lung cancer screening CT protocols
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1. technique is used to obtain twice as many projections per rotation as detector rows This is referred to as IVR Interleaved Volume Reconstruction on the Perspective system With SAFIRE For standard sized patient defined as 5 7 155 pounds Do not adjust the Quality Reference mAs as patient size varies CAREDose4D adjusts for patient size automatically With exception of rotation time a Definition DS operated in single source mode can use the same protocol as a Sensation 64 P The tube potential selected by CARE kV can differ from exam to exam if patient positioning or size changes substantially Because it is important to use the same tube potential on serial follow up exams manual kV selection is recommended Approx Weight kg Approx Weight Ibs Approx CTDIvol mGy Small Patient 50 70 110 155 0 8 2 5 Avg Patient 70 90 155 200 1 6 3 8 Large Patient 90 120 200 265 2 4 5 0 12 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved LUNG CANCER SCREENING CT selected SIEMENS scanners continued TOPOGRAM PA scan from top of shoulder through mid liver SIEMENS Software version Scan Mode Rotation Time s Detector Configuration Pitch kV Quality ref mAs CARE Dose4D CARE kV CTDIvol RECON 1 Type Kernel Slice mm Increment mm RECON 22. GE Hitachi Neusoft Philips siemens Toshiba The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 LUNG CANCER SCREENING CT Selected GE scanners Back to INDEX SCOUT AP S60 1400 scan from top of shoulder through mid liver if automatic exposure control is used PA scout if manual mA is used GE Optima 660 Scan Type Helical Rotation Time s 0 6 Beam Collimation mm 40 Detector Configuration 64x0 625 Pitch 1 375 Speed mm rot 55 0 kV 120 mA 50 SFOV Large Body CTDIvol 1 8 mGy RECON 1 Plane Axial Algorithm Bone or Lung Recon Mode Full Thickness mm 1 25 Interval mm 1 25 ASIR if used SS50 RECON 2 Axial DMPR Plane create Sag Cor reformats Algorithm Bone or Lung Recon Mode Full Thickness mm 0 625 Interval mm 0 625 ASIR if used SS50 For standard sized patient defined as 5 7 155 pounds For small patients mA may be reduced by as much as 50 for large patients mA may be increased by 50 100 These protocols use direct multi planar reconstruction DMPR on Recon 2 to automatically create Sagittal and Coronal reformats The user may select the thickness of the Sagittal and Coronal images to be 1 2
3. Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Definition Flash Dual source 128 slice Back to INDEX Definition Force Dual source 192 slice VA44 VA50 Spiral Spiral 0 28 0 25 128 x 0 6mm 192 x 0 6 mm 64 x 0 6 mm 38 4 mm 96 x 0 6 mm 57 6 mm 1 0 1 0 120 100Sn 25 150 ON ON OFF Not applicable 1 7 mGy 0 5 mGy Axial Axial 150 ee o Bv49 strength 2 1 0 1 0 Axial MIP B50 Axial MIP Kernel 150 strength 2 Br54 strength 2 Slice mm 20 20 Increment mm 25 2 5 RECON 3 Type Axial Axial Kernel B31 Br40 strength 2 Slice mm 1 0 1 0 Increment mm 0 7 0 7 RECON 4 Type Axial MIP Axial MIP Kernel B31 Br40 strength 2 Slice mm 20 20 Increment mm 2 5 2 5 Indicates that a z axis flying focal spot technique is used to obtain twice as many projections per rotation as detector rows This is referred to as IVR Interleaved Volume Reconstruction on the Perspective system With SAFIRE or ADMIRE For standard sized patient defined as 5 7 155 pounds Do not adjust the Quality Reference mAs as patient size varies CAREDose4D adjusts for patient size automatically a With exception of rotation time a Definition DS operated in single source mode can use the same protocol as a Sensation 64 The tube potential selected by CARE kV can differ from exam
4. 9mGy 3 3 mGy Thin Lung Axial Axial Lung20 1 0 5 30 Axial F20 1 0 5 30 mp mp E e Back to INDEX Indicates that a z axis flying focal spot technique is used to obtain twice as many projections per rotation as detector rows Approx Weight kg Approx Weight Ibs Approx CTDIvol mGy Small Patient Avg Patient 50 70 110 155 1 0 2 8 70 90 155 200 1 9 4 3 90 120 200 265 3 3 5 6 Large Patient Copyright July 3 2015 by AAPM All rights reserved The disclaimer found on page 1 is an integral part of this document SURVIEW PA scan from top of shoulder through mid liver Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Lung Cancer Screening CT selected PHILIPS scanners PHILIPS eae eee Scan Type Helical Helical Rotation Time s 0 5 0 5 Collimation 16 x 1 5mm 64 x 0 625 mm Coverage mm 24 40 kV 120 120 ms masses wate a DASE ag ORE equivalent diameter reference reference Tube current modulation ZDOM ZDOM Pitch 1 0 1 0 CTDIvol 1 8 mGy 1 7 mGy RECON 1 Axial Lung Type Axial Axial Filter YA YA Thickness mm 2 1 Increment mm 1 0 5 Matrix 768 768 iDose Level 5 5 RECON 2 Axial Soft tissue Type Axial Axial Filter A A Thickness mm 3 3 Increment mm 1 5 1 5 Matrix 512 512 iDose Level 5 5 Back to INDEX For scanners wit
5. a standard sized patient as measured using the 32 cm diameter CTDI phantom By definition a standard sized patient is approximately 5 7 and 155 pounds or 170 cm and 70 kg with a BMI S 24 e Some form of scanner output adjustment for patient size must be used This adjustment may be accomplished through either Use of automatic methods such as automatic exposure control AEC and or automatic kV selection Use of a manual technique chart that prescribes different tube current and or kV values as a function of patient size e Examples of manual adjustment may include but are not limited to e Reducing the mAs for small patients defined below by 50 e Increasing the mAs for large patients defined below by 50 100 e When AEC is used careful attention must be paid to the values selected to define the desired level of image quality e g Noise Index Quality Reference mAs Standard Deviation Dose Right Index Each manufacturer will have recommendations unique to their systems and system features Be sure to work with your CT equipment manufacturer and a qualified medical physicist to ensure safe and appropriate operation of AEC systems e If more than one CT localizer radiograph is acquired AEC systems from different manufacturers can differ with respect to which one is used to determine mA and or kV settings Please refer to individual manufacturer protocol instructions e AEC systems also may differ in response when the prescribe
6. 5 5mm For LightSpeed 16 BrightSpeed 16 and depending on system configuration DMPR could be used if available If DMPR is not available user will need to create Sag Cor images manually in Reformat using an image thickness of 1 25 5mm Approx Weight kg Approx Weight Ibs mA Approx CTDIvol mGy Small Patient 50 70 110 155 25 50 0 9 2 3 Avg Patient 70 90 155 200 50 75 1 8 3 6 Large Patient 90 120 200 265 75 100 2 7 4 6 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved LUNG CANCER SCREENING CT selected HITACHI scanners SCANOGRAM PA scan from top of shoulder through mid liver Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Back to INDEX HITACHI ECLOS 16 SCENARIA 64 Scan Type Volume Volume Rotation Time s 0 8 0 5 Detector Collimation T 1 25 mm 0 625 mm Number of Active Channels 16 64 Detector Configuration 1 25 x 16 0 625 x 64 Mode thick pitch speed 1 25 1 3125 26 25 0 625 0 8281 33 13 Pitch 1 3125 0 8281 Speed mm rot 26 25 33 13 kV 120 120 mA 50 50 Adaptive mA IntelliEC No No SFOV 500 500 CTDIvol 2 6 2 7 RECON 1 Series Description Lung Lung Type Axial Axial Filter 21 Lung 21 Lung Thickness mm 1 25 1 Interval mm 0 625 0 5 RECON 2 Series Description Soft Tissue Soft Tissue Type Axial Ax
7. 5 7 155 pounds Do not adjust the SD as patient size varies SureExposure modulates mA automatically based on patient size Recon 1 Axial Soft Tissue SUREIQ Setting Body Std Axial Body Std Axial Body Std Axial AIDR 3D AIDR 3D STD AIDR 3D STD AIDR 3D STD Body Std Axial AIDR 3D STD Recon 2 Axial Lung Lung Std Axial Lung Sta Axil ADR3DSTD_ ADR 3D STD Thickness mm Recon 3 MPR Soft Tissue Volume Volume Voume voume A o Body Std Volume Body Std Volume ADR3DSTD_ _AIDR 3D STD Thickness mm 0 5 Ce a iy E 0 5 0 5 0 3 0 3 1 1 Interval mm 0 3 Multiview Sagittal Coronal Sagittal Coronal Body Std Volume Body Std Volume i i E T 1 1 Volume reconstructions are required in order to create Multiplanar reconstructions 14 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Recon 4 MPR Lung Volume Volume Volume SUREIQ Setting Lung Std Volume Lung Std Volume Lung Std Volume AIDR 3D AIDR 3D STD AIDR 3D STD AIDR 3D STD Thickness mm 0 5 0 5 3 0 3 03 0 Multiview Sagittal Coronal Sagittal Coronal _ Sagittal Coronal Sagittal Coronal SUFEIQ Setting Lung Std Volume Lung Std Volume Thickness mm 1 SS interval mm Volume reconstructions are required in order to create Multiplan
8. Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 DISCLAIMER TO THE EXTENT ALLOWED BY LOCAL LAW THIS INFORMATION IS PROVIDED TO YOU BY THE AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE A NON PROFIT ORGANIZATION ORGANIZED TO PROMOTE THE APPLICATION OF PHYSICS TO MEDICINE AND BIOLOGY ENCOURAGE INTEREST AND TRAINING IN MEDICAL PHYSICS AND RELATED FIELDS AAPM AS IS WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND WHETHER ORAL OR WRITTEN EXPRESS OR IMPLIED AAPM SPECIFICALLY DISCLAIMS ANY IMPLIED WARRANTIES OR CONDITIONS OF MERCHANTABILITY SATISFACTORY QUALITY NONINFRINGEMENT AND FITNESS FOR A PARTICULAR PURPOSE SOME JURISDICTIONS DO NOT ALLOW EXCLUSIONS OF IMPLIED WARRANTIES OR CONDITIONS SO THE ABOVE EXCLUSION MAY NOT APPLY TO YOU YOU MAY HAVE OTHER RIGHTS THAT VARY ACCORDING TO LOCAL LAW TO THE EXTENT ALLOWED BY LOCAL LAW IN NO EVENT WILL AAPM OR ITS SUBSIDIARIES AFFILIATES OR VENDORS BE LIABLE FOR DIRECT SPECIAL INCIDENTAL CONSEQUENTIAL OR OTHER DAMAGES INCLUDING LOST PROFIT LOST DATA OR DOWNTIME COSTS ARISING OUT OF THE USE INABILITY TO USE OR THE RESULTS OF USE OF THE PROVIDED INFORMATION WHETHER BASED IN WARRANTY CONTRACT TORT OR OTHER LEGAL THEORY AND WHETHER OR NOT ADVISED OF THE POSSIBILITY OF SUCH DAMAGES YOUR USE OF THE INFORMATION IS ENTIRELY AT YOUR OWN RISK THIS INFORMATION IS NOT MEANT TO BE USED AS A SUBSTITUTE FOR THE REVIEW OF SCAN PROTOCOL PARAMETERS BY A QUALIFIED AND CERTIFIED PROFE
9. SSIONAL USERS ARE CAUTIONED TO SEEK THE ADVICE OF A QUALIFIED AND CERTIFIED PROFESSIONAL BEFORE USING ANY PROTOCOL BASED ON THE PROVIDED INFORMATION AAPM IS NOT RESPONSIBLE FOR A USER S FAILURE TO VERIFY OR CONFIRM APPROPRIATE PERFORMANCE OF THE PROVIDED SCAN PARAMETERS SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES SO THE ABOVE LIMITATION MAY NOT APPLY TO YOU The disclaimer on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 LUNG CANCER SCREENING CT NOTE The Lung Cancer Screening Protocols described in this document are a set of reasonable protocols developed by the AAPM s Working Group on Standardization of CT Nomenclature and Protocols that are to be used in the specific context of Lung Cancer Screening These protocols were based in part on manufacturers Low Dose Chest protocols but were adapted based on the Working Group s experience with the National Lung Screening Trial and other screening studies The primary goal of lung cancer screening CT is to detect abnormalities that may represent lung cancer and may require further diagnostic evaluation In addition examinations should be reviewed for other abnormalities in accordance with the ACR SCBT MR SPR Practice Parameter for the Performance of Thoracic Computed Tomography CT This document is ONLY meant to desc
10. ar reconstructions Approx Weight kg Approx Weight Ibs Approx CTDIvol mGy Small Patient 50 70 110 155 0 8 1 8 Avg Patient 70 90 155 200 1 6 2 7 Large Patient 90 120 200 265 2 4 3 6 15 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved
11. calizer radiograph is acquired the reported CTDIlvol is not patient specific but is based on a generic patient size The CTDIlvol values provided here are approximate and are intended only to provide reference ranges for the user to consider In this document a small patient is considered to be approximately 50 70 kg 110 155 Ibs an average patient approximately 70 90 kg 155 200 Ibs and a large patient 90 120 kg 200 265 Ibs However weight is not a perfect indication of patient size A person s height gender and distribution of weight across the body also must be taken into account The thickness of the body over the area to be scanned is the best indication of patient size Body mass index BMI may also be considered Underweight BMI lt 18 5 Normal weight BMI of 18 5 24 9 Overweight BMI of 25 29 9 Obesity BMI of 30 or greater It is recognized that the median 50 percentile patient size for adults in the USA is larger than 70 kg However the 70 kg patient represents the Reference Man as defined by the International Commission on Radiation Protection ICRP upon which AEC systems and tissue weighting factors used for effective dose estimation are based The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 References ACR STR Practice Parameter for the Performance a
12. d scan range extends beyond the boundaries of the CT localizer radiograph please consult the user manual to identify how the AEC system will respond when this occurs Effective Dose Effective dose is defined in ICRP 103 as a population dose metric and should not be used to estimate dose or risk to an individual From a screening population point of view one method to estimate the effective dose is to calculate the Dose Length Product DLP and then apply a conversion factor described in AAPM TG Report 96 to estimate the effective dose For an idealized standard sized patient defined above and a 25 cm scan length and using the k factor of 0 014 mSv mGy cm these protocols should result in an effective dose below 1 mSv see table below The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Dose values for an idealized standard sized patient NOT for any individual Dose Descriptor Reported at Scanner Y N CTDIvol lt 3 0 mGy Asan E DLP Ct mGy om OY Effective Dose DLP x 014 The CTDIvol and DLP values in this fable a are for an idealized patient only individual patients may have higher or lower values to reflect adjustment for patient size Effective Dose is calculated for a population and should NOT be reported for an individual CTDI measurements and calculations e Some manufactu
13. hout the iPatient interface the default water equivalent diameter is 33 cm for all protocols unless otherwise defined by the user with a manual DoseRight reference image For standard sized patient defined as 5 7 155 pounds Approx Weight kg Approx Weight Ibs Approx CTDIvol mGy Small Patient 50 70 110 155 0 9 1 8 Avg Patient 70 90 155 200 1 7 2 7 Large Patient 90 120 200 265 2 7 3 6 10 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Lung Cancer Screening CT selected PHILIPS scanners Back to INDEX SURVIEW PA scan from top of shoulder through mid liver PHILIPS Scan Type Rotation Time s Collimation Coverage mm kV mAs mAs slice water equivalent diameter Tube current modulation Pitch CTDIvol RECON 1 Lung Type Filter Thickness mm Increment mm Matrix iDose Level RECON 2 Soft tissue Type Filter Thickness mm Increment mm Matrix iDose Level For scanners without the iPatient interface the default water equivalent diameter is 33 cm for all protocols unless otherwise defined by the user with a manual DoseRight reference image For standard sized patient defined as 5 7 155 pounds Approx Weight
14. ial Filter 31 Soft tissue 31 Soft tissue Thickness mm 1 25 1 Interval mm 0 625 0 5 For standard sized patient defined as 5 7 155 pounds For small patients mA may be reduced by as much as 50 for large patients mA may be increased by 50 100 Approx Weight kg Approx Weight Ibs mA Approx CTDIvol mGy Small Patient 50 70 110 155 25 50 1 3 2 7 Avg Patient 70 90 155 200 50 75 2 6 4 1 Large Patient 90 120 200 265 75 100 3 9 5 4 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved kk NEUSOFT Scan Type Patient size Small Me Rotation Time s Collimation x 1 5 kVp Reference mAs Pitch Displayed FOV mm Resolution Standarc Dose Modulation ClearView SNR Level CTDIvol RECON 1 Type Filter Thickness mm Increment mm ClearView RECON 2 Filter For standard sized patient defined as 5 7 155 pounds Because this technique is for a large patient the CTDIvol exceeds 3 0 mGy Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 LUNG CANCER SCREENING CT selected NEUSOFT scanners SCOUT PA scan from top of shoulder through mid liver Adjust Displayed FOV to 1 cm beyond the rib cage NeuViz64i NeuViz64i NeuViz64e NeuViz64e Helical Large 240cm 64 x 0 625 50 300 350 Standard 1
15. kg Approx Weight Ibs Approx CTDIvol mGy Small Patient 50 70 110 155 0 8 1 7 Avg Patient 70 90 155 200 1 6 2 6 Large Patient 90 120 200 265 2 4 3 4 11 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 LUNG CANCER SCREENING CT selected SIEMENS scanners TOPOGRAM PA scan from top of shoulder through mid liver Back to INDEX SIEMENS Emotion 16 Perspective 64 Software version VB42 VC28 Scan Mode Spiral Spiral Rotation Time s 0 6 0 6 Detector 64 x 0 6 mm Configuration Tee OE tinin 32 x 0 6 mm 19 2 mm Pitch 1 0 1 2 kV 110 110 Quality ref mAs 20 25 CARE Dose4D ON ON CARE kV NA NA CTDIvol 1 6 mGy 2 0 mGy RECON 1 Type Axial Axial B50 Kernel B50 150 strength 2 Slice mm 1 0 1 0 Increment mm 0 7 0 7 RECON 2 Type Axial MIP Axial MIP B50 Kernel pe 150 strength 2 Slice mm 20 20 Increment mm 2 5 2 5 RECON 3 Type Axial Axial B31 Kemel Eo 131 strength 2 Slice mm 1 0 1 0 Increment mm 0 7 0 7 RECON 4 Type Axial MIP Axial MIP B31 Kernel Bl 131 strength 2 Slice mm 20 20 Increment mm 2 5 2 5 Indicates that a z axis flying focal spot
16. l and sagittal reformations as well as MIPS may be helpful and are encouraged e CTDIvol lt 3 0 mGy for a standard sized patient see table with adjustments made for smaller and larger patients e This typically requires a 16 detector row or greater scanner to meet these requirements Contrast These studies are performed without any contrast e Oral None e Injected None Patient Positioning e Center the patient within the gantry this is critical for proper functioning of AEC systems e Patient supine arms above head The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Scan Range e From top of lungs through the bottom of lungs Suspension of Respiration e Patient should be instructed to hold his her breath at end of inspiration during entire scan Additional Image Reconstructions e Coronal and sagittal planar MPRs as well as axial MIPS may be helpful and are encouraged e Very thin images approximately lt 1 mm may need to be reconstructed to serve as source images for the sagittal and or coronal reformatted images e Creation use and archival of these additional images are at the discretion of the supervising radiologist and or departmental policy Very large datasets may result from these additional reconstructions Radiation Dose Management e CTDIvol must be lt 3 0 mGy for
17. nd Reporting of Lung Cancer Screening Thoracic Computed Tomography CT Available at http www acr org media ACR Documents PGT S quidelines LungScreening padf United States Preventive Services Task Force USPSTF Recommendations on Lung Cancer Screening using Low Dose CT Available at http www uspreventiveservicestaskforce org Page Document RecommendationStatementFinal lung cancer screening CMS Medicare Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography LDCT CAG 00439N http www cms gov medicare coverage database details nca decision memo aspx NCAId 274 ACR Lung Cancer Screening Resources Available at http Awww acr org Quality Safety Resources Lung Imaging Resources ICRP Report 103 International Commission on Radiological Protection The 2007 Recommendations of the International Commission on Radiological Protection ICRP Publication 103 International Commission on Radiological Protection Essen 2007 AAPM TG Report 96 American Association of Physicists in Medicine The Measurement Reporting and Management of Radiation Dose in CT Report of AAPM Task Group 23 ISBN 9781888340730 http www aapm org pubs reports RPT 96 pdf The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 INDEX OF LUNG CANCER SCREENING PROTOCOLS by manufacturer
18. rers utilize a z axis flying focal spot in which two unique projections are acquired at the same z axis table position When this technique is used we identify it with The CTDIvol on the console accurately accounts for use of this feature Approximate Volume CT Dose Index CTDIvol Values e Approximate values for CTDIvol are listed for three different patient sizes Approx Weight kg Approx Weight lbs Approx CTDIvol mGy Small Patient 50 70 110 155 0 25 2 8 Average Patient 70 90 155 200 0 5 4 3 Large Patient 90 120 200 265 1 0 5 6 The approximate CTDIvol values are for reference only and represent a dose to the 32 cm diameter CTDI phantom under very specific conditions The CTDIvol displayed on the scanner for a patient of a given size should be similar but not necessarily an exact match to those listed in the above table It is essential that users recognize that when using automatic exposure control the CTDIvol values reported on the user console prior to acquiring CT localizer radiographs on a particular patient do not represent the CTDlvol that will be delivered during that patients scan CT systems rely on the CT localizer radiograph to 1 estimate the patient s size 2 determine the tube current settings for each tube angle and table position that will yield the requested level of image quality and 3 calculate the average CTDIvol for the patient over the prescribed scan range Until the CT lo
19. ribe the technical elements of a lung cancer screening CT exam It is NOT intended to be a comprehensive description of the elements of a screening program e g who should and should not be screened the patient management process for following up a positive screen test Some examples of guidance in such a program are the ACR STR Practice Parameter for the Performance and Reporting of Lung Cancer Screening Thoracic Computed Tomography CT the USPSTF recommendations and the CMS Decision Memo on Lung Cancer Screening these provide information on eligibility criteria exam specifications interpretation and reporting of these exams Additional resources are available on the ACR Lung Cancer Screening Resources webpage Indications For individuals with no known signs or symptoms of lung cancer that have appropriate risk factors such as those recommended by professional societies and health care organizations See the ACR Lung Cancer Screening Resources webpage for more information Diagnostic Tasks include but are not limited to e The primary goal of lung cancer screening CT is to detect abnormalities that may represent lung cancer and may require further diagnostic evaluation e Therefore the primary task is to detect nodules or masses and characterize their size shape and relationships to organs Key Elements e One breath hold thoracic motion is problematic e Thin image thicknesses 2 5 mm lt 1 0 mm preferred reconstruction of corona
20. to exam if patient positioning or size changes substantially Because it is important to use the same tube potential on serial follow up exams manual kV selection is recommended 100Sn 100 kV with 0 6 mm tin Sn filtration This removes lower energy photons and hence a higher Quality ref mAs is required Small Patient Avg Patient Large Patient Approx Weight kg Approx Weight Ibs Approx CTDIvol mGy 50 70 110 155 0 25 1 7 70 90 155 200 0 5 2 7 90 120 200 265 1 0 3 4 13 The disclaimer found on page 1 is an integral part of this document Copyright July 3 2015 by AAPM All rights reserved Lung Cancer Screening CT Protocols Version 3 0 3 July 2015 Lung Cancer Screening CT selected Toshiba scanners Back to INDEX Scanogram PA and LAT dual Scanogram scan from top of shoulder through mid liver Aq PRIME Aq PRIME ae TOSHIBA 40 Rows 80 Rows Aq ONE Vision Scan Type Helical Helical s Detector Fast 1 434 Standard 0 825 Standard 0 813 Standard 0 813 Minimum amp Min mA 20 Min mA 20 Min mA 20 Min mA 20 Maximum mA Max mA 110 Max mA 120 Max mA 120 Max mA 150 5 mm Target Slice 5 mm Target Slice 5 mm Target Slice 5 mm Target Slice C PN Ss CTDIvol 1 8 Ie Create a new SureExp setting using Body Std Axial SurelQ with 5 mm Target Slice and the given SD min and max mA values For standard sized patient defined as
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