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
| |||