GE Revolution CT User manual

Revolution CT

User Manual

OPERATING DOCUMENTATION

5480385-1EN

Revision 1

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Revision History

Revision Date Reason For Change

1 August 2014 Initial release.

The original language of this document is

English, Direction Number 5480385-1EN,

Revision 1.

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Table of Contents

Chapter 1 USER INFORMATION.......................................................................................................... 37

1 Introduction....................................................................................................................................37

2 User Documentation......................................................................................................................38

3 GE Approved Accessories.............................................................................................................39

Chapter 2 REGULATORY INFORMATION............................................................................................41

1 Applicable Regulations and Standards......................................................................................... 41

2 Product Description....................................................................................................................... 43

2.1 Intended Use of the System................................................................................................. 43

2.2 Indications for Use of the System.........................................................................................43

2.3 Contraindications..................................................................................................................43

3 Product Manufacturer....................................................................................................................44

Chapter 3 SAFETY.................................................................................................................................45

1 General Safety Guidelines.............................................................................................................45

2 Safety Conventions....................................................................................................................... 47

3 Symbols and Warning Labels........................................................................................................48

3.1 Symbols................................................................................................................................48

3.2 Equipment Warning Labels.................................................................................................. 52

3.2.1 Laser Warning Labels..................................................................................................52

3.2.2 X-ray Warning Labels.................................................................................................. 53

3.2.3 Table Warning Labels..................................................................................................53

3.2.4 Power Distribution Unit (PDU) Warning Labels........................................................... 54

3.2.5 Scanner Desktop Labels..............................................................................................55

3.2.6 External Accessory Labels.......................................................................................... 55

4 Radiation Safety ........................................................................................................................... 59

4.1 X-Ray Protection.................................................................................................................. 59

4.2 General Radiation Safety..................................................................................................... 60

4.3 Scans Acquired at the Same Tomographic Plane................................................................61

4.4 Geometric Dose Efficiency................................................................................................... 61

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4.5 Backup Timer Indicator.........................................................................................................62

4.6 Starting Scans from the Scan Room.................................................................................... 62

4.7 CTDI

vol

.................................................................................................................................. 62

5 Implantable Device Safety.............................................................................................................64

5.1 Recommendations prior to scanning.................................................................................... 64

5.2 Recommendations after scanning........................................................................................ 64

6 Electrical Safety.............................................................................................................................65

7 Electromagnetic Compatibility Safety............................................................................................68

8 Fire Safety..................................................................................................................................... 69

9 Mechanical Safety......................................................................................................................... 70

9.1 General Mechanical Safety.................................................................................................. 70

9.2 Patient Positioning................................................................................................................70

9.3 Gantry Air Inlets....................................................................................................................73

10 Emergency Devices and Emergency Egress.............................................................................. 74

10.1 Emergency Devices............................................................................................................74

10.1.1 Emergency Stop........................................................................................................ 74

10.1.2 System Emergency OFF Buttons using Main Disconnect Control............................ 75

10.2 Emergency Patient Care During X-ray ON.........................................................................76

10.3 Emergency Egress............................................................................................................. 76

11 Laser Safety................................................................................................................................ 77

12 Reconstructed Image Orientation................................................................................................79

13 Data Safety..................................................................................................................................81

14 Application Specific Safety Topics...............................................................................................83

14.1 Axial and Helical Scanning................................................................................................. 83

14.2 Cardiac Imaging................................................................................................................. 83

14.3 CT Integrated Cardiac Module........................................................................................... 85

14.4 Advanced Application Safety..............................................................................................85

14.5 Measurements....................................................................................................................85

14.6 Segment Tools................................................................................................................... 86

14.7 Filming and Saving Images................................................................................................ 86

15 Application Software Safety.........................................................................................................88

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16 Accuracy of Measurements.........................................................................................................89

16.1 Measure Distance for Axial, Helical, and Cine Images.......................................................89

16.2 Measure Distance for Scout Images.................................................................................. 89

16.3 Measure Angle................................................................................................................... 90

16.4 Voxel Dimensions...............................................................................................................91

16.5 ROI..................................................................................................................................... 91

16.6 CT Number......................................................................................................................... 91

16.6.1 CT Number Mean and Standard Deviation................................................................92

16.6.2 CT Number Accuracy................................................................................................ 92

16.7 Range, Precision and Accuracy of Displayed Values.........................................................92

17 Accessory Safety.........................................................................................................................93

17.1 Monitor Safety.................................................................................................................... 93

17.2 IV Pole Safety.....................................................................................................................93

17.3 Table Tray Safety............................................................................................................... 94

17.4 Systems With Metal-Free Cradles and Accessories.......................................................... 94

17.5 Power Injector Safety......................................................................................................... 94

17.6 Phantom Safety.................................................................................................................. 94

18 Maintenance and Cleaning..........................................................................................................95

19 Hazardous Substances............................................................................................................... 96

20 System Performance...................................................................................................................97

Chapter 4 READ ME FIRST...................................................................................................................99

1 About This Manual........................................................................................................................99

1.1 Notices ................................................................................................................................99

1.2 Purpose of this guide ..........................................................................................................99

1.3 Prerequisite skills ................................................................................................................99

2 Scan Monitor............................................................................................................................... 100

2.1 New Patient....................................................................................................................... 100

2.2 Patient Schedule............................................................................................................... 101

2.3 Scan Setup......................................................................................................................... 102

3 Image Monitor..............................................................................................................................108

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3.1 Icons and System Status Area........................................................................................... 108

3.2 Reconstruction and Image Processing Area...................................................................... 110

3.3 Image Viewports.................................................................................................................112

3.4 File Manager.......................................................................................................................113

4 User Interface Conventions.........................................................................................................116

4.1 Select items from a list...................................................................................................... 116

4.2 Cancel .............................................................................................................................. 116

4.3 Button and text appearance ............................................................................................. 116

4.4 Pop-up windows ............................................................................................................... 117

4.5 Mouse controls ................................................................................................................. 117

5 System Troubleshooting Tips......................................................................................................119

Chapter 5 PEDIATRICS AND SMALL PATIENTS............................................................................... 121

1 Overview......................................................................................................................................121

2 Radiation Exposure..................................................................................................................... 122

2.1 Radiation exposure sensitivity .......................................................................................... 122

2.2 Dose reporting considerations ..........................................................................................122

2.3 Minimize pediatric and small patient doses........................................................................ 123

2.3.1 Perform only necessary CT examinations.................................................................123

2.3.2 Scan only the organ or anatomical region indicated..................................................123

2.3.3 Minimize multi-phase contrast CT examinations....................................................... 124

2.3.4 Properly center all patients in the gantry................................................................... 124

2.3.5 Lower mA settings for chest and bone imaging.........................................................124

2.3.6 Scan signal-to-noise.................................................................................................. 124

2.3.7 Consider using in-plane Bismuth shields...................................................................124

2.3.8 Use pediatric positioning accessories........................................................................124

2.3.9 Make a kid friendly environment................................................................................124

3 Pediatric and small patient scans................................................................................................126

3.1 Optimize pediatric protocols for your facility....................................................................... 126

3.2 Pediatric protocols.............................................................................................................. 126

3.3 Color Coding for Kids Protocol Selection........................................................................... 127

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3.4 Set up a pediatric or small patient exam............................................................................ 128

3.5 Adjust pediatric and small patient scan parameters........................................................... 129

3.5.1 Adjust the parameters by size, age, weight, height, and indications......................... 129

3.5.2 Consider decreasing the kV.......................................................................................130

3.5.3 Center the patient properly when using SmartmA.....................................................131

3.5.4 Increase the pitch...................................................................................................... 131

3.5.5 Use Small SFOV Filters.............................................................................................131

Chapter 6 LARGE PATIENT................................................................................................................ 133

1 Overview......................................................................................................................................133

2 Large Patients............................................................................................................................. 134

2.1 Scanning large patients...................................................................................................... 134

2.1.1 Perform only necessary CT examinations.................................................................134

2.1.2 Patient weight and patient size..................................................................................134

2.1.3 Properly position large patients in the gantry.............................................................134

2.2 Guidelines for adjusting individual exposure parameters by patient.................................. 135

2.2.1 Adjust parameters......................................................................................................135

2.2.2 High kV...................................................................................................................... 135

2.2.3 mA adjustment...........................................................................................................135

2.2.4 Lower pitch / slow rotation time................................................................................. 135

2.2.5 Scan Type..................................................................................................................135

2.2.6 Increase slice thickness.............................................................................................136

2.3 Radiation exposure and dose reporting..............................................................................136

Chapter 7 DOSE CHECK.....................................................................................................................137

1 Overview......................................................................................................................................137

1.1 Introduction.........................................................................................................................137

1.2 Protocol Considerations..................................................................................................... 138

1.3 Terminology........................................................................................................................138

1.3.1 Notification Value (NV).............................................................................................. 138

1.3.2 Alert Value (AV).........................................................................................................138

1.3.3 Dose Check Administrator.........................................................................................138

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1.3.4 Dose Check AV Exceeding User...............................................................................138

1.3.5 Protocol Change Control........................................................................................... 138

2 Set the Dose Check Administrator Role......................................................................................139

3 Set the Dose Check AV Exceeding User Role............................................................................141

4 Configure the System for Dose Check........................................................................................ 143

5 Configure the AV by Age Threshold............................................................................................145

6 Build Protocols With Access Controls......................................................................................... 147

7 Build Protocols with Notification Values...................................................................................... 148

8 Build Protocols with Notification Values by Factor...................................................................... 149

9 Scan Using Alert Value Checking............................................................................................... 150

10 Scan Using Notification Value Checking................................................................................... 152

11 Use the Dose Audit Tool............................................................................................................154

11.1 Display a Dose Check Log............................................................................................... 154

11.2 Display the Protocol Summary......................................................................................... 154

11.3 Display the Invalid Protocols............................................................................................ 154

11.4 Export Dose Check Log, Protocol Summary, Invalid Protocols Data and User

Protocols................................................................................................................154

Chapter 8 EQUIPMENT....................................................................................................................... 157

1 Overview......................................................................................................................................157

2 Scanner Desktop.........................................................................................................................158

2.1 Computer ..........................................................................................................................160

2.2 Reconstruction hardware...................................................................................................160

2.3 Monitors ............................................................................................................................160

2.4 Scan Control Interface and Keyboard............................................................................... 161

2.5 Preset W/L keys – F5 through F11 ................................................................................... 163

2.6 Page Up/Page Down keys ................................................................................................163

2.7 W/L control keys ............................................................................................................... 163

2.8 Operate the mouse controls ............................................................................................. 163

3 Gantry..........................................................................................................................................165

3.1 Gantry display ...................................................................................................................165

3.2 Internal components........................................................................................................... 168

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3.3 Gantry and console interfaces ..........................................................................................169

3.3.1 Left rear plug-in panel...............................................................................................170

3.3.2 Console AC power box.............................................................................................171

3.4 Operate the gantry controls .............................................................................................. 172

3.5 Cardiac trigger monitor...................................................................................................... 175

3.5.1 Integrated cardiac trigger monitor..............................................................................175

3.5.2 External cardiac trigger monitor.................................................................................176

4 Table............................................................................................................................................178

4.1 System operation and limitations that reduce the risk of collision with the patient............ 178

4.2 Use the Load/Unload foot pedals ..................................................................................... 180

4.3 Patient comfort and accessories........................................................................................ 180

4.3.1 Cradle pad................................................................................................................. 180

4.3.2 Cradle extender, Axial and Coronal head holders.....................................................180

4.3.3 Cradle extender pad.................................................................................................. 181

4.3.4 Patient arm board...................................................................................................... 181

4.3.5 Catheter bag holder...................................................................................................181

4.3.6 Table tray...................................................................................................................181

4.3.7 IV pole .......................................................................................................................181

4.3.8 Positioning straps...................................................................................................... 181

5 Hardware Components................................................................................................................183

5.1 Components ..................................................................................................................... 183

5.2 Coverage............................................................................................................................ 183

5.3 Axial interval ..................................................................................................................... 183

5.4 Helical pitch, scan mode, and collimation .........................................................................183

5.5 Detector configuration ...................................................................................................... 184

5.5.1 Axial .........................................................................................................................184

5.5.2 Helical ......................................................................................................................184

6 Power Distribution Unit................................................................................................................185

7 System Cabinet........................................................................................................................... 186

8 X-ray Tube and Generator...........................................................................................................187

8.1 X-ray tube .......................................................................................................................... 187

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8.2 Generator Serial Load Rating.............................................................................................187

9 Purchasable Options................................................................................................................... 189

Chapter 9 STARTUP AND SHUTDOWN............................................................................................. 191

1 Overview......................................................................................................................................191

2 System Startup and Shutdown....................................................................................................192

2.1 Prepare the system .......................................................................................................... 192

2.2 Log On/Log Off.................................................................................................................. 192

2.2.1 Logon window............................................................................................................192

2.2.2 Log On ......................................................................................................................194

2.2.3 Log Off.......................................................................................................................194

2.3 Start up the system ...........................................................................................................195

2.3.1 Routine daily start up when the system was not shut down...................................... 195

2.3.2 Routine daily start up from system shutdown............................................................195

2.3.3 Start up from power off.............................................................................................. 196

2.3.4 System start up failures ............................................................................................ 196

2.4 Shut down or restart the system........................................................................................196

2.4.1 Considerations...........................................................................................................196

2.4.2 Shutdown process..................................................................................................... 196

2.4.3 Restart process..........................................................................................................197

3 Daily Quality Assurance.............................................................................................................. 198

3.1 Tube Warmup.....................................................................................................................198

3.2 Calibration.......................................................................................................................... 198

3.2.1 Daily calibration......................................................................................................... 198

3.2.2 Full system calibration............................................................................................... 198

3.2.3 Non-GE X-ray tube.................................................................................................... 198

3.3 Daily QA workflow.............................................................................................................. 199

3.4 Tube Warmup ...................................................................................................................199

3.5 Run Fast Calibrations......................................................................................................... 202

Chapter 10 PATIENT SCHEDULE.......................................................................................................203

1 Overview......................................................................................................................................203

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2 Patient Schedule......................................................................................................................... 204

2.1 Schedule features..............................................................................................................204

2.1.1 Schedule window.......................................................................................................204

2.1.2 Schedule columns..................................................................................................... 204

2.1.3 Schedule buttons and icons.......................................................................................205

2.1.4 Schedule dropdown menu.........................................................................................206

2.2 New and completed records .............................................................................................207

2.3 Add a patient to the Schedule........................................................................................... 207

2.4 Edit a patient in the schedule ........................................................................................... 208

2.5 Delete a patient from the schedule ...................................................................................209

2.6 View more patient information on the schedule.................................................................210

2.7 Select a patient from the schedule ................................................................................... 210

2.8 Check a patient's status ....................................................................................................210

2.9 Search for a Patient on the Schedule.................................................................................211

2.10 HIS/RIS Search................................................................................................................ 211

2.11 Setting up the HIS/RIS Refresh........................................................................................213

2.12 Update the patient schedule ...........................................................................................215

Chapter 11 SCAN.................................................................................................................................217

1 Overview......................................................................................................................................217

2 Scan Theory................................................................................................................................ 218

2.1 Dose Deterministic Effects................................................................................................. 218

2.2 CT Perfusion.......................................................................................................................220

2.2.1 Purpose of CT Perfusion .......................................................................................... 220

2.2.2 Components of a CT Perfusion Study....................................................................... 221

2.2.2.1 Body perfusion considerations..........................................................................221

2.2.2.2 Perfusion acquisition types .............................................................................. 221

2.2.2.3 Scan parameter effects on dose.......................................................................222

2.2.2.3.1 kV effects on dose................................................................................... 222

2.2.2.3.2 mA effects on dose.................................................................................. 222

2.2.2.4 Considerations for peak skin dose....................................................................222

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2.2.2.5 Required image attributes for perfusion imaging ............................................ 223

2.2.2.6 Contrast injection considerations......................................................................223

2.2.2.7 Other considerations and references................................................................223

2.2.2.8 Recommended reading.................................................................................... 224

2.3 Total Scan Time................................................................................................................. 226

2.4 Automatic Exposure Control...............................................................................................227

2.4.1 How AEC works.........................................................................................................227

2.4.2 Adaptation to anatomy...............................................................................................227

2.4.3 When to use AEC...................................................................................................... 228

2.4.4 When not to use AEC................................................................................................ 228

2.4.5 AEC does not guarantee reduction of radiation doses in all patients........................ 228

2.4.6 Effect of AEC control setting......................................................................................228

2.4.7 AEC considerations of patient size, shape, composition, and age............................229

2.4.8 Dynamic AEC scanning.............................................................................................229

2.4.9 How to tell if the dose has changed...........................................................................229

2.4.10 Summary................................................................................................................. 229

2.4.11 AEC Messaging.......................................................................................................230

2.5 Slice Thickness Reference Noise Index and Noise Index Values...................................... 231

2.6 SmartmA/ODM................................................................................................................... 232

2.6.1 SmartmA....................................................................................................................232

2.6.1.1 SmartmA background....................................................................................... 232

2.6.1.2 SmartmA theory................................................................................................233

2.6.1.3 References....................................................................................................... 234

2.6.1.4 SmartmA FAQs.................................................................................................234

2.6.2 SmartmA....................................................................................................................239

2.6.3 Organ Dose Modulation (ODM).................................................................................239

2.7 kV Assist.............................................................................................................................241

2.7.1 kV Assist background................................................................................................ 241

2.7.2 kV Assist theory.........................................................................................................242

2.7.3 Image Display............................................................................................................243

2.7.4 kV Assist FAQs..........................................................................................................243

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2.7.5 References................................................................................................................ 244

3 Exam Workflow............................................................................................................................245

3.1 Exam Workflow Concepts.................................................................................................. 245

3.1.1 Positioning a patient ................................................................................................. 245

3.1.2 Using protocols .........................................................................................................245

3.1.3 Using contrast............................................................................................................245

3.2 Exam Workflow Windows.................................................................................................. 245

3.2.1 Patient Information window........................................................................................245

3.2.2 Patient Position area..................................................................................................246

3.2.3 Scan Settings window................................................................................................247

3.3 Exam Workflow Procedures.............................................................................................. 249

3.3.1 Set up and position the patient.................................................................................. 250

3.3.2 Set up the patient's information ................................................................................ 252

3.3.2.1 Enter patient ID or accession number with the bar code reader.......................254

3.3.2.2 Modify the Patient Information presets............................................................. 254

3.3.3 Select a protocol........................................................................................................255

3.3.4 Acquire a scout..........................................................................................................256

3.3.5 Adjust the Graphic Rx................................................................................................257

3.3.6 Enter contrast descriptions ....................................................................................... 261

3.3.6.1 Selecting a contrast preset............................................................................... 262

3.3.6.2 Adding a contrast preset...................................................................................262

3.3.7 Start a scan ...............................................................................................................262

3.3.8 Duplicate a series...................................................................................................... 264

3.3.9 Stop a scan ...............................................................................................................264

3.3.9.1 Abort a scan in progress...................................................................................264

3.3.9.2 Pause a scan in progress................................................................................. 264

3.3.9.3 Emergency stop scan, electronics, and x-radiation.......................................... 264

3.3.10 Close the exam .......................................................................................................264

4 Scan Parameters.........................................................................................................................265

4.1 Scan Type.......................................................................................................................... 265

4.1.1 Axial...........................................................................................................................265

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4.1.2 Helical........................................................................................................................265

4.1.3 Cardiac Axial..............................................................................................................265

4.1.4 Cine........................................................................................................................... 265

4.1.5 Hi Res Mode..............................................................................................................265

4.1.6 Rotation Time............................................................................................................ 266

4.2 Coverage Speed collection.................................................................................................266

4.3 kV and mA Control............................................................................................................. 270

4.3.1 kV Mode.....................................................................................................................270

4.3.1.1 Manual kV Mode...............................................................................................270

4.3.1.2 kV Assist kV Mode............................................................................................271

4.3.2 mA Mode................................................................................................................... 271

4.3.2.1 Manual mA Mode..............................................................................................272

4.3.2.2 SmartmA Mode.................................................................................................272

4.3.2.3 mA Max and mA Min........................................................................................ 273

4.3.2.4 ODM Mode....................................................................................................... 273

4.3.3 Noise Index................................................................................................................275

4.3.4 Cardiac Modulated mA.............................................................................................. 276

4.4 Anatomy Selection..............................................................................................................276

4.5 Scan parameters workflow ................................................................................................ 277

4.5.1 Choose the Scan Type ............................................................................................. 279

4.5.2 Set the Coverage Speed options ..............................................................................280

4.5.3 Set the kV and mA Control........................................................................................ 281

4.5.3.1 Set the mA........................................................................................................ 281

4.5.3.2 Set the kV......................................................................................................... 282

4.5.4 Set the Anatomy Selection........................................................................................ 283

4.5.4.1 Set the Start and End Locations....................................................................... 283

4.5.4.2 Set the Scan Field of View ...............................................................................283

4.5.4.3 Set the Display Field of View (DFOV) for the primary recon............................ 284

4.5.4.4 Set the R/L Center coordinates for the primary recon...................................... 285

4.5.4.5 Set the A/P Center coordinates for the primary recon...................................... 285

5 Timing Parameters...................................................................................................................... 287

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5.1 Timing Parameters collection............................................................................................. 287

5.2 Timing parameters workflow ..............................................................................................287

5.2.1 Set Prep Delay time ..................................................................................................287

5.2.2 Set Inter Scan Delay time..........................................................................................288

6 Recon Parameters.......................................................................................................................289

6.1 Recon Parameter descriptions........................................................................................... 289

6.1.1 Recon Type............................................................................................................... 289

6.1.2 Hi Res........................................................................................................................289

6.1.3 Axial Plus Recon Mode..............................................................................................289

6.1.4 Cardiac Axial Plus Recon Mode................................................................................ 289

6.1.5 Full and Plus Recon Modes for Helical scan types....................................................289

6.1.6 IQ Enhance for Helical scan types.............................................................................289

6.1.7 Quality Check (QC) Images.......................................................................................290

6.1.8 Flip / Rotate............................................................................................................... 290

6.1.9 Copy Forward............................................................................................................ 291

6.2 Primary Recon collection....................................................................................................291

6.3 Primary Recon parameters workflow..................................................................................293

6.3.1 Set the Slice Thickness............................................................................................. 293

6.3.2 Set the Image Interval................................................................................................293

6.3.3 Set the Recon Type...................................................................................................294

6.3.4 Set Recon Options for Helical scan types................................................................. 295

6.3.4.1 Recon Mode..................................................................................................... 295

6.3.4.2 IQ Enhance.......................................................................................................295

6.3.5 ASiR-V for all scan types...........................................................................................295

6.3.6 Adjust Window Width and Window Level for all scan types...................................... 295

6.3.7 Image Flip Orientation for all scan types................................................................... 296

6.4 Secondary Recon Parameters........................................................................................... 296

6.4.1 Overlapped Axial Recon mode..................................................................................299

6.4.2 Secondary Recon Slice Thickness............................................................................ 299

7 Auto Voice................................................................................................................................... 301

7.1 Auto Voice workflow ......................................................................................................... 301

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7.2 Set the Auto Voice language ............................................................................................ 301

7.3 Set the Voice/Lights/Timer options ....................................................................................302

7.4 Change the Auto Voice preset delay ................................................................................. 302

8 Additional Scan Features............................................................................................................ 303

8.1 Add or delete a group ....................................................................................................... 303

8.1.1 Add a group ............................................................................................................. 303

8.1.2 Delete a group ......................................................................................................... 303

8.1.3 Duplicate a series...................................................................................................... 303

8.2 Optimize technical parameters........................................................................................... 303

8.3 Optimize patient dose .......................................................................................................304

8.3.1 Pediatric Protocols.....................................................................................................304

8.3.2 SmartmA....................................................................................................................304

8.3.3 Organ Dose Modulation (ODM).................................................................................304

8.3.4 AEC with Cardiac Modes...........................................................................................304

8.3.5 SmartHelical.............................................................................................................. 305

8.3.6 Advanced Artifact Reduction (AAR)...........................................................................305

8.3.7 Adaptive Statistical Iterative Recon (ASiR-V)............................................................305

8.3.8 kV Assist....................................................................................................................305

8.3.9 Auto Gating Configuration......................................................................................... 305

8.3.10 Dose Reports...........................................................................................................305

8.4 View the Dose Report .......................................................................................................305

8.4.1 Prerequisites ............................................................................................................305

8.4.2 Dose Report Generation............................................................................................305

8.5 Dose Information .............................................................................................................. 306

Chapter 12 SCAN APPLICATIONS..................................................................................................... 307

1 Overview......................................................................................................................................307

2 ASiR-V.........................................................................................................................................308

2.1 ASiR

TM

-V Theory................................................................................................................ 308

2.2 Dose adjustment Factor - Manual mA method................................................................... 309

2.3 Reconstruction....................................................................................................................310

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2.4 ASiR-V Image annotation ................................................................................................. 311

2.5 Acquire a scan ..................................................................................................................311

3 SmartPrep................................................................................................................................... 312

3.1 SmartPrep Workflow...........................................................................................................312

3.2 SmartPrep Windows/Elements..........................................................................................313

3.2.1 SmartPrep Baseline Setup window........................................................................... 313

3.2.2 Monitor Phase Setup window.................................................................................... 316

3.2.3 Monitor Phase window...............................................................................................317

3.3 Set up a SmartPrep series................................................................................................ 319

3.4 Acquire a scan without Dynamic Transition........................................................................322

3.4.1 Baseline Phase without Dynamic Transition..............................................................322

3.4.2 Monitor Phase without Dynamic Transition............................................................... 323

3.5 Acquire a scan with Dynamic Transition.............................................................................324

3.5.1 Baseline Phase with Dynamic Transition...................................................................324

3.5.2 Monitor Phase with Dynamic Transition.................................................................... 324

3.6 Scan Phase — Diagnostic Scan.........................................................................................325

4 Enhanced Xtream Injector...........................................................................................................326

4.1 About Enhanced Xtream Injector........................................................................................326

4.1.1 Indications for use ....................................................................................................326

4.1.2 Protocol considerations ........................................................................................... 326

4.2 Enhanced Xtream Injector window.................................................................................... 326

4.3 Contrast report ..................................................................................................................329

4.4 Set up the Enhanced Xtream Injector ...............................................................................329

Chapter 13 CARDIAC.......................................................................................................................... 331

1 Overview......................................................................................................................................331

2 Cardiac Workflow........................................................................................................................ 332

2.1 Prepare the patient ........................................................................................................... 332

2.1.1 Exam prep instructions ............................................................................................ 332

2.1.2 Consent forms ......................................................................................................... 332

2.1.3 Breathing instructions .............................................................................................. 332

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2.1.4 IV setup and contrast ...............................................................................................333

2.2 Attach ECG electrodes to the patient................................................................................. 333

2.2.1 Adjust ECG Trigger Device Settings..........................................................................337

2.2.1.1 User Console.................................................................................................... 337

2.2.1.2 Gantry Display.................................................................................................. 337

2.2.1.3 External ECG Trigger Device........................................................................... 337

2.2.2 Check Electrode Impedance......................................................................................337

2.2.2.1 Initiating Electrode Impedance Check.............................................................. 338

2.2.2.2 Electrode Impedance Check Results................................................................338

2.3 Acquire a scout scan ........................................................................................................ 338

2.4 Acquire a heart localizer or calcium score scan (optional, but recommended) ................ 339

2.5 Acquire a manual bolus timing scan .................................................................................340

2.6 Acquire a contrast enhanced cardiac scan .......................................................................342

3 Cardiac Scan Parameters........................................................................................................... 345

3.1 Scan Type.......................................................................................................................... 345

3.2 Primary Recon....................................................................................................................345

3.3 Secondary Recon............................................................................................................... 345

3.4 Cardiac scan modes .........................................................................................................345

3.4.1 Anatomy Selection.....................................................................................................346

3.4.1.1 Considerations..................................................................................................346

3.4.1.2 Graphic Prescription (Graphic Rx)....................................................................346

3.4.2 Scan Overlap.............................................................................................................347

3.4.3 Single Table Position.................................................................................................347

3.5 Set the ECG and Gating settings...................................................................................... 347

3.5.1 Auto Gating................................................................................................................348

3.5.1.1 Gating Based On.............................................................................................. 349

3.5.1.2 Acquisition Window Part 1................................................................................ 349

3.5.1.3 Acquisition Window Part 2................................................................................ 350

3.5.1.4 Acquisition Window Part 3................................................................................ 350

3.5.1.5 HR Variation Allowance.................................................................................... 351

3.5.1.6 Arrhythmia Retrigger.........................................................................................351

Revolution CT User Manual

Direction 5480385-1EN, Revision 1

20 Table of Contents

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GE Revolution CT User manual

GE Revolution CT User manual

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