GE Revolution CT User manual

Revolution CT
User Manual
OPERATING DOCUMENTATION
5480385-1EN
Revision 1

This page left intentionally blank.
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
2

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.
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Revision History 3

Revolution CT User Manual
Direction 5480385-1EN, Revision 1
This page left intentionally blank.
4 Revision History

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 5

4.5 Backup Timer Indicator.........................................................................................................62
4.6 Starting Scans from the Scan Room.................................................................................... 62
4.7 CTDIvol.................................................................................................................................. 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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
6 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 7

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
8 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 9

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
10 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 11

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
12 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 13

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
14 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 15

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
16 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 17

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 ASiRTM-V Theory................................................................................................................ 308
2.2 Dose adjustment Factor - Manual mA method................................................................... 309
2.3 Reconstruction....................................................................................................................310
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
18 Table of Contents

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
Revolution CT User Manual
Direction 5480385-1EN, Revision 1
Table of Contents 19

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