Siemens 16-Jun Bedienungsanleitung

SOMA T OM Emotion 6/16-slice configuration Application Guide Protocols Principles Helpful Hints Software V ersion syngo CT 2007E[...]

The inf ormation present ed in this applica tion guide is for illustration only and is not intended t o be relied upon by the r eader f or instruction as to the practice of medicine. Any health care practitioner reading this information is r eminded that they must use their own learning, training and exper t ise in dealing with their individual pat[...]

Ov er view 3 User Documentation 16 Scan and Reconstruction 18 Dose Inf ormation 42 Wor kflow Inf ormatio n 64 Contrast Medium 122 Application Inf ormation 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[...]

4 Ov er view Respiratory Gating 484 Children 508[...]

Ov er view 5[...]

6 Contents User Documentation 16 Scan and Reconstruction 18 • Concept of Scan Pro tocols 18 • Scan Set Up 19 • Feed in/Feed out 19 • T opo Length 20 • Scan Modes 21 - Sequential Scanning 21 - Spiral Scanning 21 -Q u i c k S c a n 2 2 - Dynamic Multiscan 22 - Dynamic Serioscan 22 • UFC dete ctor 23 • Acq uisition, Slice Coll imation an[...]

Contents 7 • C ARE Dose 4D 47 - How does C ARE Dose 4D work? 49 - Special Modes of C ARE Dose 4D 53 - Scanning with CARE Dose 4D 54 - Adjusting the Image Noise 58 - Activating and Deactivating 61 - Conversion of Old Pro tocols into Pro tocols with C ARE Dose 4D 61 - Additional Impor tant Information 63 Wor kflow Inf ormatio n 64 • Work Stre am [...]

8 Contents - Change paramet ers 103 - Import scan pro tocols from SOMA TOM LifeNet/CD 117 Contrast Medium 122 • Contrast Medium 122 - The Basics 122 - IV Injection 125 • Bolus T racking 126 • T es t Bolus using CA RE Bolus 128 • T es t Bolus 129 - C ARE Contrast 130 Application Inf ormation 136 • SOMA TOM Lif eNet 136 - General Informatio[...]

Contents 9 - InnerEarHRVol 180 - InnerEar 184 - InnerEarSeq 188 - Sinus 192 - SinusVol 196 - Orbit 198 - Dental 200 Neck 204 • Overview 204 - General Hints 206 - Body Kernels 207 • Scan Prot ocols 208 - NeckRoutine 208 - NeckThinSlice 212 - NeckV ol 214 Shoulder 218 • Overview 218 - General Hints 219 - Body K ernels 219 • Scan Prot ocols 22[...]

10 Contents ThoraxF ast06s 244 - ThoraxHR 246 - ThoraxHRSeq 250 - ThoraxECGHRSeq 252 -L u n g L o w D o s e / LungLowDose06s 254 -L u n g C A R E / LungC ARE06s 258 Abdomen 262 • Overview 262 - General Hints 264 - Body Kernels 265 • Scan Prot ocols 266 - AbdomenRoutine/ AbdomenRoutine06s 266 - AbdomenCombi/ AbdomenCombi06s 270 - AbdomenVol 274 [...]

Contents 11 - SpineSeq 308 - Osteo 312 Pelvis 314 • Overview 314 - General Hints 316 - Body Kernels 317 • Scan Prot ocols 318 - Pelvis 318 - PelvisV ol 322 - Hip 324 - HipVol 328 - SI_Joints 330 Upper Extremities 332 • Overview 332 - General Hints 334 - Body Kernels 335 • Scan Prot ocols 336 - WristHR 336 - ExtrRoutineHR 340 - ExtrCombi 344[...]

12 Contents Vascular 360 • Overview 360 - General Hints 363 - Head K ernels 364 - Body K ernels 365 • Scan Prot ocols 366 - HeadAngio/ HeadAngio06s 366 - HeadAngioV ol 370 -C a r o t i d A n g i o / Caro tidAngio06s 372 - Caro tidAngioV ol 376 - ThorAngioRoutine/ ThorAngioRoutine06s 380 - ThorAngioV ol 384 - ThorAngioECG/ ThorAngioECG06s 388 - [...]

Contents 13 -P o l y T r a u m a / PolyT r auma06s 426 - HeadT rauma 430 - HeadT raumaSeq 432 - Additional Impor tant Information 434 • Interventional CT - Biopsy 436 - Biopsy 437 - Biopsy Single 438 • Interventional CT - C ARE Vision 439 - The Basics 439 - C AREVision 440 - C AREVisionSingle 441 - C AREVisionBone 442 - HandC ARE 443 - Addition[...]

14 Contents Respiratory Gating 484 • Ke y Features 486 - Respiratory Gating 486 - Respiration Monitoring 486 - Respiration Synchronization 487 • Positioning of the r espiratory sensor belt 488 • Scanning Information 490 - Scan Parameters 490 - T emporal Resolution 491 - T echnical Principles 491 - Respiratory T riggering 491 - Respiratory gat[...]

15 Contents - ThoraxRoutine/ ThoraxRoutine06s 546 - ThoraxCombi/ ThoraxCombi06s 550 - ThoraxHRSeq 554 - AbdomenRoutine/ AbdomenRoutine06s 558 - Spine/ SpineRoutine 562 - SpineThinSlice 566 - ExtrRoutineHR 568 - ExtrCombi 570 - HeadAngio/ HeadAngio06s 574 -C a r o t i d A n g i o / Caro tidAngio06s 578 - BodyAngioRoutine/ BodyAngioRoutine06s 582 -B [...]

16 User Documentation For further inf ormation ab out the basic operation, please ref er to the corr esponding syngo CT Operator Manual: syngo CT Operator Manual V olume 1: syngo Security Pack age Siemens V irus Protection Basics SOMA TOM Lif eNet syngo Patient Br owser syngo Data Set Conv ersion Camtasia Sav eLog E-Logbook syngo Viewing syngo Film[...]

User Documentation 17 syngo CT Operator Manual V olume 4: syngo LungC ARE CT syngo Pulmo CT syngo Neuro Perfusion CT syngo Body Per fusion CT syngo CT Operator Manual V olume 5: syngo Calcium Scoring syngo Circulation syngo V olume Calculation syngo Dynamic Evaluation syngo Neuro DS A CT syngo CT Operator Manual V olume 6: syngo InSpace 4D CT syngo[...]

18 Scan and Reconstruction Concept of Scan Pr o t ocols The scan pro tocols f or adult and childr en are defined according t o body regions - Head , Neck , Shoulder , Thorax , Abdomen , Pe lvis , Spine , Upper Extremities , Lowe r Extremities , Vas c u l a r , RT , Specials and optional Cardiac , PET , SPECT and Private . The prot ocols for special[...]

Scan and Reconstruction 19 Scan Set U p Scans can be simply set up by selec ting a predefined examination pr ot ocol. T o repeat an y mode, just click the chronicle with the right mouse button for repeat . T o delete i t, select cut . Each range name in the chr on- icle can be easily changed befor e load . Multiple ranges can be run either automati[...]

20 Scan and Reconstruction To p o L e n g t h * only in combination with PET and SPECT , option ** only in combination with SPECT , option *** only in combination with PET , option SOMA TOM Emotion 16 Length [mm] 128, 256, 512, 7 68, 1024, 1500 Slice width [mm] 4x0.6 Angle T op, Bo ttom, Lateral SOMA TOM Emotion 6 Length [mm] 128, 256, 512, 768, 10[...]

Scan and Reconstruction 21 Scan Modes Sequential Scanning This is an incremental, slice-by-slice imaging mode in which there is no table mo vement during data acquisi- tion. A minimum interscan delay in betw een each acquisition is required to move the table to the next slice position. Spiral Scanning Spiral scanning is a continuous volume imaging [...]

22 Scan and Reconstruction Quick Scan The data is usually ac quir ed during a full 360° rotation – this is a Fu ll scan. Da ta acquisition no t using a f ull 360° ro tation is called a “Quick scan”. Quick scans ar e employ ed to reduce mo tion artifacts and improv e the temporal r esolution. Dynamic Multiscan Multiple continuous rotation s [...]

Scan and Reconstruction 23 UFC det ec tor Siemens’ proprietar y , high-speed Ultra F ast Ceramic (UFC) det ect or enables a virt ually simultaneous read- out of two projec tions for eac h det ect or element. The detec tor configuration with the r outine acquisition of the Emotion 6/16- slice configuration: SOMA TOM Emotion 16-slice configuration [...]

24 Scan and Reconstruction Acq uisition, Slice Collimation and Slice Width Slice collimation is the slice thickness resulting from the effect of the tube-side collimator and the adap tive det ector arra y design. In Multislice CT , the Z-cov erage per ro tation is given by t he product of the number of active de tect or slices and the collimation ([...]

Scan and Reconstruction 25 SOMA TOM Emot ion 16-slice configu- ration Spiral Mode HR/Neuro S piral Mode Sequence 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 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[...]

26 Scan and Reconstruction SOMA TOM Emotion 6-slice configura- tion Spiral Mode Sequence Mode HR Spiral Mode HR Sequence M ode Collimation Slice width 1 m m 1 ,1 . 2 5 ,2 ,2 . 5 ,3 ,4 ,5 ,6 ,8 ,1 0m m 2 mm 2.5, 3, 4, 5, 6, 8, 10 mm 3 mm 4, 5, 6, 8, 10 mm 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 C[...]

Scan and Reconstruction 27 Increment The increment is the distance between the recon- struct ed images in Z direc tion. When the chosen incre- ment is smaller than the slice thickness, the images are created wit h an overlap. This te chnique is useful for reducing partial volume ef fec t , giving you better de tail of the anatom y and high quality [...]

28 Scan and Reconstruction Ke r n e l s There are 4 differ ent types of kernels: “H“ stands for Head, “B“ stands for Body , “C“ stands for ChildHead and ”S” stands for Special Application, e.g. syngo Ost eo CT . The image sharpness is defined b y the numbers – the higher the number , the sharper the image; the low er the number , [...]

Scan and Reconstruction 29 Body K ern els: Child Head K ernels: K ernel description B08s ver y smooth B10s ver y smooth B19s ver y smooth B20s smoo th B29s smooth B30s medium smooth B31s medium smooth + B35s Hear tV iew medium B39f HeartView medium B40s medium B41s medium+ B46s medium B50s medium sharp B60s sharp B65s sharp B70s ver y sharp B75s ve[...]

30 Scan and Reconstruction To p o g r a m K e r n e l s : Special Application: K ernel description T10s smooth T20s standard T21s standard T80s sharp T81s sharp T90s ultra sharp K ernel description S30s Shepp-Logan S80s Shepp-Logan with no tch filter S90s Shepp-Logan without notc h filter U90s specification ke rnel[...]

Scan and Reconstruction 31 PET -K ernel: SPECT -K ernel: Ke rn e l P E T B19s smooth B29s medium smoo th B39s medium H19s smooth H29s medi um smoot h H39s medium K ernel SPECT H08s very smooth B08s very smooth[...]

32 Scan and Reconstruction Head K ernels For soft tissue head studies, the st andard k ernel 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, respec tively . The image appearance, howev er , is more acceptable due t o a "fi[...]

Scan and Reconstruction 33 Body K ernels As standard kernels f or body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (extremely soft). The kernels B31s or B41s hav e about the same visual sharpness as B30s respec tively , B40s, the image appearance, howe ver , is more acceptable due t o a "fine-grain[...]

34 Scan and Reconstruction Extended F oV SOMA TOM Emo tion 16/6-slice configuration of fers the extended field of view . The range can be individually adapt ed by the user fr om 50 cm up to 70 cm. T o u se this feature yo u have t o select the extended FoV checkbo x on the Recon subtask card. The default setting is 65 cm, but can be modified. Exten[...]

Scan and Reconstruction 35 Auto- FoV After scanning a topog ram the available ranges ar e dis- play ed in the topo segment. They can be auto matically adapte d according to the patient cont ours. When mov- ing the scan range ov er the topogram and pr ess the " ctrl " key simultaneous, the adaptation will be d one automatically . Please ma[...]

36 Scan and Reconstruction Hints • When positioning the arms along the body , the Auto- FoV will also cover the arms. • When scanning two extrem it ies at the same time, the Auto-FoV will also cov er both extremities.[...]

Scan and Reconstruction 37 Neur o Modes In addition to t he standard collimations, the SOMA- TOM Emo tion 16-slice configuration provides a special mode which is optimized f or Neuro applications. Ex cel- lent low contrast and de tail resolution are ac hieved. For spiral scans 4 x 0.6 acquisition mode is provided in the range of the cerebrum. This [...]

38 Scan and Reconstruction Aut omatic Bone Corr ection The head pro tocols pr ovide significant impr ovements regar ding image quality f or heads. An automatic bone correc tion algorithm has been included in the standard image reconstruc tion. Using a new it erative t echnique, typical artifacts arising from the beam-har dening effect, f or example[...]

Scan and Reconstruction 39 Positioning In order to op timize image quality versus radiation dose, scans in body regions “Head” and “AngioHead” are pr ovided within a maximum scan field of 300 mm with respec t to the iso-cent er . No r econ job with a field of view exceeding those limits will be possible. There- for e, patient positioning ha[...]

40 Scan and Reconstruction Image F ilters If you use k ernels, the images are r econstruct ed again with the select ed k ernel value. If you use image filters, the images are no t reconstruct ed again and the result is much quicker . Three different filt ers are available: LCE: The Low-con trast enhancement filter enhances low-contrast det ectabili[...]

Scan and Reconstruction 41 "HCE": The High-contrast enhancement (HCE) filt e r enhances high-contrast detectability . It increases the image sharpness, similar to reconstruction with a sharper k ernel. • Increases sharpnes s • F aster than ra w-data reconstruction • Enhances high-contrast det ectability • Automatic post-pr ocessin[...]

42 Dose Information CTDI W and CTDI Vol The av erage dose in the scan plane is best described by the CTDI W f or the selected scan parame ters. The CTDI W is measured in dedicated plastic phantoms – 16 cm diamet er for head and 32 cm diamet er fo r body (as defined in IEC 60601 – 2 – 44). For scan modes with z- Sharp the CTDI100 is calculat e[...]

Dose Information 43 Note : Previously t he dose display on the user interface was labeled “CTDI W “. This displa yed CTDI W was also cor- rec ted for the pitc h and was therefor e identical to the current CTDI Vol . The CT DI w value does no t pro vide the entire inf orma- tion of the radiation risk associated wit h CT examina- tion. For this p[...]

44 Dose Information Impac tDose For most of the scan pro tocols, the effec tive dose num- bers for standard male* and female* ar e calculated, and listed the r esult in the description of each scan pro- toc ol . The calculation was performed using the commercially availa ble prog ram "Impac tDose" (W ellhoef er Dosime- tr y). For pediatri[...]

Dose Information 45 Ef f ectiv e mAs In sequential scanning, the dose ( D seq ) applied to the patient is the pr oduct of the tube curr ent-time (mAs) and the CTDI w per mAs: In spiral scanning, howe ver , the applied dose (D spiral ) is influenced by the conventional mAs (mA x Ro t Time) and additionally by the pitch factor . For example, if a Mul[...]

46 Dose Information For spiral scan pro tocols, t he indicated mAs is the effectiv e mAs per image. The correlation be tween tube current and effec tive mAs of spiral scans on a Multi- slice CT scanner is expres sed by the f ollowing formula: where Slice collimation refers to the collimation of one detec tor r ow , and nrow is the number of used de[...]

Dose Information 47 C ARE Dose 4D C ARE Dose 4D is an aut omated exposur e control, which ensures constant diagno stic image quality o ver all body regions at the lowest pos sible dose. C ARE Dose 4D combines thre e different adaptation methods to optimize image quality at the lowest dose lev el: • Aut omatic adaptation of the tube current t o th[...]

48 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 y ou can adjust image quality (image noise) t o the diagnostic requir ements and the individual pref erence[...]

Dose Information 49 How does CARE Dose 4D work? C ARE Dose 4D combines two types of tube current modulatio n: 1) Axial tube current modulation: Based on a single T opogram (a.p. or lateral) the atten- uation profile alo ng the patien t’s long axis is measured in direc tion of the projecti on and estimated f or the per- pendicular direc tion by a [...]

50 Dose Information 2) Angular tube current modulation: Based on the abov e described axial ef f. mAs profiles, the tube current is modulat ed during each tube ro ta- tion. Therefor e the angular attenuation profile is mea- sured automatically during the scan and the tube cur- rent is mo dulate d accordi ngly in rea l time to ac hiev e an optimum d[...]

Dose Information 51 Scan with constant mA Reduced dose level Real-time angular slice position x-ray dose based on topogram dose modulation[...]

52 Dose Information Principle of automatic tube current adaptation b y C ARE Dose 4D for a spiral scan fr om shoulder to pelvis (very high table feed fo r 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 curr[...]

Dose Information 53 Special Modes of C ARE Dose 4D For certain examination pr otocols CARE Dose 4D uses modified tube current modulation, to mee t specific conditions, for ex ample: • for Adult He ad pro tocols the tube current is adap ted to the variation alo ng the pa tient ’s long axis and not to the angular attenuation profile. • for Extr[...]

54 Dose Information Scanning with C ARE Dose 4D If the settings of Image Quality Ref erence mAs ar e cor- rec tly predefined*, no fur ther adjustment of the tube current is r equir ed to perform a scan. CA RE Dose 4D automatically adap ts the tube current to different patient sizes and anat omic shapes, but it widely ignores me tal implants. Note :[...]

Dose Information 55 Outside the topogram range, C ARE Dose 4D will con- tinue the scan with the last a vailable topogram inf or- mation. Without a topogram, CARE Dose 4D cannot be switched on. Repositioning of the patient on the table and exces sive motion of the patient must be avoided between the to pogram and the scan. If two topograms of the sa[...]

56 Dose Information After the topogram has been scanned, the (eff.) mAs value in the Routine tab card displa ys the mean (eff.) mAs estimated b y C ARE Dose 4D based on the t opo- gram*. After the scan has been per formed this va lue is updated to the mean (eff.) mAs that was applied. The values may differ slightly due to the online modulation acco[...]

Dose Information 57 The Quality ref erence mAs value is displayed on the Scan tab card. This defines th e ov erall image quality of the scan prot ocol currently being used. This value can be adapted f or each pr otocol accor ding to the user ’s individual requir ements of image quality . Here you can also view the effective mAs value that the sys[...]

58 Dose Information Adjusting the Image Noise The correlation be tween attenuation and tube curr ent is defined by the analytical func tion described above. This function ma y be adjusted t o adapt th e image qual- ity (image noise) accordi ng to t he diagnostic r equir e- ments and the individual pref erence of t he radiologist. – T o ada pt the[...]

Dose Information 59 If you change the quality r ef. mAs, a pop-up window is displayed. • T o change the configurat ion of C ARE Dose 4D, please open the Examination Configuration dialog box under Op tions > Configuration . In the window that then appears, please double-click the Examina- tion icon to displa y the configuration window . The ada[...]

60 Dose Information – i f the automatic dose increa se for obese patients (or patient sections) has to be mor e moderate than the prese t (ch oose obese: w eak increase ), resulting in more image noise and a lower dose for those images. – if the automatic dose decr ease for slim patients (or patient sections) has to be str onger than the prese [...]

Dose Information 61 Activating and Deac tivating C ARE Dose 4D ma y be activat ed or deactiva ted f or the current scan in the Scan tab card. If CARE Dose 4D is activated as default, the Imag e Quality Reference mAs value is se t to the default value of the pro tocol. After deactivating CARE Dose 4D, the Image Quality Reference m As is dimmed and t[...]

62 Dose Information If you ar e unsure about the co rrect Image Quality Ref- erence mAs v alue, f ollow this sim ple pr ocedure: • Enter the (eff.) mAs value used for that type of pro- tocol without CA RE Dose 4D. • There is a simple way of ascertaining what ef f. mAs C ARE Dose 4D will use along the scan range: When the topog ram is complet e [...]

Dose Information 63 Additional Import ant Information For ideal dose application it is very impor tant to posi- tion the patient in the isocente r of the gantr y . Example f or an a.p. topogram: Patient is positioned in the isocenter – optimal dose and image quality Patient is positioned too high – increased mAs Patient is positioned too low ?[...]

64 Wo r k f l o w I n f o r m a t i o n Wo r k St re a m 4 D Recon Jobs In the Recon car d, you can define up to eight recon- struction jobs f or each range with different parame ters either befor e or after you acquire the data. When y ou click on Recon , these jobs are performed automatically in the back ground. If y ou want to add more than eigh[...]

Wo r k f l o w I n fo r m a t i o n 65 3D Recon 3D Recon allows you to perf orm oblique and/ or double oblique re constructions in an y user-defined direc tion direc tly after scanning. No further post-proce ssing or data loading is needed. The high-quality SPO (spiral obli que) images are calcu- lated by using the system’s raw data. Key Fe a t u[...]

66 Wo r k f l o w I n f o r m a t i o n Workflo w Description WorkS tr eam 4D improv es your workflo w whenever non-axial images of a CT scan are requir ed, for ex ample examinations of the spine. 3D reconstructions ar e possible: – s piral scan is needed – a s soon as one scan range is finished and at least one axial reconstruction job ha s be[...]

Wo r k f l o w I n fo r m a t i o n 67 Additional Important Information Pitch fa ct or for 3 D Recon • For reconstruc tion of 3D recon jobs the maximum pitch fact or is 1.5. If the pitch fact or is > 1.5 a message windo w informs you that this 3D recon job canno t be star ted and may be delet ed. In this case use the standard 3D task card with[...]

68 Wo r k f l o w I n f o r m a t i o n Three planning segments in perpendicular orienta- tions will appear in the upper scr een area. Y ou can choose be tween MPR Thick (3 mm) and MIP Thin (10 mm) as the image type for y our planning volume using the rele vant buttons. In each segment y ou will find a pink r ectangle which represents the boundary [...]

Wo r k f l o w I n fo r m a t i o n 69 The rectangl e with the grid represents the ref erence image (topogram) whic h is added to the T opogram series including the ref erence lines after r econstruc- tion. T opographics indicator Recon area Reference line s[...]

70 Wo r k f l o w I n f o r m a t i o n Previe w Image A preview of the ac tual FoV is now available. • After pressing t he button Pre view Image the ac tual FoV to be reconstruct e d will be displayed. • Clicking again on t he button deactiva tes the pre view image and displays the whole ref erence image again. • Double clicking into the Fo [...]

Wo r k f l o w I n fo r m a t i o n 71 Depending on the desired r esultant images, choose coronal, sagittal or oblique r econ axis. 1. Sagittal/Coronal Reconstructions • Adjust the field of view size to y our needs. • It is only possible to reconstruct images with a squared ma trix. 2. Oblique/Double-oblique Reconstructions If you want t o defi[...]

72 Wo r k f l o w I n f o r m a t i o n T o def ine the ref erence image (t opogram) to the active segment, click on the Set Reference Segment button. This defines the orientatio n of the r efer ence image which will be added t o the r esult images. Once you ha ve finished the a djustment, star t calcula- tio n of t he res ult i mage s by cl icki n[...]

Wo r k f l o w I n fo r m a t i o n 73 Additional Information As soon as you define a new r econ range, all recon ranges will be shown in the topo segment. The two numbers on the right-hand si de at the beginning of each recon range indicate the r econ job the range belongs to. The first number stands for the scan range, the second number stands fo[...]

74 Wo r k f l o w I n f o r m a t i o n Recon Planning During planning of a 3D recon range, the image dis- play ed in the FoV segment will be updated t o the new position of the recon start and end position. The corresponding r efer ence line display ed in bo th planning segments is the refer ence line to the actual image displayed in the F oV segm[...]

Wo r k f l o w I n fo r m a t i o n 75 • Oblique reconstruction of the sinuses : – Scan a t opogram – Plan your axial spiral scan r ange – Reconstruction of t he spiral images (RT images) –S e l e c t Recon job T ype ob lique – Select the sagittal image segment – Enable F ree Mode – Rotat e the r eference lines until the best view o[...]

76 Wo r k f l o w I n f o r m a t i o n Non-square Matrix for 3D Recon If you perfrom a 3D r econstruction of y our spiral scan you ha ve the possibility to choose be tween three dif- fer ent FoV matrices: 512 square, 512 non-squar e, 256 non-square. In some cases it is already sa ved to the scan pro tocol (Spine, Caro tidAngio) set up a new scan p[...]

Wo r k f l o w I n fo r m a t i o n 77 Case Examples f or 3D Recon and Non- Square Matrix Some scan protocols are delivered with predefined oblique and non-square matrix reconstructions. These protocols are mark ed with the suffix “ VOL ” •C oronal and sagittal reconstruction of the spine : – Scan a t opogram – Plan your axial spiral scan[...]

78 Wo r k f l o w I n f o r m a t i o n – Rotat e the ref erence lines until the best vie w on the sinuses is displa yed in one of the ot her seg- ments – Select this segment and pr ess butt on Set F oV Seg- ment button – Select t he Matrix size f o r example, non-squar e 512 and adjust the FoV to yo ur needs – Define your desired r econstr[...]

Wo r k f l o w I n fo r m a t i o n 79 Wo rk f l o w Patient Position A default patient position can be link ed and stor ed to each scan pro tocol. The SIEMENS default pr ot ocols are already link ed to a default pa tient position. (Head first - supine) If a scan pro tocol is select ed and confirmed in the Patient Model Dialog , the link ed patient[...]

80 Wo r k f l o w I n f o r m a t i o n Na vigation within the T opogram Navig ation within the topogram helps yo u to plan a reconstruction range. The minimum conditions f or its use are a sca nned range and the availability of RTD (Real time displa y) images. After scanning, a n orange line is displa yed within the topogram. This line corre- spon[...]

Wo r k f l o w I n fo r m a t i o n 81 API Language The API language can now be select ed direc tly in the Patient Model Dialog . When the API language is select ed, only the relevant, language specific API entries can be select ed in the Scan subtask card. This wa y it is much easier to select the correc t patient instruction.[...]

82 Wo r k f l o w I n f o r m a t i o n Befor e recording a ne w API text, first define the API lan- guage in the API setup dialog under Setup > API/Com- ment Setup in the mai n menu.[...]

Wo r k f l o w I n fo r m a t i o n 83 e - Logbook The goal o f e-Logbook is to offer an effec tive and effi- cient functionality t o proces s examination inf orma- tion. The e-Logbook consists of thr ee components: •T h e e-Logbook Configuration •T h e e-Logbook subtask card area •T h e e-Logbook Browser , where all ex aminations can be list[...]

84 Wo r k f l o w I n f o r m a t i o n Over Default Time period you can de termine how the recordings should be list ed inside the e-Logbook Browser : – T oday (which is the default setting) – This week – This month –Y e s t e r d a y – Last week –L a s t m o n t h Any ch anges can be sav ed by selec ting "Apply "[...]

Wo r k f l o w I n fo r m a t i o n 85 On the Manual Entries tab car d you can configure the System Entries and Manual Entries , that should be displayed in the e-Logbook . System Entries are aut omatically filled out by the sys- tem and display ed in the e-Logbook as read-only if they ar e configured. Default settings are: • Date of Examination [...]

86 Wo r k f l o w I n f o r m a t i o n Furthermore the Continuous Number can be set to: – Daily – Monthly – Y early If you set Continuous Number to Daily , the continu- ous number star ts with one each da y .[...]

Wo r k f l o w I n fo r m a t i o n 87 Additionally the user can define Manual En tries which will also be displayed in the e-Logbook . These infor- mation can be pre-configured and then selec ted o ver a drop down menu in the e-Logbook . T o configure new entries of the drop down menu f or each Manual Entry , just type the desired information insi[...]

88 Wo r k f l o w I n f o r m a t i o n e- Logbook Brow ser Y o u will find the e- Logbook Browse r in the main menu under Patient > e- Logbook bro wser or you can use F12 key o n yo u r ke y b oa r d . Y o u can list the e-Logbook re cord i ngs by d ate . Se le ct your desir ed timeframe in the calendar and click List now . If you want to list [...]

Wo r k f l o w I n fo r m a t i o n 89 Additional to the dat es, cer tain criteria can be selec ted to hav e a more specific search. Sear ch criteria can be defined for all entries r ecorded inside the e-Logbook . For example, the entr y Number of images is rec ord ed . A search f or datasets which ha ve a certain amount of images can be defined. A[...]

90 Wo r k f l o w I n f o r m a t i o n Hints for the Record List: 1. Calling up Patient Brow ser When you double click on an y record in the e-Logbook Browser , the patient data of the Patient Brow ser will be opened, if still a vailable and the customer has the chance to edit the patient information. This change will also be updated inside the e-[...]

Wo r k f l o w I n fo r m a t i o n 91 Study Continuatio n An existing study can be continued at a later time. T o load an existing study: • Select the desir ed study in the Patient Browser . •S e l e c t Register fr om the Patient drop-down menu. • The patient data is loaded in the Registration dialog box. The previous scan pr ot ocol is alr[...]

92 Wo r k f l o w I n f o r m a t i o n Reconstruction on the syngo CT W ork- place It is possible to start all reconstructions fr om your sat- ellite console. • Raw data has to be available in the local database • Select the ra w data series of the patient in the Patient Br owser and lo ad it int o the Recon card • Plan your r econ jobs as u[...]

Wo r k f l o w I n fo r m a t i o n 93 Examination Job Status Y o u can get an o verview of al l recon jobs by clicking on the recon task symbol in the s tatus bar or selecting T r ansfer – Examination Job status in the patient main menu in the P atient Browser . The Ex amination Job Status dialog box will appear where all recon jobs (comple ted,[...]

94 Wo r k f l o w I n f o r m a t i o n Auto Load in 3D and Postproces sing Presets Y o u can activat e the Auto l oa d i n 3 D function on the Examination task car d/ Aut o T asking and link it to a recon job, for ex ample, the 2 nd recon job with thinner slice width in some of the ex amination pro tocols. If t he post-proces sing type is chosen f[...]

Wo r k f l o w I n fo r m a t i o n 95 The same can be done for VRT presets. In the main menu under T ype > VRT Definition , you can link VRT prese ts with a series description. Some of the scan pro tocols, prim arily f or Angio ex ami- nations, are already prese t in the pro tocol with Aut o load in 3D. If you pr efer no t t o hav e this prese [...]

96 Wo r k f l o w I n f o r m a t i o n Scan Pr ot ocol Cr eation Y o u can modify or create your scan pr ot ocols in two different wa ys: • by editing/saving scan pr ot ocols • via scan prot ocol manager . Edit/Sa ve Scan Pro tocol If you want t o modify an existing prot ocol or create a new one, fo r example, you want t o have two Abdo- menRo[...]

Wo r k f l o w I n fo r m a t i o n 97 User-specific scan pr otocols can be sav ed with the f ol- lowing basic procedure: • Register a patient, you can choose any patient posi- tion in the Patient Model Dialog . • Select an existing scan pro tocol in the Patient Model Dialog . • Modify the scan pr ot ocol, change paramet ers, add new ranges e[...]

98 Wo r k f l o w I n f o r m a t i o n Additional important information: • Y ou can sa ve your scan pr ot ocol at any time during the examination. • It is recommended that you sa ve y our own scan pr o- tocol under a new name in order t o avoid o verwrit- ing the default scan pro tocol. • Do not use special charact ers or blanks. Allowed ar [...]

Wo r k f l o w I n fo r m a t i o n 99 St ep 1 - What do yo u want to do? Four different operation types are pos sible: • Manipulate Scan pr ot ocols (cut, copy , pas te and delete) • Change parame ters • Import scan prot ocols from SOMA T OM Life Net/CD • Restor e prot ocols to Siemens default Additional important information • Each work[...]

100 Wo r k f l o w I n f o r m a t i o n Manipulate scan pro tocols This workflow consists of f our steps. Step 2 - Manipulate scan protocols (cut/cop y/paste/ delete) T o be able to modify existing scan pro tocols you just hav e to click with the right mouse button onto the pro- tocol y ou want to cut, copy or dele te, there a menu will be display[...]

Wo r k f l o w I n fo r m a t i o n 101 Setting the Emergency Pr otocol: One pro tocol must be labeled as the emergency pro- tocol, if you want to change the default emergency prot ocol y ou hav e to select the desired pro tocol a nd click onto the Emergency icon. An Application Restart is necessary to set the new defa ult emergency pro to- col. Th[...]

102 Wo r k f l o w I n f o r m a t i o n Step 3 - Confirmation Here y ou can check t he modifications and sav e the changes. All rele vant inform ation such as the Name of the manipulated scan pr ot ocols, destination Folder , Name of the deleted pr ot ocols and the changed Emer- gency protocols ar e displayed inside the Change ov er- view . Step 4[...]

Wo r k f l o w I n fo r m a t i o n 103 Change paramet ers This workflow consists of five steps. Step 2 - Select the scan pro tocols you want to change Here y ou can select: • scan pro tocols with cer tain recon jobs • all scan prot ocols with ECG • all customized or Siemens scan pr ot ocols for modifi- cation • all scan pro tocols Addition[...]

104 Wo r k f l o w I n f o r m a t i o n All scan pro tocols selec ted in S tep 2 ar e display ed. For each paramet er you can select the scan prot ocols you want to apply y our changes. The < Select All> check- box is con venient f or the user to select and deselect all scan pro tocols list ed. If the parame ter values in t he select ed row [...]

Wo r k f l o w I n fo r m a t i o n 105 Protocol Select single scan pr ot ocol or all scan prot ocols you want to modify in this subsect ion. In the subsection Pr ot ocol the f ollowing changes can be made: – Pro tocol Name This entr y is onl y available in single pro tocol selec- tion. Here you can re name your scan prot ocol. – Default Patien[...]

106 Wo r k f l o w I n f o r m a t i o n The four buttons: Column Configuration , Show/Hide Parameters , Parameter Proper ty and Find/Replace are no w available. – Column Configuration With the column configuration you can include or exclude specific entries that will be display ed in the sub foo tprint line and also change the order of the entri[...]

Wo r k f l o w I n fo r m a t i o n 107 To p o g r a m Select single scan pr ot ocol or all scan prot ocols you want to modify in this subsect ion. In the subsection topog ram the following c hanges can be made: –m A Set the mA value f or the topog ram. – T op ogram length All available t opo lengths are list ed in the dropdo wn list. –T u b [...]

108 Wo r k f l o w I n f o r m a t i o n Scan Select single scan pr ot ocol or all scan prot ocols you want to modify in this subsection. Additionally y ou can select the scan mode entries: – Sequence – Spiral – Multiscan – CA R E V i s i o n The display ed parameters depend on t he selection you hav e made. • If no special scan mode is s[...]

Wo r k f l o w I n fo r m a t i o n 109 It is possible to insert the Autorange brackets in a selected Multi Range by using the right mouse button and removing the Pause fr om the pro tocol. Y ou are also able to put a pause into your selec ted Ranges so you ar e scanning the ranges seperatly .[...]

110 Wo r k f l o w I n f o r m a t i o n Scan Parameters Spiral Mode Sequence Mode Multisca n Mode CareVision Mode Mixed Mode mAs X X X X eff. m As X X CA RE Dose typ e X X X Dose modulat ion X X X Quality Ref mAs X X X kV X X X X X Slice X X X X X Cycle Time X Rot atio n Time X X X X X Pitch X T able feed X Scan Time X X X X Scan Direc tion X X Ha[...]

Wo r k f l o w I n fo r m a t i o n 111 Recon Y o u can select all recon jo bs, Sequence, Spiral, Multi- scan and CareVision Scan Entries yo u want to modify in this subsection, of course you can also only select single Recon jobs out of the list. Additionally y ou can display inf ormation about the scan range: • When < include scan range info[...]

112 Wo r k f l o w I n f o r m a t i o n In the subsection Recon the f ollowing changes can be made: Scan Parameters Spiral Mode Sequence Mode Multisca n Mode CareV ision Mode Mixed Mode Slice X X X X X Reco n Increment X X Ke rn e l X X X X X Window X X X X X Mirror X X X X X No of images X X X X X Extended FoV X X X X Recon type X X Series descri[...]

Wo r k f l o w I n fo r m a t i o n 113 Auto T asking Select single r econ job or all recon jobs you want to modify in this subsection. Additionally you can displa y information about the scan range: • When "include scan range information" is select ed, an information line f or each scan range is listed befor e the recon jobs belonging [...]

114 Wo r k f l o w I n f o r m a t i o n In the subsection Aut o T asking the following changes can be made: • Auto transf er 1,2,3 •A u t o V i e w i n g •A u t o R e c o n • Aut o Film ing • Auto P ostprocessing • Auto Ref erence lines (only if selec ted in the pro tocol) • Body Par t Examined[...]

Wo r k f l o w I n fo r m a t i o n 115 T rigger Select single, all, all sequ ence or all spiral scan prot o- cols with trigger , • When "include scan range a nd recon information" is select ed, an information line f or each scan range and reconstruc tion is listed befor e the recon jobs belong- ing to this scan range, you might ha ve t[...]

116 Wo r k f l o w I n f o r m a t i o n Some paramet ers listed are associat ed with each other . If you input a value which influences ano ther value and theref ore causes a conflic t, the influenced param- et er values are aut o correct ed and displa yed in gr een. If an invalid pr ot ocol is loaded, the paramet ers with the incorrec t value wi [...]

Wo r k f l o w I n fo r m a t i o n 117 Import scan protocols from SOMA TOM LifeNet/CD In this workflow y ou can import new scan pr ot ocols either fr om SOMA TOM Lif eNe t, if a remo te connec tion is availabl e, or from CD. Befor e you can import new scan pro tocols, you ha ve to download them fr om the SOMA T OM LifeNe t. This workflow consists [...]

118 Wo r k f l o w I n f o r m a t i o n Restoring protocols to Siemens default This workflow consists of f our steps: St ep 2- Select the scan protocols y ou want to restore to Siemens default. In this workflow y ou can restor e or import Siemens default scan prot ocols. Adult and Child pro tocols are managed apart. • Select what you want t o do[...]

Wo r k f l o w I n fo r m a t i o n 119 If no customized scan pr ot ocols are selec ted, the radio buttons < Replace customized protocols with same name > and < Add Siemens protocols as duplicates > will be dimmed. • Select dele ted Siemens scan pr ot ocols –T h e < Select Dele ted > checkbox is con venient for the user to sel[...]

120 Wo r k f l o w I n f o r m a t i o n Step 4 -C h ang es saved In this step y ou can decide if y ou want t o pass a differ- ent modification workflow or if you want to exit the Scan Prot ocol Assistant . List all Scan Protocols and all select ed Protocols T o list all available pro tocols, selec t the List all proto- cols ic on i n t he lowe r l[...]

Wo r k f l o w I n fo r m a t i o n 121[...]

122 Contrast Medium Contrast Medium The Basics The administration of intrav enous (IV) contrast mate- rial during spiral scanning impr ov es the tissue and lesion charact erization, as well as the opacity of ves- sels. The contrast scan will yield good results only if acquisition is performed during the optimal phase of enhancement in the region of[...]

Contrast Medium 123 The dynamics of the contrast enhancement is det er- mined by: • Patient cardiac output •I n j e c t i o n r a t e • T otal volu me of contrast medium inje cte d • Concentration of the contrast medium • T ype of inject ion – un i-phasic or bi-phasic • Patient pathology Aortic time-enhancement cur v es after i.v . co[...]

124 Contrast Medium Injection rate: 2 ml/s, 120 ml, 300 mg I/ml Injection rat e: 4 ml/s, 120 ml, 300 mg I/ml T o tal volume of contrast medium injected: 80 ml, 4 ml/s, 30 0 mg I/ml T o tal volume of contrast medium injected: 120 ml, 4 ml/s, 300 mg I/ml T ype of injec tion: Uni- phase 140 ml, 4 ml/s, 370 mg I/ml T ype of inj ection: Bi- phase 70 ml,[...]

Contrast Medium 125 IV Injection* The administration of a contrast medium depends on the indication and on the delay times t o be used during the examination. The patients weight and circulat or y situation also play a r ole. In general, no more than 3 ml per k g of body weight f or adults and 2 ml per k g of body weight f or childr en should be ap[...]

126 Contrast Medium Bolus T racking An automatic Bolus T racking program is av ailable which enables triggering of the spiral scanning a t the optimal phase of the contrast enhancement. Additional Important Information 1. This mode can be used in combination with any spi- ral scanning prot ocol. Simply insert Bolus T r acking by clicking the right [...]

Contrast Medium 127 – Move the monit oring scan line toward the optimal position and release the mouse button, it will be snapped automatically . (T rick: if you move the mon- itoring scan line away from the op timal position the snapping mechanism will be inactive). 4. Place a ROI in the premonitoring scan on the targe t area or ves sel used for[...]

128 Contrast Medium T est Bolus using C ARE Bolus Y o u can use the CARE Bolus option as a T est Bolus . Method 1. Inser t a Bolus T racking via the context menu prior to the spiral. 2. Inser t contrast from the context menu. Note : By inser ting contrast you are int errupting the Auto rang e function pre venting an automa tic star t of the spiral.[...]

Contrast Medium 129 T est Bolus This is a low dose sequential pro tocol without table feed used t o calculate t he star t dela y of a spiral scan to ensure optimal enhancement after the contrast medium injec tion. The syngo Dynamic Evaluation function may be used t o generate the time density cur ve. Y ou will find the T est Bol us scan pr ot ocol [...]

130 Contrast Medium 6. Load the images into the DynEva task card and det ermine the time to peak enhancement. Alterna- tively , on t he 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 calcula[...]

Contrast Medium 131 Wor k fl ow T o star t a contrast enhanced examination in coupled mode: • Select the Scan subtask card. • Selec t under the menu field Scan Start either the entr y Injector coupled (Star t button) or the entr y Inject or coupled (Footswitch) – Injec tor coupled (S tart button): The Star t button of the CT scanner will st a[...]

132 Contrast Medium After the inject or is armed the scan and the injector can be star ted b y pressing either the Star t button/ Footswitc h at the scanner , or the St a r t button at t he inject or panel outside of the scan room or dir ectly at the inject or inside the scan room. Note : If the injector is no t ready the scan cannot be star ted. I[...]

Contrast Medium 133 Additional Important Information •I f Coupled Mode is select ed the CT checks if ther e is an injector a vailable. The scan mode cannot be loaded if a connec tion can- not be established or if the injector does no t accept coupling (The injector will no t accept coupling while injecting). A message appears: Injec tor is no t c[...]

134 Contrast Medium The injector r eports a tec hnical problem: The connection be tween scanner and injec tor is int er- rupt ed, or the injection was stopped due t o technical problems. In this ca se the scan continues and an erro r message pops up. The user can decide if he wants t o stop the scan or if he would lik e to continue. • If the inje[...]

Contrast Medium 135[...]

136 Application Information SOMA T OM LifeNe t General Information SOMA TOM Lif eNet is our information and ser vice por- tal that can be accessed dir ectly at t he syngo Acq uisi- tion W orkplace , syngo CT W orkplace , and syngo MultiModality Workplace . It provides up-t o-date news about y our scanner , helpful configuration inf or- mation about[...]

Application Information 137 Key Fe a t u r e s SOMA TOM Lif eNet offline (All users): • General Information about your system and configu- ration • Access to syngo E-Learning SOMA TOM Lif eNet online (In combination with a Sie- mens Remot e Ser vice connection): • Newstic ker ar chive and F AQ (freq uently asked ques- tions) section • F ree[...]

138 Application Information SOMA TOM LifeNe t offline Start SOMA TOM Life Net by sele cting SOMA TOM LifeNe t under Options in your syngo menu bar and you will find a bro wser window that allo ws you to access various inf ormation about y our hard- and soft- ware environ ment. Under Sy stem Info rmation , f or example, y ou will find information su[...]

Application Information 139 The syngo Basics E-Lea rning is pre-installed on your system and can dir ectly be used b y selecting E- T rain- ing . The syngo Adv anced Application E-Learning can be downloaded in t he SOMA TOM LifeNe t online area or is sent to y ou automatically on CD if trial soft- ware is r equest ed via SOMA TOM Lif eNet. In case [...]

140 Application Information SOMA TOM LifeNet online When you star t up your syst em you will receive up-to- date inf ormation in the Newsticker and see the expi- ration date of installed trial software. Access the Siemens Extranet b y clicking on SOMA T OM LifeNe t online . After entering your CT system serial number you will be forwarded t o the i[...]

Application Information 141 Download of Files Each download will be per formed in the bac kg round and even if you disconnect your SOMA TOM Lif eNet online session and start to w ork with the CT scanner , it will continue the proces s until the download is com- plet ed. Due to bandwidth restrictions it is only possible to perform one download at a [...]

142 Application Information The E-training is automatically inst alled as soon as it is downloaded and can be star ted within the SOMA TOM LifeNe t offline section under SOMA TOM Educate > E- Tr a i n i n g . For syngo Acquisition W orkplaces , you can down- load and install scan pro tocols. T o inst all the downloaded pro tocols open the Scan P[...]

Application Information 143 All new pr otocols, including those you did not choose to imp or t to t he Customer Folder will also be stored in the Siemens Folder so that the y can be copied later . All downloaded scan pro toc ols ar e named "D L_.." so they can be easily identified when mixed with pre- installed prot ocols. Also, see the c[...]

144 Application Information Contact Func tion Contacting Siemens via Email is possible directly from your scanner and e ven DIC OM imag es can be attached t o y o u r m e s s a g e . To a t t a c h a n i m a g e , p l e a s e f i r s t s e l e c t the images on y our Viewing task card first and then export these images to H:SiteDataOffline as a D[...]

Application Information 145 T rial Order and Installation As a SOMA TOM CT user y ou can request trial clinical software directly fr om the scanner . The request ed soft- ware will be made available and installed automa ti- cally through our Siemens Remot e Services connec- tion. After you ha ve accessed the SOMA TOM LifeNe t online area, you can c[...]

146 Application Information Forwarding information via Email This ser vice enables those customers who do not have a printing device connect ed to their CT Scanner , but would lik e to ha ve th e informa tion provide d in SOMA- TOM Lif eNet sent t o their regular email account or f or- warded t o a contact person of int erest as an e mail. Informat[...]

Application Information 147 Image Con verter The CT application Commo n DIC OM Adapt er can con- vert dif fer ent DIC OM data sets to f ormats pro vided by other CT v endors. – Y ou will find the converter in the Applications me nu of the Patient Browser .[...]

148 Application Information In the pop-up window y ou can selec t the application for whic h you want to con vert the images[...]

Application Information 149 Split-Up Multi-Phase Series 1. Select Split-up series according to trigger delay from the sec tion Split-up Heartview 4D series , if you intend t o split-up the series of multi-phase hear t reconstruction accor ding to t he different heart phases included. Or 2. Select Split-up series according to slice position to split[...]

150 Application Information Repor t T emplat e Configuration Under Options/Configuration you will find the Report T emplate Configuration . With the Report Configuration you can edit the basic infor mation, e.g. clinic inf ormation f or y our report templat es of the applications: – syngo Calcium Scoring – syngo Colonography CT – syngo Lung C[...]

Application Information 151 File Br ow ser The File Browser pr ovides y ou with a secure means of accessing and managing data in a private fo lder , which is a well defined part of the computer file system. This user par tition is strictly separated from the system operating file syst em. The user par tition is shar ed read only and ma y be used fo[...]

152 Application Information Raw data transf er : Raw data se t can be transferr ed. First configure the dir ect ory where the ra w data should be transferre d to: • Open the File Br owser . • Choose the desired dir ectory from the navig ation tree t o the left of the File Br ow ser . • Select the it em Set as Expor t Root from the CT Data Tr [...]

Application Information 153 Burn on CD : • Do not writ e files to CD-R while o ther jobs are being transferred. • Make sur e that the volume of data to be recorded does not ex ceed the CD -R st orage capacity . • Select the desired files and cop y & paste or drag & drop them int o the f older CDBurn (or send them via the right mou se [...]

154 Application Information Review reports and movies : • Select the desired files and double-click on them. • The corresponding program, f or example, Movie Media Player , will be opened and you can review what you ha ve sa ved. • Y ou can now transf er these files to floppy disk or copy them ont o a CD . Additional Important Information: ?[...]

Application Information 155 Camtasia Camtasia is a separate software t ool that allows y ou to film your deskt op activities. Y ou can save t hese recor d- ings as avi files for documentation and presentation purposes. Key fe a t u r e s • Camtasia Recorder : to captur e avi files. Befor e star ting recor ding you can selec t the area you want to[...]

156 Application Information Under T ools > Options you can define special settings for reco rding : • A VI – to define Video and Audio op tions • File – to define the output op tions (files and fo lders) • Hotk eys – t o define special hotk eys, e.g. f or star t/ stop record ing • Live – to define live sour ce options[...]

Application Information 157 • Program – t o define capture options[...]

158 Application Information The Effects Options dialog bo x allows you t o set options f or your r ecording, f or exam ple, cursor ef fec ts.[...]

Application Information 159 Additional Import ant Information • T o transfer avi files from the file br owser t o any exter- nal storage device, f or exam ple CD, or USB stick use RMB menu Send to . Drag&drop and copy/paste to any st orage device is no t possible within the F ile Browser . • T o disp lay t he main menu, set T oggleView - Co[...]

160 Application Information Patient Pr o tocol Scan: number of scan range kV: kilo Volt mAs: av eraged applied mAs of the range ref. mAs q uality ref. mAs of the range TI: Rotation Time cSL: collimat ed Slice CTDI vol : For further information please ref er to the chap ter “Dose Inf ormation“. DLP: Dose Length Product T otal DLP DLP value of th[...]

Application Information 161[...]

162 Over view In this chap ter y ou will find all scan pro tocols relating to th e Head region, their descriptions, individual indi- cations, and import ant hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, str oke, brain tumors, cranial trauma, cere- bral atroph y , h ydrocephalus, and inflammat or y chan[...]

Head 163 For SOMA TOM Emotion 16- slice configuration: – HeadRoutine Spiral mode for routine head studies – HeadNeuro Special spiral mode u sing an acq. of 4 x 0.6 mm – HeadSeq Sequential mode f or r outine head studies – InnerEarHR Spiral mode for high resolution inner ear studies – InnerEarHRV ol Spiral mode for high resolution inner ea[...]

164 Head For SOMA TOM Emo tion 6- slice configuration: – HeadRoutine Spiral mode for r outine head studies – HeadSeq Sequential mode for r outine head studies – InnerEarHR Spiral mode for high reso lution inner ear studies – InnerEarHRV ol Spiral mode for high r esolu tion inner ear studies and double oblique studies – InnerEar Spiral mod[...]

Head 165 General Hints • T op ogram: Lateral, 256 mm. • Patient positioning: Patient lying in supine posi tion, arms resting against body , secur e head well in the head holder , support lower legs. • Gantr y tilt is a vailable for seq uence scanning. Howe ver , image ar tifacts ma y occur if spirals are acquir ed with a tilt angle g reat er [...]

166 Head Head K ernels • For soft tissue head studies, the standar d 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, how ever , is more agr eeable due to a ”f ine-grained” noise struc- ture; qui[...]

Head 167[...]

168 Head Scan Pr o tocols HeadRoutine Indications : Spiral mode f or r outine hea d studies, f or ex ample, strok e, brain tumors, cranial trauma, cerebral atroph y , hydr ocephalus, and inflammation, etc. For SOMA TOM Emotion 16 -slice configu ration: A range for the base of 4 cm will be cov ered in 14.36 sec., a range f or the cerebrum of 8 cm wi[...]

Head 169 Emotion 16 Base Cerebrum kV 130 130 Effect ive m As/ Quality ref. mAs 220 240 Rotation time 1. 5 sec. 1.5 sec. Acquisition 16 x 0.6 mm 16 x 1.2 mm Slice collimation 0. 6 mm 1.2 mm Slice width 4.0 mm 6.0 mm Feed/Rotatio n 5.3 mm 10.6 mm Pitch factor 0.55 0.55 Increment 4.0 mm 6.0 mm K ernel H31s H31s CTDI Vol 58.52 mGy 57.60 mGy Effect ive [...]

170 Head Emotion 6 Base Cerebrum kV 130 130 Effective mAs/ Quality ref. mAs 220 250 Rotation time 1.5 sec. 1.5 sec. Acquisition 6 x 1.0 mm 6 x 2.0 mm Slice collimation 1.0 mm 2.0 m m Slice width 4.0 mm 6.0 mm Feed/Rotation 2.4 mm 4.8 mm Pitch factor 0.40 0.40 Increment 4.0 mm 6.0 mm K ernel H31s H31s CTDI Vol 60.50 mGy 58.75 mGy Effective dose Male[...]

Head 171 Hints • An automatic bone correc tion allows f or impro ved head image quality , withou t an y additional postpro- cessing. • In order t o optimize image quality v ersus radiation dose, scans are provided wit hin a maximum scan field of 300 mm with r espect t o the iso-center . No recon job with a field of vi ew ex ceeding those limits[...]

172 Head HeadNeuro Indications: Special spiral neuro mode for dedicat ed head studies. T wo ranges are pr edefined for t he base of the skull using an acquisition of 16x0.6 mm and for the cere- brum using an acq uisition of 4x0 .6 mm. A range for the base of 4 cm will be cov ered in 9.58 sec., a range f or the cerebrum of 8 cm will be cov- ered in [...]

Head 173 Hints • An automatic bone correc tion allows f or impro ved head image quality , withou t an y additional postpro- cessing. • In order t o optimize image quality v ersus radiation dose, scans are provided wit hin a maximum scan field of 300 mm with respect to the isocent er . No recon job with a field of vi ew ex ceeding those limits w[...]

174 Head HeadSeq Indications : Sequence mode for r outine head studies, e.g. strok e, brain tumors, cranial trauma , cerebral atrophy , hydro- cephalus, and inflammation, etc. T wo ranges are predefined f or the base of the skull and for the cer ebrum. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 12.30 cm. For SOMA[...]

Head 175 Emotion 16 BaseSeq CerebrumSeq kV 130 130 Effect ive m As/ Quality ref. mAs 270 270 Rotation Time 1.5 sec. 1.5 sec. Acquisition 2 x 5.0 mm 2 x 8.0 mm Slice collimation 5.0 m m 8.0 mm Slice width 5.0 mm 8.0 mm Feed/Scan 10 mm 16 mm K ernel H31s H31s CTDI Vol 58. 32 mGy 57.24 mGy Effect ive d ose Male: 1.08 mSv Fema le: 1.20 mSv Male: 1.96 m[...]

176 Head Hints • An automatic bone corr ection allo ws for im pro ved head image quality , without any additional postpro- ces sing. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-cent er . No recon job with a field of vi e w exceeding those limits [...]

Head 177 InnerEarHR Indications : Spiral mode for inner ear high r esolution studies, e.g. inflammatory changes, tumorous pr ocesses of p yra- mids, cerebellopontine an g le tumors, posttr aumatic changes, etc. For SOMA TOM Emotion 16- slice configuration: A range of 4.0 cm will be cover ed in 24.22 sec. For SOMA TOM Emotion 6 - slice configuration[...]

178 Head Emotion 16 InnerEar 2 nd reconstr . kV 130 Effective mAs/ Quality ref. mAs 130 Rotation Time 1.0 sec. Acquisition 4 x 0.6 m m Slice collimation 0.6 mm Slice width 2.0 mm 0.75 mm Feed/Rotation 1.1 mm Pitch Factor 0.45 Increment 2.0 mm 0.6 mm K ernel H90s H90s CTDI Vol 38.35 mGy Effective dose Male: 0.74 mSv Female: 0.78 mSv Emotion 6 InnerE[...]

Head 179 Hints • For image reconstruc tion of sof t tissue, use kernel H30s/H31s. • An automatic bone correc tion allows f or impro ved head image quality , withou t an y additional postpro- cessing. • In order t o optimize image quality v ersus radiation dose, scans are provided wit hin a maximum scan field of 300 mm with r espect t o the is[...]

180 Head InnerEarHRV ol Indications: Spiral mode for high r esolution inner ear studies, e.g.malformations of the inner ear , inflammator y- changes, pathologies of the mastoid proces s, tumor- proces ses of the pyramids, posttraumatic changes,etc. Three recon jobs ar e predefined f or reconstruc tion: the first for axial bone structure, the second[...]

Head 181 Emotion 6 Inner Ear 2 nd recon. 3 d recon. kV 130 Effect ive m As/ Quality ref. mAs 130 Rotation Time 1.0 sec. Acquisition 6 x 0.5 mm Slice collimation 0.5 mm Slice widt h 2.0 mm 2.0 mm 2.0 mm Feed/Rotatio n 2.6 mm Pitch Fac tor 0.85 Incr ement 2.0 mm 2.0 mm 2.0 mm K ernel H90s H90s H90s CTDI Vol 35.88 mGy Effect ive do se Male: 0. 57 mSv [...]

182 Head Hints • For image reconstruction of soft tissue, use k ernel H30s/H31s. • An automatic bone corr ection allo ws for im pro ved head image quality , without any additional postpro- ces sing. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respect t o the isoce[...]

Head 183[...]

184 Head InnerEar Indications: Spiral mode f or inner ear studies, e.g. inflam matory changes, tumorous proces ses of pyramids, cer ebel- lopontine angle tumors, post-traumatic changes, etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 4 cm will be covered in 7.21 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 4 cm will [...]

Head 185 Emotion 16 InnerEar 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 120 Rotation Time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 0.75 mm Feed/Rotatio n 7.7 mm Pitch Fac tor 0.80 Increment 2.0 mm 0.5 mm K ernel H90s H90s CTDI Vol 31.92 m Gy Ef fective dose Male: 0.77 mSv Female: 0.83 mSv Emotion 6 [...]

186 Head Hints • For image reconstruction of soft tissue, use k ernel H30s/H31s. • An automatic bone corr ection allo ws for im pro ved head image quality , without any additional postpro- ces sing. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-c[...]

Head 187[...]

188 Head InnerEarSeq Indications: Sequence mode for inner ear studies, e.g. inflamma- tory changes, tumorous proces ses of p yramids, cere- bellopontine angle tumors, post-traumatic changes, etc. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 8.6 mm. For SOMA TOM Emo tion 6- slice configuration: A scan range is prede[...]

Head 189 Emotion 16 InnerEarSeq kV 130 Effect ive m As/ Quality ref. mAs 140 Rotation Time 1.0 sec. Acquisition 12 x 0.6 mm Slice collimation 0.6 mm Slice width 0.6 mm Feed/Scan 7.2 mm Ke r n e l H 9 0 s CTDI Vol 42.0 0 mGy Effect ive do se Male: 1.51 mSv Fem al e: 1. 62 mS v Emotion 6 InnerEarSeq kV 130 Effect ive m As/ Quality ref. mAs 140 Rotati[...]

190 Head Hints • For image reconstruction of soft tissue, use k ernel H30s/H31s. • An automatic bone corr ection allo ws for im pro ved head image quality , without any additional postpro- ces sing. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-c[...]

Head 191[...]

192 Head Sinus Indications: Spiral mode for paranasal sinuses studies, e.g. sinusi- tis, mucocele, pneumatizatio n, polyposis, tumor , cor- rec tions etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 80 mm will be cov ered in 12.42 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 80 mm will be cov ered in 17.69 sec.[...]

Head 193 Emotion 16 Sinus 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effect ive mAs/ Quality ref. mAs 35 Rot atio n time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 5.0 mm 1.0 mm 1.0 mm Feed/ Rot atio n 7.7 mm Pitch Fac tor 0.80 Incremen t 5.0 mm 5.0 mm 0.7 mm 0.7 mm K ernel H70s H30s H70s H30s CTDI Vol 9.31 mG y Ef[...]

194 Head Hint • For low dose studies use only 20 mAs. Emotion 6 S inus 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effective mAs/ Quality ref. mAs 35 Rotation time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 5. 0 mm 1.25 m m 1.25 mm Feed/ Rotation 5.1 mm Pitch Factor 0.85 Increment 5.0 mm 5. 0 mm 0.8 mm 0.8 mm K ern[...]

Head 195[...]

196 Head SinusV ol Indications: Spiral mode for axial and coronal paranasal sinuses studies, e.g. sinusitis, muco cele, polyposis, tumor , cor- rec tions etc. Three recon jobs ar e predefined f or reconstruc tion: the first for axial bone structur e and the second for the coronal soft tissue in 3D images display view and the third f or the coronal [...]

Head 197 Hint • For lo w dose studies use only 20 mAs. Emotion 6 Sinus 2 nd recon. 3 d recon. kV 130 Effect ive m As/ Quality ref. mAs 35 Rotation Time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimat ion 1.0 mm Slice width 5.0 m m 3.0 mm 3.0 mm Feed/Rotatio n 5.1 mm Pitch F act or 0.85 Increment 5.0 mm 3.0 mm 3.0 mm K ernel H70s H30s H60s CTDI Vol[...]

198 Head Orbit Indications: Spiral mode for orbital studies, e.g. fracture. For SOMA TOM Emotion 16 -slice configu ration: A range of 50 mm will be covered in 8.51 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 50 mm will be cov ered in 11.80 sec. Emotion 16 Orbit 2 nd reco nstr . kV 130 Effective mAs/ Quality ref. mAs 70 Rotation Ti[...]

Head 199 Hint • For lo w dose studies use only 20 mAs. Emotion 6 Orbit 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 70 Rotation Time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 1.25 mm Feed/Rotatio n 5.1 mm Pitch F act or 0.85 Increment 5.0 mm 0.5 mm K ernel H70s H70 s CTDI Vol 19.25 mGy Ef fective dose[...]

200 Head Dental I ndications : This is the scan pro tocol fo r the syngo Dental applica- t i o n p a c k a g e . I t i s u s e d f o r evaluation and r eformatting of the upper and lower ja ws. It enables the displa y and measurement of the bone structures of t he upper and lower ja w as the basis for planning in oral surgery. For SOMA TOM Emo tion[...]

Head 201 Emotion 16 Dental kV 130 Effect ive m As/ Quality ref. mAs 45 Rotation Time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 0.75 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Incremen t 0.5 mm K ernel H70s CTDI Vol 11 .97 mGy Effect ive do se Male: 0.25 mSv Female: 0.26 mSv[...]

202 Head For further information on the scan pr ot ocols and how to u se syngo Dental CT , please refer to the Application Guide "Clinical Applications". Emotion 6 Dental kV 130 Effective mAs/ Quality ref. mAs 45 Rotation Time 0.8 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 1.25 mm Feed/Rotation 5.1 mm Pitch Factor 0.[...]

Head 203 Hint • An automatic bone correc tion allows f or impro ved head image quality , withou t an y additional postpro- cessing. • In order t o optimize image quality v ersus radiation dose, scans are provided wit hin a maximum scan field of 300 mm with r espect t o the iso-center . No recon job with a field of vi ew ex ceeding those limits [...]

204 Over view In this chap ter y ou will find all scan pro tocols relating to th e Neck region, t heir descriptions, individual indi- cations, and import ant hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, tumors, lymphoma, and abscesses. Neck[...]

Neck 205 For SOMA TOM Emotion 16- slice configuration: – NeckRoutine Spiral mode for soft tissue routine neck studies – NeckV ol Spiral mode for axial, coro nal and sagittal neck stud- ies For SOMA TOM Emotion 6 - slice configuration: – NeckRoutine Spiral mode for soft tissue routine neck studies – NeckThinSlice Spiral mode for thin slice s[...]

206 Neck General Hints • T opog ram: Lateral, 256 m m or AP 512 mm. • Patient positioning Patient lying in supine position, hypere xtend neck slightly , secure head well in head holder . • Patient respirat or y instruction: do not breathe, do not sw allow . • For contrast studies, C ARE Bolus (optional) may be used to optimize the bolus tim[...]

Neck 207 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-grained” noise st[...]

208 Neck Scan Pr ot ocols NeckRoutine Indications : Spiral mode f or so ft tissue studies in the cervical region, e.g. tumors, lym phoma, abscesses e tc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 20 cm will be covered in 28.04 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 20 cm will be covered in 17.2[...]

Neck 209 Emotion 16 NeckRoutine 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 130 Rotation Time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 5.0 mm 0.7 mm K ernel B50s B50s CTDI Vol 16.25 mGy Ef fective dose Male: 3.61 mSv Female: 3.90 mSv Emotion [...]

210 Neck Hints • Due to its iodine content, the thyroid g land is hyper- dense in relation t o the neighboring muscles bo th befor e and af ter an IV CM injection. F or displays of the parotid or thyr oid gland or the floor of the mouth, the slice thicknes s should be < 5 mm and the length of the range should be adapt ed to matc h the anatomic[...]

Neck 211[...]

212 Neck NeckThinSlice Indications : Spiral mode using thin slices for soft tissue studies, e.g. the functional study of the throat. For SOMA TOM Emo tion 6- slice configuration: A typical range of 20 cm will be covered in 32.97 sec. Emotion 6 NeckThinSlice 2 nd reconstr . kV 130 Effective mAs/ Quality ref. mAs 130 Rotation Time 0.8 sec. Acquisitio[...]

Neck 213 Hints • Due to its iodine cont ent, the thyroid gland is hyper- dense in relation t o the neighboring muscles bo th befor e and after an IV CM injection. For displays of the paro tid or thyroid gland or the floor of the mouth, the slice thicknes s should be < 5 mm and the length of the range should be adapted to match the anatomic reg[...]

214 Neck NeckV ol Indications: Spiral mode f or so ft tissue studies in the cervical region, e.g. tumors, lym phoma, abscesses e tc. Three recon jobs ar e predefined f or reconstruc tion: the first for axial, the second f or coronal and thir d for sagg- ittal studies in 3D images display . For SOMA TOM Emotion 16 -slice configu ration: A typical ra[...]

Neck 215 Emotion 6 Neck 2 nd recon. 3 rd recon. kV 130 Effect ive m As/ Quality ref. mAs 130 Rotation Time 0.8 s ec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 5.0 mm 5.0 mm Feed/Rotatio n 5.1 mm Pitch F act or 0.85 Increment 5.0 mm 5.0 mm 5.0 mm K ernel B50s B20s B20s CTDI Vol 16. 51 mGy Effect ive d ose Ma le: 4.06 m Sv Fe[...]

216 Neck Hints • Due to its iodine content, the thyroid g land is hyper- dense in relation t o the neighboring muscles bo th befor e and af ter an IV CM injection. F or displays of the parotid or thyr oid gland or the floor of the mouth, the slice thicknes s should be < 5 mm and the length of the range should be adapt ed to matc h the anatomic[...]

Neck 217[...]

218 Over view In this chap ter y ou will find all scan pro tocols relating to th e Shoulder region, their descriptions, individual indications, and import an t hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, mas ses, trauma, dislocations, and orthope- dic indications. For SOMA TOM Emotion 16 -slice confi[...]

Shoulder 219 General Hints • T op ogram: AP , 256 m m. • Patient positioning: Patient lying in supine position, the uninjured arm placed above the head, the injur ed arm placed flat against his body . If only one side is under investiga- tion, position this side in the center and support the other side with a Bocollo pillow (optional). • If o[...]

220 Shoulder Scan Pr ot ocols Shoulder Indications : Spiral mode for bone studies and soft tissue, e.g. evaluation of joint cavities, masses, trauma, disloca- tions, orthopedic indications etc. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 15 cm will be covered in 26.44 sec. For SOMA TOM Emo tion 6- slice configuration: A scan rang[...]

Shoulder 221 Emotion 16 Shoulder 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 100 Rotation Time 1.5 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 9.6 mm Pitch F actor 1.0 Increment 5.0 mm 0.7 mm Ke r n e l B 6 0 s B 6 0 s CTDI Vol 12.50 mGy Effect ive do se Male: 3. 38 mSv Female: 3.75 mSv Em[...]

222 Shoulder Hints • Use raw data to re view a targe t region if necessary . • For image reconstruction of soft tissue use k ernel B31s and a slice width of 5. 0 mm. • Coronal and sagittal 2D planar r econstructions ar e important for evaluation of the joint space & bursa sacs in CT ar thograms. • 3D renderings are helpful f or complex [...]

Shoulder 223[...]

224 Shoulder ShoulderV ol Indications : Spiral mode for bone studies and soft tissues, e.g. eval- uation of joint cavities, masses, trauma, dislocations, orthopedic indications etc. Three recon jobs ar e predefined f or reconstruc tion: the first for soft tissue axial, the second for soft tissue coro- nal and third f or sagittal bone studies in 3D [...]

Shoulder 225 Hints • Use raw da ta to r eview a tar get region if neces sar y . • For image reconstruc tion of soft tissue use k ernel B31s and a slice width of 5.0 mm. • Coronal and sagittal 2D planar r econstructions ar e important for evaluation of the joint space & bursa sacs in CT ar thograms. • 3D renderings ar e helpful for compl[...]

226 Over view In this chap ter y ou will find all scan pro tocols relating to th e Thor ax region, their descriptions, individual indications, and import an t hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, tumors, metastases, lymphoma, lymph nodes, vascular anomalies, and interstitial changes in the lun[...]

Thorax 227 For SOMA TOM 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, cor onal soft tissue and cor onal lung studies – ThoraxHR Spiral mode for high resolution lung studies [...]

228 Thorax For SOMA TOM Emo tion 6- slice configuration: – ThoraxRoutine/ThoraxRoutine06s Spiral mode for r outine thorax studies – ThoraxCombi/ThoraxCombi06s Spiral mode for the combination of thin slice lung and routine thorax studies – ThoraxV ol Spiral mode f or axial, cor o nal soft tissue and coronal lung studies – ThoraxF ast/ThoraxF[...]

Thorax 229 General Hints • T op ogram: AP , 512 m m. • Patient positioning: Patient lying in supine po sition, arms positioned comfortably above the head in the head-arm re st, lower legs supported. • Contrast medium administration: in general, IV injections are em ployed in all mediastinal examina- tions, but not in r outine Hi gh Resolution[...]

230 Thorax • Lung images should be documented in bo th soft tis- sue window and lung window. • It is also possible to interlea ve the soft tissue & lung setting images in one film shee t. This can be set up in the configur ation for filming. • T o further optimize MPR image quality we recom- mend that you reduce one or mor e of the follow[...]

Thorax 231 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-grained” noise [...]

232 Thorax Scan Pr o tocols ThoraxRoutine/ ThoraxRoutine06s Indications: Routine spiral studies f or the region of thorax , e.g. examination of tumors, me tast ases, lymphoma, lymph nodes, vascular anomalies etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 30 cm will be covered in 12.92 sec. For SOMA TOM Emo tion 6- slice configuratio[...]

Thorax 233 Emotion 16 ThorRoutine 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 70 Rotation Time 0.6 sec. Acquisition 16 x 1 .2 mm Slice collimation 1.2 mm Slice width 5.0 mm 5.0 mm Feed/Rotation 15.40 mm Pitch F act or 0.80 Incremen t 5.0 mm 5.0 mm K ernel B41s B70s CTDI Vol 7.84 mGy Ef fec tive dose Male: 4.36 mSv Female: 5.55 mSv Emotion [...]

234 Thorax Hint • For lung cancer evaluation, this pro tocol can be com- bined with pro tocol Nec kRoutine . Contrast medium IV injection Start delay 25 – 30 sec. Flow rat e 2.5 ml/sec. T o tal amount 80 ml[...]

Thorax 235 ThoraxCombi/ ThoraxCombi06s Indications: Combining thi n slice lung and r outine thorax studies with one spiral scan. E.g. th orax studies in general and interstitial changes in the lungs. For SOMA TOM Emotion 16- slice configuration: A range of 30 cm will be co vered in 13.70 sec. For SOMA TOM Emotion 6 - slice configuration: A range of[...]

236 Thorax Emotion 16 Thor Combi 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effective mAs/ Quality ref. mAs 70 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 5.0 mm 1.0 mm 1.0 mm Feed/ Rotation 14.4 mm Pitch Factor 1.50 Increment 5.0 mm 5.0 mm 0.7 mm 0.7 mm K ernel B41s B90 s B41s B70s CTDI Vol 8.75 mGy E[...]

Thorax 237 Emotion 6 Thor Combi 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effect ive mAs/ Quality ref. mAs 70 Rot atio n time 0.8/0.6 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5. 0 mm 5.0 mm 1.25 m m 1.25 m m Feed/ Rot atio n 10.8/9.0 mm Pitch Factor 1.80/1.50 Incremen t 5.0 mm 5.0 mm 0.8 mm 0.8 mm K ernel B41s B90s B41s B70[...]

238 Thorax Hints • In addition to the mediastinum and the lungs, it may be necessary to evaluat e the axillar y fatty tissue and the bilateral mammary glands. A third r econstruc- tion can be set up with a wider FoV in t he Recon task car d. • For lung cancer evaluation, this pro tocol can be com- bined with pr ot ocol “Neck Routine”. Contr[...]

Thorax 239[...]

240 Thorax ThoraxV ol Indications: Routine spiral studies f or the region of thorax , e.g., visualization of tumors, metas tases, lymphoma, lymph nodes, vascular anomalies etc. Four recon jobs ar e predefin ed f or reconstruction: the first for soft tissue axial, the second for lung axial, t he third for soft tissue coronal and f ourth for soft tis[...]

Thorax 241 Emotion 16 Thor Combi 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effect ive mAs/ Quality ref. mAs 70 Rot atio n time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 5.0 mm 5.0 mm 5.0 mm Feed/ Rot atio n 14.4 mm Pitch Fac tor 1.50 Incremen t 5 .0 mm 5.0 mm 5.0 mm 5.0 mm K ernel B41s B70s B41s B70s CTDI Vol 8.7[...]

242 Thorax For th e 3 rd and 4 th reconstruction a non-squar e matrix 3D recon job is predefined. Emotion 6 Thor Combi 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effective mAs/ Quality ref. mAs 70 Rotation time 0.8 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 5. 0 mm 5.0 mm 5.0 mm Feed/ Rotation 10.8 mm Pitch Factor 1.80 [...]

Thorax 243 Hint • In addition to the mediastinum and the lungs, it may be necessary to evaluat e the axillar y fatty tissue and the bilateral mammary glands. A third r econstruc- tion can be set up with a wider FoV in the Recon task card. • For lung cancer ev aluation, this pro tocol can be com- bined with pro tocol NeckRoutine . Contrast mediu[...]

244 Thorax ThoraxF ast/ ThoraxF ast06s Indications: F ast spiral mode for lung s tudies, e.g. when a patient has diff iculty with breat hhold. For SOMA TOM Emo tion 6- slice configuration: A complet e thorax scan in a range of 30 cm will be cov- ered in 7.87 sec. with ThoraxF ast.[...]

Thorax 245 Hints • For lung cancer ev aluation, this pro tocol can be com- bined with pro tocol “Neck Routine”. Emotion 6 ThorFast 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 70 Rotation Time 0.8/0.6 sec. Acquisition 6 x 3.0 mm Slice collimation 3.0 mm Slice width 6.0 mm 6.0 mm Feed/Rotatio n 27.0 mm Pitch F act or 1.50 Increme nt 6.[...]

246 Thorax ThoraxHR Indications : Spiral mode fo r high resolution studies, e.g. int erstitial changes in the lungs. For SOMA TOM Emotion 16 -slice configu ration: A range of 30 cm for the comple te thorax will be cov- ered in 13 .70 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 30 cm for the comple te thorax will be cov- ered in 28[...]

Thorax 247 Emotion 16 ThorHR 2 nd recon. 3 rd recon. 4 th recon. kV 130 Effect ive mAs/ Quality ref. mAs 100 Rot atio n time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 5.0 mm 1.0 mm 1.0 mm Feed/ Rot atio n 14.4 mm Pitch Fac tor 1.50 Incremen t 5 .0 mm 5.0 mm 0.7 mm 0.7 mm K ernel B90s B41s B70s B41 s CTDI Vol 12.50[...]

248 Thorax Hints • With studies of interstitial changes in the lungs, con- trast medium is not necessary . • This examination is normally per formed f ollowing a standard thorax st udy or used for regular follow up studies for high risk patient groups with a history of exposure t o carcinogenic agents e.g. asbest os. Emotion 6 ThorHR 2 nd recon[...]

Thorax 249[...]

250 Thorax ThoraxHRSeq Indications : Sequence mode for high-r es olution lung studies, f or example, int erstitial changes in the lungs using a f eed of 10 mm. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 30.1 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 30.0 cm. Emotion 16 Thor[...]

Thorax 251 Hints • If you want to reconstruct thin slices every 10 or 20 mm instead of 15 mm as predefined, simply change the Feed/Scan bef ore loading the mode. • With studies of interstitial ch anges in the lungs, con- trast medium is not necessary. Emotion 6 ThorHRSeq kV 130 Effect ive m As/ Quality ref. mAs 100 Rotation time 1.0 sec. Acquis[...]

252 Thorax ThoraxECGHRSeq Indications : Sequence mode for High Resolution, ECG trigger ed lung studies, e.g. interstitial chang es in the lungs. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 19.1 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 12.0 cm. Emotion 16 ThoraxECGHR kV 130 [...]

Thorax 253 Hints • With studies of interstitial ch anges in the lungs, con- trast 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 bef ore loading the mode. Emotion 6 ThoraxECGHR kV 130 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.8 sec. Acqui[...]

254 Thorax LungLowDose/ LungLowDose06s Indications: Spiral lung studies wit h lo w dose se tting, e.g. early visualization of pulmonar y nodules. For SOMA TOM Emotion 16 -slice configu ration: A typical thorax study in a range of 30 cm will be cov- ered in 19.95 sec. For SOMA TOM Emo tion 6- slice configuration: A typical thorax study in a range of[...]

Thorax 255 Emotion 16 Lung Low Dose 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effect ive mAs/ Quality ref. mAs 16 Rot atio n time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5. 0 mm 5.0 mm 1.0 mm 1.0 mm Feed/ Rot atio n 9.6 mm Pitch Factor 1.00 Incremen t 5.0 mm 5.0 mm 0.7 mm 0.7 mm K ernel B41s B90s B41s B70s CTDI Vol 1.[...]

256 Thorax Emotion 6 LungLowDose 2 nd recon. kV 110 Effective mAs/ Quality ref. mAs 16 Rotation Time 0.8/0.6 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm 5.0 mm Feed/Rotation 12.0/10.2 mm Pitch Factor 1. 00/0.85 Increment 5.0 mm 5.0 mm K ernel B70s B30s CTDI Vol 1.14 mGy Effective dose Male: 0.57 mSv Female: 0.62/0.74 mSv[...]

Thorax 257 Hints • For lung cancer ev aluation, this pro tocol can be com- bined with pro tocol “Neck Routine”. • Low dose lung images are usually eval uated using lung window setting. Soft tissue/bone window set- tings may be used to de tec t the presence of calcifica- tions in the nodules. • It is essential to use the same pr ot ocol fo[...]

258 Thorax LungC ARE/ LungC ARE06s Indications : Spiral lung study with low do se setting f or early visual- ization of pathologies, used f or the application Lung- CAR E . For SOMA TOM Emotion 16 -slice configu ration: A typical thorax study in a range of 30 cm will be cov- ered in 13.70 sec. For SOMA TOM Emo tion 6- slice configuration: A typical[...]

Thorax 259 Emotion 16 Lung CA RE 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effect ive mAs/ Quality ref. mAs 15 Rot atio n time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 5.0 mm 1.0 mm 1.0 mm Feed/ Rot atio n 14.4 mm Pitch F act or 1.50 Incremen t 5 .0 mm 5.0 mm 0.7 mm 0.7 mm K ernel B41s B90s B4 1s B70s CTDI Vol 1[...]

260 Thorax Emotion 6 Lung CA RE 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effective mAs/ Quality ref. mAs 15 Rotation time 0.8/0.6 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 5. 0 mm 1.25 m m 1.25 m m Feed/ Rotation 10.8 mm Pitch Factor 1.80 Increment 5.0 mm 5. 0 mm 0.8 mm 0.8 mm K ernel B41s B90s B41s B70 s CTDI Vol 1.[...]

Thorax 261 Hints • For lung cancer ev aluation, this pro tocol can be com- bined with pro tocol Neck Routine or y ou can use the pro tocol Nec kThorax. • Low dose lung images are usually eval uated using lung window setting. Soft tissue/bone window set- tings may be used t o visualize the pr esence of calci- fications in the nodules. • It is [...]

262 Over view In this chap ter y ou will find all scan pro tocols relating to th e Abdomen region, their descrip tions, individual indications, and import an t hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, liv er , pancr eas, and kidney abnormalities For SOMA TOM Emotion 16 -slice configu ration: – A[...]

Abdomen 263 – AbdMultiPhase Spiral mode for three phases liver studies – AbdSeq Sequential mode for abdominal studies – Colonography Spiral mode used for the application syngo Colonography For SOMA TOM Emotion 6 - slice configuration: – AbdomenRoutine/AbdomenRoutine06s Spiral mode for routine abdominal studies – AbdomenCombi/AbdomenCombi0[...]

264 Abdomen General Hints • T opog ram: AP , 512. • Patient positioning: Patient lying in supine position, arms positioned comf or tably abov e the head in the head-arm rest, lower legs supported. • Patient respirat or y i nstruction: inspiration. • Oral administration of contrast medium: For abdominal studies, it is necessar y to delineate[...]

Abdomen 265 – In general, f or abdominal st udies such as liver , gall bladder (quer y stones), pancreas, gastr ointestinal studies, focal lesion of the kidneys and CT A studies, it is sufficient to use just wat er . W at er is more effec- tive than positiv e oral cont rast agent in depicting the linings of the stomac h & intestines in post e[...]

266 Abdomen Scan Pr o tocols AbdomenRoutine/ AbdomenRoutine06s Indications: Spiral mode f or r outine studi es in the r egion of abdo- men, e.g. ev aluation, f ollow-up ex aminations e tc. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 20 cm will be covered in 9.01 sec. For SOMA TOM Emo tion 6- slice configuration: A scan range of 2[...]

Abdomen 267 Emotion 16 AbdRoutine kV 130 Effect ive m As/ Quality ref. mAs 120 Rotation time 0. 6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 5.0 mm Feed/Rotatio n 1 5.4 mm Pitch F act or 0.80 Increment 5.0 mm Ke r n e l B 4 1 s CTDI Vol 13.44 mGy Effect ive d ose Male: 5 .81 mSv Female : 7.1 5 mSv Emotion 6 AbdRoutine kV 130 [...]

268 Abdomen Hints • Y ou could r epeat the same pro tocol simply by click- ing the chronicle with the right mouse button for “ repeat “. E.g. when both non-contrast and contrast studies are re quired. • Delay ed scans may be r equir ed for the kidneys & bladder . • If you want to use th is pro tocol f or a two-phase study , repeat the[...]

Abdomen 269[...]

270 Abdomen AbdomenCombi/ AbdomenCombi06s Indications: Combination of thin slice and routine abdominal stud- ies with one spiral scan. For SOMA TOM Emo tion 16-slice configur ation: A range of 20 cm for liver , pancreas or kidneys will be cover ed in 9.53 sec. For SOMA TOM Emo tion 6-slice configuration: A range of 20 cm for liver , pancreas or kid[...]

Abdomen 271 Emotion 16 AbdCombi 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 130 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 m m Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 5.0 mm 0.7 mm K ernel B41s B41s CTDI Vol 16.25 mGy Ef fec tive dose Male: 6.66 mSv Female: 8.09 mSv Emoti[...]

272 Abdomen Hints • Y ou could r epeat the same pro tocol simply by click- ing the chronicle with the right mouse button for “ repeat “. E.g. when both non-contrast and contrast studies are re quired. • Delay ed scans may be r equir ed for the kidneys & bladder . • If you want to use th is pro tocol f or a two-phase study , repeat the[...]

Abdomen 273[...]

274 Abdomen AbdomenV ol Indications: Spiral mode f or al l routine studies in t he re gion of abdomen, e.g. follow-up examinations etc. T wo recon jobs are pr edefined for r econstruction: the first for axial, the second for cor onal studies in 3D images dis- play vie w . For SOMA TOM Emotion 16 -slice configu ration: The whole scan range of 20 cm [...]

Abdomen 275 Emotion 6 AbdCombi 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 130 Rotation Time 0.8 Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 5.0 mm Feed/Rotatio n 9.0 mm Pitch F act or 1.50 Increment 5.0 mm 5.0 mm K ernel B41s B30s CTDI Vol 16.51 m Gy Ef fec tive dose Male: 6.32 m Sv Female: 7.85 mSv Contrast medium [...]

276 Abdomen Hints • Y ou could r epeat the same pro tocol simply by click- ing the chronicle with the right mouse button for “ repeat “. E.g. when both non-contrast and contrast studies are re quired. • Delay ed scans may be r equir ed for the kidneys & bladder . • If you want to use th is pro tocol f or a two-phase study , repeat the[...]

Abdomen 277[...]

278 Abdomen AbdomenF ast/ AbdomenF ast06s Indications: F ast spiral mode f or abdominal studies, e.g. when a patient has difficulty with breathhold. For the SOMA TOM Emotion 6-slice configuration: A range of 20 cm will be covered in 5.64 sec. with AbdomenF ast06s. Emotion 6 AbdF ast kV 130 Effective mAs/ Quality ref. mAs 120 Rotation time 0.8/0.6 s[...]

Abdomen 279 Hints • Y ou could repeat the same prot ocol simply by click- ing the chronicle with the right mouse butt on for “ repeat “. E.g. when both non-contrast and contrast studies are r equir ed. • Delay ed scans may be required f or the kidneys & bladder . • If you want to use this pro tocol f or a two-phase study , r epeat the[...]

280 Abdomen AbdMultiPhase/ AbdMultiPhase06s Indications: Combination of three phase study including liver , pan- creas and kidne y . For SOMA TOM Emotion 16 -slice configu ration: A range of 20 cm including liver , pancreas and kidney: arterial phase acquired in 5.37 sec. Emotion 16 Non Contrast kV 110 Effective mAs/ Quality ref. mAs 75 Rotation Ti[...]

Abdomen 281 A range of 20 cm including liver , pancreas and kidney: ar terial phase acq uired in 16.83 sec. Emotion 16 Arterial Phase 2 nd recon. kV 110 Effect ive m As/ Quality ref. mAs 120 Rotation Time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 5.0 mm 0.[...]

282 Abdomen A range of 20 cm including liv er , pancr eas and kidney: arterial phase acquired in 9.01 sec. Emotion 16 V enous Phase kV 130 Effective mAs/ Quality ref. mAs 120 Rotation Time 0.6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 5.0 mm Feed/Rotation 15.4 mm Pitch Factor 0.80 Increment 5.0 mm K ernel B41s CTDI Vol 13.44[...]

Abdomen 283 For SOMA TOM Emotion 6 - slice configuration: A range of 20 cm including liver , pancreas and kidney: ar terial phase acq uired in 7.87 sec. Emotion 6 Non Contrast kV 110 Effect ive m As/ Quality ref. mAs 75 Rotati on Time 0.8/0.6 s ec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm Feed/Rotatio n 18.0 mm Pitch F act[...]

284 Abdomen A range of 20 cm including liver , pancreas and kidney: arterial phase acquired in 12.96 sec. Emotion 6 Arterial Phase 2 nd recon. kV 110 Effective mAs/ Quality ref. mAs 120 Rotation Time 0.8/0.6 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm 2.5 mm Feed/Rotation 10.2 mm Pitch Factor 0.85 Increment 5.0 mm 1.7 mm[...]

Abdomen 285 A range of 20 cm including liver , pancreas and kidney: ar teria l phase acquired in 12.96 sec. * C ARE Bolus may be used to optimize the bolus tim- ing. Set the ROI for monitoring scan in the abdominal aorta at the beginning of the scan range with trig- gering threshold of 120 HU , or use manual trigger- ing. Emotion 6 V enous Phase kV[...]

286 Abdomen Hints • Y ou could r epeat the same pro tocol simply by click- ing the chronicle with the right mouse button for “ repeat “. E.g. when both non-contrast and contrast studies are re quired. • Do not administer oral co ntrast medium, as this impairs the editing of MIP/SSD/VRT images. Use water instead if necessar y . • Wat er , [...]

Abdomen 287[...]

288 Abdomen AbdomenSeq Indications: This pro tocol is creat ed for measur ement with sequen- tial mode in the region of the abdomen. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 19.5 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 30.8 cm. Emotion 16 AbdSeq kV 130 Effective mAs/ Qu[...]

Abdomen 289 Hints • Y ou could repeat the same prot ocol simply by click- ing the chronicle with the right mouse butt on for “repeat“. E.g. when bo th non-contrast and contrast studies are r equir ed. • Wat er , rather than positi ve oral contrast agents should be used. Give the last cup 200 ml just prior to positioning the patient. T o ens[...]

290 Abdomen Colonography/ Colonography06s Spiral mode used for the application syngo Colonog ra- phy . For SOMA TOM Emotion 16 -slice configu ration: A complet e colon in a range of 40 cm will be cover ed in 17.87 sec. For SOMA TOM Emo tion 6- slice configuration: A complet e colon in a range of 40 cm will be cover ed in 27.87 sec.[...]

Abdomen 291 Emotion 16 Colo_supine Colo_prone kV 130 130 Effect ive m As/ Quality ref. mAs 50 30 Rotati on Time 0.6 se c. 0.6 sec. Acquisition 16 x 0 .6 mm 16 x 0.6 mm Slice collimation 0.6 mm 0 .6 mm Slice width 1.0 mm 1.0 mm Feed/Rotation 14.4 mm 14.4 mm Pitch F actor 1.50 1.50 Incremen t 0.7 mm 0.7 mm K ernel B41s B20s CTDI Vol 6 .25 mGy 3.75 mG[...]

292 Abdomen C ARE Dose 4D is of f as defa ult because for CT Colonog- raphy pro tocols the lo west mAs values are used. For further information on the scan pr ot ocols and how to u se syngo Colonograph y , please r efer t o the Appli- cation Guide "Clinical Applications". Emotion 6 Colo_supine Colo_prone kV 130 130 Effective mAs/ Quality [...]

Abdomen 293[...]

294 Over view In this chap ter y ou will find all scan pro tocols relating to th e Spine region, their descripti ons, individual indi- cations, and import ant hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, pr olapse, degenerative c hanges, trauma, and tumors. For SOMA TOM Emotion 16 -slice configu ratio[...]

Spine 295 – SpineVol Spiral mode for axial and sagittal lumbar and tho- racic spine studies – SpineSeq Sequential mode f or lumbar and thoracic evaluation of the discs – Osteo Sequential mode used for the application syngo Osteo CT For SOMA TOM Emotion 6 - slice configuration: – C-Spine Spiral mode for cervical spine studies – C-SpineVol [...]

296 Spine General Hints • T opog ram: 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 comf or tably abov e the head in the head-arm rest, lower legs supported. • Patient positioning for cervical spine studie[...]

Spine 297 • T o fur ther optimize MPR image quality we recom- mend that you reduce one or more of the following: collimation, reconstruction incr ement, and slice width for image r econstruction. • With C AREDose 4D t he mA values are adap ted f or each osteo range, accor ding to the patient diame ter . Theref ore special o bese pro tocols f or[...]

298 Spine Scan Pr o tocols C-Spine Indications : Spiral mode for cervical spi ne studies, e.g. prolapse, degenerative changes, trauma , tumors etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 15 cm will be cover ed in 21.53 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 15 cm will be covered in 31.41 sec.[...]

Spine 299 Emotion 16 C-Spine 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 150 Rotation Time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 1.0 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 2.0 mm 0.7 mm K ernel B3 1s B60s CTDI Vol 18 .75 mGy Effect ive do se Male: 3.49 mSv Female: 3.71 mSv Emotion 6 C-[...]

300 Spine C-SpineV ol Indications: Spiral mode for cervical spi ne studies, e.g. prolapse, degenerative changes, trauma , tumors etc. Three recon jobs ar e predefined f or reconstruc tion: the first for soft tissue axial, the second f or soft tissue sag- ittal and third fo r sagittal bone studies in 3D images display vie w . For SOMA TOM Emotion 16[...]

Spine 301 Emotion 6 C-Spine 2 nd recon. 3 rd recon. kV 130 Effect ive m As/ Quality ref. mAs 150 Rotation Time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 2.0 mm 2.0 mm 2.0 mm Feed/Rotatio n 5.1 mm Pitch F act or 0.85 Increment 2.0 mm 2.0 mm 2.0 mm K ernel B31s B20s B60s CTDI Vol 19. 05 mGy Effect ive d ose Ma le: 4.27 m Sv[...]

302 Spine SpineRoutine Indications : Spiral mode for thoracic and lumbar spine studies, e.g. prolapse, degenerativ e changes, trauma, tumors e tc. For SOMA TOM Emotion 16 -slice configu ration: A range of 15 cm will be cover ed in 26.04 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 15 cm will be covered in 27.00 sec. Emotion 16 Spin[...]

Spine 303 Emotion 6 Spine Routine 2 nd recon. 3 rd recon. kV 130 Effect ive m As/ Quality ref. mAs 190 Rotation Time 1.0 s ec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 3.0 mm 2.5 mm 2.5 mm Feed/Rotatio n 6.0 mm Pitch F act or 0.50 Increment 3.0 mm 1.5 mm 1.5 mm K ernel B31s B31s B60s CTDI Vol 20.70 mGy Effect ive d ose Ma le: 4.9[...]

304 Spine SpineThinSlice Indications : Spiral mode for thin slice thoracic and lumbar spine studies, e.g. prolapse, degenerative changes, trauma, tumors e tc. For SOMA TOM Emo tion 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 Spine ThinSlice 2 nd recon. 3 rd reco n. kV 130 Effective mAs/ Quality re[...]

Spine 305 SpineV ol Indications : Spiral mode for thoracic and lumbar spine studies, e.g. prolapse, degenerative c hanges, trauma, tumors etc. Three r econ jobs are predefined f or re construction: the first for soft tissue axial, the second f or soft tissue sag- ittal and third for coronal bone studies in 3D images display view . For SOMA TOM Emot[...]

306 Spine Emotion 6 Spine 2 nd recon. 3 rd reco n. kV 130 Effective mAs/ Quality ref. mAs 190 Rotation Time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 3.0 mm 2.0 mm 2.0 mm Feed/Rotation 3.3 mm Pitch Factor 0.55 Increment 3.0 mm 2.0 mm 2.0 mm K ernel B31s B20s B20s CTDI Vol 24.13 mGy Effective dose Male: 3.64 mSv Femal e: 7[...]

Spine 307[...]

308 Spine SpineSeq Indications : Sequence mode for spine studies, e.g. pr olapse, degenerative changes, trauma , tumors etc. This pro tocol contains thr ee ranges: L3-L4, L4-L5, L5- S1. Three different typical gantr y tilts are pr edefined: for L3-L4: 0°, for L4-L5: +5° and for L5-S1: +15° For SOMA TOM Emotion 16 -slice configu ration: A scan ra[...]

Spine 309 Emotion 16 L3-4 L4-5 L5-S1 kV 130 130 130 Effect ive m As/ Quality ref. mAs 280 280 320 Rotation time 1.5 sec. 1.5 sec. 1.5 sec. Acquisition 1 2 x 0.6 mm 12 x 0.6 mm 12 x 0.6 mm Slice collimation 0.6 mm 0.6 mm 0.6 mm Slice width 2.4 mm 2 .4 mm 2.4 mm Feed/Scan 7.2 mm 7.2 mm 7.5 mm K ernel B31s B31s B31s CTDI Vol 38.64 mGy 38.49 mGy 42.66 [...]

310 Spine Hint • Y ou could r epeat the same pr otocol b y simply click- ing the chronicle with the right mouse button for repeat . Emotion 6 L3-4 L4-5 L5-S1 kV 130 13 0 130 Effective mAs/ Quality ref. mAs 280 280 320 Rotation time 1.5 sec. 1.5 sec. 1.5 sec. Acquisition 6 x 1.0 mm 6 x 1.0 mm 6 x 1.0 mm Slice collimation 1.0 mm 1.0 mm 1.0 mm Slice[...]

Spine 311[...]

312 Spine Osteo This is the scan pro tocol fo r the syngo Osteo CT appli- cation package t o assist the physician wit h the quanti- tative as sessment of v er t ebral bone mineral density (BMD) in the diagnosis and f ollow-up of osteopenia and osteoporosis. Emotion 16 Osteo kV 80 Effective mAs/ Quality ref. mAs 220 Rotation time 1.0 sec. Acquisitio[...]

Spine 313 • With CAREDose 4D t he mA values ar e adap ted f or each osteo range, accor ding to the patient diame ter . Theref ore special o bese pro tocols f or the ost eo ev al- uation are no t longer necessary . Load all ranges in the application syng o Osteo CT . For further information, plea se ref er to the Application Guide “Clinical Appl[...]

314 Over view In this chap ter y ou will find all scan pro tocols relating to t he Pelvis region, their descriptions, individual indi- cations, and import ant hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, abnormalities of the pr ostate, urinary blad- der , r ectum, joint cavity , masses, and trauma. Fo[...]

Pelvis 315 For SOMA TOM Emotion 6 - slice configuration: – Pelvis Spiral mode for routine soft tissue pelvis studies – Pelvis Vol Spiral mode for axial and coronal pelvis studies – Hip Spiral mode for routine hip studies – HipV ol Spiral mode for axial and cor onal hip studies – SI_Joints Spiral mode for sacral iliac joints studies[...]

316 Pelvi s General Hints • T opog ram: AP , 512 mm fo r pelvis studies and 256 mm for studies of the hip and SI Joints. • Patient positioning: Patient lying in supine position, arms positioned comf or tably abov e the head in the head-arm rest, lower legs supported. • A breathing command is not neces sarily requir ed for the pelvic examinati[...]

Pelvis 317 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-grained” noise [...]

318 Pelvi s Scan Pr o tocols Pelvis Indications: Spiral mode for routine pelvis studies, e.g. pr ocesses of the prostate, urinary bladder , rectum, gynecological indications etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 20 cm will be covered in 8.94 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 20 cm[...]

Pelvis 319 Emotion 16 Pelvis kV 130 Effect ive m As/ Quality ref. mAs 120 Rotation Time 1.0 sec. Acquisition 16 x 1.2 mm Slice collimation 1. 2 mm Slice width 5.0 mm Feed/Rotatio n 28.8 mm Pitch F act or 1.50 Increment 5.0 mm Ke r n e l B 4 1 s CTDI Vol 13.44 mGy Effect ive d ose Male: 5. 32 mSv Female: 9.14 mSv Emotion 6 Pelvis kV 130 Effect ive m[...]

320 Pelvi s * If the ex amination per formed req uires a full urinar y bladder , wait at least 3 minutes following IV adminis- tration of the contr ast medium. Contrast medium IV injection Start delay 50 sec.* Flow rate 2.0 – 3.0 ml/sec. T otal amount 100 – 120 ml[...]

Pelvis 321[...]

322 Pelvi s PelvisV ol Indications: Spiral mode f or pelv is stud ies, e.g. pr ocesses of the prostate, urinary bladder , rec tum, gynecological indi- cations etc. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second for cor onal studies in 3D images display vie w . For SOMA TOM Emotion 16 -slice configu ration: A ty[...]

Pelvis 323 * If the ex amination performed requires a full urinary bladder , w ait at least 3 minutes follo wing IV adminis- tration of the contrast medium. Emotion 6 Pelvis 2 nd reco nstr. kV 130 Effect ive m As/ Quality ref. mAs 120 Rotation Time 1.0 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm 5.0 mm Feed/Rotatio n 18.[...]

324 Pelvi s Hip Indications : Spiral mode fo r bone studies and sof t tissue studies of the Hip. E.g. evaluation of joint cavity , mas ses, trauma, dysplasia, necrosis of the head of the hip, cong ruence evaluations, orthopedic indications etc. For SOMA TOM Emo tion 16-slice configuration: A typical range of 10 cm will be covered in 8.94 sec. For S[...]

Pelvis 325 Emotion 16 Hip 2 nd recons tr . kV 130 Effect ive m As/ Quality ref. mAs 100 Rotation Time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 5.0 mm 0.7 mm K ernel B70s B70s CTDI Vol 12.50 mGy Ef fec tive Dose Male: 2.31 mSv Female: 5.93 mSv Emotion 6 H[...]

326 Pelvi s Hints • In case of 3D study only , images should be recon- structed with at least 50% overlapping and k ernel B10. • If only one side is examined, it is advisable to enter the side in the comment line on the Routine card.[...]

Pelvis 327[...]

328 Pelvi s HipV ol Indications: Spiral mode fo r bone studies and sof t tissue studies of the Hip, e.g. eval uation of joint ca vity , mas ses, trauma, dysplasia, necrosis of the head of the hip, cong ruence evaluations, orthopedic indications etc. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second for cor onal st[...]

Pelvis 329 Hint • In case of 3D study on ly , images should be r econ- structed with at least 50% overlapping and k ernel B10. • If only one side is examined, it is advisable to enter the side in the comment line on the r outine card. Emotion 6 Hip 2 nd reconstr. kV 130 Effect ive m As/ Quality ref. mAs 100 Rotation time 1.0 sec. Acquisition 6 [...]

330 Pelvi s SI_Joints Indications : Spiral mode for bone studies of the sacral ilia c joints, e.g. evaluation of joint ca vity , mas ses, trauma, dyspla- sia, necrosis, congruence e valuations, or thopedic indi- cations etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 8 cm will be covered in 7.56 sec. For SOMA TOM Emo tion 6- [...]

Pelvis 331 Emotion 16 SI_Joints 2 nd recons tr . kV 130 Effect ive m As/ Quality ref. mAs 120 Rotation time 1.0 s ec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 3.0 mm 0.7 mm K ernel B70s B70s CTDI Vol 15. 00 mGy Effect ive d ose Ma le: 2.21 mSv Female: 5.44 mSv Em[...]

332 Over view In this chap ter you will find the scan prot ocol relating to th e Upper Extremities region, its descrip tion, indi- vidual indications, and im por tant hints on using it. Y o u can use the f ollowing scan pro tocol t o clarify , f or example, trauma, mas ses, disorders of the joint, and orthopedic indications. Upper Extremities[...]

Upper Extremities 333 For SOMA TOM Emotion 16- slice configuration: – W ristHR 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 rou ti ne st ud ie s For SOMA TOM Emotion 6 - slice configuration: – W ri[...]

334 Upper Extremities General Hints • T opog ram: AP , 256 mm for joint st udies. • Patient positioning: Depends on the region of examination. In general, for bilate ral studies, you should always tr y to position the patient evenly whenever the patient can comply . For wrists and elbow scans: Patient lying in prone position , hands stre tched [...]

Upper Extremities 335 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-graine[...]

336 Upper Extremities Scan Pr ot ocols W ristHR Indications : Spiral mode for resolution bone study of thewrist, f or example, trauma, orthopedic indications etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 6 cm will be done in 35.33 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 6 cm will be done in 25.53 sec.[...]

Upper Extremities 337 Emotion 16 W ristHR 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 40 Rotation time 1.0 sec. Acquisition 4 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 0.6 mm Feed/Rotatio n 1.8 mm Pitch F act or 0.75 Increment 2.0 mm 0.4 mm K ernel U90s U90s CTDI Vol 5.52 mGy Effect ive do se Male: < 0 mSv Fema le: < 0[...]

338 Upper Extremities Hints • For image reconstruction of soft tissue, use k ernel B30s/B31s.[...]

Upper Extremities 339[...]

340 Upper Extremities ExtrRoutineHR Indications : Spiral mode for high-r esolution bone study , f or exam- ple, trauma, orthoped ic indications etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 10 cm will be done in 57.56 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 10 cm will be done in 41.22 sec.[...]

Upper Extremities 341 Emotion 16 ExtrHR 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 60 Rotation time 1.0 sec. Acquisition 4 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 0.6 mm Feed/Rotatio n 1.8 mm Pitch F act or 0.75 Increment 2.0 mm 0.4 mm K ernel U90s U90s CTDI Vol 8. 28 mGy Ef fective dose Male: 0.02 mSv Female: 0.02 mSv Em[...]

342 Upper Extremities Hint • For image reconstruction of soft tissue, use k ernel B30s/B31s.[...]

Upper Extremities 343[...]

344 Upper Extremities ExtrCombi Indications : Spiral mode f or the combinat ion of bone and soft tis- sue studies, e.g. masses, tr auma, disorders of t he joint etc. For SOMA TOM Emo tion 16-slice configuration: A range of 15 cm will be done in 12.42 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 10 cm will be done in 13.11 sec. Emot[...]

Upper Extremities 345 Hint • For image reconstruc tion of sof t tissue, use kernel B30s/B31s. Emotion 6 ExtrCombi 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 50 Rotation time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 4.0 mm 1.25 mm Feed/Rotatio n 9.0 mm Pitch F act or 1.50 Increment 4.0 mm 0.8 mm K ernel B4[...]

346 Over view In this chap ter you will find the scan prot ocol relating to th e Lower Extremities region, its description, indi- vidual indications, and im por tant hints on using it. Y o u can use the f ollowing scan pro tocol t o clarify , f or example, masses, disor ders of the joint, and orthope- dic indications. For SOMA TOM Emotion 16 -slice[...]

Low er Extremities 347 For SOMA TOM 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 rou ti ne st ud ie s[...]

348 Low er Extremities General Hints • T opog ram: AP , 256 mm for joint st udies. • Patient positioning: Depends on the region of examination. In general, for bilat eral studies, you should alwa ys tr y to posi- tion the patient e venly whene ver the patient can comp ly . • For knee scan: Patient lying in supine position, feet fi r st , p ro[...]

Low er Extremities 349 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-grain[...]

350 Low er Extremities Scan Pr o tocols Knee Indications : Spiral mode for knee bone study , e.g. trauma, or thope- dic indications etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 15 cm will be done in 21.53 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 15 cm will be done in 31.41 sec.[...]

Low er Extremities 351 Hints • For image reconstruc tion of sof t tissue, use kernel B30s/B31s. Emotion 16 Knee 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 80 Rotation time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 3.0 mm 0.7 mm K ernel U90s[...]

352 Low er Extremities Foot Indications : Spiral mode for f oot bone study , e.g. trauma, orthope- dic indications etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 15 cm will be done in 21.53 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 15 cm will be done in 31.41 sec.[...]

Low er Extremities 353 Hints • For image reconstruc tion of sof t tissue, use kernel B30s/B31s. Emotion 16 Foot 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 60 Rotation time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0. 6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 3.0 mm 0.7 mm K ernel U9 [...]

354 Low er Extremities ExtrRoutineHR Indications : Spiral mode for high r esolution bone study , e.g. trauma, or thopedic indications e tc. For SOMA TOM Emotion 16 -slice configu ration: A range of 10 cm will be done in 57.56 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 10 cm will be done in 41.22 sec.[...]

Low er Extremities 355 Emotion 16 ExtrHR 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs* 60 Rotation time 1.0 s ec. Acquisition 4 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 0.6 mm Feed/Rotatio n 1 .8 mm Pitch F act or 0.75 Increment 2.0 mm 0.4 mm K ernel U90s U90s CTDI Vol 8.28 mGy Ef fec tive dose Male: 0.01 mSv Female: 0.01 mS[...]

356 Low er Extremities * Adjust the mAs value to the body region. Hint • For image reconstruction of soft tissue, use k ernel B30s/B31s. Emotion 6 ExtrHR 2 nd recons tr . kV 130 Effective mAs/ Quality ref. mAs* 60 Rotation time 1.0 sec. Acquisition 6 x 0.5 mm Slice collimation 0.5 mm Slice width 2.0 mm 1.0 mm Feed/Rotation 2.6 mm Pitch Factor 0.8[...]

Low er Extremities 357[...]

358 Low er Extremities ExtrCombi Indications: Spiral mode f or the combinat ion of bone and soft tis- sue studies, e.g. masses, tr auma, disorders of t he joint etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 15 cm will be done in 12.42 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 10 cm will be done in 13.11 sec. Emo[...]

Low er Extremities 359 * Adjust the mAs value to the body r egion. Hint • For image reconstruc tion of sof t tissue, use kernel B30s/B31s. Emotion 6 ExtrCombi 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs* 50 Rotation time 1.0 s ec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 4.0 mm 1.25 mm Feed/Rotatio n 9 .0 mm Pitch [...]

360 Over view In this chap ter y ou will find all scan pro tocols relating to th e Va s c ul a r region, their descriptions, individual indications, and import an t hints on using them. Y o u can use the following scan pro tocols t o clarify , f or example, vascular abnormalities, st enosis or occlu- sions, coarse plaques an omalies, aneur ysm, and[...]

Va s c u l a r 361 For SOMA TOM Emotion 16- slice configuration: – HeadAngio Spiral mode for routine head CT Angio studies – HeadAngioV ol Spiral mode f or axial and coronal HeadCT Angio s tud- ies – CarotidAngio Spiral mode for car otid CT Angio studies – CarotidAngioV ol Spiral mode for axial a nd coronal car otid CT Angio studies – Tho[...]

362 Va s c u l a r For SOMA TOM Emo tion 6- slice configuration: – HeadAngio/HeadA ngio06s Spiral mode for r outine head CT Angio studies – HeadAngioVol Spiral mode fo r axial and coro nal HeadCT Angio stud- ies – CarotidAngio/CarotidAngio06s Spiral mode for car otid CT Angio studies – CarotidAngioV ol Spiral mode for axial and coro nal car[...]

Va s c u l a r 363 General Hints • T op ogram: AP , 51 2/1024, L A T 256 • Patient positioning: Patient lying in supine po sition, arms positioned comfortably above the head in the head-arm re st, lower legs supported. • Patient respirat or y i nstructions: inspiration. • Oral administration of contrast medium: The use of water will no t ob[...]

364 Va s c u l a r Head K ernels • For soft tissue head studies, the standar d 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, how ever , is more agr eeable due to a ”f ine-grained” noise struc-[...]

Va s c u l a r 365 Body K ernels • As standard k ernels f or body tissue studies B30s or B40s are r ecommended; softer images are obtained with B20s or B10s (extremely soft ). The k ernels B31s or B41s have about the same visual sharpnes s as B30s, respec tively , B40s, the image appearance, howe ver , is more agreeable due to a ”fine-grained?[...]

366 Va s c u l a r Scan Pr ot ocols HeadAngio/ HeadAngio06s Indications : Spiral mode for cerebral CT Angi o studies, e.g. cer ebral vascular abnormalities, tumo rs and follow up studies etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 80 mm will be cov ered in 7.45 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 80 mm w[...]

Va s c u l a r 367 Emotion 16 HeadAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 7.7 m m Pitch F act or 0.80 Increment 3. 0 mm 0.7 mm K ernel H31s H20s CTDI Vol 12.46 mGy Ef fective dose Male: 0.43 mSv Female: 0.48 mSv[...]

368 Va s c u l a r Hint • Use of C ARE Bolus with monitoring scans positioned at the level of the basilar arter y or caro tid ar tery. Se t the trigger threshold at 120 HU, or use manual trig- gering. Contrast medium IV injection Start delay 18 sec. Flow rat e 3.5 ml/sec. T o tal amount 75 ml[...]

Va s c u l a r 369[...]

370 Va s c u l a r HeadAngioVol Indications: Spiral mode for cerebral CT Angi o studies, e.g. cer ebral vascu-lar abnormalities, tu mors and f ollow-up studies etc. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second for cor onal studies in 3D images display vie w . The coronal view images will be r econstruct ed as[...]

Va s c u l a r 371 Hint • Use of C ARE Bolus with monitoring scans positioned at the lev el of the basilar arter y or car otid arter y . Se t the trigger threshold at 120 HU , or use manual trig- geri ng. Emotion 6 HeadAngio 2 nd reconstr. kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.8 sec. Acquisition 6 x 1.0 mm Slice collimation [...]

372 Va s c u l a r CarotidAngio/ CarotidAngio06s Indications : CT angiography of the car otid arteries, e.g. carotid stenosis or o cclusion, coar se plaq ues abnormalities of the caro tids or vertebral ar teries, etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 20 cm including the aorta arch will be cov- ered in 9.53 sec. For SOMA TOM[...]

Va s c u l a r 373 Emotion 16 CarotidAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 5.0 mm 0.7 mm K ernel B30s B20s CTDI Vo l 5.60 mGy Effect ive d ose Ma le: 1.28 m Sv Female: 1.4[...]

374 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI fo r monitoring scan in the aor tic arch with triggering threshold of 120 HU, or use manual triggering. • High quality 2D & 3D postprocessing can be achie ved using a thin slice thickness and 50% ov erlapping increments. • Thick MPRs and T[...]

Va s c u l a r 375[...]

376 Va s c u l a r CarotidAngioV ol Indications : CT angiography of the car otid arteries, e.g. carotid stenosis or occlusions, coar se plaques abnorma lities of the caro tids and vertebral ar teries, etc. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second for cor onal studies in 3D images display vie w . The coron[...]

Va s c u l a r 377 Emotion 6 CarotidAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.8 s ec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 3.0 mm Feed/Rotatio n 9.0 mm Pitch F act or 1.50 Increment 5.0 mm 3.0 mm K ernel B31s B20s CTDI Vo l 5.81 mGy Effect ive d ose Ma le: 0.57 m Sv Female: 0.62 [...]

378 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI fo r monitoring scan in the aor tic arch with triggering threshold of 120 HU, or use manual triggering. • High quality 2D & 3D postprocessing can be achie ved using a thin slice thickness and 50% ov erlapping increments. • Thick MPRs and T[...]

Va s c u l a r 379[...]

380 Va s c u l a r ThorAngioRouti ne/ ThorAngioRoutine06s Indications : Spiral mode fo r thorax CT Angio studies, e.g. visualiza- tion of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. For SOMA TOM Emotion 16 -slice configu ration: A range of 30 cm will be covered in 13.70 sec. For SOMA TOM Emo tion 6- slice configuration: A ran[...]

Va s c u l a r 381 Emotion 16 ThorAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 14.4mm Pitch F act or 1.50 Increment 5.0 mm 0.7 mm K ernel B31s B 20s CTDI Vo l 5.60 mGy Effect ive d ose Ma le: 2.92 m Sv Female: 3.78 m[...]

382 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI fo r monitoring scan in the aor tic arch with triggering threshold of 120 HU, or use manual triggering. • Thick MPRs and ThinMIPs can be creat ed ver y quickly on the 3D T ask Card b y just clicking on the appr opri- ate icons. The thickness of [...]

Va s c u l a r 383[...]

384 Va s c u l a r ThorAngioVol Indications : Spiral mode fo r thorax CT Angio studies, e.g. visualiza- tion of tumors, metastases, lymphoma, lymph nodes, vascular anomalies etc. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second f or double-oblique studies in 3D images display vie w . The oblique view images will [...]

Va s c u l a r 385 Emotion 6 ThorAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 70 Rotation time 0.8 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 3.0 mm Feed/Rotatio n 9.0 mm Pitch F act or 1.50 Increment 5.0 mm 3.0 mm K ernel B31s B30s CTDI Vo l 5.81 mGy Effect ive d ose Ma le: 2.96 m Sv Female: 3.83 mSv[...]

386 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI fo r monitoring scan in the aor tic arch with triggering threshold of 120 HU, or use manual triggering. • Thick MPRs and ThinMIPs can be creat ed ver y quickly on the 3D T ask Card b y just clicking on the appr opri- ate icons. The thickness of [...]

Va s c u l a r 387[...]

388 Va s c u l a r ThorAngioECG/ ThorAngioECG06s Indications : This is a spiral scanning pro t ocol using a collimat ion of 1.2 mm and an ECG gating t echnique f or thorax CT An- gio studies. For SOMA TOM Emotion 16 -slice configu ration: A range of 25 cm will be covered in 18.13 sec. For SOMA TOM Emo tion 6: A range of 15 cm will be covered in 19.[...]

Va s c u l a r 389 Emotion 16 ThorAngioECG 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 280 Rotation Time 0.5 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 3.0 mm 1.5 mm Feed/Rotatio n 7.3 mm Pitch F act or 0.38 Increment 3.0 mm 0.8 mm K ernel B31s B31s Te m p . r e s o l u t i o n * *. depends on heart rate up to 12[...]

390 Va s c u l a r Emotion 6 ThorAngioECG 2 nd reconstr . kV 130 Effective mAs/ Quality ref. mAs 210 Rotation Time 0.6 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5. 0 mm 2.5 mm Feed/Rotation 4.8 mm Pitch Factor 0. 40 Increment 5.0 mm 1.5 mm K ernel B31s B31s Te m p . r e s o l u t i o n * *. depends on heart rate up to 150 ms [...]

Va s c u l a r 391 Hints • C ARE Bolus may be used t o optimize the bolus tim- ing. • Set the ROI f or monitoring scan in the aor tic arc h with triggering threshold of 1 20 HU, or use manual triggering. Contrast medium IV injection Start delay 4 – 10 sec. Flow rat e 2.5 ml/sec. T otal amount 80 – 100 ml[...]

392 Va s c u l a r ThorAngioECGSeq Indications: Sequential, ECG triggered stud y for location and ext ent of aneur ysms, dissection, and ruptur es of the thoracic aort a with typical scan range of 29.9 cm. Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI fo r monitoring scan in the aor tic arch with triggering thr[...]

Va s c u l a r 393[...]

394 Va s c u l a r Embolism/ Embolism06s Indications : Spiral mode f or pulmo nar y embolism st udies. For SOMA TOM Emotion 16 -slice configu ration A range of 30 cm will be covered in 13.70 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 28 cm will be covered in 19.87 sec.[...]

Va s c u l a r 395 Emotion 16 Embolism 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 80 Rotation Time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 0.75 m m Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 3.0 mm 0.5 mm K ernel B31s B20s CTDI Vol 6.4 0 mGy Effect ive do se Male: 3.28 mSv Female: 4.26 mS[...]

396 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI f or monitoring scan in the pulmonar y tru nk wi th tr igge ring thre shold of 120 HU, or use manual trigger ing. Contrast medium IV injection Start delay 6 – 10 sec. Flow rat e 4 ml/sec. T otal amount 80 – 100 ml[...]

Va s c u l a r 397[...]

398 Va s c u l a r BodyAngioRoutine/ BodyAngioRoutine06s Indications : Spiral mode for abdominal CT Angio studies. For SOMA TOM Emotion 16 -slice configu ration: A typical study in a range of 40 cm will be cover ed in 17.87 sec. For SOMA TOM Emo tion 6- slice configuration: A typical study in a range of 20 cm will be cover ed in 14.53 sec.[...]

Va s c u l a r 399 Emotion 16 BodyAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 90 Rotation Time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 5.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch F act or 1.50 Increment 5.0 mm 0.7 mm K ernel B31s B20s CTDI Vol 7.2 0 mGy Effect ive do se Male: 5.04 mSv Female: 6.36 mSv[...]

400 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI f or monitoring scan in the abdominal aort a with triggering threshold of 120 HU , or use manual trigger ing. • Do not administer oral co ntrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast. • The l[...]

Va s c u l a r 401[...]

402 Va s c u l a r BodyAngioV ol Indications : Spiral mode for abdominal CT Angio studies. T wo recon jobs ar e predefined f or reconstruction: the first for axial, the second for cor onal studies in 3D images display vie w . The coronal view images will be reconstruct ed as MIP images. For SOMA TOM Emo tion 16-slice configur ation: A typical study[...]

Va s c u l a r 403 Emotion 6 BodyAngio 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 90 Rotation Time 0.8 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 5.0 mm 3.0 mm Feed/Rotatio n 9.0 mm Pitch F act or 1.50 Increment 5.0 mm 3.0 mm K ernel B31s B30s CTDI Vol 7.4 7 mGy Effect ive do se Male: 2.83 mSv Female: 3.51 mSv[...]

404 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI f or monitoring scan in the abdominal aort a with triggering threshold of 120 HU , or use manual trigger ing. • Do not administer oral co ntrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast. • The l[...]

Va s c u l a r 405[...]

406 Va s c u l a r BodyAngioF ast/ BodyAngioF ast06s Indications : Spiral mode for longer co verage and lar ger vess els. For SOMA TOM Emo tion 6- slice configuration: A typical study of the whole aorta including its bran- chiocephalic trunk and iliac arteries in a range of 30 cm will be cov ered in 9.77 sec.[...]

Va s c u l a r 407 Emotion 6 BodyAngio Fa s t 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 90 Rotation Time 0.8/0.6 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm 2.5 mm Feed/Rotatio n 21.0 mm Pitch F act or 1.75 Increment 5.0 mm 1.5 mm K ernel B31/B30s B31s CTDI Vol 6.3 9 mGy Effect ive do se Male: 3.45 mSv Fem[...]

408 Va s c u l a r Hints • C ARE Bolus may be used to op timize t he bolus tim- ing. • Set the ROI f or monitoring scan in the abdominal aort a with triggering threshold of 120 HU , or use manual trigger ing. • Do not administer oral co ntrast medium, as this impairs the editing of MIP/SSD/VRT images. • Use water as oral contrast. • The l[...]

Va s c u l a r 409[...]

410 Va s c u l a r AngioRunOff/ AngioRunOff06s Indications : Spiral mode for CT Angio s tudies of the extremities. For SOMA TOM Emotion 16 -slice configu ration: A range of 80 cm will be done in 17.87 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 80 cm will be done in 23.42 sec.[...]

Va s c u l a r 411 Emotion 16 AngioRunOff 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 90 Rotation Time 0.6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 6.0 mm 1.5 mm Feed/Rotatio n 28.8 mm Pitch F act or 1.50 Increment 6.0 mm 1.0 mm K ernel B31s B31s CTDI Vol 6.4 8 mGy Effect ive do se Male: 4.98 mSv Female: 5.08 m[...]

412 Va s c u l a r Hints • C ARE Bolus may be used t o optimize the bolus timing and with a triggering threshold of 120 HU, or use manual trigger ing. • If T opo length 1024 mm is not long enough, you can also choose the T opo length of 1500 mm. • Posit ion the patie nt as fe et first. Be nd the f eet togethe r i f ne cess ar y. Contrast medi[...]

Va s c u l a r 413[...]

414 Va s c u l a r WholeBodyAngio Indications : For CT Angio spiral studies of t he whole body . For SOMA TOM Emotion 16 -slice configu ration: A range of 80 cm will be done in 17.87 sec. Emotion 16 WholeBody 2 nd reconstr. kV 110 Effective mAs/ Quality ref. mAs 90 Rotation Time 0.6 sec. Acquisition 16 x 1. 2 mm Slice collimation 1.2 mm Slice width[...]

Va s c u l a r 415 Hints • C ARE Bolus may be used t o optimize the bolus tim- ing. • Set the ROI f or monitoring scan with triggering threshold of 120 HU, or use manual triggering. • If T opo length 1024 mm is not long enough, you can also choose the 1540 mm long T opogram. • Position the patient as feet first. Bend the feet toge ther if n[...]

416 Specials Over view The examination pr otocols designed for some of these applications are under t he “Special” folder . T rauma In any trauma situation, time means lif e and the qual- ity of lif e for th e sur vivor . T o faci litate the e xamina- tions, five pro tocols ar e provided. For SOMA TOM Emotion 16 -slice configu ration: – Tr a [...]

Specials 417 For SOMA TOM Emotion 6 - slice configuration: – PolyT rauma/PolyT rauma06s This is a combined mode for the ex amination of mul- tiple ranges, for ex ample, Head, Neck, Thorax, Abdo- men and Pelvis – HeadT r auma Spiral head pro tocol f or trauma studies with a F oV of 500 and theref ore lowe red image quality – HeadT r aumaSeq Se[...]

418 Specials Inter ventio nal CT For SOMA TOM Emotion 16 -slice configu ration: – Biopsy This is the multislice biopsy mode. With three times 4.8 mm, the images will be r econstruct ed and dis- play ed for eac h scan. – BiopsySingl e This is a single multislice biopsy mode. One 10mm slice is aquired. – CA R E V i s i o n The C ARE Vision prot[...]

Specials 419 For SOMA TOM Emotion 6 - slice configuration: – Biopsy This is the multislice biopsy mode. With three times 6.0 mm, the images will be r econstructed and dis- play ed for each scan. – BiopsySingle This is a single multislice b iopsy mode. One 10mm slice is aquired. – CA RE V i s io n The CA RE Vision prot ocol is a spiral mode wi[...]

420 Specials T est Bolus For SOMA TOM Emotion 16 -slice configu ration: – T estBo lus This mode can be used to t est the start delay of opti- mal enhancement after the contrast medium injec- tion. For SOMA TOM Emo tion 6- slice configuration: – T estBo lus This mode can be used to t est the start delay of opti- mal enhancement after the contras[...]

Specials 421[...]

422 Specials Tr a u m a P r o t o c o l s In any trauma situation, time means lif e and the qual- ity of lif e for t he survivor . General Information • Check that the emergency drug trolley is w ell stock ed and that all accessories suc h as in-room o xy- gen supply , r espirator and resuscitation equipment that may be req uired during the exami[...]

Specials 423[...]

424 Specials T rauma This is a one-rang e mode for fast scr eening f or emer- gency studies. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 50 cm wi ll be done in 11.62 s. Emotion 16 T rauma 2 nd recon. 3 rd recon. kV 130 Effective mAs/ Quality ref. mAs 85 Rotation Time 0.6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice[...]

Specials 425 T raumaV ol This is a one-range mode for fast screening f or emer- gency studies. Three r econ jobs are predefined f or re construction: the first for axial, the second for cor onal and the third sag- ittal studies in 3D images display view . For SOMA TOM Emotion 16- slice configuration: A scan range of 50 cm will be done in 11.62 sec.[...]

426 Specials PolyT rauma/ PolyT rauma06s T wo combined ranges are pr edefined, head with neck and thorax with abdomen. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 12/14 cm wi ll be done in 13 .36/9.68 sec. Emotion 16 Head Neck kV 130 130 Effective mAs/ Quality ref. mAs 240 150 Rotation time 1.0 sec. 1.0 sec Acquisition 16 x 1.2 m[...]

Specials 427 T ake a new T opogram for the thorax and abdomen rang e. A scan range of 20/40 cm will be done in 9.01/ 9.53 sec. Emotion 16 Thorax AbdPelvis kV 130 130 Effect ive m As/ Quality ref. mAs 50 90 Rotation time 0.6 sec. 0.6 sec Acquisition 16 x 1.2 mm 16 x 1. 2 mm Slice collimation 1.2 mm 1.2 mm Slice width 8.0 mm 8.0 mm Feed/Rotation 15.4[...]

428 Specials For SOMA TOM Emo tion 6- slice configuration: A scan range of 12/1 4 cm will be done in 9.84/13 .67 sec. Emotion 6 Head Neck kV 130 130 Effective mAs/ Quality ref. mAs 250 150 Rotation time 1.0 sec. 1.0 sec Acqui sition 6 x 3.0 mm 6 x 2.0 mm Slice collimation 3.0 mm 2 .0 mm Slice width 6.0 mm 5.0 mm Feed/Rotation 15.3 mm 12.0 m m Pitch[...]

Specials 429 T ake a new T opogram for the thorax and abdomen rang e. A scan range of 20/40 cm will be done in 9.04/ 10.09 sec. Emotion 6 Thorax AbdPelvis kV 130 130 Effect ive m As/ Quality ref. mAs 50 90 Rotation time 0.8/0.6 sec. 0.8/0.6 sec Acquisition 6 x 3.0 mm 6 x 3.0 mm Slice collimation 3.0 mm 3.0 m m Slice width 8.0 mm 8.0 mm Feed/Rotatio[...]

430 Specials HeadT rauma A spiral mode f or emergency head studies with a max. FoV of 500 mm. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 12 cm will be covered in 20.05 sec. For SOMA TOM Emo tion 6- slice configuration: A scan range of 12 cm will be cover ed in 30.27 sec. Emotion 16 Head 2 nd reconstr . kV 130 Effective mAs/ Qual[...]

Specials 431 Emotion 6 Head 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 250 Rotation time 1.5 sec. Acquisition 6 x 2. 0 mm Slice collimation 2.0 mm Slice width 6.0 mm 6.0 mm Feed/Rotatio n 6.6 mm Pitch F act or 0.55 Increment 6.0 mm 6.0 mm K ernel H31s H60s CTDI Vol 58.75 mGy Effect ive do se Male: 2.76 m Sv Female: 2.98 mSv[...]

432 Specials HeadT raumaSeq A sequence mode for emer gency head studies with a max. FoV o f 500 mm. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 12.5 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 12.0 cm. Emotion 16 HeadSeq kV 130 Effective mAs/ Quality ref. mAs 270 Rotation time[...]

Specials 433 Emotion 6 HeadSeq kV 130 Effect ive m As/ Quality ref. mAs 270 Rotation time 1.5 sec. Acquisition 6 x 3.0 mm Slice collimation 3.0 m m Slice width 6.0 mm 6.0 mm Feed/Scan 18.0 mm 18.0 mm K ernel H31s H60s CTDl Vol 59.4 0 mGy Effect ive d ose Male : 3.05 mSv Fem al e: 3. 17 mS v[...]

434 Specials Additional Important Information • Y ou can selec t which pro tocol is the emergency pr o- toco l. • For long range scanning, pl ease pay att ention to the scannable range mark on the table mattres s while positioning the patient. • In some cases, it might be advisable t o positio n the patient fee t first so that there will be m[...]

Specials 435[...]

436 Specials Inter ventional CT - Biopsy T o facilit ate CT interventional procedur es, we creat ed dedicated multislice and sing le slice sequential modes. Any of these pr ot ocols can be appended to a spiral pro- tocol f or CT interventional procedures, such as biopsy , abscess drainage, pain t herapy , minimum in vasive operations, joint studies[...]

Specials 437 Biopsy With this routine pr otocol images will be r econstructed with three time 4.8/6.0 mm or one time 10 mm slice thickness. Emotion 16 Biopsy kV 130 Effect ive m As/ Quality ref. mAs 110 Rotation time 0.6 sec. Acquisition 12 x 1.2 mm Slice collimation 1. 2 mm Slice width 4.8 mm Feed/Scan 0.0 mm K ernel B31s CTDI vol 12.10 mGy Emotio[...]

438 Specials Biopsy Single One 10 mm slice images will be reconstruc ted and dis- play ed for eac h scan. Emotion 16 Biopsy Si ngle kV 130 Effective mAs/ Quality ref. mAs 50 Rotation time 0.6 sec. Acquisition 2 x 5.0 mm Slice collimation 5.0 mm Slice width 10.0 mm Feed/Scan 0.0 mm Ke r n e l B 31 s CTDl Vol 5.10 mGy Emotion 6 Biopsy Single kV 130 E[...]

Specials 439 Inter ventional CT - CARE Vis i o n C ARE Vision is a CT Fluoroscopic mode for interven- tions with 1 or 3 combined slices and up to 10 images per sec. display ed (depending on the har dware config- uration). The Basics Any of t he predefined CARE Vision scan prot ocols can be appended to a spiral pr ot ocol for interventional pro- ced[...]

440 Specials C AREVision With this routine pr otocol, the image will be recon- struct ed and displayed using thr ee times 4.8/6.0 mm or one time 10 mm slice thickness and a kernel of B30 in the CARE V iew mo de. Emotion 16 CAREV ision kV 130 Effective mAs/ Quality ref. mAs 30 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm S[...]

Specials 441 C AREVisionSingle The images will be reconstructed and display ed with one time 10 mm slice thickness and a kernel of B30. Emotion 16 CAREV ision kV 130 Effect ive m As/ Quality ref. mAs 30 Rotation time 0.6 sec. Acquisition 2 x 5.0 mm Slice collimation 5.0 mm Slice width 10.0 m m Feed/Scan 0.0 Increment 1.0 mm Ke r n e l B 3 1 s CTDI [...]

442 Specials C AREVisionBone The images will be reconstruc ted and displa yed in the C ARE View mode with three times 4 .8/6.0 mm or one time 10 mm slice thickne ss and a kernel o f B50. Emotion 16 CAREV ision kV 130 Effective mAs/ Quality ref. mAs 30 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 4.8 mm Feed/Sc[...]

Specials 443 HandC ARE HandCARE is a dedicated algorithm f or dose reduc tion during the interventional procedure. It switches off the x-ray exposur e for a 100° angle between thr ee different positions (10:00, 12:00 and 2:00 o’ clock). Thus pro vides a significant dose saving to the opera- tor ’s hand, while keeping the image quality constant[...]

444 Specials The HandCARE item list of fers “None“ and thr ee select- able pro tection ar eas. Y o u can select this values inde- pendent of the current or a future patient position. The list elements are sorted cl ockwise from a view to the fron t of the gantry . Values: {“None“, “10:00 o’ clock”, “12:00 o ’ clock”, “2:00 o?[...]

Specials 445 Application Procedure 1. Load and scan a spiral protocol of the int erest ed body region. 2. Scroll through t he images to define a tar get slice. 3. Click on Same TP under T able position, in the routine card. Mo ve the table t o the desir ed table position. 4. T urn on the light marker on the Gantr y to localize the entr y point, and[...]

446 Specials Y ou can c hange the follo wing Scan Parameters on the examination task card during radiation: • Gantr y Tilt • T abl e position • T able mo vement type • Feed in/Feed out Hints • Press the f ootswitc h either to position the needle or to contr ol the needle position. • Without HandC ARE every ti me you release the f oot- s[...]

Specials 447 Additional Import ant Information Pause C ARE Vision Scan Range If you pause the CARE Vision Scan Range the SlicePo- sition and T ableHeight will be displayed in the Image Te x t . Reference Imag e Displa y T o display a ref erence image during the examination procedure , the Viewing task card can be display ed on a second monitor . Ad[...]

448 Specials Radiation exposure to patients • C ARE Vision applies continuous exposure at moder- ate mA le vels. • Due to t he pot entially lo ng scan times and the lim- ited scan volume, the dose f or cert ain slices may increase to levels significantly higher than those known from standard CT applications. • The patient ’s exposure leve l[...]

Specials 449 Radiation expos ure to personnel During the procedure the ph ysician is in the scan room and close to t he exposed scan plane. • T ake special care to a void exces sive and unnecessary radiation exposure. Pro tection ag ainst primar y x-ray exposure: • In the worst case, an y body parts in the scan plane may r eceive appro ximately[...]

450 Specials General Inf ormation f or Biopsy and C ARE V ision Inter v entional T oolbar If you want t o perform a CareVision or Biopsy Scan y ou can activat e the new Interventional T o ol Bar in the main menu under Imange - Int er ventio n. The Interventional T oolbar will be disply ed as soon as an Interventional Scan entr y is being loaded. In[...]

Specials 451 • Inter ventiona l Window 1/2 /3 With the special window toggle butt on you can apply three different windo w settings t o your image, t he default values are: Abdomen (300/40), Lu ng (1200/- 600) and Bone (1500/450). Y o u can choose dif fer ent window settings under Options>Configuration>Examination>Int er ven- tion , thes[...]

452 Specials • Screen lay out In the interventional T oolbar for CA R E Vi s i o n you can change the Lay out of the Display . There are three dif- fer ent modes available. – Blow up (one big image) – CARE V iew (three eq ual sized images) – CARE View Blow up (one big and tw o smaller images on each side) If you choose certain slice thickne[...]

Specials 453 C AREView The item C AREView indicates when a combined image is displayed. When the number of Slice P ositions per scan is three, CARE V iew is ac tivated and shown on the Routine subtask card. On the Recon subtask card y ou can selec t the C ARE View image position, dependi ng on the patient posi- tion, e.g. if you want to display the[...]

454 Specials C ARE Vision and Biopsy layout for Single image display C ARE Vision layout f or CAREV iew large-size displa y[...]

Specials 455 C ARE Vision and Bi opsy layout for CAREView equal- size display Biopsy two se gment[...]

456 Specials Configuration Dose Display The maximum displayed value of the Dose is set as a default to 2000 mGy . It is pos sible to configure this from 100-200 mGy under Options>Configura- tion>Examination>Int ervention . Exceeding this con- figuration maximu m value will no t sto p the scan, just the Dose scale bar will change to r ed. I[...]

Specials 457 Example 3.5 second scan done. Then at least four images ar e sav ed depending on con- figu rati on: • Conf: 1ima/s – Central image - after 1st second – Central image - after 2nd second – Central image - after 3rd second – Central image - after 3,5 seconds (last) – All toge ther - 4 images • Conf: 1ima/s + l ast 3 C ARE Vi[...]

458 Specials Routine Subtask card Move table/scanrange to displa yed image position. The function Move T abl e/Scanrange to displa yed image position in the Routine subtask car d allows you to mov e the table to t he position of the display ed tomo image in the select ed segment. If y ou use the CARE View Mode you can use the Head of the F eet imag[...]

Specials 459 Additional Import ant Information Independently from the Interventional Window but- tons on the Int erventional T oolbar y ou can use for faster windowing the function k e ys F2, F3 and F4 are implemented with standar d window settings f or Abdo- men, Lung and Bone. Modifying them is pos sible under Options> Configuration> Examin[...]

460 Specials T estBolus Pr ot ocol T estBolus This mode can be used to test t he star t delay of an opti- mal enhancement after the contrast medium injec- tion. Emotion 16 T estBolus kV 110 Effective mAs/ Quality ref. mAs 40 Rotation time 0.6 sec. Acquisition 2 x 5.0 mm Slice collimation 5.0 mm Slice width 10.0 mm Feed/Scan 0.0 mm K ernel B31s CTDI[...]

Specials 461[...]

462 Radiation Therap y Radiation Therapy Planning The SOMA TOM Emo tion 16/6-slice configuration are ver y well suited to Radiat ion Therapy Planning (RTP) with its er gonomic enlarged gantry opening and its scan plane located only 35cm from the gantry front. Using the external laser mark ers and the connect ed workstations, the system provides the[...]

Radiation Therapy 463 C OHERENCE Dosim etrist Remember the challeng es of Radiation Therapy… • Precisely locat e and delineate t he tumor volume • Establish reliable external r efer ences on the patient surf ace[...]

464 Radiation Therap y • Spare as much health y tissue as possible • Precisely position t he patient for treatment f or the entire course o f treatment (t ypically 25-35 frac tions)[...]

Radiation Therapy 465 Benefits • No limitations f or patient set-up within 85 c m gantr y opening and the ability to scan at a low table posi- tion thereby maximizing gantr y "freespace" • Comple te anat omical visualization f or optimized localization and dose ca lculation with extended 85 cm FO V 85 cm Display FoV 50 cm Scan FoV[...]

466 Radiation Therap y • High volume coverag e in time (16 X2.0 mm in 0.6 s) minimizing mo tion artifact s and breath hold ti me • Thin slice imaging f or high qu ality DRRs (Digitally Reconstruct ed Radiograph) and MPRs, especially for conformal 3D therapy and IMRT (Int ensity Modu- lated Radiation Therap y) • Comple te CT simulation solutio[...]

Radiation Therapy 467 • New long-range gantry la ser lights with position adjustment possible without opening gantry cove rs for easier installation and synchronization with r oom RTP lasers • Integrat ed solution for Virtual Simu lation with syngo based C OHERENCE Dosimetrist or VSim on syngo MultiModali ty Wo rkplace • Display of gantry til[...]

468 Radiation Therap y Wo r k f l o w Simulation: 1. Patient positioning on CT table (external lasers) 2. Patient markin g (external lasers) 3. CT scan 4. Offline: Vir tual Simulation and D ose Planning T reatment: 1. Patient positioning on the therapy table (external lasers) 2. Verification of irradiation area (light field projection) 3. T reatmen[...]

Radiation Therapy 469[...]

470 Radiation Therap y Scan Pr ot ocols Over view Y o u can use the following scan pr ot ocols for the Radia- tion Therapy Planning: For SOMA TOM Emotion 16 -slice configu ration: – RT_Head Spiral mode for r outine radiation therapy planning head st udies – RT_Thorax Spiral mode for r outine fradiation therapy planning thoracic studies – RT_B[...]

Radiation Therapy 471 For SOMA TOM Emotion 6 - slice configuration: – RT_Head Spiral mode for routine ra diation therapy planning head studies – RT_Thorax Spiral mode for routine fradiation therapy planning thoracic studies – RT_Breast Spiral mode for routine ra diation therapy planning studies of the breast – RT_Abdomen Spiral mode for rou[...]

472 Radiation Therap y RT_Head Indications: Spiral mode for r outine radiation therapy planning head studies. For SOMA TOM Emotion 16 -slice configu ration: A range of 12 cm will be covered in 20.05 sec. For SOMA TOM Emo tion 6-slice configuration: A range of 12 cm will be covered in 30.27 sec. Emotion 16 Head 2 nd recon. kV 130 Effective mAs/ Qual[...]

Radiation Therapy 473 Emotion 6 Head 2 nd reco n. kV 130 Effect ive m As/ Quality ref. mAs 250 Rotation time 1.5 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 3.0 mm 3.0 mm Feed/Rotatio n 6.6 mm Pitch F act or 0. 55 Increment 3.0 mm 3.0 mm K ernel H31s H60s CTDI Vol 58.75 mGy Effect ive d ose Male: 2.76 m Sv Female: 2.98 mSv[...]

474 Radiation Therap y RT_Thorax Indications: Spiral mode fo r routine radi ation therap y planning tho- racic studies. For SOMA TOM Emotion 16 -slice configu ration: A range of 30 cm will be covered in 12.92 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 30 cm will be covered in 25.13 sec. Emotion 16 Thorax 2 nd recon. kV 130 Effect[...]

Radiation Therapy 475 Emotion 6 Thorax 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 90 Rotation time 0. 8 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 8.0 mm 8.0 mm Feed/Rotatio n 10.2 mm Pitch F act or 0.85 Increment 8.0 mm 5.0 mm K ernel B41 s B70s CTDI Vol 9.8 1 mGy Effect ive d ose Male: 4.9 8 mSv Female: 6.45 mSv[...]

476 Radiation Therap y RT_Breast Indications: Spiral mode fo r routine radi ation therap y planning tho- racic studies of the mammae. For SOMA TOM Emotion 16 -slice configu ration: A range of 30 cm will be covered in 12.92 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 30 cm will be covered in 25.13 sec. Emotion 16 Breast 2 nd recon.[...]

Radiation Therapy 477 Emotion 6 Breast 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 90 Rotation time 0. 8 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 8.0 mm 8.0 mm Feed/Rotatio n 10.2 mm Pitch F act or 0.85 Increment 8.0 mm 5.0 mm K ernel B41 s B70s CTDI Vol 9.8 1 mGy Effect ive d ose Male: 4.9 8 mSv Female: 6.45 mSv[...]

478 Radiation Therap y RT_Abdomen Indications: Spiral mode for r outine radiation therapy planning abdominal studies. For SOMA TOM Emo tion 16-slice configuration: A range of 20 cm will be covered in 9.01 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 20 cm will be covered in 17.29 sec. Emotion 16 Abdomen 2 nd recon. kV 130 Effective[...]

Radiation Therapy 479 Emotion 6 A bdomen 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 150 Rotation time 0. 8 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 8.0 mm 8.0 mm Feed/Rotatio n 10.2 mm Pitch F act or 0.85 Increment 8.0 mm 8.0 mm K ernel B41 s B60s CTDI Vol 16.35 mGy Effect ive d ose Male: 6. 33 mSv Female: 7.87 mSv[...]

480 Radiation Therap y RT_Pelvis Indications: Spiral mode for routine radi ation therapy planning pel- vis studies. For SOMA TOM Emotion 16 -slice configu ration: A range of 20 cm will be covered in 8.94 sec. For SOMA TOM Emo tion 6- slice configuration: A range of 20 cm will be covered in 13.11 sec.[...]

Radiation Therapy 481 Emotion 16 Pelvis 2 nd recon. kV 130 Effect ive m As/ Quality ref. mAs 150 Rotation time 1.0 sec. Acquisition 16 x 1.2 mm Slice collimation 1. 2 mm Slice width 3.0 mm 3.0 mm Feed/Rotatio n 28.8 mm Pitch F act or 1.50 Increment 3.0 mm 3.0 mm K ernel B41 s B60s CTDI Vol 16.80 mGy Effect ive d ose Male: 6.6 8 mSv Female: 11.42 mS[...]

482 Radiation Therap y Additional Important Information HU values The HU values ar e of crucia l im port ance for the therap y planning systems of radiation t herapists! • With huge objects, the CT value is independent of the kernel. With smaller objec ts, edge effec ts pro- duced by the k ernel influence the HU values as well as the scanning. Fe[...]

Radiation Therapy 483[...]

484 Respirator y Gating When imaging of the chest or abdomen is performed by CT , there may be artifacts produced causing prob- lems with r eproducibilit y and resolution o f images due to patient respiration. Or gans will move with e very res- pirator y motion. Especially in the radiation ther apy planning using a lin- ear accelerator for tumor tr[...]

Respirator y Gating 485 The respiratory gating hardwa re (AZ-733V) is com- posed of a: • Respiratory Sensor (RS) to detec t patient's abdomi- nal motions (pr essure cha nges) to get a patient's r es- piratory inf ormation, • Sensor Port (SP) to am plify and to transmit analog signals from RS, • Wa v e Deck (WD) to receive t he respi[...]

486 Respirator y Gating Ke y F e a t u r e s Respiratory Gating • is capturing slow moving anatomical struc tures such as lung lesions during respi ration up t o a respiration cycle time of 10sec by low pitch spiral. • helps the radio-oncologists in selecting the appropri- ate phase of the respirat or y cycle in order t o plan a treatment more [...]

Respirator y Gating 487 Respiration Synchronization • Synchr onization of CT data acquisition with respira- tion: 4D CT - prospectiv ely Respirator y T riggering or re trospec tively Respirator y Gating. • Synchroniza tion of 4D simulation data with respira- tion • Synchronized T reatment: trigger ed beaming on-off on Linac (Linear Accelerato[...]

488 Respirator y Gating Positioning of the r espirat or y sensor belt The correc t placement of the abdo minal belt is essen- tial in order to receiv e a cl ear respiratory signal result- ing in precise generation of inspiration and expiration gates. Impr oper positioning of the respirat or y belt will result in an unstab le respiratory signal whic[...]

Respirator y Gating 489 For proper belt positioning please f ollow the instruc- tions below: For further information on the respirat or y gating sys- tem AZ-733V (Anzai Medical, Japan), please refe r to the Operational manual "Re spiratory Gating" or Anzai User's manual. Step 2 Ste p 4 patient load ce ll fixing belt The blue part sho[...]

490 Respirator y Gating Scanning Inf ormation The expect ed benefits in radiation treatment planning, e.g. for lung and abdominal tumors are: • Information about tumor motion in 3D coordinates and over time • More accurate tumor shape delineation and ther e- for e a more precise RTP (radia tion therapy planning) • Pot ential for sparing of he[...]

Respirator y Gating 491 T emporal Resolut ion T e mporal resolution, also ca lled time resolution, r epre- sents the time window of the data that is used for image reconstruc tion. It is essential f or respirat or y CT imaging. The higher the t emporal r esolution, the fe wer the mo tion artifacts. A temp oral resolution of a half of the Ro tation [...]

492 Respirator y Gating Respirator y gating The respiration of the patients is simultaneously recorded during the Spiral acquisition. Data are acquired during the entire r espiration cycle and Images are r econstructed b y matching data to the respiration trace. The respiration level (am plitude) is defined as an abso- lute value. The display of th[...]

Respirator y Gating 493 The timebase of the respiratory cu rve is realtime in an updating mode. Images can be reconstruct ed at any user defined Inha- lation- or Exhalati on lev el. Exampl e: – 20% Ex: Patient has e xhaled to 80% – 20% In: Patient has inhaled to 20 % Inhalation Ph ase 100% Inspiration Exhalation Phase 0% Expiration[...]

494 Respirator y Gating Prospective respirat or y triggering ver- sus retrospectiv e respiratory gating With prospectiv e respiratory triggering, the lung vol- ume for ex ample is cov ered in a "step-and-shoo t" tech- nique. The patient's respirat or y signal is used to star t sequential scans at a predefined re spiratory level of th[...]

Respirator y Gating 495 Cur ve Editor The respiration curve editor is used to modify the res- pirator y signal. This editing tool is available after spiral scan data has been acquired. By using the right mouse menu on the T rigger t abcard y ou have a ccess to se veral modification tools f or the respirat or y Syncs (purple dots abov e and below th[...]

496 Respirator y Gating The recorded Respiration curve can be edited similar t o the ECG T race editing in Cardiac CT . Inspiration Syncs can be dele ted, disabled and inserted. Expiration Syncs can be delete d, disabled and inser ted.[...]

Respirator y Gating 497 Synthetic T rigger/Sync By default, the " Synthetic T rigger" (R espirator y-trig- gered scanning) or "Synthetic Sync" (Respirat or y-gated scanning) is activated f or all predefined Respiratory scan pro tocols. It is r ecommended to alw ays k eep it activated f or examinations with contrast medium. In ca[...]

498 Respirator y Gating Wo r k f l o w Reconstruction and Post pr ocessing For respirat or y gating a slice width of 3 mm and an increment of 1.9 mm is used for image acq uisition. T wo recon jobs are predefined: • 20% Inspiration •8 0 % E x p i r a t i o n If more Inspiration or Expiration phases are neces sar y new recon jobs can be added. Af[...]

Respirator y Gating 499 Additional impor tant Inf ormation • For operating the r espiratory gating system (AZ- 733V , Anzai Medical, Japan), please refer t o the Operational manual "Respirator y Gating" or Anzai User´s manual. • For the usage of Anzai´s respirat or y phantom f or the respirat or y gating system (AZ-733V , Anzai medi[...]

500 Respirator y Gating Scan Pr ot ocol RespSeq Indications: A sequential mode f or studies with respiration trigger- ing. For SOMA TOM Emotion 16 -slice configu ration: The scan length is pr edefined with 30.5 cm. For SOMA TOM Emo tion 6- slice configuration: The scan length is pr edefined with 30.3 cm. Emotion 16 RespSeq kV 130 Effective mAs/ Qua[...]

Respirator y Gating 501 Emotion 6 RespSeq kV 130 Effect ive m As/ Quality ref. mAs 16 Rotation time 0.6 sec. Acquisition 6 x 3.0 mm Slice collimation 3.0 mm Slice width 3.0 mm Feed/Scan 18.0 mm Ke r n e l B 3 1 s CTDI vol 1.63 mGy Effect ive d ose Male: 1 .29 mSv Female: 1.81 mSv[...]

502 Respirator y Gating Resp Indications: A spiral mode for patients with a respiration rate per minute gr eater than 10 using respiration gating. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 30 cm will be cover ed in 94.95 sec. For SOMA TOM Emo tion 6- slice configuration: A scan range of 30 cm will be cover ed in 86.04 sec. Emot[...]

Respirator y Gating 503 Emotion 6 Resp 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 230 Rotation time 0.8 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 3.0 mm 3.0 mm Feed/Rotatio n 1.8 Pitch F act or 0.15 Increment 2.0 mm 2.0 mm K ernel B31 s B31s CTDI vol 25.07 mGy[...]

504 Respirator y Gating RespModBreathRate Indications: A spiral mode for patients with a respiration rate per minute gr eater than 7.5, using re spiration gating. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 23 cm will be cover ed in 94.15 sec. For SOMA TOM Emo tion 6- slice configuration: A scan range of 14 cm will be cover ed in[...]

Respirator y Gating 505 Emotion 6 RespMode 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 320 Rotation time 0.8 s ec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 3.0 mm 3.0 mm Feed/Rotatio n 1.2 Pitch F actor 0.10 0.10 Incremen t 2.0 mm 2.0 mm K ernel B31s B31s CTDI vol 34.88 mGy[...]

506 Respirator y Gating RespLowBreathRate Indications: A spiral mode for patients with a respiration rate per minute gr eater than 6.5, using re spiration gating. For SOMA TOM Emotion 16 -slice configu ration: A scan range of 18 cm will be cover ed in 87.23 sec. For SOMA TOM Emo tion 6- slice configuration: A scan range of 11 cm will be cover ed in[...]

Respirator y Gating 507 Emotion 6 RespLow 2 nd reconstr . kV 130 Effect ive m As/ Quality ref. mAs 320 Rotation time 1.0 s ec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 3.0 mm 3.0 mm Feed/Rotatio n 1.2 Pitch F act or 0.10 Incremen t 2.0 mm 2.0 mm K ernel B31s B31s CTDI vol 34.88 mGy Ef fec tive dose Male: 6.40 mSv Fema le: 9.14 mS[...]

508 Children Over view The scan pro tocols f or children a re defined accor ding to body regions - He ad , Neck , Thorax , Abdomen , Spine , Upper Extremities , Low er Extremities , Va s- cular and Special s . As default the quality refe rence mAs with CARE Dose 4D is defined for 20 kg and/or five year old children. For children older than six y ea[...]

Children 509 • Neck – NeckRoutine Spiral mode for soft tissues routine neck studies • Thorax – Thora xRoutine Spiral mode for routine thorax studies – ThoraxHRSeq Sequential mode f or high resolution lung studies • Abdomen – AbdomenRoutine Spiral mode for routine abdominal studies • Spine – Spine Spiral mode for routine spine stud[...]

510 Children For SOMA TOM Emo tion 6- slice configuration: • Head – HeadRoutine Spiral mode for routine head studies – HeadSeq Sequential mode for routine head studies – InnerEarHR Spiral mode for high reso lution inne r ear studies – InnerEar Spiral mode f or inner ear studies – InnerEarSeq Sequential mode f or routine inner ear studie[...]

Children 511 • 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 Extr emities – ExtrRout ineHR Spiral mode f or routine high r esolutio n extremit y studies ?[...]

512 Children General Hints • T opograms: 256 mm lateral topograms are defined for the head modes, and 512 mm AP t opograms are defined for the body modes. Please k eep in mind that the children’s size can be dramatically different. Y o u should press the "Hold Measurement" butt on whenever the range shown on the r eal-time gr owing to[...]

Children 513 • Oral and rec tal contrast administration: Depending on the reason f or the exam/status of the patient, oral contrast may or may no t be given t o these patients. In general, oral contrast is recommended to opacify the intestinal tract, as unopacified bowel can ha ve the appearance of abdomina l f lui d o r ma ss e f fect. Oral, as [...]

514 Children Central lines and por ts may need t o be hand injected or power injected at a very low fl ow rate (1 ml/sec.). PIC lines and 24 gauge (or smaller) lines are usually hand injected. All of these pr otocols should be decided on by your institution ’ s appropriate personnel. • Applications with 80 kV: For CT A prot ocols, the tube volt[...]

Children 515 Head K ernels The endings “s” or “f” depend on the ro tation time. • For head scans of small children, the k ernels C20s, C30s (for exam ple, for soft tissue studies) and C60s (for exa mple, for sinuses ar e provided) should be chosen instead of the ”adult” head kernels H20s, H30s and H60s. • For soft tissue head studie[...]

516 Children Body K ernels The endings “s” or “f ” depend on the rotation time. • As standard kernels f or body tissue studies B30s or B40s are recommended; softer images are obtained with B20s or B10s (ext remely soft). The kernels B31s or B41s have about the same visual sharpness as B30s, respectiv ely , B40s, the image appearance, howe[...]

Children 517[...]

518 Children Scan Pr ot ocols HeadRoutine Indications : Spiral mode f or r outine hea d studies, f or ex ample, tumors, hydr ocephalus, hemo rrhaging, abnormalities, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 12 cm covered in 20.05 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 8.5 cm co vere d in [...]

Children 519 * The conv ersion factor for a 7-year -old child, and a scan range of 120 mm was used. Emotion 16 Head kV 110 Effect ive m As/ Quality ref. mAs 230 Rotation time 1. 5 sec. Acquisition 16 x 1. 2 mm Slice collimation 1.2 mm Slice width 4.0 mm Feed/Rotatio n 10.6 mm Pitch F act or 0.55 Incremen t 4.0 mm Ke r n e l C 3 0 s CTDI Vol 36.80 m[...]

520 Children Hints • Children, who ar e older than age 6, should be scanned with an adult prot ocol as the skull by this time is fu lly grown. • When bone structure is of inte rest, use kernel C60s for image r econstruction. • An advanced algorithm allows for impr oved head image qual ity , wi thout a dditional post-pro cessing. • In order [...]

Children 521[...]

522 Children HeadSeq Indications : Sequential mode for routine head studies for children, for ex ample, tumors, hydrocephalus, hemorrhaging, abnormalities, etc. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 8.5 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 9.0 cm. Emotion 16 HeadS[...]

Children 523 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 117 mm was used. Emotion 6 HeadSeq kV 110 Effect ive m As/ Quality ref. mAs 260 Rotation time 1. 5 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 6.0 mm Feed/Scan 12.0 mm Ke r n e l C 3 0 s CTDI Vol 40.82 mGy Effectiv e dose Male: 1.86 mSv* Female: [...]

524 Children Hints • Children, who ar e older than age 6, should be scanned with an adult prot ocol as the skull by this time is fu lly grown. • When bone structure is of inte rest, use kernel C60s for image r econstruction. • An advanced algorithm allows for impr oved head image qual ity , wi thout a dditional post-pro cessing. • In order [...]

Children 525[...]

526 Children InnerEarHR Indications : Spiral mode for high-r esolution inner ear studies, for example, malformations of the inner ear , i nflamma- tory changes, pathologies of the mastoid process, tumor proces ses of the py ramids, post-traumatic changes, etc. Note : Same as f or adults except f or the FoV of 300. For SOMA TOM Emotion 16 -slice con[...]

Children 527 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 45 mm was used. Emotion 16 InnerEar kV 110 Effect ive m As/ Quality ref. mAs 50 Rotation time 1.0 s ec. Acquisition 4 x 0.6 mm Slice collimation 0.6 mm Slice width 0.6 mm Feed/Rotatio n 1.8 mm Pitch F act or 0.75 Increment 0.4 mm K ernel H90s CTDI Vol 10 .30 mGy Effe[...]

528 Children Hints • Children, who ar e older than age 6, should be scanned with an adult prot ocol as the skull by this time is fu lly grown. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-cent er . No recon job with a field of vi e w exceeding tho[...]

Children 529[...]

530 Children InnerEar Indications : Spiral mode for r outine inner ear studies, f or exam ple, malf ormations of the inner ear , inflammato r y changes, pathologies of the mastoid proces s, tumor proces ses of the pyramids, post-traumatic changes, etc. Note : Same as f or adults except f or the FoV of 300. For SOMA TOM Emotion 16 -slice configu rat[...]

Children 531 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 45 mm was used. Emotion 16 InnerEar kV 110 Effect ive m As/ Quality ref. mAs 50 Rotation time 1.0 s ec. Acquisition 16 x 0.6 m m Slice collimation 0.6 mm Slice width 0.75 mm Feed/Rotatio n 7.7 mm Pitch F act or 0.80 Increment 0.5 mm K ernel H90s CTDI Vol 8.9 0 mGy Ef[...]

532 Children Hints • Children, who ar e older than age 6, should be scanned with an adult prot ocol as the skull by this time is fu lly grown. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-cent er . No recon job with a field of vi e w exceeding tho[...]

Children 533[...]

534 Children InnerEarSeq Indications: Sequential mode f or r outine inner ear studies, for example, Inflammat or y changes, tumoro us pro-cesses of pyramids, cer ebellopontine angle tumors, post- traumatic changes, e tc. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 4.3 cm. For SOMA TOM Emo tion 6- slice configurati[...]

Children 535 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 40 mm was used. Emotion 6 InnerEarSeq kV 110 Effect ive m As/ Quality ref. mAs 90 Rotation time 1.0 s ec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 1.0 mm Feed/Scan 6.0 mm K ernel H90s CTDI Vol 16.56 mGy Effectiv e dose Male: 0.41 mSv* Female: 0.42 [...]

536 Children Hints • Children, who ar e older than age 6, should be scanned with an adult prot ocol as the skull by this time is fu lly grown. • In order to op timize image quality versus radiation dose, scans are pro vided within a maximum scan field of 300 mm with respec t to the iso-cent er . No recon job with a field of vi e w exceeding tho[...]

Children 537[...]

538 Children SinusOrbit Indications : Spiral mode f or r outine spi ral studies of the sinuses and paranasal sinuses, for exam ple, sinusitis, pneuma- tization, polyposis, malformations, tumors e tc. Spiral mode f or r outine studi es of the orbitae, for example, fracture. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 6 cm cover[...]

Children 539 Emotion 16 Sinus Orbi 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effect ive mAs/ Quality ref. mAs 50 Rot atio n time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 3.0 mm 1.0 mm 1.0 mm Feed/ Rot atio n 7.7 mm Pitch Fac tor 0.80 Incremen t 3.0 mm 3.0 mm 0.7 mm 0.7 mm K ernel C60s C30s C60s C30 s CTDI Vol 8.[...]

540 Children * The conversion factor f or a 7-year -old child, and a scan range of 60 mm was used. Emotion 6 Sinus Orbi 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effective mAs/ Quality ref. mAs 50 Rotation time 1.0 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 3.0 mm 3. 0 mm 1.25 mm 1.25 mm Feed/ Rotation 5.1 mm Pitch Factor 0.8[...]

Children 541 Hints • Children older than age 6 should be scanned wit h an adult pro tocol. • The second recon job is defined with k ernel H60s and with an overlap f or visualizing bone structures with MPR. •T o w o r k without CARE Dose 4D use for children < 3 years 40 mAs 3-6 years 60 mAs. Contrast medium IV injection Start delay exam dep[...]

542 Children NeckRoutine Indications : Spiral mode f or r outine nec k studies, f or e xample, tumors, lymphoma, abscesses, e tc. NeckRoutine: For SOMA TOM Emotion 16 -slice configu ration: A typical range of 15 cm cover ed in 7.21 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15 cm covered in 8.27 sec.[...]

Children 543 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 170 mm was used. Emotion 16 Neck 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 50 Rotation time 1.0 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 5.0 mm 1.5 mm Feed/Rotatio n 28.8 mm Pitch Fac tor 1.50 Increment 5.0 mm 1.0 m m K ernel B[...]

544 Children Hints • If necessary , scan down to the aor tic arc h or medi- astinum to include the entir e lesion. • Cooperative ch ildren can be instruc ted t o hold their breath during t he acquisition. • Children older than age 6 should be scanned with an adult pro tocol. •T o w o r k without C ARE Dose 4D u se for children < 3 years [...]

Children 545[...]

546 Children ThoraxRoutine/ ThoraxRoutine06s Indications : Spiral mode f or r outine t horax studies,f or ex ample, pneumonia, tumors, metastases, lymphoma, vascular abnormalities etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 15 cm covered in 4.33 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15 cm c[...]

Children 547 Emotion 16 Thor Routine 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effect ive mAs/ Quality ref. mAs 39 Rot atio n time 0.6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 3 .0 mm 3.0 mm 1.5 mm 1.5 mm Feed/ Rot atio n 28.8 mm Pitch Fac tor 1 .50 Incremen t 3.0 mm 3.0 mm 1.0 mm 1.0 mm K ernel B41s B60s B4 1s B60s CTDI V[...]

548 Children * The conversion factor f or a 7-year -old child, and a scan range of 150 mm was used. Emotion 6 ThorRoutine 2 nd reconstr . kV 110 Effective mAs/ Quality ref. mAs 26 Rotation time 0.8/ 0.6 sec. Acquisition 6 x 2.0 mm Slice collimation 2.0 mm Slice width 5.0 mm 5.0 mm Feed/Rotation 18.0 mm Pitch Factor 1.5 0 Increment 5.0 mm 5.0 mm K e[...]

Children 549 Hints • Children with a body weight of more than 55 k g should be examined with an adult pr ot ocol. • The first and second recon jobs are defined for visu- alization of the mediastinum and the lungs, respec- tively . •T o w o r k without CARE Dose 4D use for children < 15 kg 17 mAs 15-24 kg 20 mAs 25-34 kg 30 mAs 35-54 kg 60 [...]

550 Children ThoraxCombi/ ThoraxCombi06s Indications : Combining thin slice and routine thorax studies with one spiral scan, for ex ample, thorax studies in general and interstitial changes in t he lungs. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15 cm covered in 11.20 sec.[...]

Children 551 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 150 mm was used. Emotion 6 ThorC ombi 2 nd recon. 3 rd recon. 4 th recon. kV 110 Effect ive mAs/ Quality ref. mAs 39 Rot atio n time 0.8/0.6 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 3. 0 mm 3.0 mm 1.25 mm 1.25 mm Feed/ Rot atio n 9.0 mm Pitch [...]

552 Children Hints • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. •F o r t h e 2 nd reconstruction t he Autoload int o MPRthick Range on the 3D Car d is activat ed. The images will be automaticall y loaded int o 3D, MPRthick, and a coronal MPRt hic k Range will pop up. Please notice, if you ar e no[...]

Children 553[...]

554 Children ThoraxHRSeq Indications : Sequence mode for high-r es olution lung studies, f or example, interstitial changes in the lungs, using a 10 mm feed. For SOMA TOM Emotion 16 -slice configu ration: A scan range is predefined with 15.1 cm. For SOMA TOM Emo tion 6- slice configuration: A scan range is predefined with 15.0 cm.[...]

Children 555 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 200 mm was used. Emotion 16 ThoraxHRSeq kV 110 Effect ive m As/ Quality ref. mAs 36 Rotation time 1.0 s ec. Acquisition 4 x 0.6 mm Slice collimation 0.6 mm Slice width 1.2 mm Feed/Scan 10.0 mm Ke r n e l B 9 0 s CTDI Vol 0. 81 mGy Effectiv e dose Male: 0.31 mSv* Fema[...]

556 Children Hints • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. • If you want to acq uire the patient at full inspiration or full expiration, you should practice br eathing with the patient a fe w times befo re beginning the scan to impr ove r eproduc tbility . •T o w o r k without C ARE D ose [...]

Children 557[...]

558 Children AbdomenRoutine/ AbdomenRoutine06s Indications: Spiral mode for r outine studies in the region of abdo- men and pelvis, f or example, tumors, lym phoma, abscesses, post-traumatic changes, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 20.0 cm covered in 5.37 sec. For SOMA TOM Emo tion 6- slice configuration: A ty[...]

Children 559 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 200 mm was used. Emotion 16 AbdRoutine kV 110 Effect ive m As/ Quality ref. mAs 60 Rotation time 0. 6 sec. Acquisition 16 x 1.2 mm Slice collimation 1.2 mm Slice width 5.0 mm Feed/Rot ation 28.8 mm Pitch F act or 1.50 Incremen t 5.0 mm Ke r n e l B 4 1 s CTDI Vol 4. [...]

560 Children Hints • Delay ed scans may be r equir ed for the kidneys & bladder . • Rectal contrast may be r equired f or eva luation of pel- vic mass. • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. •T o w o r k withou t C ARE Dose 4D use for children < 25 k g 30 mAs 25-34 kg 55 mAs 35-5[...]

Children 561[...]

562 Children Spine/ SpineRoutine Indications : Spiral mode for spine studie s, f or exam ple, post-trau- matic changes, tumor s, malformations, orthopedic indication, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 15 cm cover ed in 26.04 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15 cm covered in 1[...]

Children 563 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 160 mm was used. Emotion 16 Spine 2 nd reconstr . kV 110 Effect ive m As/ Quality ref. mAs 60 Rotation time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 2.0 mm 1.0 mm Feed/Rotatio n 6.2 mm Pitch Fac tor 0.65 Increment 2.0 mm 0.7 mm K ernel B4[...]

564 Children Hints • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. •T o w o r k withou t C ARE Dose 4D use for children < 25 k g 30 mAs 25-34 kg 55 mAs 35-54 kg 120 mAs[...]

Children 565[...]

566 Children SpineThinSlice Indications : Spiral mode for the spine when Multi Planar Reforma- tion (MPR) ar e intended, f or example, post-traumatic changes, tumors, malformations, etc. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15 cm cover ed in 47.45 sec. * The conversion factor f or a 7-year -old child, and a scan range of[...]

Children 567 Hints • Children with a body weight of more than 55 k g should be examined with an adult pr ot ocol. •T o w o r k without CARE Dose 4D use for children < 25 kg 40 mAs 25-34 kg 70 mAs 35-54 kg 90 mAs[...]

568 Children ExtrRoutineHR Indications : Spiral mode for high-r esolution bone studies, for example, tumors, post-traumatic c hanges, or thopedic indications, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 6 cm cover ed in 35.33 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 10 cm covered in 35.33 sec.[...]

Children 569 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 60 mm was used. ** Adjust the mAs value t o the body region. Hints • Children with a body weight of more than 55 k g should be examined with an adult pr ot ocol. •T o w o r k without CARE Dose 4D use for children < 25 kg 26 mAs 25-34 kg 40 mAs 35-54 kg 80 mAs [...]

570 Children ExtrCombi Indications: Spiral mode f or the combinat ion of bone and soft tis- sue studies, for exam ple, ma sses, trauma, disorders of the joint e tc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 10 cm covered in 8.94 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 10 cm covered in 13.11 sec.[...]

Children 571 * The conv ersion factor f or a 7-year -old child, and a scan range of 100 mm was used. Emotion 16 ExtrCombi 2 nd reco nstr. kV 110 Effect ive m As/ Quality ref. mAs 25 Rotation time 1.0 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch Fac tor 1.50 Incremen t 3.0 mm 0.7 mm K e[...]

572 Children Hints • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. •T o w o r k withou t C ARE Dose 4D use for children < 25 k g 26 mAs 25-34 kg 35 mAs 35-54 kg 70 mAs Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site To t a l amount 1 – 2 [...]

Children 573[...]

574 Children HeadAngio/ HeadAngio06s Indications : Spiral mode for head CT Angio studies, for exam ple, cerebral vascular abnormalities, tumors etc. For SOMA TOM Emo tion 16-slice configuration: A typical range of 6 cm cover ed in 3.70 sec. For SOMA TOM Emo tion 6- slice configuration: A typical range of 6 cm cover ed in 5.20 sec. Emotion 16 HeadAn[...]

Children 575 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 60 mm was used. Emotion 6 HeadAngio 2 nd re const r . kV 80 Effect ive m As/ Quality ref. mAs 80 Rotation time 0.8/0.6 sec. Acquisition 6 x 1.0 mm Slice collimation 1.0 mm Slice width 2.0 mm 1.25 mm Feed/Rotatio n 9.0 mm Pitch Fac tor 1.50 Incremen t 2.0 mm 0.8 mm K [...]

576 Children Hints • Children older than age 6 should be examined with an adult pro tocol. • C ARE Bolus may be used t o optimize the bolus timing with a triggering threshold of 120 HU, or use manual triggering. • An advanced algorithm allow for impro ved head image quality , without any additional post-process- ing. •T o w o r k withou t C[...]

Children 577[...]

578 Children CarotidAngio/ CarotidAngio06s Indications : Spiral mode for car otid CT Angio studies, f or example, caro tidstenosis or occlusion, vascular abnormalities of thecaro tids or vertebral arteries, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 17 cm covered in 8.28 sec. For SOMA TOM Emo tion 6- slice configuration:[...]

Children 579 * The conv ersion factor for a 7-ye ar-old child, and a scan range of 170 mm was used. Emotion 16 CarotidAngio 2 nd reconstr . kV 80 Effect ive m As/ Quality ref. mAs 40 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch Fact or 1.50 Increment 3.0 mm 0.7 mm K e[...]

580 Children Hints • Children older than age 6 should be scanned with an adult pro tocol. • C ARE Bolus may be used t o optimize the bolus timing with a triggering threshold of 120 HU, or use manual triggering. •T o w o r k withou t C ARE Dose 4D use for children < 3 years 100 mAs 3-6 years 150 mAs Contrast medium IV injection Start delay [...]

Children 581[...]

582 Children BodyAngioRoutine/ BodyAngioRoutine06s Indications : For abdominal CT Angio studies, f or ex ample, vascular abnormalities, aneur ysms, etc. For SOMA TOM Emotion 16 -slice configu ration: A typical range of 20.0 cm covered in 9.53 se c. For SOMA TOM Emo tion 6- slice configuration: A typical range of 15.0 cm cover ed in 11.20 sec.[...]

Children 583 * The conv ersion factor f or a 7-year-old c hild, and a scan range of 200 mm was used. Emotion 16 BodyAngio 2 nd recons tr . kV 80 Effect ive m As/ Quality ref. mAs 80 Rotation time 0.6 sec. Acquisition 16 x 0.6 mm Slice collimation 0.6 mm Slice width 3.0 mm 1.0 mm Feed/Rotatio n 14.4 mm Pitch Fac tor 1.50 Incremen t 3.0 mm 0.7 mm K e[...]

584 Children Hints • Children with a body weig ht of more than 55 kg should be examined with an adult pro tocol. • C ARE Bolus may be used to op timize t he bolus tim- ing. Set the ROI f or monitoring scan in the abdominal aort a with triggering threshold of 120 HU , or use manual trigger ing. •T o w o r k withou t C ARE Dose 4D use for child[...]

Children 585[...]

586 Children BodyAngioF ast/ BodyAngioF ast06s Indication: Spiral mode for fast abdominal CT Angio studies, for example, vascular abnormalities, aneurysms, ect. For SOMA TOM Emo tion 6- slice configuration: A range of 15 cm will be covered in 11.20 sec. with BodyAngioFast06s Emotion 6 BodyAngioFast kV 80 Effective mAs/ Quality ref. mAs** 80 Rotatio[...]

Children 587 NeonateBody/ NeonateBody06s Indications : Spiral mode for neonate body studies, f or exam ple, tumors, abnormalities, malf ormations, absces ses, etc. For SOMA TOM Emotion 16- slice configuration: A typical range of 15 cm cover ed in 4.33 sec. For SOMA TOM Emotion 6 - slice configuration: A typical range of 15 cm covered in 6.20 sec.[...]

588 Children * The conversion fact or for a 8-week -old child, and a scan range of 150 mm was used. Emotion 16 NeonateBody kV 80 Effective mAs/ Quality ref. mAs 35 Rotation time 0.6 sec. Acquisition 16 x 1.2 mm Slice collimation 1. 2 mm Slice width 5.0 mm Feed/Rotation 28.8 mm Pitch Factor 1.5 0 Increment 5.0 mm Ke r n e l B 4 1 s CTDI Vol 1.02 mGy[...]

Children 589 Hints • C ARE Bolus may be used t o optimize bolus timing. Set the ROI f or monitoring scan in the abdominal aort a with triggering thr e shold of 120 HU, or use manual triggering. Contrast medium IV injection Start delay exam dependent Flow rate dependent upon needle size/Access site To t a l amount 1 – 2 ml per kg of body w eight[...]

Manufacturer Siemens Shanghai Medical Equipment Ltd. (SSME) 278 Zhou Zh u Road 201318 Shanghai, P .R. China T elephone: +86 21 38895000 Authorized Represent ative according to t he Medical Device Directive 93/42/ EEC Siemens AG Medical Solutions Henkestr . 127 D-91052 Erlangen Germany T elephone: +49 9131 84-0 © 2002-2007, Siemens A G Order No. C2[...]