How to create a protocol on GE Rev HD

1. How to create a protocol on GE Rev HD

2. How to create a protocol on GE Rev HD 1 2 3 On the CT console’s left screen, select Protocol Management twice. If asked, enter the administrator password. Note: If you don’t know this password, refer to the person responsible for the protocols on your site or your GE application specialist. Click on the anatomy corresponding to the protocol you’ll use as base to create your new protocol (e.g. Non-Contrast Head protocol) GE Reference Your customized Protocols protocols

3. How to create a protocol on GE Rev HD 4 5 4 5 6 6 7 7 8 8 • Select the protocol you’ll use as base to create your new multiphase CTA protocol (e.g. Non-Contrast Head protocol) • and click on “Copy”, then click on an available line in the protocols list, and click on “Paste”. • Rename this new protocol (e.g. Stroke Multiphase CTA protocol). To do so, click on the protocol you just pasted in the list and type in the new name. • Click on “Edit” to build this new protocol. - Make sure the figure is set in the right position (supine, head first) - Adjust the scouts’start and end locations to make sure the scouts will be long enough to include the aortic arch up to the vertex, depending on where you plan on centering the patient (OM or Sternal Node?) (ex: if SN, start: S 250 end: I 200 if OM, start: S 150 end: I 300) - Adjust other parameters if necessary Once the parameters have been adjusted, click on “Next series” to adjust the other series.

4. How to create a protocol on GE Rev HD 9 9 The 1st series is the non-contrast series. If you used the copy-paste method at the beginning, the parameters have been copied from your base protocol. Adjust acquisition/reconstruction parameters of non-contrast if necessary. Once the parameters have been adjusted, click on “Create New series” to build the multiphase CTA series. Select “Axial” and “Create After” 10 10 11

5. How to create a protocol on GE Rev HD The 2nd series is the multiphase CTA series. You will need to adjust all the parameters. • Add a series description • Click on Scan Type and adjusts parameters as shown on screenshot. • GSI Mode OFF (if applicable) • HI Res Mode OFF (if applicable) • Scan Type Helical • Rotation Time 0.6 • Rotation Length Full • Shuttle Mode OFF (if applicable) • MAR Mode OFF (if applicable) •  OK 12 12 13 13 13

6. How to create a protocol on GE Rev HD The 2nd series is the multiphase CTA series. You will need to adjust all the parameters. • Adjust Start and End locations: Type in I50 and D( D Duplicates the end from the previous series (e.g. non contrast) • Number of images will automatically adapt, no action needed. • Select Thick Speed and adjust as shown on screenshot. • Detector Coverage 40 • Helical Thickness 0.625 • Pitch & Speed 0.984:1 / 39.37 • Rotation Time 0.6 •  OK • Adjust Interval to 0.625 • Gantry tilt should be S0.0 • Adjust SFOV to Small Body • Adjust kV to 120 14 14 15 15 16 17 16 17 15 18 18 19 19

7. How to create a protocol on GE Rev HD The 2nd series is the multiphase CTA series. You will need to adjust all the parameters. • Adjust mA • Auto mA AND Smart mA ON (=yellow) • Adjust mA range : Min – Max - Noise Index depending on desired IQ-Dose • Example on opposite screenshot • (Don’t pay attention to the Reference Noise Index) • Adjust SmartPrepwith parameters used to scan neck and head CTA (example in screenshot below, others parameters can be selected if desired, such as Dynamic Transition, ...) 20 20 21 21

8. How to create a protocol on GE Rev HD The 2nd series is the multiphase CTA series. You will need to adjust all the parameters. • - Adjust reconstruction parameters as wished. • - D can be used for DFOV and R/L, A/P center of recons to duplicate values from previous series, boxes will be exactly the same. • - Recon Type can be Detail, Standard or Soft. • - The following Recon Option are advised: • Recon Mode Plus • IQ Enhance ON (yellow) • Window Level 440 40 • ASIR 50% • Flip/Rotate None • - Other recons/DMPR can be activated depending on needs. 22 22

9. How to create a protocol on GE Rev HD The 2nd series is the multiphase CTA series. You will need to adjust all the parameters. • Use Add Group to add 2 or 3 groups depending if you want to scan 3 or 4 phases. • If these images are to be reviewed using the GE FastStroke software, DO NOT activate the split series function. • Adjust acquisition time (Prep Group) between groups to get the 2nd group to start ~10s after the 1st one, and then the 3rd one to start ~8s after the 2nd one. Same time between 3rd and 4th if a 4th group is needed. • (Don’t forget to take the total exposure time into account = time to actually run the scan) • Adjust noise indexes for each group if you wish to lower the doses a bit on the different acquisitions. Once the parameters have been adjusted, click on “Create New series” to build the CT Perfusion series (if applicable). Select “Axial” and “Create After” 23 23 24 24 25 26 26 27 25

10. How to create a protocol on GE Rev HD The 3rd series is the CT Perfusion series. You will need to adjust all the parameters as desired. If you already have a perfusion protocol, you can look at your parameters and use the same ones. Adjust ALL acquisition/reconstruction parameters as desired. (Series description, Scan type, Start/End locations, Thick Speed,.. Opposite screenshot is an example. The GE CT Brain Perfusion reference protocol you can find in the GE list of protocols in your CT scanner can also be used. (see page 2 of this document to access the GE list of protocols in your CT scanner) 28 28 29 Once the parameters have been adjusted, click on “Accept” to save this new protocol.