Renal
Priority Description
1. P1 High probability of potentially life threatening condition
2. P2 High probability of condition potentially causing significant long term harm
3. P3 Possibility of potentially life threatening condition
4. P4 Possibility of condition potentially causing significant long term harm
5. P5 Unlikely to be life threatening or cause significant long term harm
| Protocol code | When to use |
|---|---|
| ?Ca 2Wk | ? Cancer 2ww – use as normal – scan to be scheduled within 2 weeks |
| Urgent | Urgent – use as normal – scan to be scheduled within 4 weeks |
| COVID – Semi Urgent | Examination needs performing during next few months |
| Routine | Do not use during Covid pandemic |
| COVID P5 Cancel | Examination is P5 exam and will be cancelled and re refer back to clinician |
| Cancel | Examination to be cancelled due to non-justification of examination only ( not due to COVID) |
| On hold | Use as normal |
All routine are reclassified as above.
| Indication | COVID Cancel | COVID Urgent | Brief description | Slice thickness and reconstruction kernel | Further details of contrast timing/explanation of what the radiographers do | Abbreviation |
|---|---|---|---|---|---|---|
|
Renal stones? |
CT Kidneys Ureter Bladder (non-contrast, low dose) |
1.5 mm B30f, 1.2 mm increment. |
No contrast |
CT KUB
| ||
|
Follow up of VUJ stones |
Limited CT bladder (non-contrast) |
1.5 mm B30f, 1.2 mm increment. |
No contrast |
CT bladder
| ||
|
Cause of PUJ obstruction, not from stones |
Pre, arterial and delayed - Change to pre + combined dual bolus angio and delayed? |
1.5 mm B30f, 1.2 mm increment. |
CT IVU but renal angio YZT
| |||
|
Haematuria:
| ||||||
|
Asymptomatic Microscopic haematuria Low risk (<40 years, no other risk factor) |
If persistent |
Renal tract US, Plain KUB BUT In persistent haematuria CT IVU |
1.5 mm B30f, 1.2 mm increment. |
CT IVU - Pre, bolus 5 minutes before, repeat bolus and 90 second scan |
CT IVU
| |
|
Symptomatic microscopic haematuria Low risk (<40 years, no other risk factor) |
X |
CT KUB non contrast , low dose |
1.5 mm B30f, 1.2 mm increment. |
No contrast |
CT KUB
| |
|
Symptomatic microscopic haematuria High risk (>40 years, smokers, occupational history, drugs, pelvic radiation, UTIs, LUTS, familial) |
X |
CT IVU (contrast) and flexible cystoscopy |
1.5 mm B30f, 1.2 mm increment. |
CT IVU - Pre, bolus 5 minutes before, repeat bolus and 90 second scan |
CT IVU
| |
|
Macroscopic haematuria (20% malignant) Low risk (<40 years, no other risk factor) |
X |
CT KUB for stone diagnosis (non-contrast) and flexible cystoscopy |
1.5 mm B30f, 1.2 mm increment. |
No contrast |
CT KUB
| |
|
Macroscopic haematuria (20% malignant) High risk(>40 years, smokers, occupational history, drugs, pelvic radiation, familial) |
X |
CT IVU (contrast) and flexible cystoscopy |
1.5 mm B30f, 1.2 mm increment. |
CT IVU - Pre, bolus 5 minutes before, repeat bolus and 90 second scan |
CT IVU
| |
|
Abnormality on ultrasound for characterisation Follow up of Bosniak cysts (2F and greater) |
X |
Pre contrast and 90 second (nephrographic) Or Pre, arterial and 90 seconds I have been asked to add both of these and have been protocolling some as one, some as another. If you have a way to differentiate, please let me know |
1.5 mm B30f, 1.2 mm increment. |
Pre-contrast and 90 seconds |
CT dual phase renal or triple phase renal
| |
|
Renal cell cancer staging |
X |
CT kidneys (arterial) and chest, abdomen and pelvis (PV phase) |
1.5 mm B30f, 1.2 mm increment. |
CT renal staging
| ||
|
Renal cell cancer follow up |
X |
CT kidneys (arterial) and chest, abdomen and pelvis (PV phase) |
1.5 mm B30f, 1.2 mm increment. |
CT CAP + C + art renal
| ||
|
| ||||||
|
Potential live donor |
CT pre, renal angiogram and venous phase + topogram delayed |
1.5 mm B30f, 1.2 mm increment. |
Bolus track arterial and pv. Timings? HU threshold? |
|||
|
Potential transplant recipient |
Non contrast abdomen and pelvis |
1.5 mm B30f, 1.2 mm increment. |
Old split bolus was 50 ml at 1.6 ml/s, pause 10 seconds, 50 ml at 4 ml/s, 50 ml flush at 4 ml/s Now, just non con to look for iliac calcific atheroma |
Non con abdo pelvis | ||
|
Hypertension, renal artery stenosis? |
CT renal angiogram |
1.5 mm B30f, 1.2 mm increment. |
Bolus track arterial (HU 100, 12 second delay) |
CT renal angio | ||
|
Hypertension, renal or adrenal? |
Pre adrenals and review for full adrenals + renal, otherwise just renal angio |
1.5 mm B30f, 1.2 mm increment. |
Bolus track arterial (HU 100, 12 second delay) |
CT adrenals and renal angio | ||
|
Follow up RFA |
X |
Triple phase kidneys - Pre/art/nephrographic (90 s) |
1.5 mm B30f, 1.2 mm increment. |
Triple phase kidneys | ||