Liver

Indication	COVID Cancel	COVID Urgent	Brief description	Slice thickness and reconstruction kernel	Further details of contrast timing/explanation of what the radiographers do	Abbreviation
Cholangiocarcinoma?		X	Triple phase liver (Art/PV/5 min delayed)	1.5 mm B30f, 5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	Triple phase liver (Art/PV/5 min)
Staging cholangiocarcinoma		X	Appropriate scans according to recent characterisation scan and whatever else is needed e.g. chest and pelvis
Follow up cholangiocarcinoma		X	5 min delayed liver and PV Chest, abdomen and pelvis	1.5 mm B30f, 5 mm B30f, 1.2 mm increment.	As above	CAP with 5 min delayed liver
Characterise liver lesion/HCC		X	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, 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		X	Appropriate scans according to recent characterisation scan and whatever else is needed e.g. chest and pelvis
Liver metastases		X	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, 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, 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, 5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	CT triple phase liver
Post RFA	See either Liver metastases protocol or HCC protocol, some people want pre contrast	1.5 mm B30f, 5 mm B30f, 1.2 mm increment.	Bolus tracked as above.	See either Liver metastases protocol or HCC protocol
Post embolisation f/u of HCC	Aterial, portal venous and delayed phases	1.5 mm B30f, 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, 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
Splenic lesions	Triple phase abdomen	1.5 mm B30f, 5 mm B30f, 1.2 mm increment.	As above	CT triple phase spleen