CT — Torace: Olympus (MCB)

Updated 05/01/24 CT Chest Olympus (Endobronchial Valve) Reviewed 05/14/25 Indications - pre procedural imaging prior to endobronchial valve placement and should be ordered as Olympus protocol by Pulmonology. Use CT Chest without Contrast charge. GENERAL SCAN NOTES The patient's arms must be over his/her head. Remove any metal from the imaging field of view. Have the patient cough a few times to clear secretions. This reduces incidence of small lung nodules. Topogram - lung apices through diaphragm (obtained during end inspiration). Craniocaudal scan coverage - lung apices through adrenal glands (obtained during maximum end inspiration). Adjust FOV (field of view) on topogram to smallest without cropping anatomy. Scan parameters are the same as routine chest protocol. See end of protocol for requirements for the axial TLC thins recons. IV Contrast: not given for this protocol. For GE scanners, it is essential for the 1st recon thickness on the scanner to match the 1st recon thickness in this protocol book for the prescribed Noise Index to be valid. The 1st recon should generally be the thickest recon in the protocol. SIEMENS PARAMETERS & RECONS Scan
Care
Scan
Mode kV mAs Care
Dose kV & Lvl Pitch Acq Coll Rot Time Time Sensation 16 spiral 120 100 on NA 1.15 16 0.75 0.5 10.9 Go Up 32 spiral 130 51 on on 80 1.50 32 0.7 0.8 7.1 Sensation 64 spiral 120 100 on NA 1.40 64 0.6 0.5 5.6 Definition 64 spiral 120 110 on on 1.20 64 0.6 0.5 6.5 Go Top 64 spiral 120 62 on on 80 1.20 64 0.6 0.33 2.1 Drive 128 spiral 120 66 on on 1.20 128 0.6 0.5 3.3 Force 192 spiral 110 51 on on 1.20 192 0.5 0.5 2.6 Recon
Name of Series Thick Interval Kernel Window IR
Lvl Direction AX LUNG 3.0 3.0 Br57 / B70f lung 3 head/feet AX SOFT 3.0 3.0 Br40 / B41f mediastinum 3 head/feet COR SOFT 3.0 3.0 Br40 / B41f mediastinum 3 front/back SAG SOFT 3.0 3.0 Br40 / B41f mediastinum 3 left/right TLC INSP 1.0 1.0 Br44 / B41f 3 mediastinum head/feet Olympus specific recon. AX MIPS 8.0 3.0 Br40 / B41f lung 3 head/feet

CT Chest Olympus (Endobronchial Valve) GE PARAMETERS & RECONS Scan
Smart
Slice
Beam
Rot
Dose
Scan
Pitch Speed Type SFOV kV mA
Range Noise
Index mA Thick Coll Time Red ASIR Time LS 16 helical large 120 100-440 16.36 on 2.5 20 1.375 27.50 0.5 NA NA 5.5 Opt 540 helical large 120 100-440 16.36 on 2.5 20 1.375 27.50 0.5 NA NA 5.5 LS VCT 64 helical large body 120 100-650 18.38 on 2.5 40 1.375 55.00 0.4 50 50 2.2 Disc VCT 64 helical large body 120 100-650 18.38 on 2.5 40 1.375 55.00 0.4 NA NA 2.2 Window
Recon
Name of Series Thickness Interval Recon
Algorithm Width/Level Direction AX LUNG 2.5 2.5 lung 1600/-600 head/feet Must be first recon. AX SOFT 2.5 2.5 std full 400/40 head/feet COR SOFT 2.5 2.5 std full 400/40 front/back SAG SOFT 2.5 2.5 std full 400/40 left/right TLC INSP 1.25 1.25 std full 400/40 head/feet Olympus specific recon. AX MIPS 8.0 3.0 std full 1600/-600 head/feet PHILIPS PARAMETERS & RECONS Scan
Dose
3D
Scan
Mode kV Avg
mAs Index Dose Pitch Detect Colli Rot Time Time 0.75 Incisive 128 helical 120 92 19 on 1.00 64 0.625 5.6 Name of Series Thick Interval Filter Window iDose Recon
Direction AX LUNG 3.0 3.0 YA lung 3 head/feet AX SOFT 3.0 3.0 B mediastinum 3 head/feet COR SOFT 3.0 3.0 B mediastinum 3 front/back SAG SOFT 3.0 3.0 B mediastinum 3 left/right TLC INSP 1.0 1.0 B mediastinum 3 head/feet Olympus specific recon. AX MIPS 8.0 2.0 B lung 3 head/feet

CT Chest Olympus (Endobronchial Valve) For the Axial TLC Thins recons: The cranial/top image should begin 1-2 slices above the top of both lungs. The caudal/bottom image should stop 1-2 slices below the bottom of both lungs. The FOV of the transverse/axial plane should tightly fit the lungs (outer rib to outer rib at widest part of the chest). Transverse/Axial FOV

CT Acquisition Guidelines Quick Reference Guide NOTE: To ensure an optimal QCT Analysis, please adhere to the following guidelines. It is important that the patient fully understands the breath hold and scanning procedure, and that any concerns are addressed prior to performing the CT scan. The technologist will ask women if they might be pregnant and will not scan them if they answer affirmatively. CT Parameters n Breath-hold at TLC n Slice thickness of ≤1.5 mm n No severe motion artifacts n Slice spacing ≤ slice thickness n Complete anatomic coverage of lungs n Non-contrast-enhanced n Smooth reconstruction kernel Breath-Holding Instructions For the static TLC scan, the patient is told to “take your biggest breath in until you feel your lungs are completely full, in the same way you do in the lung function laboratory and hold the breath.” 1 2 Technologist should watch the chest to ensure that the breath hold maneuver is done properly and that the scanning only starts when the patient has reached breath hold and relaxed their body. Subject Positioning The patient will lie in the supine position going head first into the CT gantry. 1 2 Place patient in a supine position, arms positioned comfortably above the head in a head-arm rest, lower legs supported. Using the laser positioning lights, line up the patient so the chest is at the iso-center (in the middle: left-right; up-down) of the CT gantry. Move the table so the patient is in the correct position for a chest CT scan. MORE INSTRUCTIONS ON REVERSE

2 CT Acquisition Guidelines Quick Reference Guide NOTE: To ensure an optimal QCT Analysis, please adhere to the following guidelines. It is important that the patient fully understands the breath hold and scanning procedure, and that any concerns are addressed prior to performing the CT scan. The technologist will ask women if they might be pregnant and will not scan them if they answer affirmatively. Scan Coverage CT scan must include the lungs, but ONLY the lungs. Start the scan precisely at the apex of the lungs and stop it once the scan is through the base of the lungs. 1 The DFOV should tightly fit the TLC lung (i.e. outer rib to outer rib at widest part of chest) for the QCT reconstruction. 2 Caution: Federal law restricts this device to sale by or on the order of a physician. Olympus is a registered trademark of Olympus Corporation, Olympus America Inc., and/or their affiliates. I Medical devices listed may not be available for sale in all countries. For more information, contact your Olympus

sales representative, or call 800-848-9024. 3500 Corporate Parkway, PO Box 610, Center Valley, PA 18034 www.medical.olympusamerica.com ©2018 Olympus America Inc. All rights reserved. Printed in USA OAIRES12818QRG28614

CT Acquisition Guidelines for
SeleCT Portal Quick Reference Guide NOTE: To ensure an optimal QCT Analysis, please adhere to the following guidelines. It is important that the patient
fully understands the breath hold and scanning procedure, and that any concerns are addressed prior to performing the
CT scan. The technologist will ask women if they might be pregnant and will not scan them if they answer affirmatively. CT Parameters SIEMENS PHILIPS TOSHIBA GE Breathhold AT TLC TLC TLC TLC Slice Thickness ≤1.5mm ≤1.5mm ≤1.5mm ≤1.5mm Slice Spacing Contiguous Contiguous Contiguous Contiguous Anatomic Coverage
(For guidance see Scan Coverage section) Full  coverage
of the lungs Full  coverage
of the lungs Full  coverage
of the lungs Full  coverage
of the lungs Smooth Kernel Reconstruction ≤ B45, ≤ I45, ≤ Br45 B, C, or D ≤ FC52 Bone, Standard,
Lung Severe Motion Artifact Absent Absent Absent Absent Contrast Enhanced None None None None Breath-Holding Instructions For the static TLC scan, the patient is told to “take your biggest breath in until you feel your lungs are
completely full, in the same way you do in the lung function laboratory and hold the breath.” 1 2 Technologist should watch the chest to ensure that the breath hold maneuver is done properly
and that the scanning only starts when the patient has reached breath hold and relaxed their body. Subject Positioning The patient will lie in the supine position going head first into the CT gantry. 1 2 Place patient in a supine position, arms positioned comfortably above the head in a head-arm rest, lower legs supported. Using the laser positioning lights, line up the patient so the chest is at the iso-center (in the middle: left-right; up-down) of the CT gantry. Move the table so the patient is in the correct position for a chest CT scan. MORE INSTRUCTIONS ON REVERSE

2 CT Acquisition Guidelines for
SeleCT Portal Quick Reference Guide Scan Coverage CT scan must include the lungs, but ONLY the lungs. Start the scan precisely at the apex of the lungs and stop it once the scan is through the base of the lungs. 1 The DFOV should tightly fit the TLC lung (i.e. outer rib to outer rib at widest part of chest) for the QCT reconstruction. 2 Should you have any questions regarding the CT acquisition guidelines, please contact your Olympus Sales Representative or SeleCT by MedQIA customer service at 855-832-0144. Caution: Federal law restricts this device to sale by or on the order of a physician. Olympus is a registered trademark of Olympus Corporation, Olympus America Inc., and/or their affiliates. I Medical devices listed may not be available for sale in all countries. For more information, contact your Olympus

sales representative, or call 800-848-9024. 3500 Corporate Parkway, PO Box 610, Center Valley, PA 18034 www.medical.olympusamerica.com ©2019 Olympus America Inc. All rights reserved. Printed in USA OAIRES0419QRG30379