Liver

Indication	Brief description	Slice thickness and reconstruction kernel	Further details of contrast timing/explanation of what the radiographers do	Abbreviation
Cholangiocarcinoma?	Triple phase liver (Art/PV/5 min delayed)	1.5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	Triple phase liver (Art/PV/5 min)
Staging cholangiocarcinoma	Appropriate scans according to recent characterisation scan and whatever else is needed e.g. chest and pelvis
Follow up cholangiocarcinoma	5 min delayed liver and PV Chest, abdomen and pelvis	1.5 mm B30f, 1.2 mm increment.	As above	CAP with 5 min delayed liver
Characterise liver lesion/HCC	CT triple phase liver Usually do not require pre-contrast unless possible focal fat, etc. Non contrast, arterial, PV and 5 minute delayed liver. (No pelvis required unless clinically indicated)	1.5 mm B30f, 1.2 mm increment.	ROI placed over aorta, monitoring begins after 10 seconds and bolus tracking triggers scan at 100 HU with a delay of 12 seconds. After arterial scan 30 s delay till PV scan.	CT Quad/triple Phase Liver
Hepatocellular carcinoma staging	Appropriate scans according to recent characterisation scan and whatever else is needed e.g. chest and pelvis
Liver metastases	CT liver Depends on primary site. If colorectal only need PV phase. Breast/renal/neuroendocrine/melanoma/sarcoma/lung usually include chest	1.5 mm B30f, 1.2 mm increment.	If colorectal, lung, squamous cell, adeno ca. (hypovascular) 65 seconds abdomen and pelvis.	CT PV liver
Breast, melanoma, lung: Arterial chest and liver 65 seconds abdomen and pelvis	CT Art + PV liver
Haemangioma	CT triple phase liver and delayed Art, PV and 5 minute liver	1.5 mm B30f, 1.2 mm increment.	MRI preferable (see new protocol for incidental liver lesion pick up). Bolus tracked as above.	CT triple phase liver
Post TACE	CT triple phase liver (arterial/portal venous/5 min delayed)	1.5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	CT triple phase liver
Post RFA	CT triple phase liver (pre/arterial/portal venous/5 min delayed)	1.5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	CT quad phase liver
Post embolisation f/u of HCC	Aterial, portal venous and delayed phases	1.5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	CT triple phase liver
Post embolization f/u of liver metastatic deposit	CT arterial or arterial/PV liver	1.5 mm B30f, 1.2 mm increment.	If colorectal, lung, squamous cell, adeno ca. (hypovascular) 65 seconds abdomen and pelvis.	CT PV liver
Breast, melanoma, lung: 40 seconds chest and liver 65 seconds abdomen and pelvis	CT art + PV liver