CT HAND INDICATIONS: Trauma, fracture, dislocation, pain PATIENT PREP: None IV CONTRAST: None ORAL CONTRAST: None POSITIONING: Head First Prone-Arm Extended TOPOGRAMS: AP. Range: Distal to fingers through wrist. 25 mA, 110 kV. Lateral. Range: Distal to fingers through wrist. 25 mA, 110 kV. SCAN TYPE: Spiral/Helical NOTES: Scan in as close to Axial Plane as possible. Then do 2mm Reconstructions in Axial/Coronal/Sagittal planes angled to body part in question. On the Recon Card use 3D Axial/Coronal/Sagittal to do this. Send Thin Slice Volume Source Images (Recon #1 0.75 x 0.7 mm) to PACS. Check if referring physician has specific orders ALARA – Keep radiation dose As Low As Reasonably Achievable. * 3D Only if Ordered by Referring Physician or requested by Radiologist. Obtain order for 3D from referring physician. For 3D Only: Send Recon 3D 0.75 x 0.4mm to Vital Workstation for 3D and call Spokane HAND Scan Scan Direction Respiration Scan CARE Quality kV Detector Configuration Pitch Rotation SFOV Range Delay DOSE Reference Time (cm) Scan Type (Seconds) 4D mAs Slices Per Tube Rotation Table Increment/Speed: (mm/rotation) (Seconds) Carpals Through Craniocaudal Quiet 3 ON 60 110 Detectors: 16 x 0.6 mm Pitch: 0.8 1.0 50 Distal Phalanges Spiral/Helical Respiration Seconds Slices Per Tube Rotation: 16 Table Increment/Speed: 7.68 mm/rotation Seconds cm Plane Slice Interval Kernal Window DFOV Thickness Width/Level (cm) RECON – AXIAL BONE Original Scan 0.75 mm 0.7 mm B70s Osteo FOV Small Send To PACS Thin Slice Volume Source Images Sharp 1500/450 To Fit Anatomy RECON – AXIAL BONE MPR Axials Angled in Plane to Body Part 2.0 mm 2.0 mm B70s Osteo FOV Small Axials Angled in Plane to Body Part Recon Card 3D Axial MPR Sharp 1500/450 To Fit Anatomy RECON – AXIAL SOFT TISSUE MPR Axials Angled in Plane to Body Part 2.0 mm 2.0 mm B30s Mediastinum FOV Small Axials Angled in Plane to Body Part Recon Card 3D Axial MPR Medium Smooth 400/40 To Fit Anatomy RECON – CORONAL BONE MPR Coronals Angled to Body Part 2.0 mm 2.0 mm B70s Osteo FOV Small Coronals Angled In Plane to Body Part Recon Card 3D Coronal MPR Sharp 1500/450 To Fit Anatomy RECON – SAGITTAL BONE MPR Sagittals Angled to Body Part 2.0 mm 2.0 mm B70s Osteo FOV Small Sagittals Angled in Plane to Body Part Recon Card 3D Sagittal MPR Sharp 1500/450 To Fit Anatomy RECON – 3D ONLY – AXIAL SOFT TISSUE Original Scan For 3D Only 0.75 mm 0.4 mm B30s Mediastinum FOV Small Send To Vital WorkStation for 3D Thin Slice Volume Source Images With Overlap Medium Smooth 400/40 To Fit Anatomy

*The operator must check the CTDIvol before and after the scan to ensure it is within the allowed dose range. Scans performed outside of the allowed range must be documented and reviewed by the designated radiologist and/or physicist. Allowed CTDIvol Dose Ranges: 1 mGy – 20 mGy for 32 cm CTDI phantom. 2 mGy – 40 mGy for 16 cm CTDI phantom. XR29 Dose Notification Value (CTDIvol): 20 mGy for 32 cm CTDI phantom. 40 mGy for 16 cm CTDI phantom.

CHARGES: Bill for 3D in Charges section when ending exam: “3D POST PROCESSING CT”. (Obtain Order for 3D) NETWORK: Exam to PACS For 3D Only: Send Recon 3D 0.75 x 0.4mm to Vital Workstation for 3D and call Spokane. 12/2017