Toshiba Camera Protocol

CEA SCAN ACQUISITION AND PROCESSING
FOR THE TOSHIBA SYSTEM

 

ACQUISITION

 

ENERGY SETTING: Tc99m - 140 Kev with a 20% Window.

 

PLANARS:

ˇ         Whole-body Sweep: Scan speed of 7.5 or 10 cm/minute starting at the head to the level of the mid-thigh.

OR

ˇ         Use: 256 x 256 Matrix

ˇ         Static Acquisition: Anterior and Posterior views for 10 minutes / image of the pelvis, abdomen and chest.

 

SPECT: (Always acquire the Pelvic SPECT before the Abdominal SPECT.)

 

CAMERAS: GCA-602, GCA-901, GCA-7200, GCA-7100, GCA-9300, ECAM.

ˇ         Single-head camera:

ˇ        Use a 64 matrix with 6 degree steps for 30-40 seconds/step.

ˇ         Dual-head camera:

ˇ        Use a 128 matrix with 3 degree steps for 30-40 seconds/step (The 64 X 64 matrix is adequate, but the 128 X 128 should produce better images).

ˇ        Ellipse: YES for elliptical, or

ˇ        RoboContour: ON for GCA-7100 / 7200.

ˇ        Use RoboContour to control ellipse for GCA-7100/7200.

ˇ        Ellipse Radius: Set four (4) ellipse points for GCA-602 / 901 / 9300.

ˇ         Pelvic SPECT: Position the camera to include the groin to above the bifurcation.

ˇ         Abdominal SPECT: Position the camera to include the entire liver allowing for some overlap from the Pelvic SPECT.

ˇ         Chest SPECT: (Acquire a chest SPECT ONLY if there is clinical indication; perform approximately 18-24 hours post injection ). Position the camera to include the entire chest and the axilla. Use a 64 matrix with 6 degree steps for 60-70 seconds/step.

 

IMAGE DISPLAY

 

PLANAR DISPLAY:

ˇ         Select: FORMATTED DISPLAY

ˇ         Select; STATIC or WHOLE BODY - TEMPLATE.

ˇ         Check each image varying the UPPER LEVEL to look for any suspicious areas of uptake.

ˇ         Use a LINEAR GRAY SCALE taking care to not remove any background with the LOWER LEVEL control.

ˇ         Film the images at two intensities: one lighter and the other dark enough to display the blood vessels intensely.

 

CINE DISPLAY:

ˇ         Check each SPECT for motion and vary the intensity to look for any suspicious areas of uptake.


SPECT PROCESSING

 

SELECT: SPECT

ˇ         Use: Recon - > Sagittal - Coronal

ˇ         Click on: OBJECTS

ˇ         Select: LOAD FILE

ˇ         Thickness: 2

ˇ         Set cursors to include the entire field of view

ˇ         Click on: OPTIONS

ˇ         Pre-filter:

ˇ         9BUTTERWORTH for 64 X 64 matrix, or

ˇ         F_BUTTERWORTH for 128 X 128 matrix.

ˇ         Select: FILTER PREVIEW to try various filter levels.

ˇ         Order: 8 (Toshiba only has an Order of 8.)

ˇ         Cutoff: (Use a cutoff which displays sharp edges of the vessels.)

ˇ         Use .25 to .45 if study was acquired on a 64 X 64 matrix, or

ˇ         Use .10 to .25 if study was acquired on a 128 X 128 matrix.

ˇ         Reconstruction filter: RAMP

ˇ         Click on: APPLY

 

**ATTENUATION CORRECTION: (Use only for the SPECT of the liver, if necessary.)
Occasionally the liver will display a dark rim particularly on the lateral edge of the right lobe. If there is a question of a lesion at the edge of the liver, Attention Correction may help differentiate between a reconstruction artifact and disease. Process the SPECT of the liver with and without attenuation correction and compare the images.

 

SELECT: SPECT

ˇ         Use: RECON - > Sagittal - Coronal

ˇ         Click on: ATTENUATION

ˇ         Use: CYLINDRICAL CHANG

ˇ         Select a value for Tc99m from .12 to 15 1/cm

ˇ         Continue SPECT PROCESSING

 

SPECT DISPLAY

 

Reviewing the SPECT as a 3D Volume is often helpful.

5500 Computers:

ˇ         Use: MAX INTENSITY PROJECTION

550 Computers:

ˇ         Use: GPL Program for 3-D

ˇ         To film the entire study:

SELECT: DISPLAY

ˇ         Use: SPECT DISPLAY

ˇ         Display a maximum of 16 images.

ˇ         Use a LINEAR GRAY SCALE adjusting only the UPPER LEVEL to change the intensity.

 

HELPFUL TIPS:

ˇ         Do not use any Zoom during the acquisition.

ˇ         Display a maximum of 16 images for filming.

ˇ         Read the study on the computer screen, document the abnormalities on film.

ˇ         Some images may require filming with two or more intensities.

ˇ         The use of 3D Volume Display may be helpful.

 

DISCLAIMER:

This procedure was not developed by, or is not meant as ane endorsement by Toshiba of CEA-Scan. These suggested parameters are based on the experience of various users with this type of equipment and are not a substitute for the physician's or technologist's professional experience or knowledge. Users are ultimately responsible for determining if this procedure is usable with their equipment and standard practices. It is assumed that Quality Control of the imaging equipment is performed according to the manufacturer's recommendations. Please refer to the full product prescribing information and consult your equipment manufacturer's updated user's manual prior to the first use of CEA-Scan.