Embedded Files
Pancreas CT Protocol
Early Arterial phase (~20 sec), delayed arterial phase or pancreatic phase (~45 sec), Portal venous phase (~75 sec).
During portal venous phase the pancreas should increase attenuation by 100-150HU
Coronary Artery
Click gallery
Then Click pick
Do axial survey of the heart, then coronary
Cardiac MRI Protocol
Structure, function, LGE is the standard
Add stir for myocarditis
Add 4 chamber stack for RV questions
If it is a mass: add fat suppressed and one non fat suppressed image
Cardiac MRI
Need to go to the workstation in CT room
Find patient
Click cardiac vx
Load all
Change mode to cross reference
MSK MRI
According to MSK attendings the only thing we should get out of the ED is for MSK is a osteomyelitis study. Calcaneus US and MRI for acl is not stat and should be put in as urgent
Pediatrics
Pediatrics
Limping child protocol
Bilateral hips/pelvis ap and front leg lateral pelvis
AP lat femur
AP lateral tib/fib
3 views of foot
Nuclear Medicine
Nuclear Medicine
***MSK PROTOCOLS***
***MSK PROTOCOLS***
DEXA
Can select - “Perform as ordered”
*if no hyperparathyroidism
Bone Scan- Standard
Tc99m HDP/MDP 20mCi IV
[Say Body part]
Bone Scan- Shin Splints
Tc99m HDP/MDP 20mCi IV
Blt tib/fib
Bone Scan- r/o compartment syndrome
Tc99m HDP 20mCi IV
3-phase
Exercise protocol
Tib/Fibs
Bone Scan- look for mets
Tc99m HDP/MDP 20mCi IV
Whole Body
Bone Scan- Peds
Tc99m HDP/MDP 0.25 mCi/kg IV min 1 mCI
Whole body blood pool
Pelvis to feet
Spots of hips
Pediatric DEXA
DEXA
Peds: Lumbar Spine + Whole Body
DEXA Body Composition
Lumbar spine, Blt Hips
Whole body for body composition
***CARDIAC PROTOCOLS***
***CARDIAC PROTOCOLS***
Myocardial Perfusion
Tc99 m sestamibi 10 mCi IV rest per protocol
Tc 99m sestamibi 30 mCi IV stress per protocol
Lexiscan 0.4 mg IV
(If shortage of Tc99m, 8 mCi and 25 mCi)
PYP Cardiac Amyloid
Tc99m PYP 15 mCi IV
Cardiac amyloid protocol
MPS- Asthma/COPD
Tc99 m sestamibi 10 mCi IV rest per protocol
Tc 99m sestamibi 30 mCi IV stress per protocol
Lexiscan 0.4 mg IV
Verify not actively wheezing
***ONCOLOGY PROTOCOLS***
***ONCOLOGY PROTOCOLS***
(Note FGD dose changed to 6-9 from 6-8 on 12/11/2024 per request from Sarah. D/w Dr/ Dinh)
Standard PET
F18 FDG 6-9 mCi IV
Skull base-mid thighs
Arms up
Melanoma/Myeloma PET
F18 FDG 6-9 mCi IV
Vertex through the feet- melanoma protocol
PET head and Neck cancer
F18 FDG 6-9 mCi IV
Skull base-mid thighs; Head & Neck
PSMA PET CT – PROSTATE CA
GA-68 PSMA 5 mCi IV
Skull vertex to mid thighs
Arms up
DOTATATE PET/CT
Ga-68 DOTATATE 5 mCi IV
Skull base to mid thighs
Arms up
*can do skull vertex to mid thighs, arms down if looking at paraganglioma
***GASTROINTESTINAL***
***GASTROINTESTINAL***
Outpatient HIDA
Tc99m mebrofenin 5mCi IV
CCK 0.02mcg/kg IV
Gastric Emptying
Tc99m SCOL 1 mCi by mouth
Standard egg meal
Milk Study- r/o aspiration only
Tc 99m SCOL 0.5 mCi by mouth in half of normal AM feed
Followed by remaining half of AM feed
Keep NGT in place, do not remove
Aspiration 1,3 hr images
Gastric Emptying
No Reflux
***GU PROTOCOLS***
***GU PROTOCOLS***
NM Kidney Imaging
Tc-99m MAG3 5 mCi
IV Lasix 1mg/kg (max 40mg) IV
***PULMONARY PROTOCOLS***
***PULMONARY PROTOCOLS***
V/Q on Call
Tc-99m DTPA 30 mCi aerosolized
Tc-99m MAA, 4 mCi IV
Q on call- not pregnant
Tc-99m MAA, 4 mCI IV
Q on call pregnant
Tc-99m MAA, 2 mCi IV
**nml CXR- > Q only
**older, comorbid, CXR abnl -> V/Q
***Neuro***
***Neuro***
Brain Death
Tc 99m HMPAO 20mCi IV
Brain Death
NM Brain SPECT (Parkinson’s)
Pretreatment with Potassium iodide/Lugol's solution (equivalent of 100mg of iodine) at least 1 hour before
I-123 ioflupane 3-5mCi IV
***MISC***
***MISC***
Thyroid
I 123 200-300 uCi (microcuries) by mouth
Parathyroid
Tc 99m Sestamibi 25 mCi IV
Lymphoscintigraphy
Tc99m TILMANOCEPT (Lymphoseek)
1mCi in 2 syringes intradermal
Schedule for XX (needle loc before)
Tagged WBC scan
In-111 WBC 0.5 mCi IV
Tc-99m SCOL 10 mCi IV
[body part]
MAG3 Peds renal study
**At least 6 weeks old***
Tc99m MAG3 0.15mCi/kg IV (min: 1mCi)
Lasix 1mg/kg IV
Mapping for Y90
Tc-99m MAA 4mCi administered via hepatic artery catheter by IR
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