Spiral Scanning 21 - Quick Scan 22 - Dynamic Multiscan 22 - Dynamic Serioscan 22 UFC detector 23 Acquisition, Slice Collimation and Slice Width 24 - SOMATOM Emotion 16-slice configuration 25 - SOMATOM Emotion 6-slice configuration 26 Increment 27 Pitch 27 Kernels 28 - Head Kernels 32 - Child H
Contents • CARE Dose 4D 47 - How does CARE Dose 4D work? 49 - Special Modes of CARE Dose 4D 53 - Scanning with CARE Dose 4D 54 - Adjusting the Image Noise 58 - Activating and Deactivating 61 - Conversion of Old Protocols into Protocols with CARE Dose 4D 61 - Additional Important Information 63 Workflow Information • • • • 64 WorkStream4D 64 - Recon Jobs 64 - 3D Recon 65 - 1. Sagittal/Coronal Reconstructions 71 - 2.
Contents - Change parameters 103 - Import scan protocols from SOMATOM LifeNet/CD 117 Contrast Medium • • • • Contrast Medium - The Basics - IV Injection Bolus Tracking Test Bolus using CARE Bolus Test Bolus - CARE Contrast Application Information • • • • • • SOMATOM LifeNet - General Information - Key Features - SOMATOM LifeNet offline - SOMATOM LifeNet online Image Converter Report Template Configuration File Browser Camtasia - Key features - Additional Important Information Patient Protocol Head •
Contents - InnerEarHRVol InnerEar InnerEarSeq Sinus SinusVol Orbit Dental Neck • • Overview - General Hints - Body Kernels Scan Protocols - NeckRoutine - NeckThinSlice - NeckVol Shoulder • • Overview - General Hints - Body Kernels Scan Protocols - Shoulder - ShoulderVol Thorax • • Overview - General Hints - Body Kernels Scan Protocols - ThoraxRoutine/ ThoraxRoutine06s - ThoraxCombi/ ThoraxCombi06s - ThoraxVol - ThoraxFast/ 180 184 188 192 196 198 200 204 204 206 207 208 208 212 214 218 218 219
Contents ThoraxFast06s ThoraxHR ThoraxHRSeq ThoraxECGHRSeq LungLowDose/ LungLowDose06s - LungCARE/ LungCARE06s - Abdomen • • Overview - General Hints - Body Kernels Scan Protocols - AbdomenRoutine/ AbdomenRoutine06s - AbdomenCombi/ AbdomenCombi06s - AbdomenVol - AbdomenFast/ AbdomenFast06s - AbdMultiPhase/ AbdMultiPhase06s - AbdomenSeq - Colonography/ Colonography06s Spine • • 10 Overview - General Hints - Body Kernels Scan Protocols - C-Spine - C-SpineVol - SpineRoutine - SpineThinSlice - SpineVol
Contents - SpineSeq - Osteo Pelvis • • Overview - General Hints - Body Kernels Scan Protocols - Pelvis - PelvisVol - Hip - HipVol - SI_Joints Upper Extremities • • Overview - General Hints - Body Kernels Scan Protocols - WristHR - ExtrRoutineHR - ExtrCombi Lower Extremities • • Overview - General Hints - Body Kernels Scan Protocols - Knee - Foot - ExtrRoutineHR - ExtrCombi 308 312 314 314 316 317 318 318 322 324 328 330 332 332 334 335 336 336 340 344 346 346 348 349 350 350 352 354 358 11
Contents Vascular • • Overview - General Hints - Head Kernels - Body Kernels Scan Protocols - HeadAngio/ HeadAngio06s - HeadAngioVol - CarotidAngio/ CarotidAngio06s - CarotidAngioVol - ThorAngioRoutine/ ThorAngioRoutine06s - ThorAngioVol - ThorAngioECG/ ThorAngioECG06s - ThorAngioECGSeq - Embolism/ Embolism06s - BodyAngioRoutine/ BodyAngioRoutine06s - BodyAngioVol - BodyAngioFast/ BodyAngioFast06s - AngioRunOff/ AngioRunOff06s - WholeBodyAngio Specials • • 12 Overview - Trauma - Interventional CT - Te
Contents - PolyTrauma/ PolyTrauma06s - HeadTrauma - HeadTraumaSeq - Additional Important Information • Interventional CT - Biopsy - Biopsy - Biopsy Single • Interventional CT - CARE Vision - The Basics - CAREVision - CAREVisionSingle - CAREVisionBone - HandCARE - Additional Important Information • General Information for Biopsy and CARE Vision - Interventional Toolbar - CAREView - Configuration - Routine Subtask card - Additional Important Information • TestBolus Protocol - TestBolus Radiation Therapy • •
Contents Respiratory Gating • • • • • • Key Features 486 - Respiratory Gating 486 - Respiration Monitoring 486 - Respiration Synchronization 487 Positioning of the respiratory sensor belt 488 Scanning Information 490 - Scan Parameters 490 - Temporal Resolution 491 - Technical Principles 491 - Respiratory Triggering 491 - Respiratory gating 492 - Prospective respiratory triggering versus retrospective respiratory gating 494 - Curve Editor 495 - Synthetic Trigger/Sync 497 Workflow 498 - Reconstruction and
Contents - ThoraxRoutine/ ThoraxRoutine06s - ThoraxCombi/ ThoraxCombi06s - ThoraxHRSeq - AbdomenRoutine/ AbdomenRoutine06s - Spine/ SpineRoutine - SpineThinSlice - ExtrRoutineHR - ExtrCombi - HeadAngio/ HeadAngio06s - CarotidAngio/ CarotidAngio06s - BodyAngioRoutine/ BodyAngioRoutine06s - BodyAngioFast/ BodyAngioFast06s - NeonateBody/ NeonateBody06s 15 546 550 554 558 562 566 568 570 574 578 582 586 587
User Documentation For further information about the basic operation, please refer to the corresponding syngo CT Operator Manual: syngo CT Operator Manual Volume 1: syngo Security Package Siemens Virus Protection Basics SOMATOM LifeNet syngo Patient Browser syngo Data Set Conversion Camtasia SaveLog E-Logbook syngo Viewing syngo Filming syngo CT Operator Manual Volume 2: Preparations Examination MPPS HeartView CT Respiratory Gating CT CARE Bolus CT CARE Vision CT syngo CT Operator Manual Volume 3: syngo 3D
User Documentation syngo CT Operator Manual Volume 4: syngo LungCARE CT syngo Pulmo CT syngo Neuro Perfusion CT syngo Body Perfusion CT syngo CT Operator Manual Volume 5: syngo Calcium Scoring syngo Circulation syngo Volume Calculation syngo Dynamic Evaluation syngo Neuro DSA CT syngo CT Operator Manual Volume 6: syngo InSpace 4D CT syngo Colonography 17
Scan and Reconstruction Concept of Scan Protocols The scan protocols for adult and children are defined according to body regions - Head, Neck, Shoulder, Thorax, Abdomen, Pelvis, Spine, Upper Extremities, Lower Extremities, Vascular, RT, Specials and optional Cardiac, PET, SPECT and Private. The protocols for special applications are defined in the Application Guide “Clinical Applications” or in the case of a Heart View examination, in the Application Guide “Cardiac CT“.
Scan and Reconstruction Scan Set Up Scans can be simply set up by selecting a predefined examination protocol. To repeat any mode, just click the chronicle with the right mouse button for repeat. To delete it, select cut. Each range name in the chronicle can be easily changed before load. Multiple ranges can be run either automatically with auto range, which is denoted by a bracket connecting the two ranges, or separately with a pause in between.
Scan and Reconstruction Topo Length SOMATOM Emotion 16 Length [mm] Slice width [mm] Angle SOMATOM Emotion 6 Length [mm] Slice width [mm] Angle 128, 256, 512, 768, 1024, 1500 4x0.
Scan and Reconstruction Scan Modes Sequential Scanning This is an incremental, slice-by-slice imaging mode in which there is no table movement during data acquisition. A minimum interscan delay in between each acquisition is required to move the table to the next slice position. Spiral Scanning Spiral scanning is a continuous volume imaging mode. The data acquisition and table movements are performed simultaneously for the entire scan duration.
Scan and Reconstruction Quick Scan The data is usually acquired during a full 360° rotation – this is a Full scan. Data acquisition not using a full 360° rotation is called a “Quick scan”. Quick scans are employed to reduce motion artifacts and improve the temporal resolution. Dynamic Multiscan Multiple continuous rotations at the same table position are performed for data acquisition. Normally, it is applied for fast dynamic contrast studies, such as syngo Neuro Perfusion CT.
Scan and Reconstruction UFC detector Siemens’ proprietary, high-speed Ultra Fast Ceramic (UFC) detector enables a virtually simultaneous readout of two projections for each detector element.
Scan and Reconstruction Acquisition, Slice Collimation and Slice Width Slice collimation is the slice thickness resulting from the effect of the tube-side collimator and the adaptive detector array design. In Multislice CT, the Z-coverage per rotation is given by the product of the number of active detector slices and the collimation (e.g. 6 x 1.0mm for the SOMATOM Emotion 6-slice configuration or 16 x 0.6mm for the SOMATOM Emotion 16slice configuration ).
Scan and Reconstruction SOMATOM Emotion 16-slice configuration Spiral Mode Collimation/ Acquisition Slice width 16 x 0.6 mm 0.75, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 mm 16 x 1.2 mm 1.5, 2.0, 3.0, 4.0, 5.0, 6.0, 8.0, 10.0 mm HR/Neuro Spiral Mode Collimation/ Acquisition Slice width 4 x 0.6 mm 0.6, 0.75, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 mm Sequence Mode Collimation/ Acquisition Slice width 4 x 0.6 mm 0.6, 1.2, 2.4 mm 12 x 0.6 mm 0.6, 2.4, 7.2 mm 16 x 0.6 mm 1.2, 2.4, 4.8, 9.6 mm 2 x 5 mm 5.0, 10.
Scan and Reconstruction SOMATOM Emotion 6-slice configuration Spiral Mode Collimation Slice width 1 mm 1, 1.25, 2, 2.5, 3, 4, 5, 6, 8, 10 mm 2 mm 2.5, 3, 4, 5, 6, 8, 10 mm 3 mm 4, 5, 6, 8, 10 mm Sequence Mode Collimation Slice width 1 mm 1, 2, 3 mm 2 mm 2, 4, 6, 12 mm 3 mm 3, 6, 9, 18 mm 5 mm 5, 10 mm HR Spiral Mode Collimation Slice width 0.5 mm 0.63, 0.75, 1, 1.25, 2, 2.
Scan and Reconstruction Increment The increment is the distance between the reconstructed images in Z direction. When the chosen increment is smaller than the slice thickness, the images are created with an overlap. This technique is useful for reducing partial volume effect, giving you better detail of the anatomy and high quality 2D and 3D postprocessing. The increment can be freely adapted from 0.1 - 10 mm.
Scan and Reconstruction Kernels There are 4 different types of kernels: “H“ stands for Head, “B“ stands for Body, “C“ stands for ChildHead and ”S” stands for Special Application, e.g. syngo Osteo CT. The image sharpness is defined by the numbers – the higher the number, the sharper the image; the lower the number, the smoother the image.
Scan and Reconstruction Body Kernels: Kernel B08s B10s B19s B20s B29s B30s B31s B35s B39f B40s B41s B46s B50s B60s B65s B70s B75s B80s B90s description very smooth very smooth very smooth smooth smooth medium smooth medium smooth + HeartView medium HeartView medium medium medium+ medium medium sharp sharp sharp very sharp very sharp (Emotion 16-slice configuration only) ultra sharp ultra sharp Child Head Kernels: Kernel C20s C30s C60s description smooth medium smooth sharp 29
Scan and Reconstruction Topogram Kernels: Kernel T10s T20s T21s T80s T81s T90s description smooth standard standard sharp sharp ultra sharp Special Application: Kernel S30s S80s S90s U90s 30 description Shepp-Logan Shepp-Logan with notch filter Shepp-Logan without notch filter specification kernel
Scan and Reconstruction PET-Kernel: Kernel B19s B29s B39s H19s H29s H39s PET smooth medium smooth medium smooth medium smooth medium SPECT-Kernel: Kernel H08s B08s SPECT very smooth very smooth 31
Scan and Reconstruction Head Kernels For soft tissue head studies, the standard kernel is H40s; softer images are obtained with H30s or H20s, H10s, sharper images with H50s. The kernels H21s, H31s, H41s yield the same visual sharpness as H20s, H30s or H40s, respectively. The image appearance, however, is more acceptable due to a "fine-grained" noise structure; quite often, the low contrast detectability is improved by using H31s, H41s instead of H30s, H40s.
Scan and Reconstruction Body Kernels As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s respectively, B40s, the image appearance, however, is more acceptable due to a "fine-grained" noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s.
Scan and Reconstruction Extended FoV SOMATOM Emotion 16/6-slice configuration offers the extended field of view. The range can be individually adapted by the user from 50 cm up to 70 cm. To use this feature you have to select the extended FoV checkbox on the Recon subtask card. The default setting is 65 cm, but can be modified. Extended FoV can be used with each scan protocol.
Scan and Reconstruction Auto-FoV After scanning a topogram the available ranges are displayed in the topo segment. They can be automatically adapted according to the patient contours. When moving the scan range over the topogram and press the "ctrl" key simultaneous, the adaptation will be done automatically. Please make sure, that the whole object is covered within the default FoV.
Scan and Reconstruction Hints • When positioning the arms along the body, the AutoFoV will also cover the arms. • When scanning two extremities at the same time, the Auto-FoV will also cover both extremities.
Scan and Reconstruction Neuro Modes In addition to the standard collimations, the SOMATOM Emotion 16-slice configuration provides a special mode which is optimized for Neuro applications. Excellent low contrast and detail resolution are achieved. For spiral scans 4 x 0.6 acquisition mode is provided in the range of the cerebrum. This approach shows a minimized partial volume effect, i.e. low level of artifacts in the base of the skull or near vertebral bodies, as 0.
Scan and Reconstruction Automatic Bone Correction The head protocols provide significant improvements regarding image quality for heads. An automatic bone correction algorithm has been included in the standard image reconstruction. Using a new iterative technique, typical artifacts arising from the beam-hardening effect, for example, Hounsfield bar, are minimized without additional post-processing.
Scan and Reconstruction Positioning In order to optimize image quality versus radiation dose, scans in body regions “Head” and “AngioHead” are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible. Therefore, patient positioning has to be performed accurately to ensure a centered location of the skull.
Scan and Reconstruction Image Filters If you use kernels, the images are reconstructed again with the selected kernel value. If you use image filters, the images are not reconstructed again and the result is much quicker. Three different filters are available: LCE: The Low-contrast enhancement filter enhances low-contrast detectability. It reduces the image noise.
Scan and Reconstruction "HCE": The High-contrast enhancement (HCE) filter enhances high-contrast detectability. It increases the image sharpness, similar to reconstruction with a sharper kernel.
Dose Information CTDI and CTDIVol W The average dose in the scan plane is best described by the CTDIW for the selected scan parameters. The CTDIW is measured in dedicated plastic phantoms – 16 cm diameter for head and 32 cm diameter for body (as defined in IEC 60601 – 2 – 44). For scan modes with zSharp the CTDI100 is calculated using the single number of tomographic sections (not doubled by z-Sharp) to remain within the terms of IEC 60601-2-44.
Dose Information Note: Previously the dose display on the user interface was labeled “CTDIW“. This displayed CTDIW was also corrected for the pitch and was therefore identical to the current CTDIVol. The CTDIw value does not provide the entire information of the radiation risk associated with CT examination. For this purpose, the concept of the “Effective Dose“ was introduced by ICRP (International Commission on Radiation Protection).
Dose Information ImpactDose For most of the scan protocols, the effective dose numbers for standard male* and female* are calculated, and listed the result in the description of each scan protocol. The calculation was performed using the commercially available program "ImpactDose" (Wellhoefer Dosimetry). For pediatric protocols, the ImpactDose calculation and the correction factors published in "Radiation Exposure in Computed Tomography"** are used.
Dose Information Effective mAs In sequential scanning, the dose (Dseq) applied to the patient is the product of the tube current-time (mAs) and the CTDIw per mAs: Dseq = DCTDIw x mAs In spiral scanning, however, the applied dose (Dspiral) is influenced by the conventional mAs (mA x Rot Time) and additionally by the pitch factor.
Dose Information For spiral scan protocols, the indicated mAs is the effective mAs per image. The correlation between tube current and effective mAs of spiral scans on a Multislice CT scanner is expressed by the following formula: Effective mAs = mA x RotTime Pitch Factor Pitch Factor = Feed per Rotation nrow x Slice collimation mA = effective mAs RotTime x Pitch Factor where Slice collimation refers to the collimation of one detector row, and nrow is the number of used detector rows.
Dose Information CARE Dose 4D CARE Dose 4D is an automated exposure control, which ensures constant diagnostic image quality over all body regions at the lowest possible dose. CARE Dose 4D combines three different adaptation methods to optimize image quality at the lowest dose level: • Automatic adaptation of the tube current to the patient size • Automatic adaptation of the tube current to the attenuation of the patient’s long axis, the so-called zaxis.
Dose Information Based on a user defined Image Quality Reference mAs, CARE Dose 4D automatically adapts the (eff.) mAs to the patient size and attenuation changes within the scan region. With the setting of the Image Quality Reference mAs you can adjust image quality (image noise) to the diagnostic requirements and the individual preference of the radiologist.
Dose Information How does CARE Dose 4D work? CARE Dose 4D combines two types of tube current modulation: 1) Axial tube current modulation: Based on a single Topogram (a.p. or lateral) the attenuation profile along the patient’s long axis is measured in direction of the projection and estimated for the perpendicular direction by a sophisticated algorithm. Attenuation (log) Lateral Scan Range Example of lateral and a.p. attenuation profile evaluated from an a.p. Topogram.
Dose Information no ise 2) Angular tube current modulation: Based on the above described axial eff. mAs profiles, the tube current is modulated during each tube rotation. Therefore the angular attenuation profile is measured automatically during the scan and the tube current is modulated accordingly in real time to achieve an optimum distribution of the X-ray intensity for every viewing angle. im ag e ns tan t co m sli w a e str vera ak on ge de g d cre rel.
Dose Information Reduced dose level based on topogram Real-time angular dose modulation x-ray dose Scan with constant mA slice position 51
Dose Information Principle of automatic tube current adaptation by CARE Dose 4D for a spiral scan from shoulder to pelvis (very high table feed for demonstration): High tube current and strong modulation in shoulder and pelvis, lower tube current and low modulation in abdomen and thorax. The dotted lines represent the min. and max. tube current at the corresponding table position and result from the attenuation profile of the Topogram.
Dose Information Special Modes of CARE Dose 4D For certain examination protocols CARE Dose 4D uses modified tube current modulation, to meet specific conditions, for example: • for Adult Head protocols the tube current is adapted to the variation along the patient’s long axis and not to the angular attenuation profile. • for Extremities, CARE Vision, syngo Neuro Perfusion CT, syngo Body Perfusion CT and other special protocols (indicated as CARE Dose), only angular tube current modulation is supported.
Dose Information Scanning with CARE Dose 4D If the settings of Image Quality Reference mAs are correctly predefined*, no further adjustment of the tube current is required to perform a scan. CARE Dose 4D automatically adapts the tube current to different patient sizes and anatomic shapes, but it widely ignores metal implants. Note: Otherwise the magnification of the topogram would be distorted which would lead to an underestimation or overestimation of the required eff. mAs.
Dose Information Outside the topogram range, CARE Dose 4D will continue the scan with the last available topogram information. Without a topogram, CARE Dose 4D cannot be switched on. Repositioning of the patient on the table and excessive motion of the patient must be avoided between the topogram and the scan. If two topograms of the same projection exist for one scan range, the last acquired will be used for determining the (eff.) mAs. If a lateral and a.p.
Dose Information After the topogram has been scanned, the (eff.) mAs value in the Routine tab card displays the mean (eff.) mAs estimated by CARE Dose 4D based on the topogram*. After the scan has been performed this value is updated to the mean (eff.) mAs that was applied. The values may differ slightly due to the online modulation according to the patient’s angular attenuation profile.
Dose Information The Quality reference mAs value is displayed on the Scan tab card. This defines the overall image quality of the scan protocol currently being used. This value can be adapted for each protocol according to the user’s individual requirements of image quality. Here you can also view the effective mAs value that the system is going to use for the current scan range. You can also deselect CARE Dose4D on this tab card.
Dose Information Adjusting the Image Noise The correlation between attenuation and tube current is defined by the analytical function described above. This function may be adjusted to adapt the image quality (image noise) according to the diagnostic requirements and the individual preference of the radiologist. – To adapt the image noise for a scan protocol the Image Quality Reference mAs value in the Scan tab card may be adjusted.
Dose Information If you change the quality ref. mAs, a pop-up window is displayed. • To change the configuration of CARE Dose 4D, please open the Examination Configuration dialog box under Options > Configuration. In the window that then appears, please double-click the Examination icon to display the configuration window. The adaptation strength of CARE Dose 4D may be influenced for slim, obese patients, or body parts of a patient by changing the CARE Dose 4D settings in the Patient tab card.
Dose Information – if the automatic dose increase for obese patients (or patient sections) has to be more moderate than the preset (choose obese: weak increase), resulting in more image noise and a lower dose for those images. – if the automatic dose decrease for slim patients (or patient sections) has to be stronger than the preset (choose slim: strong decrease), resulting in more image noise and a lower dose for those images.
Dose Information Activating and Deactivating CARE Dose 4D may be activated or deactivated for the current scan in the Scan tab card. If CARE Dose 4D is activated as default, the Image Quality Reference mAs value is set to the default value of the protocol. After deactivating CARE Dose 4D, the Image Quality Reference mAs is dimmed and the (eff.) mAs value has to be adjusted to the individual patient’s size! If CARE Dose 4D is switched on again, the Image Quality Reference mAs is reactivated.
Dose Information If you are unsure about the correct Image Quality Reference mAs value, follow this simple procedure: • Enter the (eff.) mAs value used for that type of protocol without CARE Dose 4D. • There is a simple way of ascertaining what eff. mAs CARE Dose 4D will use along the scan range: When the topogram is complete shrink the scan range to it's minimum. As you move this small box over the topogram you can see how the eff.
Dose Information Additional Important Information For ideal dose application it is very important to position the patient in the isocenter of the gantry. Example for an a.p.
Workflow Information WorkStream4D Recon Jobs In the Recon card, you can define up to eight reconstruction jobs for each range with different parameters either before or after you acquire the data. When you click on Recon, these jobs are performed automatically in the background. If you want to add more than eight recon jobs, simply click the icon for an already completed recon job in the chronicle with the right mouse button and select delete recon job.
Workflow Information 3D Recon 3D Recon allows you to perform oblique and/ or double oblique reconstructions in any user-defined direction directly after scanning. No further post-processing or data loading is needed. The high-quality SPO (spiral oblique) images are calculated by using the system’s raw data.
Workflow Information Workflow Description WorkStream 4D improves your workflow whenever non-axial images of a CT scan are required, for example examinations of the spine. 3D reconstructions are possible: – spiral scan is needed – as soon as one scan range is finished and at least one axial reconstruction job has been performed (RTD or RTR images). Select a new recon job and mark Recon Job Type – 3D on the Recon card.
Workflow Information Additional Important Information Pitch factor for 3D Recon • For reconstruction of 3D recon jobs the maximum pitch factor is 1.5. If the pitch factor is > 1.5 a message window informs you that this 3D recon job cannot be started and may be deleted. In this case use the standard 3D task card with an axial image series for reconstruction.
Workflow Information Three planning segments in perpendicular orientations will appear in the upper screen area. You can choose between MPR Thick (3 mm) and MIP Thin (10 mm) as the image type for your planning volume using the relevant buttons. In each segment you will find a pink rectangle which represents the boundary of the result images. The image with the right down marker represents the field of view (FoV) of the result images (viewing direction).
Workflow Information The rectangle with the grid represents the reference image (topogram) which is added to the Topogram series including the reference lines after reconstruction.
Workflow Information Preview Image A preview of the actual FoV is now available. • After pressing the button Preview Image the actual FoV to be reconstructed will be displayed. • Clicking again on the button deactivates the preview image and displays the whole reference image again. • Double clicking into the FoV image activates or deactivates the Preview Image function as well.
Workflow Information Depending on the desired resultant images, choose coronal, sagittal or oblique recon axis. 1. Sagittal/Coronal Reconstructions • Adjust the field of view size to your needs. • It is only possible to reconstruct images with a squared matrix. 2.
Workflow Information To define the reference image (topogram) to the active segment, click on the Set Reference Segment button. This defines the orientation of the reference image which will be added to the result images. Once you have finished the adjustment, start calculation of the result images by clicking on the Recon button. You can start a recon job at any time, independently of other ongoing jobs (asynchronous reconstruction).
Workflow Information Additional Information As soon as you define a new recon range, all recon ranges will be shown in the topo segment. The two numbers on the right-hand side at the beginning of each recon range indicate the recon job the range belongs to. The first number stands for the scan range, the second number stands for the recon job to which the range belongs. If no recon job is pending, only the scan ranges are shown in the topo segment.
Workflow Information Recon Planning During planning of a 3D recon range, the image displayed in the FoV segment will be updated to the new position of the recon start and end position. The corresponding reference line displayed in both planning segments is the reference line to the actual image displayed in the FoV segment.
Workflow Information • Oblique reconstruction of the sinuses: – Scan a topogram – Plan your axial spiral scan range – Reconstruction of the spiral images (RT images) – Select Recon job Type oblique – Select the sagittal image segment – Enable Free Mode – Rotate the reference lines until the best view of the sinuses is displayed in one of the other segments – Select this segment and press the Set FoV Segment button – Adjust the FoV to your needs – Define your desired reconstruction parameters (e.g.
Workflow Information Non-square Matrix for 3D Recon If you perfrom a 3D reconstruction of your spiral scan you have the possibility to choose between three different FoV matrices: 512 square, 512 non-square, 256 non-square. In some cases it is already saved to the scan protocol (Spine, CarotidAngio) set up a new scan protocol or want to modify an existing one you can save the non-square matrix together with the recon parameters. • 512 square: the FoV stays quadratic with a 512x512 matrix size.
Workflow Information Case Examples for 3D Recon and NonSquare Matrix Some scan protocols are delivered with predefined oblique and non-square matrix reconstructions.
Workflow Information – Rotate the reference lines until the best view on the sinuses is displayed in one of the other segments – Select this segment and press button Set FoV Segment button – Select the Matrix size for example, non-square 512 and adjust the FoV to your needs – Define your desired reconstruction parameters (e.g.
Workflow Information Workflow Patient Position A default patient position can be linked and stored to each scan protocol. The SIEMENS default protocols are already linked to a default patient position. (Head first - supine) If a scan protocol is selected and confirmed in the Patient Model Dialog, the linked patient position stays active until the user changes it, even if a scan protocol with different patient position is selected.
Workflow Information Navigation within the Topogram Navigation within the topogram helps you to plan a reconstruction range. The minimum conditions for its use are a scanned range and the availability of RTD (Real time display) images. After scanning, an orange line is displayed within the topogram. This line corresponds to the axial image in the tomo segment.
Workflow Information API Language The API language can now be selected directly in the Patient Model Dialog. When the API language is selected, only the relevant, language specific API entries can be selected in the Scan subtask card. This way it is much easier to select the correct patient instruction.
Workflow Information Before recording a new API text, first define the API language in the API setup dialog under Setup > API/Comment Setup in the main menu.
Workflow Information e - Logbook The goal of e-Logbook is to offer an effective and efficient functionality to process examination information. The e-Logbook consists of three components: • The e-Logbook Configuration • The e-Logbook subtask card area • The e-Logbook Browser, where all examinations can be listed for viewing, sorting, searching and printing e- Logbook Configuration You will find the e- Logbook Configuration under Options >Configuration >e- Logbook Configuration.
Workflow Information Over Default Time period you can determine how the recordings should be listed inside the e-Logbook Browser: – Today (which is the default setting) – This week – This month – Yesterday – Last week – Last month Any changes can be saved by selecting "Apply" 84
Workflow Information On the Manual Entries tab card you can configure the System Entries and Manual Entries, that should be displayed in the e-Logbook. System Entries are automatically filled out by the system and displayed in the e-Logbook as read-only if they are configured. Default settings are: • Date of Examination • Patient Name • Patient ID • Date of birth • Scan Protocol Name • Total mAs The Continuous Number field is an incremental number to mark each recorded study within a defined time range.
Workflow Information Furthermore the Continuous Number can be set to: – Daily – Monthly – Yearly If you set Continuous Number to Daily, the continuous number starts with one each day.
Workflow Information Additionally the user can define Manual Entries which will also be displayed in the e-Logbook. These information can be pre-configured and then selected over a drop down menu in the e-Logbook. To configure new entries of the drop down menu for each Manual Entry, just type the desired information inside and click on add. To remove already existing entries, just select the entry and click on delete. Additionally you can customize up to five Manual Entries fields.
Workflow Information e- Logbook Browser You will find the e- Logbook Browser in the main menu under Patient > e- Logbook browser or you can use F12 key on your keyboard. You can list the e-Logbook recordings by date. Select your desired timeframe in the calendar and click List now. If you want to list the e-Logbook recordings from today, click on Today and the recordings will be displayed immediately, no confirmation is needed.
Workflow Information Additional to the dates, certain criteria can be selected to have a more specific search. Search criteria can be defined for all entries recorded inside the e-Logbook. For example, the entry Number of images is recorded. A search for datasets which have a certain amount of images can be defined. Additional conditions can be defined in this case: – is greater than – greater or equal – is less than – less or equal – equals The conditions vary with the selected search criteria.
Workflow Information Hints for the Record List: 1. Calling up Patient Browser When you double click on any record in the e-Logbook Browser, the patient data of the Patient Browser will be opened, if still available and the customer has the chance to edit the patient information. This change will also be updated inside the e-Logbook. 2. Updating the Recon List The e-Logbook is updated automatically when the examination data has changed within the Patient Browser with Correct and Rearrange.
Workflow Information Study Continuation An existing study can be continued at a later time. To load an existing study: • Select the desired study in the Patient Browser. • Select Register from the Patient drop-down menu. • The patient data is loaded in the Registration dialog box. The previous scan protocol is already preselected, but it is also possible to select any desired scan protocol. After the patient has been registered, the patient is loaded into the Examination card.
Workflow Information Reconstruction on the syngo CT Workplace It is possible to start all reconstructions from your satellite console.
Workflow Information Examination Job Status You can get an overview of all recon jobs by clicking on the recon task symbol in the status bar or selecting Transfer – Examination Job status in the patient main menu in the Patient Browser. The Examination Job Status dialog box will appear where all recon jobs (completed, queued and in work) are listed. You can stop, restart and delete each job by clicking the according button. To give a selected job a higher priority click urgent.
Workflow Information Auto Load in 3D and Postprocessing Presets You can activate the Auto load in 3D function on the Examination task card/Auto Tasking and link it to a recon job, for example, the 2nd recon job with thinner slice width in some of the examination protocols. If the post-processing type is chosen from the pull-down menu, the reconstructed images will be loaded automatically into the 3D task card on the syngo Acquisition Workplace with the corresponding post-processing type.
Workflow Information The same can be done for VRT presets. In the main menu under Type > VRT Definition, you can link VRT presets with a series description. Some of the scan protocols, primarily for Angio examinations, are already preset in the protocol with Auto load in 3D. If you prefer not to have this preset, deselect the Auto load in 3D and save your scan protocol. Some of the scan protocols are preset in the protocol with links to a post-processing protocol.
Workflow Information Scan Protocol Creation You can modify or create your scan protocols in two different ways: • by editing/saving scan protocols • via scan protocol manager. Edit/Save Scan Protocol If you want to modify an existing protocol or create a new one, for example, you want to have two AbdomenRoutine Protocols with different slice widths, we recommend you do this directly on the Examination task card.
Workflow Information User-specific scan protocols can be saved with the following basic procedure: • Register a patient, you can choose any patient position in the Patient Model Dialog. • Select an existing scan protocol in the Patient Model Dialog. • Modify the scan protocol, change parameters, add new ranges etc. to adapt the new protocol to your requirements. • Scan your patient as usual. • Check that all parameters are as you desire. • Select Edit/Save Scan Protocol in the main menu.
Workflow Information Additional important information: • You can save your scan protocol at any time during the examination. • It is recommended that you save your own scan protocol under a new name in order to avoid overwriting the default scan protocol. • Do not use special characters or blanks. Allowed are all numbers from 0 to 9, all characters from A to Z and a to z and explicitly the _ (under-score), but no country-specific characters, for example, à, ê, å, ç, ñ.
Workflow Information Step 1 - What do you want to do? Four different operation types are possible: • Manipulate Scan protocols (cut, copy, paste and delete) • Change parameters • Import scan protocols from SOMATOM LifeNet/CD • Restore protocols to Siemens default Additional important information • Each workflow consists of up to five steps, indicated by the footprints. • Depending on the workflow step you can list all scan protocols or all selected scan protocols.
Workflow Information Manipulate scan protocols This workflow consists of four steps. Step 2 - Manipulate scan protocols (cut/copy/paste/ delete) To be able to modify existing scan protocols you just have to click with the right mouse button onto the protocol you want to cut, copy or delete, there a menu will be displayed where you can choose what you want to do.
Workflow Information Setting the Emergency Protocol: One protocol must be labeled as the emergency protocol, if you want to change the default emergency protocol you have to select the desired protocol and click onto the Emergency icon. An Application Restart is necessary to set the new default emergency protocol. The emergency protocol is displayed with the Emergency icon in front of the protocol name. This protocol can not be deleted.
Workflow Information Step 3 - Confirmation Here you can check the modifications and save the changes. All relevant information such as the Name of the manipulated scan protocols, destination Folder, Name of the deleted protocols and the changed Emergency protocols are displayed inside the Change overview. Step 4 - Changes saved In this step you can decide if you want to pass a different modification workflow or if you want to exit the Scan Protocol Assistant.
Workflow Information Change parameters This workflow consists of five steps. Step 2 - Select the scan protocols you want to change Here you can select: • scan protocols with certain recon jobs • all scan protocols with ECG • all customized or Siemens scan protocols for modification • all scan protocols Additionally you can choose in the protocol list: • single scan protocols • all scan protocols within a body region • several body regions Adult and Child protocols are managed apart.
Workflow Information All scan protocols selected in Step 2 are displayed. For each parameter you can select the scan protocols you want to apply your changes. The
Workflow Information Protocol Select single scan protocol or all scan protocols you want to modify in this subsection. In the subsection Protocol the following changes can be made: – Protocol Name This entry is only available in single protocol selection. Here you can rename your scan protocol. – Default Patient Position Enter the patient position you want to have as default displayed in the Patient Model Dialog.
Workflow Information The four buttons: Column Configuration, Show/Hide Parameters, Parameter Property and Find/Replace are now available. – Column Configuration With the column configuration you can include or exclude specific entries that will be displayed in the sub footprint line and also change the order of the entries with the drag&drop functionality. – Show/Hide Parameters You can decide if you want to show/hide the parameters in the parameter area of the selected protocols.
Workflow Information Topogram Select single scan protocol or all scan protocols you want to modify in this subsection. In the subsection topogram the following changes can be made: – mA Set the mA value for the topogram. – Topogram length All available topo lengths are listed in the dropdown list. – Tube position Set the tube position either to Top or Lateral. – kV Can be defined individually to the Scan value.
Workflow Information Scan Select single scan protocol or all scan protocols you want to modify in this subsection. Additionally you can select the scan mode entries: – Sequence – Spiral – Multiscan – CAREVision The displayed parameters depend on the selection you have made. • If no special scan mode is selected, the so called mixed mode is active. The mixed mode means the user can choose scan ranges from different modes(Spiral, Sequence, Multiscan, or CAREVision modes).
Workflow Information It is possible to insert the Autorange brackets in a selected Multi Range by using the right mouse button and removing the Pause from the protocol. You are also able to put a pause into your selected Ranges so you are scanning the ranges seperatly.
Workflow Information Scan Parameters Spiral Mode Sequence Mode Multisca n Mode CareVision Mode X X X Mixed Mode X X X X X X Dose modulation X X X Quality Ref mAs X X X kV X X X X X X mAs eff.
Workflow Information Recon You can select all recon jobs, Sequence, Spiral, Multiscan and CareVision Scan Entries you want to modify in this subsection, of course you can also only select single Recon jobs out of the list.
Workflow Information In the subsection Recon the following changes can be made: Scan Parameters Spiral Mode Sequence Mode Multisca n Mode CareVision Mode Mixed Mode X X X X X X X X X X X X X X X X X X X X X X X X X X X Extended FoV X X X X Recon type X X X X X Slice Recon Increment Kernel Window Mirror No of images Series description Recon job type Recon axis Image Order Non square matrix 3D Recon 112 X X X X X X X X X X X X X
Workflow Information AutoTasking Select single recon job or all recon jobs you want to modify in this subsection. Additionally you can display information about the scan range: • When "include scan range information" is selected, an information line for each scan range is listed before the recon jobs belonging to this scan range, you might have to scroll to the right side of the line to get the information visible.
Workflow Information In the subsection Auto Tasking the following changes can be made: • Auto transfer 1,2,3 • Auto Viewing • Auto Recon • Auto Filming • Auto Postprocessing • Auto Reference lines (only if selected in the protocol) • Body Part Examined 114
Workflow Information Trigger Select single, all, all sequence or all spiral scan protocols with trigger, • When "include scan range and recon information" is selected, an information line for each scan range and reconstruction is listed before the recon jobs belonging to this scan range, you might have to scroll to the right side of the line to get the information visible.
Workflow Information Some parameters listed are associated with each other. If you input a value which influences another value and therefore causes a conflict, the influenced parameter values are auto corrected and displayed in green. If an invalid protocol is loaded, the parameters with the incorrect value will be highlighted in yellow. If you insert incorrect values these will be marked in yellow and will be auto corrected. All the values will be adjusted after the first change is made.
Workflow Information Import scan protocols from SOMATOM LifeNet/CD In this workflow you can import new scan protocols either from SOMATOM LifeNet, if a remote connection is available, or from CD. Before you can import new scan protocols, you have to download them from the SOMATOM LifeNet. This workflow consists of three steps: Step 2 - Import scan protocols Follow the instructions on this page to import the scan protocols.
Workflow Information Restoring protocols to Siemens default This workflow consists of four steps: Step 2- Select the scan protocols you want to restore to Siemens default. In this workflow you can restore or import Siemens default scan protocols. Adult and Child protocols are managed apart. • Select what you want to do – Replace customized protocols with same name. All selected modified scan protocols will be replaced with the Siemens default scan protocol settings.
Workflow Information If no customized scan protocols are selected, the radio buttons and will be dimmed. • Select deleted Siemens scan protocols – The
Workflow Information Step 4 -Changes saved In this step you can decide if you want to pass a different modification workflow or if you want to exit the Scan Protocol Assistant. List all Scan Protocols and all selected Protocols To list all available protocols, select the List all protocols icon in the lower left corner of any arbitrary step. Comparisons between Siemens default and customized protocols is possible with this table. You are able to print, export to floppy and export this sheet as a .
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Contrast Medium Contrast Medium The Basics The administration of intravenous (IV) contrast material during spiral scanning improves the tissue and lesion characterization, as well as the opacity of vessels. The contrast scan will yield good results only if acquisition is performed during the optimal phase of enhancement in the region of interest. Therefore, it is essential to initiate the acquisition with the correct start delay.
Contrast Medium The dynamics of the contrast enhancement is determined by: • • • • • • Patient cardiac output Injection rate Total volume of contrast medium injected Concentration of the contrast medium Type of injection – uni-phasic or bi-phasic Patient pathology Aortic time-enhancement curves after i.v. contrast injection (computer simulation*). All curves are based on the same patient parameters (male, 60-year-old, 75 kg).
Relative Enhancement [HU] Relative Enhancement [HU] Contrast Medium Time [s] Time [s] Injection rate: 4 ml/s, 120 ml, 300 mg I/ml Relative Enhancement [HU] Relative Enhancement [HU] Injection rate: 2 ml/s, 120 ml, 300 mg I/ml Time [s] Time [s] Total volume of contrast medium injected: 120 ml, 4 ml/s, 300 mg I/ml Relative Enhancement [HU] Relative Enhancement [HU] [ ] Total volume of contrast medium injected: 80 ml, 4 ml/s, 300 mg I/ml Time [s] Type of injection: Uniphase 140 ml, 4 ml/s, 37
Contrast Medium IV Injection* The administration of a contrast medium depends on the indication and on the delay times to be used during the examination. The patients weight and circulatory situation also play a role. In general, no more than 3 ml per kg of body weight for adults and 2 ml per kg of body weight for children should be applied. For a CTA study (arterial phase), the principle is to keep the contrast flowing throughout the duration of the scan.
Contrast Medium Bolus Tracking An automatic Bolus Tracking program is available which enables triggering of the spiral scanning at the optimal phase of the contrast enhancement. Additional Important Information 1.This mode can be used in combination with any spiral scanning protocol. Simply insert Bolus Tracking by clicking the right mouse button in the chronicle. This inserts the entire set-up including pre-monitoring, i.v. bolus, and the monitoring scan protocol.
Contrast Medium – Move the monitoring scan line toward the optimal position and release the mouse button, it will be snapped automatically. (Trick: if you move the monitoring scan line away from the optimal position the snapping mechanism will be inactive). 4.Place a ROI in the premonitoring scan on the target area or vessel used for triggering with one left mouse click.
Contrast Medium Test Bolus using CARE Bolus You can use the CARE Bolus option as a Test Bolus. Method 1.Insert a Bolus Tracking via the context menu prior to the spiral. 2.Insert contrast from the context menu. Note: By inserting contrast you are interrupting the Auto range function preventing an automatic start of the spiral. 3.Start with the topogram. 4.Position the premonitoring scan and the spiral. 5.Perform the premonitoring scan, position and accept the ROI. 6.
Contrast Medium Test Bolus This is a low dose sequential protocol without table feed used to calculate the start delay of a spiral scan to ensure optimal enhancement after the contrast medium injection. The syngo Dynamic Evaluation function may be used to generate the time density curve. You will find the Test Bolus scan protocol in the chapter Specials. Method 1.Select the spiral mode that you want to perform and then Append the Test Bolus mode under Special protocols. 2.
Contrast Medium 6.Load the images into the DynEva task card and determine the time to peak enhancement. Alternatively, on the image segment, click select series with the right mouse button and position an ROI on the first image. This ROI will appear on all images in the test bolus series. Find the image with the peak HU value, and calculate the time delta t taken to reach the peak HU value (do not forget to add the preset start delay time).
Contrast Medium Workflow To start a contrast enhanced examination in coupled mode: • Select the Scan subtask card. • Select under the menu field Scan Start either the entry Injector coupled (Start button) or the entry Injector coupled (Footswitch) – Injector coupled (Start button): The Start button of the CT scanner will start the injector. – Injector coupled (Footswitch): The footswitch of the CT scanner will start the injector.
Contrast Medium After the injector is armed the scan and the injector can be started by pressing either the Start button/ Footswitch at the scanner, or the Start button at the injector panel outside of the scan room or directly at the injector inside the scan room. Note: If the injector is not ready the scan cannot be started. If both systems are ready to START and the user disarms the injector, the bubble Check Injector is shown again.
Contrast Medium Additional Important Information • If Coupled Mode is selected the CT checks if there is an injector available. The scan mode cannot be loaded if a connection cannot be established or if the injector does not accept coupling (The injector will not accept coupling while injecting). A message appears: Injector is not connected. • Scanning interrupted If the injector does not accept the START from the CT the scan mode is cancelled.
Contrast Medium The injector reports a technical problem: The connection between scanner and injector is interrupted, or the injection was stopped due to technical problems. In this case the scan continues and an error message pops up. The user can decide if he wants to stop the scan or if he would like to continue. • If the injection is longer than the CT scan, the CT scanner does not stop the injection. A new scan mode can be loaded.
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Application Information SOMATOM LifeNet General Information SOMATOM LifeNet is our information and service portal that can be accessed directly at the syngo Acquisition Workplace, syngo CT Workplace, and syngo MultiModality Workplace. It provides up-to-date news about your scanner, helpful configuration information about your system, and enables you to access the SOMATOM LifeNet online area where you will find further functions to ease your daily work.
Application Information Key Features SOMATOM LifeNet offline (All users): • General Information about your system and configuration • Access to syngo E-Learning SOMATOM LifeNet online (In combination with a Siemens Remote Service connection): • Newsticker archive and FAQ (frequently asked questions) section • Free trial software order and installation • Download of information, manuals and scan protocols • Log Book order functionality: A contact function for an easy and fast interface to Siemens including t
Application Information SOMATOM LifeNet offline Start SOMATOM LifeNet by selecting SOMATOM LifeNet under Options in your syngo menu bar and you will find a browser window that allows you to access various information about your hard- and software environment. Under System Information, for example, you will find information such as software version or a scan second counter. Under Customer Information you can enter your contact data.
Application Information The syngo Basics E-Learning is pre-installed on your system and can directly be used by selecting E-Training. The syngo Advanced Application E-Learning can be downloaded in the SOMATOM LifeNet online area or is sent to you automatically on CD if trial software is requested via SOMATOM LifeNet. In case a pdf document (e.g.
Application Information SOMATOM LifeNet online When you start up your system you will receive up-todate information in the Newsticker and see the expiration date of installed trial software. Access the Siemens Extranet by clicking on SOMATOM LifeNet online. After entering your CT system serial number you will be forwarded to the information and service portal. You can find the serial number by selecting system information in the offline part of SOMATOM LifeNet.
Application Information Download of Files Each download will be performed in the background and even if you disconnect your SOMATOM LifeNet online session and start to work with the CT scanner, it will continue the process until the download is completed. Due to bandwidth restrictions it is only possible to perform one download at a time. Depending on your connection speed downloading of larger files like, for example, the Advanced Application Training may take quite some time.
Application Information The E-training is automatically installed as soon as it is downloaded and can be started within the SOMATOM LifeNet offline section under SOMATOM Educate > ETraining. For syngo Acquisition Workplaces, you can download and install scan protocols. To install the downloaded protocols open the Scan Protocol Manager via Options > Configuration. Select Import Scan Protocols in the menu Scan Protocol.
Application Information All new protocols, including those you did not choose to import to the Customer Folder will also be stored in the Siemens Folder so that they can be copied later. All downloaded scan protocols are named "DL_.." so they can be easily identified when mixed with preinstalled protocols. Also, see the chapter Scan Protocol Assistant for more information.
Application Information Contact Function Contacting Siemens via Email is possible directly from your scanner and even DICOM images can be attached to your message. To attach an image, please first select the images on your Viewing task card first and then export these images to H:\SiteData\Offline as a DICOM image. After exporting the image, open the Siemens Extranet and choose Contact.
Application Information Trial Order and Installation As a SOMATOM CT user you can request trial clinical software directly from the scanner. The requested software will be made available and installed automatically through our Siemens Remote Services connection. After you have accessed the SOMATOM LifeNet online area, you can choose system-specific trial software under SOMATOM Expand > Trial Licenses.
Application Information Forwarding information via Email This service enables those customers who do not have a printing device connected to their CT Scanner, but would like to have the information provided in SOMATOM LifeNet sent to their regular email account or forwarded to a contact person of interest as an email. Information about current courses and clinical training programs, as well as CT accessories can be sent from the scanner to any email account.
Application Information Image Converter The CT application Common DICOM Adapter can convert different DICOM data sets to formats provided by other CT vendors. – You will find the converter in the Applications menu of the Patient Browser.
Application Information In the pop-up window you can select the application for which you want to convert the images 148
Application Information Split-Up Multi-Phase Series 1.Select Split-up series according to trigger delay from the section Split-up Heartview 4D series, if you intend to split-up the series of multi-phase heart reconstruction according to the different heart phases included. Or 2.Select Split-up series according to slice position to split up the series according to the different slice positions it contains. After conversion you can load these data sets into the application of your choice.
Application Information Report Template Configuration Under Options/Configuration you will find the Report Template Configuration. With the Report Configuration you can edit the basic information, e.g. clinic information for your report templates of the applications: – syngo Calcium Scoring – syngo Colonography CT – syngo Lung CARE CT Additionally you can insert your logo and select which reference data you want to use.
Application Information File Browser The File Browser provides you with a secure means of accessing and managing data in a private folder, which is a well defined part of the computer file system. This user partition is strictly separated from the system operating file system.
Application Information Raw data transfer: Raw data set can be transferred. First configure the directory where the raw data should be transferred to: • Open the File Browser. • Choose the desired directory from the navigation tree to the left of the File Browser. • Select the item Set as Export Root from the CT Data Transfer drop down menu. • Select the raw data files you want to transfer in the content area of the Patient Browser.
Application Information Burn on CD: • Do not write files to CD-R while other jobs are being transferred. • Make sure that the volume of data to be recorded does not exceed the CD-R storage capacity. • Select the desired files and copy & paste or drag & drop them into the folder CDBurn (or send them via the right mouse button menu to the folder CDBurn). • Open the LocalJobStatus in the Patient Browser and clear all entries. • Select Record to Offline in the Transfer menu of the Patient Browser.
Application Information Review reports and movies: • Select the desired files and double-click on them. • The corresponding program, for example, Movie Media Player, will be opened and you can review what you have saved. • You can now transfer these files to floppy disk or copy them onto a CD. Additional Important Information: • Files with the following extensions cannot be started/ opened from the File Browser “bat“, “cmd“, “com“, “exe“, “reg“, “dot“, “htm“, “html“, “pl“, “vbs“, “js“, “wsf“, “wsh“, “xml“.
Application Information Camtasia Camtasia is a separate software tool that allows you to film your desktop activities. You can save these recordings as avi files for documentation and presentation purposes. Key features • Camtasia Recorder: to capture avi files. Before starting recording you can select the area you want to capture. • Camtasia Player: to play avi files • Camtasia Producer: to edit avi files To open the Camtasia tool, select in the main menu Application > Desktop > Camtasia Recorder.
Application Information Under Tools > Options you can define special settings for recording: • AVI – to define Video and Audio options • File – to define the output options (files and folders) • Hotkeys – to define special hotkeys, e.g.
Application Information • Program – to define capture options 157
Application Information The Effects Options dialog box allows you to set options for your recording, for example, cursor effects.
Application Information Additional Important Information • To transfer avi files from the file browser to any external storage device, for example CD, or USB stick use RMB menu Send to. Drag&drop and copy/paste to any storage device is not possible within the File Browser. • To display the main menu, set ToggleView - Compact. • AVI files can only be played on the syngo CT Workplace. • For further information on how to operate the Camtasia tool, please refer to the Help menu.
Application Information Patient Protocol Scan: kV: mAs: ref. mAs TI: cSL: number of scan range kilo Volt averaged applied mAs of the range quality ref. mAs of the range Rotation Time collimated Slice CTDIvol: CTDIW Pitch Factor DLP: For further information please refer to the chapter “Dose Information“.
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Head Overview In this chapter you will find all scan protocols relating to the Head region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, stroke, brain tumors, cranial trauma, cerebral atrophy, hydrocephalus, and inflammatory changes.
Head For SOMATOM Emotion 16-slice configuration: – HeadRoutine Spiral mode for routine head studies – HeadNeuro Special spiral mode using an acq. of 4 x 0.
Head For SOMATOM Emotion 6-slice configuration: – HeadRoutine Spiral mode for routine head studies – HeadSeq Sequential mode for routine head studies – InnerEarHR Spiral mode for high resolution inner ear studies – InnerEarHRVol Spiral mode for high resolution inner ear studies and double oblique studies – InnerEar Spiral mode for routine ear studies – InnerEarSeq Sequential mode for inner ear studies – Sinus Spiral mode for routine sinus studies – SinusVol Spiral mode for axial and coronal sinus studies –
Head General Hints • Topogram: Lateral, 256 mm. • Patient positioning: Patient lying in supine position, arms resting against body, secure head well in the head holder, support lower legs. • Gantry tilt is available for sequence scanning. However, image artifacts may occur if spirals are acquired with a tilt angle greater than 8°. • For all head studies, it is very important for image quality to position the patient in the center of the scan field.
Head Head Kernels • For soft tissue head studies, the standard kernel is H40s; softer images are obtained with H30s or H20s, H10s, sharper images with H50s. The kernels H21s, H31s, H41s yield the same visual sharpness as H20s, H30s, H40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using H31s, H 41s instead of H30s, H40s. For the standard head protocols, we propose H21s, H31s, H41s.
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Head Scan Protocols HeadRoutine Indications: Spiral mode for routine head studies, for example, stroke, brain tumors, cranial trauma, cerebral atrophy, hydrocephalus, and inflammation, etc. For SOMATOM Emotion 16-slice configuration: A range for the base of 4 cm will be covered in 14.36 sec., a range for the cerebrum of 8 cm will be covered in 14.36 sec. For SOMATOM Emotion 6-slice configuration: A range for the base of 4 cm will be covered in 28.00 sec.
Head Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch factor Increment Kernel CTDIVol Effective dose Base 130 220 Cerebrum 130 240 1.5 sec. 16 x 0.6 mm 0.6 mm 4.0 mm 5.3 mm 0.55 4.0 mm H31s 58.52 mGy Male: 1.33 mSv Female: 1.43 mSv 1.5 sec. 16 x 1.2 mm 1.2 mm 6.0 mm 10.6 mm 0.55 6.0 mm H31s 57.60 mGy Male: 1.98 mSv Female: 2.
Head Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch factor Increment Kernel CTDIVol Effective dose 170 Base 130 220 Cerebrum 130 250 1.5 sec. 6 x 1.0 mm 1.0 mm 4.0 mm 2.4 mm 0.40 4.0 mm H31s 60.50 mGy Male: 0.94 mSv Female: 0.98 mSv 1.5 sec. 6 x 2.0 mm 2.0 mm 6.0 mm 4.8 mm 0.40 6.0 mm H31s 58.75 mGy Male: 1.72 mSv Female: 1.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Total amount 50 – 60 ml Hints • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
Head HeadNeuro Indications: Special spiral neuro mode for dedicated head studies. Two ranges are predefined for the base of the skull using an acquisition of 16x0.6 mm and for the cerebrum using an acquisition of 4x0.6 mm. A range for the base of 4 cm will be covered in 9.58 sec., a range for the cerebrum of 8 cm will be covered in 68.67 sec. Emotion 16 kV Effective mAs/ Quality ref.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Total amount 50 – 60 ml Hints • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the isocenter. No recon job with a field of view exceeding those limits will be possible.
Head HeadSeq Indications: Sequence mode for routine head studies, e.g. stroke, brain tumors, cranial trauma, cerebral atrophy, hydrocephalus, and inflammation, etc. Two ranges are predefined for the base of the skull and for the cerebrum. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 12.30 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 12.80 cm.
Head Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose BaseSeq 130 270 CerebrumSeq 130 270 1.5 sec. 2 x 5.0 mm 5.0 mm 5.0 mm 10 mm H31s 58.32 mGy Male: 1.08 mSv Female: 1.20 mSv 1.5 sec. 2 x 8.0 mm 8.0 mm 8.0 mm 16 mm H31s 57.24 mGy Male: 1.96 mSv Female: 2.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Volume 50-60 ml Hints • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
Head InnerEarHR Indications: Spiral mode for inner ear high resolution studies, e.g. inflammatory changes, tumorous processes of pyramids, cerebellopontine angle tumors, posttraumatic changes, etc. For SOMATOM Emotion 16-slice configuration: A range of 4.0 cm will be covered in 24.22 sec. For SOMATOM Emotion 6-slice configuration: A range of 4.0 cm will be covered in 17.69 sec.
Head Emotion 16 InnerEar kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 130 1.0 sec. 4 x 0.6 mm 0.6 mm 2.0 mm 1.1 mm 0.45 2.0 mm H90s 38.35 mGy Male: 0.74 mSv Female: 0.78 mSv Emotion 6 InnerEar kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 130 178 1.0 sec. 6 x 0.5 mm 0.
Head Hints • For image reconstruction of soft tissue, use kernel H30s/H31s. • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
Head InnerEarHRVol Indications: Spiral mode for high resolution inner ear studies, e.g.malformations of the inner ear, inflammatorychanges, pathologies of the mastoid process, tumorprocesses of the pyramids, posttraumatic changes,etc. Three recon jobs are predefined for reconstruction: the first for axial bone structure, the second and third for the double oblique for each side in 3D images display view. For SOMATION Emotion 16-slice configuration: A range of 40 mm will be covered in 24.22 sec.
Head Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Inner Ear 130 130 2nd recon. 1.0 sec. 6 x 0.5 mm 0.5 mm 2.0 mm 2.0 mm 2.6 mm 0.85 2.0 mm 2.0 mm H90s H90s 35.88 mGy Male: 0.57 mSv Female: 0.59 mSv 3d recon. 2.0 mm 2.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Volume 50-60 ml Hints • For image reconstruction of soft tissue, use kernel H30s/H31s. • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the isocenter. No recon job with a field of view exceeding those limits will be possible.
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Head InnerEar Indications: Spiral mode for inner ear studies, e.g. inflammatory changes, tumorous processes of pyramids, cerebellopontine angle tumors, post-traumatic changes, etc. For SOMATOM Emotion 16-slice configuration: A range of 4 cm will be covered in 7.21 sec. For SOMATOM Emotion 6-slice configuration: A range of 4 cm will be covered in 9.84 sec.
Head Emotion 16 InnerEar kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 120 1.0 sec. 16 x 0.6 mm 0.6 mm 2.0 mm 7.7 mm 0.80 2.0 mm H90s 31.92 mGy Male: 0.77 mSv Female: 0.83 mSv Emotion 6 InnerEar kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 120 1.0 sec. 6 x 1.0 mm 1.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Total amount 50 ml Hints • For image reconstruction of soft tissue, use kernel H30s/H31s. • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
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Head InnerEarSeq Indications: Sequence mode for inner ear studies, e.g. inflammatory changes, tumorous processes of pyramids, cerebellopontine angle tumors, post-traumatic changes, etc. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 8.6 mm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 4.7 mm.
Head Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose InnerEarSeq 130 140 1.0 sec. 12 x 0.6 mm 0.6 mm 0.6 mm 7.2 mm H90s 42.00 mGy Male: 1.51 mSv Female: 1.62 mSv InnerEarSeq 130 140 1.0 sec. 6 x 1.0 mm 1.0 mm 1.0 mm 6.0 mm H90s 38.50 mGy Male: 0.68 mSv Female: 0.
Head Contrast medium IV injection Start delay 60 sec. Flow rate 2 ml/sec. Total amount 60 ml Hints • For image reconstruction of soft tissue, use kernel H30s/H31s. • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
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Head Sinus Indications: Spiral mode for paranasal sinuses studies, e.g. sinusitis, mucocele, pneumatization, polyposis, tumor, corrections etc. For SOMATOM Emotion 16-slice configuration: A range of 80 mm will be covered in 12.42 sec. For SOMATOM Emotion 6-slice configuration: A range of 80 mm will be covered in 17.69 sec.
Head Emotion 16 Sinus kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 2nd recon. 3rd recon. 4th recon. 1.0 mm 1.0 mm 0.7 mm H70s 0.7 mm H30s 130 35 1.0 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 7.7 mm 5.0 mm 0.80 5.0 mm 5.0 mm H70s H30s 9.31 mGy Male: 0.32 mSv Female: 0.
Head Emotion 6 Sinus kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width 130 35 Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 2nd recon. 3rd recon. 4th recon. 1.25 mm 1.25 0.8 mm H70s 0.8 mm H30s 1.0 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 0.85 5.0 mm 5.0 mm H70s H30s 9.63 mGy Male: 0.20 mSv Female: 0.25 mSv Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec.
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Head SinusVol Indications: Spiral mode for axial and coronal paranasal sinuses studies, e.g. sinusitis, mucocele, polyposis, tumor, corrections etc. Three recon jobs are predefined for reconstruction: the first for axial bone structure and the second for the coronal soft tissue in 3D images display view and the third for the coronal bone structure in 3D images display view. For SOMATOM Emotion 16-slice configuration: A range of 80 mm will be covered in 12.42 sec.
Head Emotion 6 Sinus kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 35 2nd recon. 1.0 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 3.0 mm 5.1 mm 0.85 5.0 mm 3.0 mm H70s H30s 9.63 mGy Male: 0.20 mSv Female: 0.25 mSv 3d recon. 3.0 mm 3.0 mm H60s Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec. Total amount 75 ml Hint • For low dose studies use only 20 mAs.
Head Orbit Indications: Spiral mode for orbital studies, e.g. fracture. For SOMATOM Emotion 16-slice configuration: A range of 50 mm will be covered in 8.51 sec. For SOMATOM Emotion 6-slice configuration: A range of 50 mm will be covered in 11.80 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 198 Orbit 130 70 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 7.7 mm 0.
Head Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Orbit 130 70 2nd reconstr. 1.0 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 1.25 mm 5.1 mm 0.85 5.0 mm 0.5 mm H70s H70s 19.25 mGy Male: 0.25 mSv Female: 0.32 mSv Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec. Total amount 75 ml Hint • For low dose studies use only 20 mAs.
Head Dental Indications: This is the scan protocol for the syngo Dental application package. It is used for evaluation and reformatting of the upper and lower jaws. It enables the display and measurement of the bone structures of the upper and lower jaw as the basis for planning in oral surgery. For SOMATOM Emotion 16-slice configuration: A range of 50 mm will be covered in 8.51 sec. For SOMATOM Emotion 6-slice configuration: A range of 50 mm will be covered in 9.44 sec.
Head Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Dental 130 45 1.0 sec. 16 x 0.6 mm 0.6 mm 0.75 mm 7.7 mm 0.80 0.5 mm H70s 11.97 mGy Male: 0.25 mSv Female: 0.
Head Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Dental 130 45 0.8 sec. 6 x 1.0 mm 1.0 mm 1.25 mm 5.1 mm 0.85 0.6 mm H70s 12.38 mGy Male: 0.19 mSv Female: 0.23 mSv For further information on the scan protocols and how to use syngo Dental CT, please refer to the Application Guide "Clinical Applications".
Head Hint • An automatic bone correction allows for improved head image quality, without any additional postprocessing. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible. Therefore, patient positioning has to be performed accurately to ensure a centered location of the skull.
Neck Overview In this chapter you will find all scan protocols relating to the Neck region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, tumors, lymphoma, and abscesses.
Neck For SOMATOM Emotion 16-slice configuration: – NeckRoutine Spiral mode for soft tissue routine neck studies – NeckVol Spiral mode for axial, coronal and sagittal neck studies For SOMATOM Emotion 6-slice configuration: – NeckRoutine Spiral mode for soft tissue routine neck studies – NeckThinSlice Spiral mode for thin slice soft tissue neck studies – NeckVol Spiral mode for axial, coronal and sagittal neck studies 205
Neck General Hints • Topogram: Lateral, 256 mm or AP 512 mm. • Patient positioning Patient lying in supine position, hyperextend neck slightly, secure head well in head holder. • Patient respiratory instruction: do not breathe, do not swallow. • For contrast studies, CARE Bolus (optional) may be used to optimize the bolus timing. • For image reconstruction of bone structure, use kernel B60. • Patient positioning is very important for artifact-free images.
Neck Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s. • For higher sharpness, as is required e.g.
Neck Scan Protocols NeckRoutine Indications: Spiral mode for soft tissue studies in the cervical region, e.g. tumors, lymphoma, abscesses etc. For SOMATOM Emotion 16-slice configuration: A typical range of 20 cm will be covered in 28.04 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 20 cm will be covered in 17.29 sec.
Neck Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose NeckRoutine 130 130 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 7.7 mm 0.80 5.0 mm 0.7 mm B50s B50s 16.25 mGy Male: 3.61 mSv Female: 3.
Neck Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec. Total amount 120 ml Hints • Due to its iodine content, the thyroid gland is hyperdense in relation to the neighboring muscles both before and after an IV CM injection. For displays of the parotid or thyroid gland or the floor of the mouth, the slice thickness should be < 5 mm and the length of the range should be adapted to match the anatomic region.
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Neck NeckThinSlice Indications: Spiral mode using thin slices for soft tissue studies, e.g. the functional study of the throat. For SOMATOM Emotion 6-slice configuration: A typical range of 20 cm will be covered in 32.97 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 212 NeckThinSlice 130 130 2nd reconstr. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 1.25 mm 5.1 mm 0.85 5.0 mm 0.
Neck Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec. Total amount 120 ml Hints • Due to its iodine content, the thyroid gland is hyperdense in relation to the neighboring muscles both before and after an IV CM injection. For displays of the parotid or thyroid gland or the floor of the mouth, the slice thickness should be < 5 mm and the length of the range should be adapted to match the anatomic region.
Neck NeckVol Indications: Spiral mode for soft tissue studies in the cervical region, e.g. tumors, lymphoma, abscesses etc. Three recon jobs are predefined for reconstruction: the first for axial, the second for coronal and third for saggittal studies in 3D images display. For SOMATOM Emotion 16-slice configuration: A typical range of 20 cm will be covered in 28.04 sec. For SOMATOM Emotion 16-slice configuration: A typical range of 20 cm will be covered in 32.97 sec.
Neck Emotion 6 Neck kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 130 2nd recon. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 5.1 mm 0.85 5.0 mm 5.0 mm B50s B20s 16.51 mGy Male: 4.06 mSv Female: 4.25 mSv 3rd recon. 5.0 mm 5.
Neck Contrast medium IV injection Start delay 45 sec. Flow rate 2.0 ml/sec. Total amount 120 ml Hints • Due to its iodine content, the thyroid gland is hyperdense in relation to the neighboring muscles both before and after an IV CM injection. For displays of the parotid or thyroid gland or the floor of the mouth, the slice thickness should be < 5 mm and the length of the range should be adapted to match the anatomic region.
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Shoulder Overview In this chapter you will find all scan protocols relating to the Shoulder region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, masses, trauma, dislocations, and orthopedic indications.
Shoulder General Hints • Topogram: AP, 256 mm. • Patient positioning: Patient lying in supine position, the uninjured arm placed above the head, the injured arm placed flat against his body. If only one side is under investigation, position this side in the center and support the other side with a Bocollo pillow (optional). • If only one side is examined, it is advisable to enter the side in the comment line on the routine card. • Contrast medium is required for soft tissue mass evaluation.
Shoulder Scan Protocols Shoulder Indications: Spiral mode for bone studies and soft tissue, e.g. evaluation of joint cavities, masses, trauma, dislocations, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A scan range of 15 cm will be covered in 26.44 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 15 cm will be covered in 40.50 sec.
Shoulder Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Shoulder 130 100 2nd recon. 1.5 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 9.6 mm 1.0 5.0 mm 0.7 mm B60s B60s 12.50 mGy Male: 3.38 mSv Female: 3.
Shoulder Hints • Use raw data to review a target region if necessary. • For image reconstruction of soft tissue use kernel B31s and a slice width of 5.0 mm. • Coronal and sagittal 2D planar reconstructions are important for evaluation of the joint space & bursa sacs in CT arthograms. • 3D renderings are helpful for complex fractures & dislocations.
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Shoulder ShoulderVol Indications: Spiral mode for bone studies and soft tissues, e.g. evaluation of joint cavities, masses, trauma, dislocations, orthopedic indications etc. Three recon jobs are predefined for reconstruction: the first for soft tissue axial, the second for soft tissue coronal and third for sagittal bone studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A scan range of 15 cm will be covered in 26.44 sec.
Shoulder Emotion 6 Shoulder kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 100 2nd recon. 1.5 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 6.0 mm 1.0 5.0 mm 5.0 mm B60s B20s 12.70 mGy Male: 2.96 mSv Female: 3.52 mSv 3rd recon. 5.0 mm 5.0 mm B20s Hints • Use raw data to review a target region if necessary. • For image reconstruction of soft tissue use kernel B31s and a slice width of 5.0 mm.
Thorax Overview In this chapter you will find all scan protocols relating to the Thorax region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, tumors, metastases, lymphoma, lymph nodes, vascular anomalies, and interstitial changes in the lungs.
Thorax For SOMATOM Emotion 16-slice configuration: – ThoraxRoutine Spiral mode for routine thorax studies – ThoraxCombi Spiral mode for the combination of thin slice lung and routine thorax studies – ThoraxVol Spiral mode for axial, coronal soft tissue and coronal lung studies – ThoraxHR Spiral mode for high resolution lung studies – ThoraxHRSeq Sequential mode for high resolution lung studies – ThoraxECGHRSeq Sequential mode for high resolution, ECG-triggered lung studies – LungLowDose Spiral mode with ver
Thorax For SOMATOM Emotion 6-slice configuration: – ThoraxRoutine/ThoraxRoutine06s Spiral mode for routine thorax studies – ThoraxCombi/ThoraxCombi06s Spiral mode for the combination of thin slice lung and routine thorax studies – ThoraxVol Spiral mode for axial, coronal soft tissue and coronal lung studies – ThoraxFast/ThoraxFast06s Spiral mode for fast chest studies – ThoraxHR Spiral mode for high resolution lung studies – ThoraxHRSeq Sequential mode for high resolution lung studies – ThoraxECGHRSeq Seque
Thorax General Hints • Topogram: AP, 512 mm. • Patient positioning: Patient lying in supine position, arms positioned comfortably above the head in the head-arm rest, lower legs supported. • Contrast medium administration: in general, IV injections are employed in all mediastinal examinations, but not in routine High Resolution studies of diffused, interstitial lung diseases.
Thorax • Lung images should be documented in both soft tissue window and lung window. • It is also possible to interleave the soft tissue & lung setting images in one film sheet. This can be set up in the configuration for filming. • To further optimize MPR image quality we recommend that you reduce one or more of the following: collimation, reconstruction increment, and slice width for image reconstruction.
Thorax Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s. • For higher sharpness, as is required e.g.
Thorax Scan Protocols ThoraxRoutine/ ThoraxRoutine06s Indications: Routine spiral studies for the region of thorax, e.g. examination of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 12.92 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm will be covered in 18.85 sec.
Thorax Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorRoutine 130 70 2nd recon. 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 5.0 mm 15.40 mm 0.80 5.0 mm 5.0 mm B41s B70s 7.84 mGy Male: 4.36 mSv Female: 5.
Thorax Contrast medium IV injection Start delay 25 – 30 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hint • For lung cancer evaluation, this protocol can be combined with protocol NeckRoutine.
Thorax ThoraxCombi/ ThoraxCombi06s Indications: Combining thin slice lung and routine thorax studies with one spiral scan. E.g. thorax studies in general and interstitial changes in the lungs. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 13.70 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm will be covered in 21.20 sec.
Thorax Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 236 Thor Combi 130 70 2nd recon. 3rd recon. 4th recon. 1.0 mm 1.0 mm 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 5.0 mm 14.4 mm 1.50 5.0 mm 5.0 mm 0.7 mm B41s B90s B41s 8.75 mGy Male: 4.51 mSv Female: 5.78 mSv 0.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Thor Combi 130 70 2nd recon. 3rd recon. 4th recon. 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 1.25 m 1.25 m m m 10.8/9.0 mm 1.80/1.50 5.0 mm 5.0 mm 0.8 mm B41s B90s B41s 8.89 mGy Male: 4.52/4.46 mSv Female: 5.85/5.79 mSv 0.
Thorax Contrast medium IV injection Start delay 25 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hints • In addition to the mediastinum and the lungs, it may be necessary to evaluate the axillary fatty tissue and the bilateral mammary glands. A third reconstruction can be set up with a wider FoV in the Recon task card. • For lung cancer evaluation, this protocol can be combined with protocol “Neck Routine”.
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Thorax ThoraxVol Indications: Routine spiral studies for the region of thorax, e.g., visualization of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. Four recon jobs are predefined for reconstruction: the first for soft tissue axial, the second for lung axial, the third for soft tissue coronal and fourth for soft tissue coronal studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 13.70 sec.
Thorax Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Thor Combi 130 70 2nd recon. 3rd recon. 4th recon. 5.0 mm 5.0 mm 5.0 mm B41s 5.0 mm B70s 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 5.0 mm 14.4 mm 1.50 5.0 mm 5.0 mm B41s B70s 8.75 mGy Male: 4.51 mSv Female: 5.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Thor Combi 130 70 2nd recon. 3rd recon. 4th recon. 5.0 mm 5.0 mm 5.0 mm B41s 5.0 mm B70s 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 10.8 mm 1.80 5.0 mm 5.0 mm B41s B70s 8.89 mGy Male: 4.52 mSv Female: 5.85 mSv For the 3rd and 4th reconstruction a non-square matrix 3D recon job is predefined.
Thorax Contrast medium IV injection Start delay 25 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hint • In addition to the mediastinum and the lungs, it may be necessary to evaluate the axillary fatty tissue and the bilateral mammary glands. A third reconstruction can be set up with a wider FoV in the Recon task card. • For lung cancer evaluation, this protocol can be combined with protocol NeckRoutine.
Thorax ThoraxFast/ ThoraxFast06s Indications: Fast spiral mode for lung studies, e.g. when a patient has difficulty with breathhold. For SOMATOM Emotion 6-slice configuration: A complete thorax scan in a range of 30 cm will be covered in 7.87 sec. with ThoraxFast.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorFast 130 70 2nd recon. 0.8/0.6 sec. 6 x 3.0 mm 3.0 mm 6.0 mm 6.0 mm 27.0 mm 1.50 6.0 mm 6.0 mm B41s B70s 7.14 mGy Male: 4.12 mSv Female: 5.25 mSv Contrast medium IV injection Start delay 25 – 30 sec. Flow rate 2.5 ml/sec.
Thorax ThoraxHR Indications: Spiral mode for high resolution studies, e.g. interstitial changes in the lungs. For SOMATOM Emotion 16-slice configuration: A range of 30 cm for the complete thorax will be covered in 13.70 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm for the complete thorax will be covered in 28.27 sec.
Thorax Emotion 16 ThorHR kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 100 2nd recon. 3rd recon. 4th recon. 1.0 mm 1.0 mm 0.7 mm B70s 0.7 mm B41s 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 5.0 mm 14.4 mm 1.50 5.0 mm 5.0 mm B90s B41s 12.50 mGy Male: 6.56 mSv Female: 8.
Thorax 3rd recon. 4th recon. 5.0 mm 1.0 mm 1.0 mm 5.0 mm 5.0 mm B90s B41s 12.70 mGy Male: 6.23 mSv Female: 8.10 mSv 0.7 mm B70s 0.7 mm B41s Emotion 6 ThorHR kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 100 2nd recon. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 9.0 mm 1.50 Hints • With studies of interstitial changes in the lungs, contrast medium is not necessary.
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Thorax ThoraxHRSeq Indications: Sequence mode for high-resolution lung studies, for example, interstitial changes in the lungs using a feed of 10 mm. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 30.1 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 30.0 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose 250 ThorHRSeq 130 100 1.0 sec. 4 x 0.6 mm 0.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose ThorHRSeq 130 100 1.0 sec. 1 x 1.0 mm 1.0 mm 1.0 mm 10.0 mm B90s 1.01 mGy Male: 0.49 mSv Female: 0.63 mSv Hints • If you want to reconstruct thin slices every 10 or 20 mm instead of 15 mm as predefined, simply change the Feed/Scan before loading the mode. • With studies of interstitial changes in the lungs, contrast medium is not necessary.
Thorax ThoraxECGHRSeq Indications: Sequence mode for High Resolution, ECG triggered lung studies, e.g. interstitial changes in the lungs. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 19.1 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 12.0 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose 252 ThoraxECGHR 130 70 0.5 sec. 4 x 0.6 mm 0.6 mm 1.2 mm 10.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose ThoraxECGHR 130 70 0.8 sec. 1 x 1.0 mm 1.0 mm 1.0 mm 10.0 mm B90s 0.71 mGy Male: 0.21 mSv Female: 0.29 mSv Hints • With studies of interstitial changes in the lungs, contrast medium is not necessary. • If you want to reconstruct thin slices every 10 or 20 mm instead of 15 mm as predefined, simply change the Feed/Scan before loading the mode.
Thorax LungLowDose/ LungLowDose06s Indications: Spiral lung studies with low dose setting, e.g. early visualization of pulmonary nodules. For SOMATOM Emotion 16-slice configuration: A typical thorax study in a range of 30 cm will be covered in 19.95 sec. For SOMATOM Emotion 6-slice configuration: A typical thorax study in a range of 30 cm will be covered in 18.85 sec.
Thorax Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 3rd recon. 4th recon. 5.0 mm 1.0 mm 1.0 mm 5.0 mm 5.0 mm B41s B90s 1.28 mGy Male: 0.68 mSv Female: 0.86 mSv 0.7 mm B41s 0.7 mm B70s Lung Low Dose 110 16 2nd recon. 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 9.6 mm 1.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 256 LungLowDose 110 16 2nd recon. 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 5.0 mm 12.0/10.2 mm 1.00/0.85 5.0 mm 5.0 mm B70s B30s 1.14 mGy Male: 0.57 mSv Female: 0.62/0.
Thorax Contrast medium IV injection Start delay 30 sec. Flow rate 2.5 ml/sec. Total amount 50 – 70 ml Hints • For lung cancer evaluation, this protocol can be combined with protocol “Neck Routine”. • Low dose lung images are usually evaluated using lung window setting. Soft tissue/bone window settings may be used to detect the presence of calcifications in the nodules. • It is essential to use the same protocol for follow-up studies to check for progression.
Thorax LungCARE/ LungCARE06s Indications: Spiral lung study with low dose setting for early visualization of pathologies, used for the application LungCARE. For SOMATOM Emotion 16-slice configuration: A typical thorax study in a range of 30 cm will be covered in 13.70 sec. For SOMATOM Emotion 6-slice configuration: A typical thorax study in a range of 30 cm will be covered in 17.87 sec.
Thorax Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Lung CARE 110 15 2nd recon. 3rd recon. 4th recon. 1.0 mm 1.0 mm 0.7 mm B41s 0.7 mm B70s 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 5.0 mm 14.4 mm 1.50 5.0 mm 5.0 mm B41s B90s 1.20 mGy Male: 0.64 mSv Female: 0.
Thorax Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 260 Lung CARE 110 15 2nd recon. 3rd recon. 4th recon. 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 1.25 m 1.25 m m m 0.8 mm B41s 0.8 mm B70s 10.8 mm 1.80 5.0 mm 5.0 mm B41s B90s 1.25 mGy Male: 0.63 mSv Female: 0.
Thorax Contrast medium IV injection Start delay 30 sec. Flow rate 2.5 ml/sec. Total amount 50 – 70 ml Hints • For lung cancer evaluation, this protocol can be combined with protocol Neck Routine or you can use the protocol NeckThorax. • Low dose lung images are usually evaluated using lung window setting. Soft tissue/bone window settings may be used to visualize the presence of calcifications in the nodules. • It is essential to use the same protocol for follow-up studies to check for progression.
Abdomen Overview In this chapter you will find all scan protocols relating to the Abdomen region, their descriptions, individual indications, and important hints on using them.
Abdomen – AbdMultiPhase Spiral mode for three phases liver studies – AbdSeq Sequential mode for abdominal studies – Colonography Spiral mode used for the application syngo Colonography For SOMATOM Emotion 6-slice configuration: – AbdomenRoutine/AbdomenRoutine06s Spiral mode for routine abdominal studies – AbdomenCombi/AbdomenCombi06s Spiral mode for the combination of thin slice and routine abdominal studies – AbdomenVol Spiral mode for axial and coronal abdomen studies – AbdomenFast/AbdomenFast06s Spiral m
Abdomen General Hints • Topogram: AP, 512. • Patient positioning: Patient lying in supine position, arms positioned comfortably above the head in the head-arm rest, lower legs supported. • Patient respiratory instruction: inspiration. • Oral administration of contrast medium: For abdominal studies, it is necessary to delineate the bowel from other structures such as lymph nodes, abdominal masses & abscesses. Various types of bowel opacifying agents can be used: - Diluted barium suspension (1%–2%) e.g.
Abdomen – In general, for abdominal studies such as liver, gall bladder (query stones), pancreas, gastrointestinal studies, focal lesion of the kidneys and CTA studies, it is sufficient to use just water. Water is more effective than positive oral contrast agent in depicting the linings of the stomach & intestines in post enhancement studies. In addition, the use of water will not obscure the blood vessels thus allowing CTA processing to be performed easily afterwards.
Abdomen Scan Protocols AbdomenRoutine/ AbdomenRoutine06s Indications: Spiral mode for routine studies in the region of abdomen, e.g. evaluation, follow-up examinations etc. For SOMATOM Emotion 16-slice configuration: A scan range of 20 cm will be covered in 9.01 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 20 cm will be covered in 12.96 sec.
Abdomen Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose AbdRoutine 130 120 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 15.4 mm 0.80 5.0 mm B41s 13.44 mGy Male: 5.81 mSv Female: 7.15 mSv AbdRoutine 130 120 0.8/0.6 sec. 6 x 2.
Abdomen Contrast medium IV injection Start delay 50 – 60 sec. Flow rate 3.0 ml/sec. Total amount 100 ml Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g. when both non-contrast and contrast studies are required. • Delayed scans may be required for the kidneys & bladder. • If you want to use this protocol for a two-phase study, repeat the same protocol as mentioned below, and choose start delay time for arterial phase as 20 - 25 sec.
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Abdomen AbdomenCombi/ AbdomenCombi06s Indications: Combination of thin slice and routine abdominal studies with one spiral scan. For SOMATOM Emotion 16-slice configuration: A range of 20 cm for liver, pancreas or kidneys will be covered in 9.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 20 cm for liver, pancreas or kidneys will be covered in 14.53 sec.
Abdomen Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose AbdCombi 130 130 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 14.4 mm 1.50 5.0 mm B41s 16.25 mGy Male: 6.66 mSv Female: 8.09 mSv AbdCombi 130 130/120 2nd reconstr. 1.
Abdomen Contrast medium IV injection Start delay 50 – 65 sec. Flow rate 3.0 ml/sec. Total amount 100 ml Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g. when both non-contrast and contrast studies are required. • Delayed scans may be required for the kidneys & bladder. • If you want to use this protocol for a two-phase study, repeat the same protocol as mentioned below, and choose start delay time for arterial phase as 20 - 25 sec.
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Abdomen AbdomenVol Indications: Spiral mode for all routine studies in the region of abdomen, e.g. follow-up examinations etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: The whole scan range of 20 cm will be covered in 9.53 sec. For SOMATOM Emotion 6-slice configuration: The whole scan range of 20 cm will be covered in 19.38 sec. Emotion 16 kV Effective mAs/ Quality ref.
Abdomen Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose AbdCombi 130 130 2nd recon. 0.8 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 9.0 mm 1.50 5.0 mm 5.0 mm B41s B30s 16.51 mGy Male: 6.32 mSv Female: 7.85 mSv Contrast medium IV injection Start delay 50 – 65 sec. Flow rate 3.0 ml/sec.
Abdomen Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g. when both non-contrast and contrast studies are required. • Delayed scans may be required for the kidneys & bladder. • If you want to use this protocol for a two-phase study, repeat the same protocol as mentioned below, and choose start delay time for arterial phase as 20 - 25 sec. In this case, the thin slice reconstruction can also be used for post-processing.
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Abdomen AbdomenFast/ AbdomenFast06s Indications: Fast spiral mode for abdominal studies, e.g. when a patient has difficulty with breathhold. For the SOMATOM Emotion 6-slice configuration: A range of 20 cm will be covered in 5.64 sec. with AbdomenFast06s. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 278 AbdFast 130 120 0.8/0.6 sec. 6 x 3.0 mm 3.0 mm 6.0 mm 27.0 mm 1.50 6.0 mm B41s 12.
Abdomen Contrast medium IV injection Start delay 25 – 30 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g. when both non-contrast and contrast studies are required. • Delayed scans may be required for the kidneys & bladder. • If you want to use this protocol for a two-phase study, repeat the same protocol as mentioned below, and choose start delay time for arterial phase as 20 - 25 sec.
Abdomen AbdMultiPhase/ AbdMultiPhase06s Indications: Combination of three phase study including liver, pancreas and kidney. For SOMATOM Emotion 16-slice configuration: A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 5.37 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 280 Non Contrast 110 75 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 28.8 mm 1.50 5.
Abdomen A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 16.83 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Arterial Phase 110 120 2nd recon. 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 7.7 mm 0.80 5.0 mm 0.7 mm B41s B41s 9.60 mGy Male: 4.05 mSv Female: 4.
Abdomen A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 9.01 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 282 Venous Phase 130 120 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 15.4 mm 0.80 5.0 mm B41s 13.44 mGy Male: 5.89 mSv Female: 7.
Abdomen For SOMATOM Emotion 6-slice configuration: A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 7.87 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Non Contrast 110 75 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 18.0 mm 1.50 5.0 mm B41s 5.33 mGy Male: 2.14 mSv Female: 2.
Abdomen A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 12.96 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 284 Arterial Phase 110 120 2nd recon. 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 2.5 mm 10.2 mm 0.85 5.0 mm 1.7 mm B41s B31/B41s 8.52 mGy Male: 3.24 mSv Female: 4.
Abdomen A range of 20 cm including liver, pancreas and kidney: arterial phase acquired in 12.96 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Venous Phase 130 120 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 10.2 mm 0.85 5.0 mm B41s 13.08 mGy Male: 5.06 mSv Female: 6.30 mSv Contrast medium IV injection Start delay 20 – 25 sec.* (arterial phase) 50 – 75 sec.
Abdomen Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g. when both non-contrast and contrast studies are required. • Do not administer oral contrast medium, as this impairs the editing of MIP/SSD/VRT images. Use water instead if necessary. • Water, rather than positive oral contrast agents should be used. Give the last cup 200 ml just prior to positioning the patient.
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Abdomen AbdomenSeq Indications: This protocol is created for measurement with sequential mode in the region of the abdomen. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 19.5 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 30.8 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose 288 AbdSeq 130 120 0.6 sec. 2 x 5.0 mm 5.0 mm 5.0 mm 10.0 mm B41s 12.
Abdomen Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose AbdSeq 130 120 0.8 sec. 6 x 2.0 mm 2.0 mm 4.0 mm 12.0 mm B41s 13.08 mGy Male: 6.77 mSv Female: 11.34 mSv Contrast medium IV injection Start delay 50 – 60 sec. Flow rate 3.0 ml/sec. Total amount 100 ml Hints • You could repeat the same protocol simply by clicking the chronicle with the right mouse button for “repeat“. E.g.
Abdomen Colonography/ Colonography06s Spiral mode used for the application syngo Colonography. For SOMATOM Emotion 16-slice configuration: A complete colon in a range of 40 cm will be covered in 17.87 sec. For SOMATOM Emotion 6-slice configuration: A complete colon in a range of 40 cm will be covered in 27.87 sec.
Abdomen Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Colo_supine 130 50 Colo_prone 130 30 0.6 sec. 16 x 0.6 mm 0.6 mm 1.0 mm 14.4 mm 1.50 0.7 mm B41s 6.25 mGy Male: 4.48 mSv Female: 6.85 mSv 0.6 sec. 16 x 0.6 mm 0.6 mm 1.0 mm 14.4 mm 1.50 0.7 mm B20s 3.75 mGy Male: 2.64 mSv Female: 4.
Abdomen Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Male: Female: Colo_supine 130 50 Colo_prone 130 30 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 1.25 mm 10.8/9.0 mm 1.80/1.50 0.8 mm B41s 6.35 mGy 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 1.25 mm 10.8/9.0 mm 1.80/1.50 0.8 mm B20s 3.81 mGy 4.61/4.53 mSv 7.01/6.96 mSv 2.77/2.72 mSv 4.20/4.18 mSv Contrast medium IV injection Start delay 50 – 60 sec.
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Spine Overview In this chapter you will find all scan protocols relating to the Spine region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, prolapse, degenerative changes, trauma, and tumors.
Spine – SpineVol Spiral mode for axial and sagittal lumbar and thoracic spine studies – SpineSeq Sequential mode for lumbar and thoracic evaluation of the discs – Osteo Sequential mode used for the application syngo Osteo CT For SOMATOM Emotion 6-slice configuration: – C-Spine Spiral mode for cervical spine studies – C-SpineVol Spiral mode for axial, sagittal soft tissue and sagittal bone studies for the cervical spine – SpineRoutine Spiral mode for routine lumbar and thoracic spine studies – SpineVol Spira
Spine General Hints • Topogram: Lateral, 512 mm for thoracic and lumbar spine and 256 mm for the C-spine. • Patient positioning for thoracic and lumbar spine studies: Patient lying in supine position, arms positioned comfortably above the head in the head-arm rest, lower legs supported. • Patient positioning for cervical spine studies: Patient lying in supine position, hyperextend neck slightly, secure head well in head holder. – Patient respiratory instruction: do not breathe, do not swallow.
Spine • To further optimize MPR image quality we recommend that you reduce one or more of the following: collimation, reconstruction increment, and slice width for image reconstruction. • With CAREDose 4D the mA values are adapted for each osteo range, according to the patient diameter. Therefore special obese protocols for the osteo evaluation are not longer necessary.
Spine Scan Protocols C-Spine Indications: Spiral mode for cervical spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be covered in 21.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be covered in 31.41 sec.
Spine Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose C-Spine 130 150 2nd recon. 1.0 sec. 16 x 0.6 mm 0.6 mm 2.0 mm 1.0 mm 7.7 mm 0.80 2.0 mm 0.7 mm B31s B60s 18.75 mGy Male: 3.49 mSv Female: 3.
Spine C-SpineVol Indications: Spiral mode for cervical spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. Three recon jobs are predefined for reconstruction: the first for soft tissue axial, the second for soft tissue sagittal and third for sagittal bone studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be covered in 21.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be covered in 31.41 sec.
Spine Emotion 6 C-Spine kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 150 2nd recon. 1.0 sec. 6 x 1.0 mm 1.0 mm 2.0 mm 2.0 mm 5.1 mm 0.85 2.0 mm 2.0 mm B31s B20s 19.05 mGy Male: 4.27 mSv Female: 4.29 mSv 3rd recon. 2.0 mm 2.
Spine SpineRoutine Indications: Spiral mode for thoracic and lumbar spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be covered in 26.04 sec. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be covered in 27.00 sec. Emotion 16 kV Effective mAs/ Quality ref.
Spine Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Spine Routine 130 190 2nd recon. 1.0 sec. 6 x 2.0 mm 2.0 mm 3.0 mm 2.5 mm 6.0 mm 0.50 3.0 mm 1.5 mm B31s B31s 20.70 mGy Male: 4.93 mSv Female: 11.26 mSv 3rd recon. 2.5 mm 1.
Spine SpineThinSlice Indications: Spiral mode for thin slice thoracic and lumbar spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be covered in 32.30 sec. F o r S O M A T Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 304 Spine ThinSlice 130 190 2nd recon. 1.0 sec. 6 x 1.0 mm 1.0 mm 3.0 mm 1.
Spine SpineVol Indications: Spiral mode for thoracic and lumbar spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. Three recon jobs are predefined for reconstruction: the first for soft tissue axial, the second for soft tissue sagittal and third for coronal bone studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be covered in 26.04 sec. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be covered in 32.30 sec.
Spine Emotion 6 Spine kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 190 306 2nd recon. 3rd recon. 1.0 sec. 6 x 1.0 mm 1.0 mm 3.0 mm 2.0 mm 3.3 mm 0.55 3.0 mm 2.0 mm B31s B20s 24.13 mGy Male: 3.64 mSv Female: 7.23 mSv 2.0 mm 2.
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Spine SpineSeq Indications: Sequence mode for spine studies, e.g. prolapse, degenerative changes, trauma, tumors etc. This protocol contains three ranges: L3-L4, L4-L5, L5S1. Three different typical gantry tilts are predefined: for L3-L4: 0°, for L4-L5: +5° and for L5-S1: +15° For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 79 mm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 84 mm.
Spine Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Male: Female: L3-4 130 280 L4-5 130 280 L5-S1 130 320 1.5 sec. 12 x 0.6 mm 0.6 mm 1.5 sec. 12 x 0.6 mm 0.6 mm 1.5 sec. 12 x 0.6 mm 0.6 mm 2.4 mm 7.2 mm B31s 38.64 mGy 2.4 mm 7.2 mm B31s 38.49 mGy 2.4 mm 7.5 mm B31s 42.66 mGy 1.75 mSv 2.45 mSv 2.15 mSv 3.78 mSv 2.43 mSv 5.
Spine Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Male: Female: L3-4 130 280 L4-5 130 280 L5-S1 130 320 1.5 sec. 6x 1.0 mm 1.0 mm 1.5 sec. 6x 1.0 mm 1.0 mm 1.5 sec. 6x 1.0 mm 1.0 mm 2.0 mm 6.0 mm B31s 35.56 mGy 2.0 mm 6.0 mm B31s 35.56 mGy 2.0 mm 6.0 mm B31s 40.64 mGy 0.88 mSv 1.44 mSv 0.91 mSv 1.96 mSv 0.81 mSv 3.
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Spine Osteo This is the scan protocol for the syngo Osteo CT application package to assist the physician with the quantitative assessment of vertebral bone mineral density (BMD) in the diagnosis and follow-up of osteopenia and osteoporosis. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref.
Spine • With CAREDose 4D the mA values are adapted for each osteo range, according to the patient diameter. Therefore special obese protocols for the osteo evaluation are not longer necessary. Load all ranges in the application syngo Osteo CT. For further information, please refer to the Application Guide “Clinical Applications“.
Pelvis Overview In this chapter you will find all scan protocols relating to the Pelvis region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, abnormalities of the prostate, urinary bladder, rectum, joint cavity, masses, and trauma.
Pelvis For SOMATOM Emotion 6-slice configuration: – Pelvis Spiral mode for routine soft tissue pelvis studies – PelvisVol Spiral mode for axial and coronal pelvis studies – Hip Spiral mode for routine hip studies – HipVol Spiral mode for axial and coronal hip studies – SI_Joints Spiral mode for sacral iliac joints studies 315
Pelvis General Hints • Topogram: AP, 512 mm for pelvis studies and 256 mm for studies of the hip and SI Joints. • Patient positioning: Patient lying in supine position, arms positioned comfortably above the head in the head-arm rest, lower legs supported. • A breathing command is not necessarily required for the pelvic examination, since respiration does not negatively influence this region.
Pelvis Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s. • For higher sharpness, as is required e.g.
Pelvis Scan Protocols Pelvis Indications: Spiral mode for routine pelvis studies, e.g. processes of the prostate, urinary bladder, rectum, gynecological indications etc. For SOMATOM Emotion 16-slice configuration: A typical range of 20 cm will be covered in 8.94 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 20 cm will be covered in 13.11 sec.
Pelvis Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Pelvis 130 120 1.0 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 28.8 mm 1.50 5.0 mm B41s 13.44 mGy Male: 5.32 mSv Female: 9.14 mSv Pelvis 130 120 1.0 sec. 6 x 2.0 mm 2.0 mm 5.
Pelvis Contrast medium IV injection Start delay 50 sec.* Flow rate 2.0 – 3.0 ml/sec. Total amount 100 – 120 ml * If the examination performed requires a full urinary bladder, wait at least 3 minutes following IV administration of the contrast medium.
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Pelvis PelvisVol Indications: Spiral mode for pelvis studies, e.g. processes of the prostate, urinary bladder, rectum, gynecological indications etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A typical range of 20 cm will be covered in 8.94 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 20 cm will be covered in 13.11 sec.
Pelvis Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective Dose Pelvis 130 120 2nd reconstr. 1.0 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 5.0 mm 18.0 mm 1.50 5.0 mm 5.0 mm B41s B41s 13.08 mGy Male: 5.13 mSv Female: 8.76 mSv Contrast medium IV injection Start delay 50 sec.* Flow rate 2.0 – 3.0 ml/sec.
Pelvis Hip Indications: Spiral mode for bone studies and soft tissue studies of the Hip. E.g. evaluation of joint cavity, masses, trauma, dysplasia, necrosis of the head of the hip, congruence evaluations, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A typical range of 10 cm will be covered in 8.94 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 10 cm will be covered in 13.11 sec.
Pelvis Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective Dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective Dose Hip 130 100 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 14.4 mm 1.50 5.0 mm 0.7 mm B70s B70s 12.50 mGy Male: 2.31 mSv Female: 5.
Pelvis Hints • In case of 3D study only, images should be reconstructed with at least 50% overlapping and kernel B10. • If only one side is examined, it is advisable to enter the side in the comment line on the Routine card.
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Pelvis HipVol Indications: Spiral mode for bone studies and soft tissue studies of the Hip, e.g. evaluation of joint cavity, masses, trauma, dysplasia, necrosis of the head of the hip, congruence evaluations, orthopedic indications etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A typical range of 10 cm will be covered in 8.94 sec.
Pelvis Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective Dose Hip 130 100 2nd reconstr. 1.0 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 5.0 mm 9.0 mm 1.50 5.0 mm 5.0 mm B70s B60s 12.70 mGy Male: 3.60 mSv Female: 3.16 mSv Hint • In case of 3D study only, images should be reconstructed with at least 50% overlapping and kernel B10.
Pelvis SI_Joints Indications: Spiral mode for bone studies of the sacral iliac joints, e.g. evaluation of joint cavity, masses, trauma, dysplasia, necrosis, congruence evaluations, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A typical range of 8 cm will be covered in 7.56 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 8 cm will be covered in 10.89 sec.
Pelvis Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose SI_Joints 130 120 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 14.4 mm 1.50 3.0 mm 0.7 mm B70s B70s 15.00 mGy Male: 2.21 mSv Female: 5.
Upper Extremities Overview In this chapter you will find the scan protocol relating to the Upper Extremities region, its description, individual indications, and important hints on using it. You can use the following scan protocol to clarify, for example, trauma, masses, disorders of the joint, and orthopedic indications.
Upper Extremities For SOMATOM Emotion 16-slice configuration: – WristHR Spiral mode for routine high resolution wrist studies – ExtrRoutineHR Spiral mode for routine high resolution extremity studies – ExtrCombi Spiral mode for the combination of thin slice and routine studies For SOMATOM Emotion 6-slice configuration: – WristHR Spiral mode for routine high resolution wrist studies – ExtrRoutineHR Spiral mode for routine high resolution extremity studies – ExtrCombi Spiral mode for the combination of thin s
Upper Extremities General Hints • Topogram: AP, 256 mm for joint studies. • Patient positioning: Depends on the region of examination. In general, for bilateral studies, you should always try to position the patient evenly whenever the patient can comply. For wrists and elbow scans: Patient lying in prone position, hands stretched above the head and lying flat on a Bocollo pillow (optional), ankles supported with a pad. Both wrists should be examined together when necessary.
Upper Extremities Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s. • For higher sharpness, as is required e.g.
Upper Extremities Scan Protocols WristHR Indications: Spiral mode for resolution bone study of thewrist, for example, trauma, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A range of 6 cm will be done in 35.33 sec. For SOMATOM Emotion 6-slice configuration: A range of 6 cm will be done in 25.53 sec.
Upper Extremities Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose WristHR 130 40 2nd reconstr. 1.0 sec. 4 x 0.6 mm 0.6 mm 2.0 mm 0.6 mm 1.8 mm 0.75 2.0 mm 0.4 mm U90s U90s 5.
Upper Extremities Hints • For image reconstruction of soft tissue, use kernel B30s/B31s.
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Upper Extremities ExtrRoutineHR Indications: Spiral mode for high-resolution bone study, for example, trauma, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A range of 10 cm will be done in 57.56 sec. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be done in 41.22 sec.
Upper Extremities Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrHR 130 60 2nd reconstr. 1.0 sec. 4 x 0.6 mm 0.6 mm 2.0 mm 0.6 mm 1.8 mm 0.75 2.0 mm 0.4 mm U90s U90s 8.28 mGy Male: 0.02 mSv Female: 0.
Upper Extremities Hint • For image reconstruction of soft tissue, use kernel B30s/B31s.
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Upper Extremities ExtrCombi Indications: Spiral mode for the combination of bone and soft tissue studies, e.g. masses, trauma, disorders of the joint etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be done in 12.42 sec. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be done in 13.11 sec. Emotion 16 kV Effective mAs/ Quality ref.
Upper Extremities Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrCombi 130 50 2nd reconstr. 1.0 sec. 6 x 1.0 mm 1.0 mm 4.0 mm 1.25 mm 9.0 mm 1.50 4.0 mm 0.8 mm B41s B70s 6.35 mGy Male: 0.01 mSv Female: 0.01 mSv Hint • For image reconstruction of soft tissue, use kernel B30s/B31s.
Lower Extremities Overview In this chapter you will find the scan protocol relating to the Lower Extremities region, its description, individual indications, and important hints on using it. You can use the following scan protocol to clarify, for example, masses, disorders of the joint, and orthopedic indications.
Lower Extremities For SOMATOM Emotion 6-slice configuration: – Knee Spiral mode for routine joint studies – Foot Spiral mode for routine wrist studies – ExtrRoutineHR Spiral mode for routine high resolution extremity studies – ExtrCombi Spiral mode for the combination of thin slice and routine studies 347
Lower Extremities General Hints • Topogram: AP, 256 mm for joint studies. • Patient positioning: Depends on the region of examination. In general, for bilateral studies, you should always try to position the patient evenly whenever the patient can comply. • For knee scan: Patient lying in supine position, feet first, promote relaxation by placing Bocollo pillows between knees and feet, bind feet together. The only exceptions are extremely light patients.
Lower Extremities Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s. • For higher sharpness, as is required e.g.
Lower Extremities Scan Protocols Knee Indications: Spiral mode for knee bone study, e.g. trauma, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be done in 21.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be done in 31.41 sec.
Lower Extremities Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Knee 130 80 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 7.7 mm 0.80 3.0 mm 0.7 mm U90s U90s 10.00 mGy Male: 0.06 mSv Female: 0.
Lower Extremities Foot Indications: Spiral mode for foot bone study, e.g. trauma, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be done in 21.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be done in 31.41 sec.
Lower Extremities Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Foot 130 60 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 7.7 mm 0.80 3.0 mm 0.7 mm U90s U90s 7.50 mGy Male: 0.02 mSv Female: 0.
Lower Extremities ExtrRoutineHR Indications: Spiral mode for high resolution bone study, e.g. trauma, orthopedic indications etc. For SOMATOM Emotion 16-slice configuration: A range of 10 cm will be done in 57.56 sec. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be done in 41.22 sec.
Lower Extremities Emotion 16 kV Effective mAs/ Quality ref. mAs* Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrHR 130 60 2nd reconstr. 1.0 sec. 4 x 0.6 mm 0.6 mm 2.0 mm 0.6 mm 1.8 mm 0.75 2.0 mm 0.4 mm U90s U90s 8.28 mGy Male: 0.01 mSv Female: 0.
Lower Extremities Emotion 6 kV Effective mAs/ Quality ref. mAs* Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrHR 130 60 2nd reconstr. 1.0 sec. 6 x 0.5 mm 0.5 mm 2.0 mm 1.0 mm 2.6 mm 0.85 2.0 mm 0.6 mm U90s U90s 7.68 mGy Male: 0.01 mSv Female: 0.01 mSv * Adjust the mAs value to the body region. Hint • For image reconstruction of soft tissue, use kernel B30s/B31s.
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Lower Extremities ExtrCombi Indications: Spiral mode for the combination of bone and soft tissue studies, e.g. masses, trauma, disorders of the joint etc. For SOMATOM Emotion 16-slice configuration: A range of 15 cm will be done in 12.42 sec. For SOMATOM Emotion 6-slice configuration: A range of 10 cm will be done in 13.11 sec. Emotion 16 kV Effective mAs/ Quality ref.
Lower Extremities Emotion 6 kV Effective mAs/ Quality ref. mAs* Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrCombi 130 50 2nd reconstr. 1.0 sec. 6 x 1.0 mm 1.0 mm 4.0 mm 1.25 mm 9.0 mm 1.50 4.0 mm 0.8 mm B41s B70s 6.35 mGy Male: 0.01 mSv Female: 0.01 mSv * Adjust the mAs value to the body region. Hint • For image reconstruction of soft tissue, use kernel B30s/B31s.
Vascular Overview In this chapter you will find all scan protocols relating to the Vascular region, their descriptions, individual indications, and important hints on using them. You can use the following scan protocols to clarify, for example, vascular abnormalities, stenosis or occlusions, coarse plaques anomalies, aneurysm, and embolism.
Vascular For SOMATOM Emotion 16-slice configuration: – HeadAngio Spiral mode for routine head CTAngio studies – HeadAngioVol Spiral mode for axial and coronal HeadCTAngio studies – CarotidAngio Spiral mode for carotid CTAngio studies – CarotidAngioVol Spiral mode for axial and coronal carotid CTAngio studies – ThorAngioRoutine Spiral mode for routine thorax CTAngio studies – ThorAngioVol Spiral mode for axial and oblique thorax CTAngio studies – ThorAngioECG Spiral mode for ECG-gated thorax CTAngio studies
Vascular For SOMATOM Emotion 6-slice configuration: – HeadAngio/HeadAngio06s Spiral mode for routine head CTAngio studies – HeadAngioVol Spiral mode for axial and coronal HeadCTAngio studies – CarotidAngio/CarotidAngio06s Spiral mode for carotid CTAngio studies – CarotidAngioVol Spiral mode for axial and coronal carotid CTAngio studies – ThorAngioRoutine/ThorAngioRoutine06s Spiral mode for routine thorax CTAngio studies – ThorAngioVol Spiral mode for axial and oblique thorax CTAngio studies – ThorAngioECG06
Vascular General Hints • Topogram: AP, 512/1024, LAT 256 • Patient positioning: Patient lying in supine position, arms positioned comfortably above the head in the head-arm rest, lower legs supported. • Patient respiratory instructions: inspiration. • Oral administration of contrast medium: The use of water will not obscure the blood vessels thus allowing CTA processing to be performed easily afterwards. • Be careful when examining pheochromocytoma patients.
Vascular Head Kernels • For soft tissue head studies, the standard kernel is H40s; softer images are obtained with H30s or H20s, H10s, sharper images with H50s. The kernels H21s, H31s, H41s yield the same visual sharpness as H20s, H30s, H40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using H31s, H41s instead of H30s, H40s. For the standard head protocols, we propose H21s, H31s, H41s.
Vascular Body Kernels • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s.
Vascular Scan Protocols HeadAngio/ HeadAngio06s Indications: Spiral mode for cerebral CT Angio studies, e.g. cerebral vascular abnormalities, tumors and follow up studies etc. For SOMATOM Emotion 16-slice configuration: A range of 80 mm will be covered in 7.45 sec. For SOMATOM Emotion 6-slice configuration: A range of 80 mm will be covered in 10.61 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose HeadAngio 110 70 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 7.7 mm 0.80 3.0 mm 0.7 mm H31s H20s 12.46 mGy Male: 0.43 mSv Female: 0.48 mSv Emotion 6 HeadAngio kV 110 Effective mAs/ 70 Quality ref. mAs Rotation time 0.8/0.6 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 3.0 mm Feed/Rotation 5.
Vascular Contrast medium IV injection Start delay 18 sec. Flow rate 3.5 ml/sec. Total amount 75 ml Hint • Use of CARE Bolus with monitoring scans positioned at the level of the basilar artery or carotid artery. Set the trigger threshold at 120 HU, or use manual triggering.
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Vascular HeadAngioVol Indications: Spiral mode for cerebral CT Angio studies, e.g. cerebral vascu-lar abnormalities, tumors and follow-up studies etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. The coronal view images will be reconstructed as MIP images. For SOMATOM Emotion 16-slice configuration: A range of 8.0 cm will be covered in 7.45 sec. For SOMATOM Emotion 6-slice configuration: A range of 8.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose HeadAngio 110 70 2nd reconstr. 0.8 sec. 6 x 1.0 mm 1.0 mm 3.0 mm 4.0 mm 5.1 mm 0.85 3.0 mm 4.0 mm H31s H20s 12.88 mGy Male: 0.37 mSv Female: 0.42 mSv Contrast medium IV injection Start delay 18 sec. Flow rate 3.5 ml/sec.
Vascular CarotidAngio/ CarotidAngio06s Indications: CT angiography of the carotid arteries, e.g. carotid stenosis or occlusion, coarse plaques abnormalities of the carotids or vertebral arteries, etc. For SOMATOM Emotion 16-slice configuration: A range of 20 cm including the aorta arch will be covered in 9.53 sec. For SOMATOM Emotion 6-slice configuration: A range of 12 cm including the aorta arch will be covered in 9.20 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose CarotidAngio 110 70 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 14.4 mm 1.50 5.0 mm 0.7 mm B30s B20s 5.60 mGy Male: 1.28 mSv Female: 1.
Vascular Contrast medium IV injection Start delay 15 sec. Flow rate 4 ml/sec. Total amount 90 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the aortic arch with triggering threshold of 120 HU, or use manual triggering. • High quality 2D & 3D postprocessing can be achieved using a thin slice thickness and 50% overlapping increments. • Thick MPRs and ThinMIPs can be created very quickly on the 3D Task Card by just clicking on the appropriate icons.
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Vascular CarotidAngioVol Indications: CT angiography of the carotid arteries, e.g. carotid stenosis or occlusions, coarse plaques abnormalities of the carotids and vertebral arteries, etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. The coronal view images will be reconstructed as MIP images. For SOMATOM Emotion 16-slice configuration: A range of 20 cm including the aorta arch will be covered in 9.53 sec.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose CarotidAngio 110 70 2nd reconstr. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 3.0 mm 9.0 mm 1.50 5.0 mm 3.0 mm B31s B20s 5.81 mGy Male: 0.57 mSv Female: 0.
Vascular Contrast medium IV injection Start delay 15 sec. Flow rate 4 ml/sec. Total amount 90 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the aortic arch with triggering threshold of 120 HU, or use manual triggering. • High quality 2D & 3D postprocessing can be achieved using a thin slice thickness and 50% overlapping increments. • Thick MPRs and ThinMIPs can be created very quickly on the 3D Task Card by just clicking on the appropriate icons.
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Vascular ThorAngioRoutine/ ThorAngioRoutine06s Indications: Spiral mode for thorax CT Angio studies, e.g. visualization of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 13.70 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm will be covered in 21.20 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorAngio 110 70 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 14.4mm 1.50 5.0 mm 0.7 mm B31s B20s 5.60 mGy Male: 2.92 mSv Female: 3.
Vascular Contrast medium IV injection Start delay 10 – 25 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the aortic arch with triggering threshold of 120 HU, or use manual triggering. • Thick MPRs and ThinMIPs can be created very quickly on the 3D Task Card by just clicking on the appropriate icons.
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Vascular ThorAngioVol Indications: Spiral mode for thorax CT Angio studies, e.g. visualization of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. Two recon jobs are predefined for reconstruction: the first for axial, the second for double-oblique studies in 3D images display view. The oblique view images will be reconstructed as MIP images. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 13.70 sec.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorAngio 110 70 2nd reconstr. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 3.0 mm 9.0 mm 1.50 5.0 mm 3.0 mm B31s B30s 5.81 mGy Male: 2.96 mSv Female: 3.
Vascular Contrast medium IV injection Start delay 10 – 25 sec. Flow rate 2.5 ml/sec. Total amount 80 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the aortic arch with triggering threshold of 120 HU, or use manual triggering. • Thick MPRs and ThinMIPs can be created very quickly on the 3D Task Card by just clicking on the appropriate icons.
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Vascular ThorAngioECG/ ThorAngioECG06s Indications: This is a spiral scanning protocol using a collimation of 1.2 mm and an ECG gating technique for thorax CTAngio studies. For SOMATOM Emotion 16-slice configuration: A range of 25 cm will be covered in 18.13 sec. For SOMATOM Emotion 6: A range of 15 cm will be covered in 19.95 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel Temp. resolution* CTDIVol Effective dose ThorAngioECG 130 280 2nd reconstr. 0.5 sec. 16 x 1.2 mm 1.2 mm 3.0 mm 1.5 mm 7.3 mm 0.38 3.0 mm 0.8 mm B31s B31s up to 125 ms 31.36 mGy Male: 13.88 mSv Female: 18.66 mSv *.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel Temp. resolution* CTDIVol Effective dose ThorAngioECG 130 210 0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 2.5 mm 4.8 mm 0.40 5.0 mm 1.5 mm B31s B31s up to 150 ms 22.89 mGy Male: 5.87 mSv Female: 8.12 mSv *. depends on heart rate 390 2nd reconstr.
Vascular Contrast medium IV injection Start delay 4 – 10 sec. Flow rate 2.5 ml/sec. Total amount 80 – 100 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the aortic arch with triggering threshold of 120 HU, or use manual triggering.
Vascular ThorAngioECGSeq Indications: Sequential, ECG triggered study for location and extent of aneurysms, dissection, and ruptures of the thoracic aorta with typical scan range of 29.9 cm. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Scan Kernel Temp. resolution* CTDIVol Effective dose ThorAngioECG 130 80 0.8 sec. 6 x 1.0 mm 1.0 mm 1.0 mm 6.0 mm B31s up to 400 ms 10.16 mGy Male: 6.92 mSv Female: 9.00 mSv *.
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Vascular Embolism/ Embolism06s Indications: Spiral mode for pulmonary embolism studies. For SOMATOM Emotion 16-slice configuration A range of 30 cm will be covered in 13.70 sec. For SOMATOM Emotion 6-slice configuration: A range of 28 cm will be covered in 19.87 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Embolism 110 80 Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Embolism 110 80 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 0.75 mm 14.4 mm 1.50 3.0 mm 0.5 mm B31s B20s 6.40 mGy Male: 3.28 mSv Female: 4.
Vascular Contrast medium IV injection Start delay 6 – 10 sec. Flow rate 4 ml/sec. Total amount 80 – 100 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the pulmonary trunk with triggering threshold of 120 HU, or use manual triggering.
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Vascular BodyAngioRoutine/ BodyAngioRoutine06s Indications: Spiral mode for abdominal CT Angio studies. For SOMATOM Emotion 16-slice configuration: A typical study in a range of 40 cm will be covered in 17.87 sec. For SOMATOM Emotion 6-slice configuration: A typical study in a range of 20 cm will be covered in 14.53 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose BodyAngio 110 90 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 5.0 mm 1.0 mm 14.4 mm 1.50 5.0 mm 0.7 mm B31s B20s 7.20 mGy Male: 5.04 mSv Female: 6.
Vascular Contrast medium IV injection Start delay 20 – 25 sec. Flow rate 3.0 – 3.5 ml/sec. Total amount 100 – 120 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the abdominal aorta with triggering threshold of 120 HU, or use manual triggering. • Do not administer oral contrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast.
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Vascular BodyAngioVol Indications: Spiral mode for abdominal CT Angio studies. Two recon jobs are predefined for reconstruction: the first for axial, the second for coronal studies in 3D images display view. The coronal view images will be reconstructed as MIP images. For SOMATOM Emotion 16-slice configuration: A typical study in a range of 40 cm will be covered in 17.87 sec. For SOMATOM Emotion 6-slice configuration: A typical study in a range of 20 cm will be covered in 19.38 sec.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose BodyAngio 110 90 2nd reconstr. 0.8 sec. 6 x 1.0 mm 1.0 mm 5.0 mm 3.0 mm 9.0 mm 1.50 5.0 mm 3.0 mm B31s B30s 7.47 mGy Male: 2.83 mSv Female: 3.
Vascular Contrast medium IV injection Start delay 20 – 25 sec. Flow rate 3.0 – 3.5 ml/sec. Total amount 100 – 120 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the abdominal aorta with triggering threshold of 120 HU, or use manual triggering. • Do not administer oral contrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast.
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Vascular BodyAngioFast/ BodyAngioFast06s Indications: Spiral mode for longer coverage and larger vessels. For SOMATOM Emotion 6-slice configuration: A typical study of the whole aorta including its branchiocephalic trunk and iliac arteries in a range of 30 cm will be covered in 9.77 sec.
Vascular Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose BodyAngio Fast 110 90 2nd reconstr. 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 2.5 mm 21.0 mm 1.75 5.0 mm 1.5 mm B31/B30s B31s 6.39 mGy Male: 3.45 mSv Female: 5.
Vascular Contrast medium IV injection Start delay 20 sec. Flow rate 3.5 ml/sec. Total amount 120 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan in the abdominal aorta with triggering threshold of 120 HU, or use manual triggering. • Do not administer oral contrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast.
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Vascular AngioRunOff/ AngioRunOff06s Indications: Spiral mode for CT Angio studies of the extremities. For SOMATOM Emotion 16-slice configuration: A range of 80 cm will be done in 17.87 sec. For SOMATOM Emotion 6-slice configuration: A range of 80 cm will be done in 23.42 sec.
Vascular Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose AngioRunOff 110 90 2nd reconstr. 0.6 sec. 16 x 1.2 mm 1.2 mm 6.0 mm 1.5 mm 28.8 mm 1.50 6.0 mm 1.0 mm B31s B31s 6.48 mGy Male: 4.98 mSv Female: 5.
Vascular Contrast medium IV injection Start delay 25 – 30 sec. Flow rate 3.0 – 3.5 ml/sec. Total amount 120 – 150 ml Hints • CARE Bolus may be used to optimize the bolus timing and with a triggering threshold of 120 HU, or use manual triggering. • If Topo length 1024 mm is not long enough, you can also choose the Topo length of 1500 mm. • Position the patient as feet first. Bend the feet together if necessary.
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Vascular WholeBodyAngio Indications: For CT Angio spiral studies of the whole body. For SOMATOM Emotion 16-slice configuration: A range of 80 cm will be done in 17.87 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 414 WholeBody 110 90 2nd reconstr. 0.6 sec. 16 x 1.2 mm 1.2 mm 6.0 mm 1.5 mm 28.8 mm 1.50 6.0 mm 1.0 mm B31s B31s 6.48 mGy Male: 9.33 mSv Female: 10.
Vascular Contrast medium IV injection Start delay 10 – 20 sec. Flow rate 3.0 – 3.5 ml/sec. Total amount 120 – 150 ml Hints • CARE Bolus may be used to optimize the bolus timing. • Set the ROI for monitoring scan with triggering threshold of 120 HU, or use manual triggering. • If Topo length 1024 mm is not long enough, you can also choose the 1540 mm long Topogram. • Position the patient as feet first. Bend the feet together if necessary.
Specials Overview The examination protocols designed for some of these applications are under the “Special” folder. Trauma In any trauma situation, time means life and the quality of life for the survivor. To facilitate the examinations, five protocols are provided.
Specials For SOMATOM Emotion 6-slice configuration: – PolyTrauma/PolyTrauma06s This is a combined mode for the examination of multiple ranges, for example, Head, Neck, Thorax, Abdomen and Pelvis – HeadTrauma Spiral head protocol for trauma studies with a FoV of 500 and therefore lowered image quality – HeadTraumaSeq Sequential head protocol for trauma studies, with a FoV of 500 and therefore lowered image quality 417
Specials Interventional CT For SOMATOM Emotion 16-slice configuration: – Biopsy This is the multislice biopsy mode. With three times 4.8 mm, the images will be reconstructed and displayed for each scan. – BiopsySingle This is a single multislice biopsy mode. One 10mm slice is aquired. – CARE Vision The CARE Vision protocol is a spiral mode without table feed, using a three times 4.8 mm slice thickness.
Specials For SOMATOM Emotion 6-slice configuration: – Biopsy This is the multislice biopsy mode. With three times 6.0 mm, the images will be reconstructed and displayed for each scan. – BiopsySingle This is a single multislice biopsy mode. One 10mm slice is aquired. – CARE Vision The CARE Vision protocol is a spiral mode without table feed, using a three times 6.0 mm slice thickness. – CARE VisionSingle The CARE Vision protocol is a spiral mode without table feed, using a 10 mm slice thickness.
Specials Test Bolus For SOMATOM Emotion 16-slice configuration: – TestBolus This mode can be used to test the start delay of optimal enhancement after the contrast medium injection. For SOMATOM Emotion 6-slice configuration: – TestBolus This mode can be used to test the start delay of optimal enhancement after the contrast medium injection.
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Specials Trauma Protocols In any trauma situation, time means life and the quality of life for the survivor. General Information • Check that the emergency drug trolley is well stocked and that all accessories such as in-room oxygen supply, respirator and resuscitation equipment that may be required during the examination are in working order. • Prepare the CT room before admitting the patient, e.g., load IV contrast into the injector.
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Specials Trauma This is a one-range mode for fast screening for emergency studies. For SOMATOM Emotion 16-slice configuration: A scan range of 50 cm will be done in 11.62 s. Emotion 16 Trauma kV Effective mAs/ Quality ref. mAs Rotation Time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 130 85 424 2nd recon. 0.6 sec. 16 x 1.2 mm 1.2 mm 8.0 mm 2.0 mm 28.8 mm 1.50 8.0 mm 1.5 mm B31s B31s 9.52 mGy Male: 7.02 mSv Female: 8.81 mSv 3rd recon.
Specials TraumaVol This is a one-range mode for fast screening for emergency studies. Three recon jobs are predefined for reconstruction: the first for axial, the second for coronal and the third sagittal studies in 3D images display view. For SOMATOM Emotion 16-slice configuration: A scan range of 50 cm will be done in 11.62 sec. kV Effective mAs/ Quality ref.
Specials PolyTrauma/ PolyTrauma06s Two combined ranges are predefined, head with neck and thorax with abdomen. For SOMATOM Emotion 16-slice configuration: A scan range of 12/14 cm will be done in 13.36/9.68 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Male: Female: 426 Head 130 240 Neck 130 150 1.0 sec. 16 x 1.2 mm 1.2 mm 6.0 mm 10.6 mm 0.55 6.0 mm H31s 57.60 mGy 1.
Specials Take a new Topogram for the thorax and abdomen range. A scan range of 20/40 cm will be done in 9.01/ 9.53 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Male: Female: Thorax 130 50 AbdPelvis 130 90 0.6 sec. 16 x 1.2 mm 1.2 mm 8.0 mm 15.4 mm 0.80 8.0 mm B41s 5.60 mGy 0.6 sec 16 x 1.2 mm 1.2 mm 8.0 mm 28.8 mm 1.50 8.0 mm B41s 10.08 mGy 1.94 mSv 2.53 mSv 8.47 mSv 10.
Specials For SOMATOM Emotion 6-slice configuration: A scan range of 12/14 cm will be done in 9.84/13.67 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Male: Female: 428 Head 130 250 Neck 130 150 1.0 sec. 6 x 3.0 mm 3.0 mm 6.0 mm 15.3 mm 0.85 6.0 mm H31s 55.00 mGy 1.0 sec 6 x 2.0 mm 2.0 mm 5.0 mm 12.0 mm 1.00 5.0 mm B50s 16.35 mGy 2.58 mSv 2.79 mSv 3.09 mSv 3.
Specials Take a new Topogram for the thorax and abdomen range. A scan range of 20/40 cm will be done in 9.04/ 10.09 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Male: Female: Thorax 130 50 AbdPelvis 130 90 0.8/0.6 sec. 6 x 3.0 mm 3.0 mm 8.0 mm 15.3 mm 0.85 8.0 mm B41s 5.10 mGy 0.8/0.6 sec 6 x 3.0 mm 3.0 mm 8.0 mm 27.0 mm 1.50 8.0 mm B41s 9.18 mGy 1.73 mSv 2.27 mSv 8.
Specials HeadTrauma A spiral mode for emergency head studies with a max. FoV of 500 mm. For SOMATOM Emotion 16-slice configuration: A scan range of 12 cm will be covered in 20.05 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 12 cm will be covered in 30.27 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 430 Head 130 240 2nd reconstr. 1.5 sec. 16 x 1.2 mm 1.
Specials Emotion 6 Head kV 130 Effective mAs/ 250 Quality ref. mAs Rotation time 1.5 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 6.0 mm Feed/Rotation 6.6 mm Pitch Factor 0.55 Increment 6.0 mm Kernel H31s 58.75 mGy CTDIVol Effective dose Male: 2.76 mSv Female: 2.98 mSv 2nd reconstr. 6.0 mm 6.
Specials HeadTraumaSeq A sequence mode for emergency head studies with a max. FoV of 500 mm. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 12.5 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 12.0 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDlVol Effective dose 432 HeadSeq 130 270 1.5 sec. 2 x 5.0 mm 5.0 mm 5.0 mm 5.0 mm 10.0 mm 10.0 mm H31s H60s 58.32 mGy Male: 2.
Specials Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDlVol Effective dose HeadSeq 130 270 1.5 sec. 6 x 3.0 mm 3.0 mm 6.0 mm 6.0 mm 18.0 mm 18.0 mm H31s H60s 59.40 mGy Male: 3.05 mSv Female: 3.
Specials Additional Important Information • You can select which protocol is the emergency protocol. • For long range scanning, please pay attention to the scannable range mark on the table mattress while positioning the patient. • In some cases, it might be advisable to position the patient feet first so that there will be more space for the intensive care equipment around. • The Trauma protocol is predefined with a Topo length of 1024 mm, the Poly Trauma protocol with a Topo length of 1536 mm.
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Specials Interventional CT - Biopsy To facilitate CT interventional procedures, we created dedicated multislice and single slice sequential modes. Any of these protocols can be appended to a spiral protocol for CT interventional procedures, such as biopsy, abscess drainage, pain therapy, minimum invasive operations, joint studies, and arthrograms. Adjust the mAs according to the body region before loading. 10 scans are predefined.
Specials Biopsy With this routine protocol images will be reconstructed with three time 4.8/6.0 mm or one time 10 mm slice thickness. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol Biopsy 130 110 0.6 sec. 12 x 1.2 mm 1.2 mm 4.8 mm 0.0 mm B31s 12.10 mGy Biopsy 130 110 0.6 sec. 6 x 3.0 mm 3.0 mm 6.
Specials Biopsy Single One 10 mm slice images will be reconstructed and displayed for each scan. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDlVol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDlVol 438 Biopsy Single 130 50 0.6 sec. 2 x 5.0 mm 5.0 mm 10.0 mm 0.0 mm B31s 5.10 mGy Biopsy Single 130 50 0.6 sec. 2 x 5.0 mm 5.0 mm 10.0 mm 0.0 mm B31s 4.
Specials Interventional CT - CARE Vision CARE Vision is a CT Fluoroscopic mode for interventions with 1 or 3 combined slices and up to 10 images per sec. displayed (depending on the hardware configuration). The Basics Any of the predefined CARE Vision scan protocols can be appended to a spiral protocol for interventional procedures, such as biopsies, abscess drainage, pain therapy, minimum invasive operations, joint studies, and arthograms. The raw data will not be available for image reconstruction.
Specials CAREVision With this routine protocol, the image will be reconstructed and displayed using three times 4.8/6.0 mm or one time 10 mm slice thickness and a kernel of B30 in the CARE View mode. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol 440 CAREVision 130 30 0.6 sec.
Specials CAREVisionSingle The images will be reconstructed and displayed with one time 10 mm slice thickness and a kernel of B30. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol CAREVision 130 30 0.6 sec. 2 x 5.0 mm 5.0 mm 10.0 mm 0.0 1.0 mm B31s 3.06 mGy CAREVision 130 30 0.6 sec.
Specials CAREVisionBone The images will be reconstructed and displayed in the CARE View mode with three times 4.8/6.0 mm or one time 10 mm slice thickness and a kernel of B50. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Increment Kernel CTDIvol 442 CAREVision 130 30 0.6 sec. 16 x 0.6 mm 0.6 mm 4.8 mm 0.
Specials HandCARE HandCARE is a dedicated algorithm for dose reduction during the interventional procedure. It switches off the x-ray exposure for a 100° angle between three different positions (10:00, 12:00 and 2:00 o’ clock). X-Ray off X-Ray on Thus provides a significant dose saving to the operator’s hand, while keeping the image quality constant.
Specials The HandCARE item list offers “None“ and three selectable protection areas. You can select this values independent of the current or a future patient position. The list elements are sorted clockwise from a view to the front of the gantry. Values: {“None“, “10:00 o’ clock”, “12:00 o’ clock”, “2:00 o’ clock}, default: “None“, label: “HandCARE“. The HandCARE position is graphically displayed on the Routine subtask card.
Specials Application Procedure 1.Load and scan a spiral protocol of the interested body region. 2.Scroll through the images to define a target slice. 3.Click on Same TP under Table position, in the routine card. Move the table to the desired table position. 4.Turn on the light marker on the Gantry to localize the entry point, and then start patient preparation. 5.Open the Patient Model Dialog. Check the checkbox Append.
Specials You can change the following Scan Parameters on the examination task card during radiation: •Gantry Tilt •Table position •Table movement type •Feed in/Feed out Hints • Press the footswitch either to position the needle or to control the needle position. • Without HandCARE every time you release the footswitch max. the last scanned 3 sec. of acquired images are automatically saved to the local database.
Specials Additional Important Information Pause CARE Vision Scan Range If you pause the CARE Vision Scan Range the SlicePosition and TableHeight will be displayed in the Image Text. Reference Image Display To display a reference image during the examination procedure, the Viewing task card can be displayed on a second monitor. Additional Dose Information CARE Vision uses scan parameters and operating conditions, which are unique and may require additional care and radiation protection measures.
Specials Radiation exposure to patients • CARE Vision applies continuous exposure at moderate mA levels. • Due to the potentially long scan times and the limited scan volume, the dose for certain slices may increase to levels significantly higher than those known from standard CT applications. • The patient’s exposure levels is usually estimated by CTDIvol. • This unit is designed to give the average dose in the scanned volume.
Specials Radiation exposure to personnel During the procedure the physician is in the scan room and close to the exposed scan plane. • Take special care to avoid excessive and unnecessary radiation exposure. Protection against primary x-ray exposure: • In the worst case, any body parts in the scan plane may receive approximately the accumulated dose as shown on the CTDI display. • Avoid being directly exposed to the x-ray beam.
Specials General Information for Biopsy and CARE Vision Interventional Toolbar If you want to perform a CareVision or Biopsy Scan you can activate the new Interventional Tool Bar in the main menu under Imange - Intervention. The Interventional Toolbar will be displyed as soon as an Interventional Scan entry is being loaded.
Specials • Interventional Window 1/2/3 With the special window toggle button you can apply three different window settings to your image, the default values are: Abdomen (300/40), Lung (1200/600) and Bone (1500/450). You can choose different window settings under Options>Configuration>Examination>Intervention, these settings correspond to the window values list.
Specials • Screen layout In the interventional Toolbar for CARE Vision you can change the Layout of the Display. There are three different modes available. – Blow up (one big image) – CARE View (three equal sized images) – CARE View Blow up (one big and two smaller images on each side) If you choose certain slice thicknesses and collimations in the Routine subtask card which are marked in bold letters, you will get in addition to your center an image that will be towards the head and one towards the feed.
Specials CAREView The item CAREView indicates when a combined image is displayed. When the number of Slice Positions per scan is three, CARE View is activated and shown on the Routine subtask card. On the Recon subtask card you can select the CARE View image position, depending on the patient position, e.g. if you want to display the images which is closer to the head of the patient on the left hand side of the image area, select Head – Left.
Specials CARE Vision and Biopsy layout for Single image display CARE Vision layout for CAREView large-size display 454
Specials CARE Vision and Biopsy layout for CAREView equalsize display Biopsy two segment 455
Specials Configuration Dose Display The maximum displayed value of the Dose is set as a default to 2000 mGy. It is possible to configure this from 100-200 mGy under Options>Configuration>Examination>Intervention. Exceeding this configuration maximum value will not stop the scan, just the Dose scale bar will change to red. If you start scanning again the Dose scale bar will be reset.
Specials Example 3.5 second scan done.
Specials Routine Subtask card Move table/scanrange to displayed image position. The function Move Table/Scanrange to displayed image position in the Routine subtask card allows you to move the table to the position of the displayed tomo image in the selected segment. If you use the CARE View Mode you can use the Head of the Feet image for adjusting your table position as well.
Specials Additional Important Information Independently from the Interventional Window buttons on the Interventional Toolbar you can use for faster windowing the function keys F2, F3 and F4 are implemented with standard window settings for Abdomen, Lung and Bone. Modifying them is possible under Options> Configuration> Examination> Windowing. If you repeat a CARE Vision or Biopsy scan range the window setting last used will be applied to your new images.
Specials TestBolus Protocol TestBolus This mode can be used to test the start delay of an optimal enhancement after the contrast medium injection. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol 460 TestBolus 110 40 0.6 sec. 2 x 5.0 mm 5.0 mm 10.0 mm 0.0 mm B31s 2.60 mGy TestBolus 110 40 0.6 sec.
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Radiation Therapy Radiation Therapy Planning The SOMATOM Emotion 16/6-slice configuration are very well suited to Radiation Therapy Planning (RTP) with its ergonomic enlarged gantry opening and its scan plane located only 35cm from the gantry front. Using the external laser markers and the connected workstations, the system provides the complete procedure of Virtual Simulation in RTP much faster and more easily. The patient can leave the department after only a few minutes of CT scanning.
Radiation Therapy COHERENCE Dosimetrist Remember the challenges of Radiation Therapy… • Precisely locate and delineate the tumor volume • Establish reliable external references on the patient surface 463
Radiation Therapy • Spare as much healthy tissue as possible • Precisely position the patient for treatment for the entire course of treatment (typically 25-35 fractions) 464
Radiation Therapy Benefits • No limitations for patient set-up within 85 cm gantry opening and the ability to scan at a low table position thereby maximizing gantry "freespace" • Complete anatomical visualization for optimized localization and dose calculation with extended 85 cm FOV 85 cm Display FoV 50 cm Scan FoV 465
Radiation Therapy • High volume coverage in time (16 X2.0 mm in 0.6 s) minimizing motion artifacts and breath hold time SOMATOM Emotion 16-slice configuration Slice 1.5 mm Rot 0.6 s 6 slice scanner RT edition Slice 2.5 mm Rot 1 s Pitch 1.
Radiation Therapy • New long-range gantry laser lights with position adjustment possible without opening gantry covers for easier installation and synchronization with room RTP lasers • Integrated solution for Virtual Simulation with syngo based COHERENCE Dosimetrist or VSim on syngo MultiModality Workplace • Display of gantry tilt angle in 0.5 degree increments • Greater accuracy of X-ray tube positioning for topogram scans: +/- 1 degree • Simplified horizontal positioning of the table.
Radiation Therapy Workflow Simulation: 1.Patient positioning on CT table (external lasers) 2.Patient marking (external lasers) 3.CT scan 4.Offline: Virtual Simulation and Dose Planning Treatment: 1.Patient positioning on the therapy table (external lasers) 2.Verification of irradiation area (light field projection) 3.Treatment The default scan protocols provide the first recon job used for soft tissue studies and the second recon job for bone structures.
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Radiation Therapy Scan Protocols Overview You can use the following scan protocols for the Radiation Therapy Planning: For SOMATOM Emotion 16-slice configuration: – RT_Head Spiral mode for routine radiation therapy planning head studies – RT_Thorax Spiral mode for routine fradiation therapy planning thoracic studies – RT_Breast Spiral mode for routine radiation therapy planning studies of the breast – RT_Abdomen Spiral mode for routine radiation therapy planning abdominal studies – RT_Pelvis Spiral mode for
Radiation Therapy For SOMATOM Emotion 6-slice configuration: – RT_Head Spiral mode for routine radiation therapy planning head studies – RT_Thorax Spiral mode for routine fradiation therapy planning thoracic studies – RT_Breast Spiral mode for routine radiation therapy planning studies of the breast – RT_Abdomen Spiral mode for routine radiation therapy planning abdominal studies – RT_Pelvis Spiral mode for routine radiation therapy planning pelvis studies 471
Radiation Therapy RT_Head Indications: Spiral mode for routine radiation therapy planning head studies. For SOMATOM Emotion 16-slice configuration: A range of 12 cm will be covered in 20.05 sec. For SOMATOM Emotion 6-slice configuration: A range of 12 cm will be covered in 30.27 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 472 Head 130 240 2nd recon. 1.5 sec. 16 x 1.2 mm 1.
Radiation Therapy Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Head 130 250 2nd recon. 1.5 sec. 6 x 2.0 mm 2.0 mm 3.0 mm 3.0 mm 6.6 mm 0.55 3.0 mm 3.0 mm H31s H60s 58.75 mGy Male: 2.76 mSv Female: 2.
Radiation Therapy RT_Thorax Indications: Spiral mode for routine radiation therapy planning thoracic studies. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 12.92 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm will be covered in 25.13 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 474 Thorax 130 90 2nd recon. 0.6 sec. 16 x 1.
Radiation Therapy Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Thorax 130 90 2nd recon. 0.8 sec. 6 x 2.0 mm 2.0 mm 8.0 mm 8.0 mm 10.2 mm 0.85 8.0 mm 5.0 mm B41s B70s 9.81 mGy Male: 4.98 mSv Female: 6.
Radiation Therapy RT_Breast Indications: Spiral mode for routine radiation therapy planning thoracic studies of the mammae. For SOMATOM Emotion 16-slice configuration: A range of 30 cm will be covered in 12.92 sec. For SOMATOM Emotion 6-slice configuration: A range of 30 cm will be covered in 25.13 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 476 Breast 130 90 2nd recon. 0.
Radiation Therapy Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Breast 130 90 2nd recon. 0.8 sec. 6 x 2.0 mm 2.0 mm 8.0 mm 8.0 mm 10.2 mm 0.85 8.0 mm 5.0 mm B41s B70s 9.81 mGy Male: 4.98 mSv Female: 6.
Radiation Therapy RT_Abdomen Indications: Spiral mode for routine radiation therapy planning abdominal studies. For SOMATOM Emotion 16-slice configuration: A range of 20 cm will be covered in 9.01 sec. For SOMATOM Emotion 6-slice configuration: A range of 20 cm will be covered in 17.29 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 478 Abdomen 130 150 2nd recon. 0.6 sec. 16 x 1.
Radiation Therapy Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Abdomen 130 150 2nd recon. 0.8 sec. 6 x 2.0 mm 2.0 mm 8.0 mm 8.0 mm 10.2 mm 0.85 8.0 mm 8.0 mm B41s B60s 16.35 mGy Male: 6.33 mSv Female: 7.
Radiation Therapy RT_Pelvis Indications: Spiral mode for routine radiation therapy planning pelvis studies. For SOMATOM Emotion 16-slice configuration: A range of 20 cm will be covered in 8.94 sec. For SOMATOM Emotion 6-slice configuration: A range of 20 cm will be covered in 13.11 sec.
Radiation Therapy Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Pelvis 130 150 2nd recon. 1.0 sec. 16 x 1.2 mm 1.2 mm 3.0 mm 3.0 mm 28.8 mm 1.50 3.0 mm 3.0 mm B41s B60s 16.80 mGy Male: 6.68 mSv Female: 11.
Radiation Therapy Additional Important Information HU values The HU values are of crucial importance for the therapy planning systems of radiation therapists! • With huge objects, the CT value is independent of the kernel. With smaller objects, edge effects produced by the kernel influence the HU values as well as the scanning. Feed and collimation do not have any influence. • An extended FoV of 800 mm means that only 500 mm are scanned, the rest will be interpolated.
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Respiratory Gating When imaging of the chest or abdomen is performed by CT, there may be artifacts produced causing problems with reproducibility and resolution of images due to patient respiration. Organs will move with every respiratory motion.
Respiratory Gating The respiratory gating hardware (AZ-733V) is composed of a: • Respiratory Sensor (RS) to detect patient's abdominal motions (pressure changes) to get a patient's respiratory information, • Sensor Port (SP) to amplify and to transmit analog signals from RS, • Wave Deck (WD) to receive the respiratory signal from the said SP and to convert them to a digital signal to be sent to the host computer (PC) of the CT system.
Respiratory Gating Key Features Respiratory Gating • is capturing slow moving anatomical structures such as lung lesions during respiration up to a respiration cycle time of 10sec by low pitch spiral. • helps the radio-oncologists in selecting the appropriate phase of the respiratory cycle in order to plan a treatment more accurately. • helps visualizing the tumor excursion for a better understanding of the target volume using InSpace 4D.
Respiratory Gating Respiration Synchronization • Synchronization of CT data acquisition with respiration: 4D CT - prospectively Respiratory Triggering or retrospectively Respiratory Gating. • Synchronization of 4D simulation data with respiration • Synchronized Treatment: triggered beaming on-off on Linac (Linear Accelerator).
Respiratory Gating Positioning of the respiratory sensor belt The correct placement of the abdominal belt is essential in order to receive a clear respiratory signal resulting in precise generation of inspiration and expiration gates.
Respiratory Gating For proper belt positioning please follow the instructions below: Step 1 Step 2 patient patient´s abdomen load cell fixing belt load cell The blue part should apply to the back of the patient. Step 3 the diaphragm load cell setting point navel Wind the load cell fixing belt around the body so that the pocket (load cell part) applies ontojust below the diaphragm. Step 4 load cell connection cable Securely fasten the fixing belt around the patient.
Respiratory Gating Scanning Information The expected benefits in radiation treatment planning, e.g.
Respiratory Gating Temporal Resolution Temporal resolution, also called time resolution, represents the time window of the data that is used for image reconstruction. It is essential for respiratory CT imaging. The higher the temporal resolution, the fewer the motion artifacts. A temporal resolution of a half of the Rotation Time can be achieved.
Respiratory Gating Respiratory gating The respiration of the patients is simultaneously recorded during the Spiral acquisition. Data are acquired during the entire respiration cycle and Images are reconstructed by matching data to the respiration trace. The respiration level (amplitude) is defined as an absolute value.
Respiratory Gating The timebase of the respiratory curve is realtime in an updating mode. Images can be reconstructed at any user defined Inhalation- or Exhalation level.
Respiratory Gating Prospective respiratory triggering versus retrospective respiratory gating With prospective respiratory triggering, the lung volume for example is covered in a "step-and-shoot" technique. The patient's respiratory signal is used to start sequential scans at a predefined respiratory level of the patient' s respiratory curve. With retrospective respiratory gating, the lung volume is covered continuously by a spiral scan.
Respiratory Gating Curve Editor The respiration curve editor is used to modify the respiratory signal. This editing tool is available after spiral scan data has been acquired. By using the right mouse menu on the Trigger tabcard you have access to several modification tools for the respiratory Syncs (purple dots above and below the curve), such as Delete, Disable, Insert. In patients with only single or few extra respiratory peaks caused, e.g.
Respiratory Gating The recorded Respiration curve can be edited similar to the ECG Trace editing in Cardiac CT. Inspiration Syncs can be deleted, disabled and inserted. Expiration Syncs can be deleted, disabled and inserted.
Respiratory Gating Synthetic Trigger/Sync By default, the "Synthetic Trigger" (Respiratory-triggered scanning) or "Synthetic Sync" (Respiratory-gated scanning) is activated for all predefined Respiratory scan protocols. It is recommended to always keep it activated for examinations with contrast medium. In case of Respiratory signal loss during the acquisition, this will ensure the continuation of the triggered scans or allows a Respiratory signal to be simulated for retrospective gating.
Respiratory Gating Workflow Reconstruction and Post processing For respiratory gating a slice width of 3 mm and an increment of 1.9 mm is used for image acquisition. Two recon jobs are predefined: • 20% Inspiration • 80% Expiration If more Inspiration or Expiration phases are necessary new recon jobs can be added.
Respiratory Gating Additional important Information • For operating the respiratory gating system (AZ733V, Anzai Medical, Japan), please refer to the Operational manual "Respiratory Gating" or Anzai User´s manual. • For the usage of Anzai´s respiratory phantom for the respiratory gating system (AZ-733V, Anzai medical, Japan), please refer to the User´s manual. • The images are reconstructed from data acquired in one Inspiration or Expiration phase – Multi Phase reconstruction is not available.
Respiratory Gating Scan Protocol RespSeq Indications: A sequential mode for studies with respiration triggering. For SOMATOM Emotion 16-slice configuration: The scan length is predefined with 30.5 cm. For SOMATOM Emotion 6-slice configuration: The scan length is predefined with 30.3 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol Effective dose 500 RespSeq 130 16 0.6 sec. 16 x 1.2 mm 1.2 mm 2.4 mm 19.2 mm B31s 1.
Respiratory Gating Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIvol Effective dose RespSeq 130 16 0.6 sec. 6 x 3.0 mm 3.0 mm 3.0 mm 18.0 mm B31s 1.63 mGy Male: 1.29 mSv Female: 1.
Respiratory Gating Resp Indications: A spiral mode for patients with a respiration rate per minute greater than 10 using respiration gating. For SOMATOM Emotion 16-slice configuration: A scan range of 30 cm will be covered in 94.95 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 30 cm will be covered in 86.04 sec. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIvol 502 Resp 130 320 0.
Respiratory Gating Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIvol Resp 130 230 0.8 sec. 6 x 2.0 mm 2.0 mm 3.0 mm 1.8 0.15 2.0 mm B31s 25.07 mGy 2nd reconstr. 3.0 mm 2.
Respiratory Gating RespModBreathRate Indications: A spiral mode for patients with a respiration rate per minute greater than 7.5, using respiration gating. For SOMATOM Emotion 16-slice configuration: A scan range of 23 cm will be covered in 94.15 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 14 cm will be covered in 94.93 sec. Emotion 16 kV Effective mAs/ Quality ref.
Respiratory Gating Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIvol RespMode 130 320 0.8 sec. 6 x 2.0 mm 2.0 mm 3.0 mm 1.2 0.10 2.0 mm B31s 34.88 mGy 2nd reconstr. 3.0 mm 0.10 2.
Respiratory Gating RespLowBreathRate Indications: A spiral mode for patients with a respiration rate per minute greater than 6.5, using respiration gating. For SOMATOM Emotion 16-slice configuration: A scan range of 18 cm will be covered in 87.23 sec. For SOMATOM Emotion 6-slice configuration: A scan range of 11 cm will be covered in 93.67 sec. Emotion 16 kV Effective mAs/ Quality ref.
Respiratory Gating Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIvol Effective dose RespLow 130 320 1.0 sec. 6 x 2.0 mm 2.0 mm 3.0 mm 1.2 0.10 2.0 mm B31s 34.88 mGy Male: 6.40 mSv Female: 9.14 mSv 2nd reconstr. 3.0 mm 2.
Children Overview The scan protocols for children are defined according to body regions - Head, Neck, Thorax, Abdomen, Spine, Upper Extremities, Lower Extremities, Vascular and Specials. As default the quality reference mAs with CARE Dose 4D is defined for 20 kg and/or five year old children. For children older than six years, use the adult protocols with the CARE Dose 4D.
Children • Neck – NeckRoutine Spiral mode for soft tissues routine neck studies • Thorax – ThoraxRoutine Spiral mode for routine thorax studies – ThoraxHRSeq Sequential mode for high resolution lung studies • Abdomen – AbdomenRoutine Spiral mode for routine abdominal studies • Spine – Spine Spiral mode for routine spine studies • Upper Extremities/Low Extremities – ExtrRoutineHR Spiral mode for routine high resolution extremity studies – ExtrCombi Spiral mode for the combination of thin slice and routine st
Children For SOMATOM Emotion 6-slice configuration: • Head – HeadRoutine Spiral mode for routine head studies – HeadSeq Sequential mode for routine head studies – InnerEarHR Spiral mode for high resolution inner ear studies – InnerEar Spiral mode for inner ear studies – InnerEarSeq Sequential mode for routine inner ear studies – SinusOrbit Spiral mode for routine sinus and orbital studies • Neck – NeckRoutine Spiral mode for soft tissues routine neck studies • Thorax – ThoraxRoutine/ThoraxRoutine06s Spiral
Children • Abdomen – AbdomenRoutine/AbdomenRoutine06s Spiral mode for routine abdominal studies • Spine – SpineRoutine Spiral mode for routine spine studies – SpineThinSlice Spiral mode for thin slice spine studies • Upper Extremities/Low Extremities – ExtrRoutineHR Spiral mode for routine high resolution extremity studies – ExtrCombi Spiral mode for the combination of thin slice and routine studies • Vascular – HeadAngio/HeadAngio06s Spiral mode for head CTAngio studies – CarotidAngio/CarotidAngio06s Spira
Children General Hints • Topograms: 256 mm lateral topograms are defined for the head modes, and 512 mm AP topograms are defined for the body modes. Please keep in mind that the children’s size can be dramatically different. You should press the "Hold Measurement" button whenever the range shown on the real-time growing topogram is long enough, in order to avoid unnecessary radiation.
Children • Oral and rectal contrast administration: Depending on the reason for the exam/status of the patient, oral contrast may or may not be given to these patients. In general, oral contrast is recommended to opacify the intestinal tract, as unopacified bowel can have the appearance of abdominal fluid or mass effect. Oral, as well as rectal contrast may be required. Usually, a diluted mixture of iodine and water is used as an oral agent.
Children Needle Size (gauge) 22 20 18 Flow Rate (ml/sec.) 1.5 2.0 – 3.0 3.0 – 5.0 Central lines and ports may need to be hand injected or power injected at a very low flow rate (1 ml/sec.). PIC lines and 24 gauge (or smaller) lines are usually hand injected. All of these protocols should be decided on by your institution’s appropriate personnel. • Applications with 80 kV: For CTA protocols, the tube voltage was set to 80 kV and the mAs values were raised by a factor of 1.5 over the reduced 120 kV values.
Children Head Kernels The endings “s” or “f” depend on the rotation time. • For head scans of small children, the kernels C20s, C30s (for example, for soft tissue studies) and C60s (for example, for sinuses are provided) should be chosen instead of the ”adult” head kernels H20s, H30s and H60s. • For soft tissue head studies, the standard kernel is H40s; softer images are obtained with H30s or H20s, H10s, sharper images with H50s.
Children Body Kernels The endings “s” or “f” depend on the rotation time. • As standard kernels for body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectively, B40s, the image appearance, however, is more agreeable due to a ”fine-grained” noise structure; quite often, the low contrast detectability is improved by using B31s, B41s instead of B30s, B40s.
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Children Scan Protocols HeadRoutine Indications: Spiral mode for routine head studies, for example, tumors, hydrocephalus, hemorrhaging, abnormalities, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 12 cm covered in 20.05 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 8.5 cm covered in 56.13 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Head 110 230 1.5 sec. 16 x 1.2 mm 1.2 mm 4.0 mm 10.6 mm 0.55 4.0 mm C30s 36.80 mGy Male: 2.83 mSv* Female: 2.89 mSv* Head 110 230 1.5 sec. 6 x 1.0 mm 1.0 mm 5.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children, who are older than age 6, should be scanned with an adult protocol as the skull by this time is fully grown. • When bone structure is of interest, use kernel C60s for image reconstruction. • An advanced algorithm allows for improved head image quality, without additional post-processing.
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Children HeadSeq Indications: Sequential mode for routine head studies for children, for example, tumors, hydrocephalus, hemorrhaging, abnormalities, etc. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 8.5 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 9.0 cm. Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose 522 HeadSeq 110 260 1.5 sec. 2 x 5.0 mm 5.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose HeadSeq 110 260 1.5 sec. 6 x 2.0 mm 2.0 mm 6.0 mm 12.0 mm C30s 40.82 mGy Male: 1.86 mSv* Female: 1.84 mSv* * The conversion factor for a 7-year-old child, and a scan range of 117 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/ Access site Total amount 1 – 2 ml per kg of body weight Hints • Children, who are older than age 6, should be scanned with an adult protocol as the skull by this time is fully grown. • When bone structure is of interest, use kernel C60s for image reconstruction. • An advanced algorithm allows for improved head image quality, without additional post-processing.
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Children InnerEarHR Indications: Spiral mode for high-resolution inner ear studies, for example, malformations of the inner ear, inflammatory changes, pathologies of the mastoid process, tumor processes of the pyramids, post-traumatic changes, etc. Note: Same as for adults except for the FoV of 300. For SOMATOM Emotion 16-slice configuration: A typical range of 4.0 cm covered in 24.22 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 4.0 cm covered in 17.69 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose InnerEar 110 50 1.0 sec. 4 x 0.6 mm 0.6 mm 0.6 mm 1.8 mm 0.75 0.4 mm H90s 10.30 mGy Male: 0.25 mSv* Female: 0.25 mSv* InnerEar 110 90 1.0 sec. 6 x 0.5 mm 0.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children, who are older than age 6, should be scanned with an adult protocol as the skull by this time is fully grown. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
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Children InnerEar Indications: Spiral mode for routine inner ear studies, for example, malformations of the inner ear, inflammatory changes, pathologies of the mastoid process, tumor processes of the pyramids, post-traumatic changes, etc. Note: Same as for adults except for the FoV of 300. For SOMATOM Emotion 16-slice configuration: A typical range of 4.0 cm covered in 7.21 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 4.0 cm covered in 9.84 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose InnerEar 110 50 1.0 sec. 16 x 0.6 mm 0.6 mm 0.75 mm 7.7 mm 0.80 0.5 mm H90s 8.90 mGy Male: 0.27 mSv* Female: 0.28 mSv* InnerEar 110 90 1.0 sec. 6 x 1.0 mm 1.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children, who are older than age 6, should be scanned with an adult protocol as the skull by this time is fully grown. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
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Children InnerEarSeq Indications: Sequential mode for routine inner ear studies, for example, Inflammatory changes, tumorous pro-cesses of pyramids, cerebellopontine angle tumors, posttraumatic changes, etc. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 4.3 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 8.3 cm. Note: Same as for adults except for the FoV of 300. Emotion 16 kV Effective mAs/ Quality ref.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose InnerEarSeq 110 90 1.0 sec. 6 x 1.0 mm 1.0 mm 1.0 mm 6.0 mm H90s 16.56 mGy Male: 0.41 mSv* Female: 0.42 mSv* * The conversion factor for a 7-year-old child, and a scan range of 40 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children, who are older than age 6, should be scanned with an adult protocol as the skull by this time is fully grown. • In order to optimize image quality versus radiation dose, scans are provided within a maximum scan field of 300 mm with respect to the iso-center. No recon job with a field of view exceeding those limits will be possible.
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Children SinusOrbit Indications: Spiral mode for routine spiral studies of the sinuses and paranasal sinuses, for example, sinusitis, pneumatization, polyposis, malformations, tumors etc. Spiral mode for routine studies of the orbitae, for example, fracture. For SOMATOM Emotion 16-slice configuration: A typical range of 6 cm covered in 9.81 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 4 cm covered in 9.84 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Sinus Orbi 110 50 2nd recon. 3rd recon. 4th recon. 1.0 mm 1.0 mm 1.0 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 7.7 mm 3.0 mm 0.80 3.0 mm 3.0 mm 0.7 mm C60s C30s C60s 8.90 mGy Male: 0.29 mSv* Female: 0.31 mSv* 0.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Sinus Orbi 110 50 2nd recon. 3rd recon. 4th recon. 1.25 1.25 mm mm 1.0 sec. 6 x 1.0 mm 1.0 mm 3.0 mm 3.0 mm 5.1 mm 0.85 3.0 mm 3.0 mm 0.8 mm C60s C30s C60s 9.20 mGy Male: 0.04 mSv* Female: 0.04 mSv* 0.8 mm C30s * The conversion factor for a 7-year-old child, and a scan range of 60 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children older than age 6 should be scanned with an adult protocol. • The second recon job is defined with kernel H60s and with an overlap for visualizing bone structures with MPR. • To work without CARE Dose 4D use for children < 3 years 40 mAs 3-6 years 60 mAs.
Children NeckRoutine Indications: Spiral mode for routine neck studies, for example, tumors, lymphoma, abscesses, etc. NeckRoutine: For SOMATOM Emotion 16-slice configuration: A typical range of 15 cm covered in 7.21 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 8.27 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Neck 110 50 2nd reconstr. 1.0 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 1.5 mm 28.8 mm 1.50 5.0 mm 1.0 mm B50s B50s 3.60 mGy Male: 0.69 mSv* Female: 0.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • If necessary, scan down to the aortic arch or mediastinum to include the entire lesion. • Cooperative children can be instructed to hold their breath during the acquisition. • Children older than age 6 should be scanned with an adult protocol.
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Children ThoraxRoutine/ ThoraxRoutine06s Indications: Spiral mode for routine thorax studies,for example, pneumonia, tumors, metastases, lymphoma, vascular abnormalities etc. For SOMATOM Emotion 16-slice configuration: A typical range of 15 cm covered in 4.33 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 6.20 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Thor Routine 110 39 2nd recon. 3rd recon. 4th recon. 1.5 mm 1.5 mm 0.6 sec. 16 x 1.2 mm 1.2 mm 3.0 mm 3.0 mm 28.8 mm 1.50 3.0 mm 1.0 mm 3.0 mm B41s B60s B41s 2.81 mGy Male: 1.21 mSv* Female: 1.49 mSv* 1.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorRoutine 110 26 2nd reconstr. 0.8/0.6 sec. 6 x 2.0 mm 2.0 mm 5.0 mm 5.0 mm 18.0 mm 1.50 5.0 mm 5.0 mm B41s B60s 1.85 mGy Male: 1.69 mSv* Female: 1.98 mSv* * The conversion factor for a 7-year-old child, and a scan range of 150 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol. • The first and second recon jobs are defined for visualization of the mediastinum and the lungs, respectively.
Children ThoraxCombi/ ThoraxCombi06s Indications: Combining thin slice and routine thorax studies with one spiral scan, for example, thorax studies in general and interstitial changes in the lungs. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 11.20 sec.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/ Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ThorC ombi 110 39 2nd recon. 3rd recon. 4th recon. 1.25 1.25 mm mm 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 3.0 mm 3.0 mm 9.0 mm 1.50 3.0 mm 3.0 mm 0.8 mm B60s B41s B60s 3.24 mGy Male: 2.82 mSv* Female: 3.33 mSv* 0.8 mm B41s * The conversion factor for a 7-year-old child, and a scan range of 150 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol. • For the 2nd reconstruction the Autoload into MPRthick Range on the 3D Card is activated. The images will be automatically loaded into 3D, MPRthick, and a coronal MPRthick Range will pop up.
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Children ThoraxHRSeq Indications: Sequence mode for high-resolution lung studies, for example, interstitial changes in the lungs, using a 10 mm feed. For SOMATOM Emotion 16-slice configuration: A scan range is predefined with 15.1 cm. For SOMATOM Emotion 6-slice configuration: A scan range is predefined with 15.0 cm.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Scan Kernel CTDIVol Effective dose ThoraxHRSeq 110 36 1.0 sec. 4 x 0.6 mm 0.6 mm 1.2 mm 10.0 mm B90s 0.81 mGy Male: 0.31 mSv* Female: 0.39 mSv* ThoraxHRSeq 110 36 1.0 sec. 1 x 1.0 mm 1.0 mm 1.0 mm 10.0 mm B90s 0.24 mGy Male: 0.20 mSv* Female: 0.
Children Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol. • If you want to acquire the patient at full inspiration or full expiration, you should practice breathing with the patient a few times before beginning the scan to improve reproductbility.
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Children AbdomenRoutine/ AbdomenRoutine06s Indications: Spiral mode for routine studies in the region of abdomen and pelvis, for example, tumors, lymphoma, abscesses, post-traumatic changes, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 20.0 cm covered in 5.37 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 30.0 cm covered in 11.20 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose AbdRoutine 110 60 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 28.8 mm 1.50 5.0 mm B41s 4.32 mGy Male: 2.78 mSv* Female: 3.38 mSv* AbdRoutine 110 60 0.8/0.6 sec. 6 x 2.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Delayed scans may be required for the kidneys & bladder. • Rectal contrast may be required for evaluation of pelvic mass. • Children with a body weight of more than 55 kg should be examined with an adult protocol.
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Children Spine/ SpineRoutine Indications: Spiral mode for spine studies, for example, post-traumatic changes, tumors, malformations, orthopedic indication, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 15 cm covered in 26.04 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 16.71 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Spine 110 60 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 2.0 mm 1.0 mm 6.2 mm 0.65 2.0 mm 0.7 mm B41s B60s 4.80 mGy Male: 1.28 mSv* Female: 1.
Children Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol.
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Children SpineThinSlice Indications: Spiral mode for the spine when Multi Planar Reformation (MPR) are intended, for example, post-traumatic changes, tumors, malformations, etc. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 47.45 sec. Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose SpineThinSlice 110 78 2nd reconstr. 1.0 sec. 6 x 1.0 mm 1.0 mm 2.0 mm 1.
Children Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol.
Children ExtrRoutineHR Indications: Spiral mode for high-resolution bone studies, for example, tumors, post-traumatic changes, orthopedic indications, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 6 cm covered in 35.33 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 10 cm covered in 35.33 sec. Emotion 16 kV Effective mAs/ Quality ref.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs** Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrHR 110 50 1.0 sec. 6 x 0.5 mm 0.5 mm 0.6 mm 3.0 mm 1.00 0.3 mm U90s 4.25 mGy Male: 0.01 mSv* Female: 0.01 mSv* * The conversion factor for a 7-year-old child, and a scan range of 60 mm was used. ** Adjust the mAs value to the body region.
Children ExtrCombi Indications: Spiral mode for the combination of bone and soft tissue studies, for example, masses, trauma, disorders of the joint etc. For SOMATOM Emotion 16-slice configuration: A typical range of 10 cm covered in 8.94 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 10 cm covered in 13.11 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose ExtrCombi 110 25 2nd reconstr. 1.0 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 14.4 mm 1.50 3.0 mm 0.7 mm B41s B70s 2.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol.
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Children HeadAngio/ HeadAngio06s Indications: Spiral mode for head CT Angio studies, for example, cerebral vascular abnormalities, tumors etc. For SOMATOM Emotion 16-slice configuration: A typical range of 6 cm covered in 3.70 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 6 cm covered in 5.20 sec. Emotion 16 kV Effective mAs/ Quality ref.
Children Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose HeadAngio 80 80 2nd reconstr. 0.8/0.6 sec. 6 x 1.0 mm 1.0 mm 2.0 mm 1.25 mm 9.0 mm 1.50 2.0 mm 0.8 mm C30s C30s 6.40 mGy Male: 0.16 mSv* Female: 0.16 mSv* * The conversion factor for a 7-year-old child, and a scan range of 60 mm was used.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children older than age 6 should be examined with an adult protocol. • CARE Bolus may be used to optimize the bolus timing with a triggering threshold of 120 HU, or use manual triggering. • An advanced algorithm allow for improved head image quality, without any additional post-processing.
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Children CarotidAngio/ CarotidAngio06s Indications: Spiral mode for carotid CT Angio studies, for example, carotidstenosis or occlusion, vascular abnormalities of thecarotids or vertebral arteries, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 17 cm covered in 8.28 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 20 cm covered in 14.53 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose CarotidAngio 80 40 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 14.4 mm 1.50 3.0 mm 0.7 mm B41s B31s 1.28 mGy Male: 0.29 mSv* Female: 0.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children older than age 6 should be scanned with an adult protocol. • CARE Bolus may be used to optimize the bolus timing with a triggering threshold of 120 HU, or use manual triggering.
Children 581
Children BodyAngioRoutine/ BodyAngioRoutine06s Indications: For abdominal CT Angio studies, for example, vascular abnormalities, aneurysms, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 20.0 cm covered in 9.53 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 15.0 cm covered in 11.20 sec.
Children Emotion 16 BodyAngio kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 80 80 2nd reconstr. 0.6 sec. 16 x 0.6 mm 0.6 mm 3.0 mm 1.0 mm 14.4 mm 1.50 3.0 mm 0.7 mm B41s B31s 2.56 mGy Male: 1.34 mSv* Female: 1.66 mSv* Emotion 6 BodyAngio kV Effective mAs/ Quality ref.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • Children with a body weight of more than 55 kg should be examined with an adult protocol. • CARE Bolus may be used to optimize the bolus timing. Set the ROI for monitoring scan in the abdominal aorta with triggering threshold of 120 HU, or use manual triggering.
Children 585
Children BodyAngioFast/ BodyAngioFast06s Indication: Spiral mode for fast abdominal CT Angio studies, for example, vascular abnormalities, aneurysms, ect. For SOMATOM Emotion 6-slice configuration: A range of 15 cm will be covered in 11.20 sec. with BodyAngioFast06s Emotion 6 kV Effective mAs/ Quality ref. mAs** Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose 586 BodyAngioFast 80 80 0.8/0.6 sec. 6 x 2.0/1.0 mm 2.0/1.0 mm 3.0 mm 21.
Children NeonateBody/ NeonateBody06s Indications: Spiral mode for neonate body studies, for example, tumors, abnormalities, malformations, abscesses, etc. For SOMATOM Emotion 16-slice configuration: A typical range of 15 cm covered in 4.33 sec. For SOMATOM Emotion 6-slice configuration: A typical range of 15 cm covered in 6.20 sec.
Children Emotion 16 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose NeonateBody 80 35 Emotion 6 kV Effective mAs/ Quality ref. mAs Rotation time Acquisition Slice collimation Slice width Feed/Rotation Pitch Factor Increment Kernel CTDIVol Effective dose NeonateBody 80 35 0.6 sec. 16 x 1.2 mm 1.2 mm 5.0 mm 28.8 mm 1.50 5.0 mm B41s 1.02 mGy Male: 0.96 mSv* Female: 1.07 mSv* 0.8/0.6 sec. 6 x 2.
Children Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site Total 1 – 2 ml per kg of body weight amount Hints • CARE Bolus may be used to optimize bolus timing. Set the ROI for monitoring scan in the abdominal aorta with triggering threshold of 120 HU, or use manual triggering.
Manufacturer Siemens Shanghai Medical Equipment Ltd. (SSME) 278 Zhou Zhu Road 201318 Shanghai, P.R. China Telephone: +86 21 38895000 Authorized Representative according to the Medical Device Directive 93/42/ EEC Siemens AG Medical Solutions Henkestr. 127 D-91052 Erlangen Germany Telephone: +49 9131 84-0 © 2002-2007, Siemens AG Order No. C2-025.630.16.01.
