Adult Routine Chest CT Protocols Version 2.

1 5/4/2016

DISCLAIMER: TO THE EXTENT ALLOWED BY LOCAL LAW,

THIS INFORMATION IS PROVIDED TO YOU BY THE
AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE, A
NON-PROFIT ORGANIZATION ORGANIZED TO PROMOTE
THE APPLICATION OF PHYSICS TO MEDICINE AND
BIOLOGY, ENCOURAGE INTEREST AND TRAINING IN
MEDICAL PHYSICS AND RELATED FIELDS ("AAPM"), 'AS IS'
WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND,
WHETHER ORAL OR WRITTEN, EXPRESS OR IMPLIED.
AAPM SPECIFICALLY DISCLAIMS ANY IMPLIED
WARRANTIES OR CONDITIONS OF MERCHANTABILITY,
SATISFACTORY QUALITY, NONINFRINGEMENT AND
FITNESS FOR A PARTICULAR PURPOSE. SOME
JURISDICTIONS DO NOT ALLOW EXCLUSIONS OF IMPLIED
WARRANTIES OR CONDITIONS, SO THE ABOVE EXCLUSION
MAY NOT APPLY TO YOU. YOU MAY HAVE OTHER RIGHTS
THAT VARY ACCORDING TO LOCAL LAW.

TO THE EXTENT ALLOWED BY LOCAL LAW, IN NO EVENT

WILL AAPM OR ITS SUBSIDIARIES, AFFILIATES OR
VENDORS BE LIABLE FOR DIRECT, SPECIAL, INCIDENTAL,
CONSEQUENTIAL OR OTHER DAMAGES (INCLUDING LOST
PROFIT, LOST DATA, OR DOWNTIME COSTS), ARISING OUT
OF THE USE, INABILITY TO USE, OR THE RESULTS OF USE
OF THE PROVIDED INFORMATION, WHETHER BASED IN
WARRANTY, CONTRACT, TORT OR OTHER LEGAL THEORY,
AND WHETHER OR NOT ADVISED OF THE POSSIBILITY OF
SUCH DAMAGES. YOUR USE OF THE INFORMATION IS
ENTIRELY AT YOUR OWN RISK. THIS INFORMATION IS NOT
MEANT TO BE USED AS A SUBSTITUTE FOR THE REVIEW
OF SCAN PROTOCOL PARAMETERS BY A QUALIFIED AND
CERTIFIED PROFESSIONAL. USERS ARE CAUTIONED TO
SEEK THE ADVICE OF A QUALIFIED AND CERTIFIED
PROFESSIONAL BEFORE USING ANY PROTOCOL BASED ON
THE PROVIDED INFORMATION. AAPM IS NOT RESPONSIBLE
FOR A USER'S FAILURE TO VERIFY OR CONFIRM
APPROPRIATE PERFORMANCE OF THE PROVIDED SCAN
PARAMETERS. SOME JURISDICTIONS DO NOT ALLOW THE
EXCLUSION OR LIMITATION OF LIABILITY FOR DAMAGES,
SO THE ABOVE LIMITATION MAY NOT APPLY TO YOU.

1
The disclaimer on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT

Indications (include but are not limited to)

• Evaluation of findings on chest radiographs or other CT exams as seen on other imaging
modalities;
• Evaluation of lung and other primary thoracic malignancies, and detection and evaluation
of metastatic disease;
• Evaluation for thoracic manifestations of known extrathoracic diseases;
• Evaluation of chest infections;
• Evaluation of inflammations involving the chest;
• Evaluation of abnormalities within the chest; i.e. fluid or abscess
• Evaluation of the chest wall;
• Evaluation of pleural disease;
• Evaluation of the mediastinum and lymph nodes.

Diagnostic Tasks (include but are not limited to)

• Detect nodules or masses and characterize their size and shape and relationships to
organs;
• Identify abnormal aeration or expansion of the lungs;
• Detect abnormal fluid collections in the chest;
• Identify abnormal air collections both in and around the lungs;
• Detect mediastinal and paravascular masses and nodules;
• Characterize chest wall masses;
• Detect calcifications in soft tissues or the mediastinum.

Key Elements
• Contrast enhancement;
• One breath-hold (motion is problematic);
• Can reconstruct additional images for high-resolution chest CT.

Contrast
• Oral: None.
• Injected: Certain indications require administration of intravenous contrast media.
• Intravenous contrast enhancement should be performed as directed by the supervising
radiologist using appropriate injection protocols and in accordance with the ACR-SPR Practice
Guideline for the Use of Intravascular Contrast Media and the ACR Manual on Contrast Media.

Patient Positioning
• Center the patient within the gantry; this is critical for proper functioning of AEC systems.
• Patient supine, arms above head;

Scan Range
• From top of lungs through the bottom of lungs. Instruct patient to hold breath at inspiration
during entire scan.

Suspension of Respiration
• Patient should be instructed to hold his/her breath at end of inspiration.

2
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

Additional Image Reconstructions

• Certain indications may require that images be reconstructed in coronal and/or sagittal planes.
• Very thin images (approximately ≤ 1 mm) may need to be reconstructed to serve as source
images for the sagittal and/or coronal reformatted images.
• Creation, use, and archival of these additional images are at the discretion of the supervising
radiologist and/or departmental policy. Very large datasets may result from these additional
reconstructions.

Radiation Dose Management

• AEC should be used whenever possible.
• Pay careful attention to the values selected to define the desired level of image quality
(e.g., Noise Index, Quality Reference mAs, Standard Deviation).
• Each manufacturer will have recommendations unique to their systems and system
features. Be sure to work with your CT equipment manufacturer and a qualified medical
physicist to ensure safe and appropriate operation of AEC systems.
• If more than one CT localizer radiograph is acquired, AEC systems from different
manufacturers can differ with respect to which one is used to determine mA and/or kV
settings. Please refer to individual manufacturer protocol instructions.

3
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

Approximate Volume CT Dose Index (CTDIvol) Values

• Approximate values for CTDIvol are listed for three different patient sizes:

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Average Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

The approximate CTDIvol values are for reference only and represent a dose to the CT Dose Index
phantom under very specific conditions. The CTDIvol displayed on the scanner for a patient of a
given size should be similar, but not necessarily an exact match, to those listed in the above table.
The provided values are all based on the 32 cm diameter “body” CTDI phantom.

It is essential that users recognize that the CTDIvol values reported on the user console prior to
acquiring CT localizer radiographs on a particular patient do not represent the CTDIvol that will be
delivered during that patient’s scan. CT systems rely on the CT localizer radiograph to 1) estimate the
patient’s size, 2) determine the tube current settings for each tube angle and table position that will
yield the requested level of image quality, and 3) calculate the average CTDIvol for the patient over
the prescribed scan range. Until the CT localizer radiograph is acquired, the reported CTDIvol is not
patient-specific, but is based on a generic patient size.

The CTDIvol values provided here are approximate, and are intended only to provide reference
ranges for the user to consider. They are for a routine CT of an adult’s chest for the general
indications given at the beginning of this document. Other indications or diagnostic tasks may have
different image quality and dose requirements, and hence reasonable ranges of CTDIvol may differ
according to those requirements.

In this document, a small patient is considered to be approximately 50-70 kg (110-155 lbs), an

average patient approximately 70-90 kg (155-200 lbs), and a large patient 90-120 kg (200-265 lbs).
However, weight is not a perfect indication of patient size. A person’s height, gender and distribution
of weight across the body also must be taken into account. The thickness of the body over the area to
be scanned is the best indication of patient size. Body Mass Index (BMI) may also be considered:

• Underweight = BMI <18.5

• Normal weight = BMI of 18.5–24.9
• Overweight = BMI of 25–29.9
• Obesity = BMI of 30 or greater

It is recognized that the median (50th percentile) patient size for adults in the USA is larger than 70 kg.
However, the 70 kg patient represents the “Reference Man”, as defined by the International
Commission on Radiation Protection (ICRP), upon which AEC systems and tissue weighting factors
(used for effective dose estimation) are based.

CTDI measurements and calculations

• Some manufacturers utilize a z-axis “flying focal spot”, in which two unique projections
are acquired at the same z-axis table position. When this technique is used, we identify it
with **. The CTDIvol on the console accurately accounts for use of this feature.

4
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

INDEX OF ADULT ROUTINE CHEST PROTOCOLS (by manufacturer)

GE
Hitachi
Neusoft
Neurologica
Philips
Siemens
Toshiba

5
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (Selected GE scanners) (Back to INDEX)

SCOUT: AP S60-I400; scan from top of shoulder through mid-liver, if automatic exposure control is used. PA scout if manual mA is
used.

LightSpeed BrightSpeed BrightSpeed 16 / LightSpeed LightSpeed VCT /

GE (Without ASIR) Ultra 16 Select Lightspeed 16 Pro16 Discovery CT750
Scan Type Helical Helical Helical Helical HD
Helical
Rotation Time (s) 0.5 0.8 0.5 0.5 0.4
Beam Collimation (mm) 10 20 20 20 40
Pitch 1.35 1.35 1.35 1.35 1.375
Speed (mm/rot) 13.5 27.5 27.5 27.5 55.0
kV 120 120 120 120 120
SmartmA min-max mA 50 – 260 100 – 440 100 – 650 100 – 650
(ave mA) No SmartmA (160) (260) (270) (500)
NI* mA = 300 11.57 11.57 11.57 13.0
SFOV Large Large Large Large Large

RECON 1
Plane Axial Axial Axial Axial Axial
Algorithm STD STD STD STD STD
Recon Mode Full Full Full Full Full
Thickness (mm) 5 5 5 5 5
Interval (mm) 5 5 5 5 5
RECON 2
Plane Axial Axial Axial Axial Axial
Algorithm Lung Lung Lung Lung Lung
Recon Mode Full Full Full Full Full
Thickness (mm) 5 5 5 5 5
Interval (mm) 5 5 5 5 5

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

*The Noise Index value and the primary (RECON 1) image reconstruction thickness both strongly impact CTDIvol and patient dose.
See: Kanal KM et al. Impact of Operator-Selected Image Noise Index and Reconstruction Slice Thickness on Patient Radiation Dose in
64-MDCT. AJR 2007; 189: 219-225.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

6
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected GE scanners)(continued) (Back to INDEX)

SCOUT: AP S60-I400; scan from top of shoulder through mid-liver, if automatic exposure control is used. PA scout if manual mA is
used.

Discovery
GE (With ASIR) VCT CT750 HD
Scan Type Helical Helical
Rotation Time (s) 0.4 0.4
Beam Collimation (mm) 40 40
Pitch 1.375 1.375
Speed (mm/rot) 55.0 55.0
kV 120 120
SmartmA min-max 100 – 650 (250) 100 – 650 (250)
NI* 13.0 (DR 50%) 16.8
SFOV Large Large
RECON 1
Plane Axial Axial
Algorithm STD STD
Recon Mode Full Full
Thickness (mm) 5 5
Interval (mm) 5 5
ASIR SS50 SS50
RECON 2
Plane Axial Axial
Algorithm Lung Lung
Recon Mode Full Full
Thickness (mm) 5 5
Interval (mm) 5 5
ASIR SS50 SS50
ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

*The Noise Index value and the primary (RECON 1) image reconstruction thickness both strongly impact CTDIvol and
patient dose. See: Kanal KM et al. Impact of Operator-Selected Image Noise Index and Reconstruction Slice Thickness
on Patient Radiation Dose in 64-MDCT. AJR 2007; 189: 219-225.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

7
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected HITACHI scanners) (Back to INDEX)

SCANOGRAM: Lat and PA (PA only for CXR4); scan from top of shoulder through mid-liver.

HITACHI CXR4 ECLOS 16 Supria 16 SCENARIA 64

Scan Type Volume Volume Volume Volume
Rotation Time (s) 0.8 0.8 0.75 0.75
Detector Configuration 2.5 x 4 1.25 x 16 1.25 x 16 0.625 x 64
Pitch 1.25 1.0625 1.0625 1.0781
Speed (mm/rot) 12.5 21.25 21.25 43.48
kV 120 120 120 120
IntelliEC: 100-400 IntelliEC: 100-400 IntelliEC: 100-600
mA 225
mA mA mA
Adaptive mA/IntelliEC Yes SD 15 SD 13 SD 16
SFOV 500 500 500 500
Prep Delay (s) 20 30 30 30
RECON 1
Series Description Mediastinum Mediastinum Mediastinum Mediastinum
Type Axial Axial Axial Axial
Filter 5 31 31 31C
Thickness (mm) 5 5 5 5
Interval (mm) 5 5 5 5
RECON 2
Series Description Lung Lung Lung Lung
Type Axial Axial Axial Axial
Filter 9 22 22 22C
Thickness (mm) 5 5 5 5
Interval (mm) 5 5 5 5

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

8
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected NEUSOFT scanners) (Back to INDEX)

SCOUT/SURVIEW: PA, 350 mm (Adjust to cover: Apices through adrenals)

NeuViz64i/e NeuViz 16
NEUSOFT
Scan Type Helical Helical
Rotation Time
0.5 0.6
(s)
Collimation 64 x 0.625* 16 x 1.5 mm

kVp 100 120

Reference
200 200
mAs
Pitch 1.2 1.07

FOV (mm) 350 350

Resolution Standard Standard

Dose
O-DOSE ACS & DOM
Modulation

RECON 1
Type Axial Axial

Filter F20 SB
Thickness
5 5
(mm)
Increment
5 5
(mm)
ClearView 30% N/A

RECON 2
Type Axial Axial

Filter Lung20 LungB

Thickness
5 5
(mm)
Increment
5 5
(mm)
ClearView 30% N/A

*Quad Sampling- Indicates that a z-axis flying focal spot technique is used to obtain twice as many projections as detector
rows. Simultaneous x-y deflection is also incorporated.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

9
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected NEUROLOGICA scanners) (Back to INDEX)

Scout: PA, scan from top of shoulder through mid-liver

NEUROLOGICA BodyTom BodyTom

Scan Type Helical Axial
Rotation Time (s) 1 1
Beam Collimation (mm) 40 10
Pitch 0.8 N/A
kV 120 120
mA with AEC mA=50 to 200 mA=50 to 200
mA without AEC mA=200 mA=200
SFOV full full
RECON 1
Plane Axial Axial
Algorithm Soft Tissue Soft Tissue
Recon Mode Full Full
Thickness (mm) 5 5
Interval (mm) 5 5
RECON 2
Plane Axial Axial
Algorithm Lung Lung
Recon Mode Full Full
Thickness (mm) 5 5
Interval (mm) 5 5

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

10
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected PHILIPS scanners) (Back to INDEX)

SURVIEW: PA; scan from top of shoulder through mid-liver.

Ingenuity CT Brilliance iCT SP Brilliance iCT

Brilliance Brilliance
PHILIPS 16 slice 64 slice (w/ iPatient) (w/ iPatient) (w/ iPatient)
Scan Type Helical Helical Helical Helical Helical
Rotation Time (s) 0.5 0.5 0.4 0.33 0.33
Collimation 16 × 1.5 mm 64 × 0.625 mm 64 × 0.625 mm 64 × 0.625 mm 128 × 0.625 mm
Coverage (mm) 24 40 40 40 80
kV 120 120 120 120 120
140 125 125
(DoseRight DRI = 21 (DoseRight DRI = 21 (DoseRight DRI = 21
mAs 140 140
143 mAs 125 mAs 125 mAs
@ 29 cm ref) @ 29 cm ref) @ 29 cm ref)
Pitch 1 1 1.1 1.2 1
FOV (mm) 350–500 350–500 350–500 350–500 350–500

RECON 1
Type Axial Axial Axial Axial Axial
Filter B/C B/C B/C B/C B/C
Thickness (mm) 5 5 5 5 5
Increment (mm) 5 5 5 5 5

RECON 2
Type Axial Axial Axial Axial Axial
Filter YA/YB YA/YB YA/YB YA/YB YA/YB
Thickness (mm) 5 5 5 5 5
Increment (mm) 5 5 5 5 5

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

11
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected SIEMENS scanners) (Back to INDEX)

TOPOGRAM: PA, 512 mm, 120/130 kV; scan from top of shoulder through mid-liver.

Perspective 64
Emotion 16 Scope Power Sensation 64
SIEMENS Perspective 128
Scan Mode Spiral Spiral Spiral Spiral
Rotation Time (s) 0.68 0.6 0.6 0.5
b a
Detector 32 x 0.6 64 × 0.6
16x0.6 16 x0.6 b
Configuration (mm) 64 x 0.6 (32 x 0.6 = 19.2)

Pitch 1.5 1.5 1.3 1.4

kV 130 130 130 120
d d
Quality ref.mAs 70 70/50 70/50 100
CARE kV - - - -
CARE Dose4D ON ON ON ON
RECON 1
Type Axial Axial Axial Axial
d d d
Kernel B41s B41s/I41s (3) B41s/I31s B31f (3)
Slice (mm) 5 5 5 5
Increment (mm) 5 5 5 5
RECON 2
Type Axial Axial Axial Axial
d d d
Kernel B70s B70s/I80s (3) B70s/I80s (3) B70f/I80f (3)

Slice (mm) 5 5 5 5
Increment (mm) 5 5 5 5

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

a
indicates that a z-axis “flying focal spot” technique is used to obtain twice as many projections per rotation as detector rows
b
IVR (Interleaved Volume Reconstruction) is available to improve spatial resolution
c
If scanner is equipped with automatic kV selection (CARE kV), this should be activated by selecting “On”.
• For non-contrast-enhanced exams, a Reference kV of 120/130 and a “Dose saving optimized for” slider position of 2 is recommended.
• For contrast-enhanced exams, a Reference kV of 120/130 and a “Dose saving optimized for” slider position of 7 is recommended.
• For exams requiring both a non-contrast-enhanced and a contrast-enhanced scan, where the change in mean CT number of a region
may be relevant to the diagnosis, it is important that the kV be the same for both scans. You can force CARE kV to use the same kV
by linking the series. The optimization is then done by considering all linked acquisitions and their individual slider settings.
d
with ADMIRE, SAFIRE or IRIS. For ADMIRE and SAFIRE, the number in parenthesis indicates the recommended for the strength

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

12
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected SIEMENS scanners) (Back to INDEX)

TOPOGRAM: PA, 512 mm, 120/130 kV; scan from top of shoulder through mid-liver.

Definition Edge
Force
Definition Definition AS+
(Dual source 192-slice)
SIEMENS (Dual Source) Flash (Dual source 128-slice)
Scan Mode Spiral Spiral Spiral
Rotation Time (s) 0.5 0.5 0.5
a a a
64 x 0.6 128 x 0.6 192 x 0.6
Detector Configuration (mm)
(32 x 0.6=19.2) (64 x 0.6=38.4) (96 x 0.6=57.6)
Pitch 1.2 1.2 1.2
kV 120 120 110
d d d
Quality ref.mAs 110/66 110/66 51
CARE Dose4D ON ON ON
c c c
CARE kV ON ON ON
RECON 1
Type Axial Axial Axial
d d d
Kernel B31f/I31f (3) B31f/I31f (3) Br40 (3)

Slice (mm) 5 5 5
Increment (mm) 5 5 5
RECON 2
Type Axial Axial Axial
d d d
Kernel B80f/I70f (3) B80f/I70f (3) Bl57 (3)

Slice (mm) 5 5 5
Increment (mm) 5 5 5

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

a
indicates that a z-axis “flying focal spot” technique is used to obtain twice as many projections per rotation as detector rows
b
IVR (Interleaved Volume Reconstruction) is available to improve spatial resolution
c
If scanner is equipped with automatic kV selection (CARE kV), this should be activated by selecting “On”.
• For non-contrast-enhanced exams, a Reference kV of 120/130 and a “Dose saving optimized for” slider position of 2 is recommended.
• For contrast-enhanced exams, a Reference kV of 120/130 and a “Dose saving optimized for” slider position of 7 is recommended.
• For exams requiring both a non-contrast-enhanced and a contrast-enhanced scan, where the change in mean CT number of a region
may be relevant to the diagnosis, it is important that the kV be the same for both scans. You can force CARE kV to use the same kV
by linking the series. The optimization is then done by considering all linked acquisitions and their individual slider settings.
d
with ADMIRE, SAFIRE or IRIS. For ADMIRE and SAFIRE, the number in parenthesis indicates the recommended for the strength

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

13
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.
 Adult Routine Chest CT Protocols Version 2.1 5/4/2016

ADULT ROUTINE CHEST CT (selected TOSHIBA scanners) (Back to INDEX)

SCANOGRAM: Dual scanogram: PA and LAT; 500 mm above shoulders to below liver.

Aq 16 Aq PRIME
TOSHIBA Aq 32 Aq 64 Aq ONE Vision
Aq RXL Aq ONE / Premium
Scan Type Helical Helical Helical Helical Helical
Rotation Time (s) 0.5 0.5 0.5 0.5 0.275
Detector
16 x 1.0 mm 32 x 0.5 64 x 0.5 80 x 0.5 80 x 0.5
Configuration
Pitch Fast (1.438) Fast (1.406) Fast (1.484) Fast (1.388) Standard (0.813)
Speed (mm/rot) 23 22.5 47.5 55.5 32.5
kV 120 120 120 120 120
mA 80-500 mA 80-500 mA 80-500 mA 80-500 mA 80-700 mA
SURE
Exposure Std (SD = 12.5) Std (SD = 12.5) Std (SD = 12.5) Std (SD – 12.5) Std (SD = 12.5)
QDS+ (Aq 16)
AIDR 3D / QDS+ AIDR 3D (Aq QDS+ AIDR 3D AIDR 3D AIDR 3D
RXL)
SFOV (mm) 400 mm (L) 400 mm (L) 400 mm (L) 400 mm (L) 400 mm (L)
RECON 1
Type Axial Axial Axial Axial Axial
SURE
IQ Setting Body Std Axial Body Std Axial Body Std Axial Body Std Axial Body Std Axial
Thickness (mm) 5 5 5 5 5
Interval (mm) 5 5 5 5 5
RECON 2
Type Axial Axial Axial Axial Axial
SURE
IQ Setting Lung Std Axial Lung Std Axial Lung Std Axial Lung Std Axial Lung Std Axial
Thickness (mm) 5 5 5 5 5
Interval (mm) 5 5 5 5 5

SURE
*The IQ setting determines the reconstruction FC as well as other post-processing and reconstruction options, such as AIDR. The
SURE
IQ settings listed in this document refer to the manufacturer’s default settings.

ADDITIONAL RECONSTRUCTIONS MAY BE NEEDED BASED ON THE CLINICAL INDICATION.

Approx. Weight (kg) Approx. Weight (lbs) Approx. CTDIvol (mGy)

Small Patient 50-70 110-155 4-10
Avg. Patient 70-90 155-200 8-16
Large Patient 90-120 200-265 14-22

14
The disclaimer found on page 1 is an integral part of this document.
Copyright © May 4, 2016 by AAPM. All rights reserved.