Liver Spleen Study

1. Preparation
   1. No patient preparation
2. Isotope administration
   1. Patient will receive 5 mci Tc^99m sulfur colloid intravenously
3. Camera Parameters
   1.  Planar imaging

1. LEHR collimators
2. Matrix 128X128

• Zoom: 1.23

1. Camera Preset: Tc99m-NMG
2. Detector: both
3. 500 Kcts per view

1. 1. SPECT imaging

1. LEHR collimators used for imaging
2. Camera peaked at Tc99m with a 15% window with scatter window

• Matrix: 128X128

1. Zoom: 1
2. Time: 25 sec per stop
3. Views: 64

• Rotation: clockwise
• Start angle: 0

1. Degree rotation: 180
2. Detector configuration 180
3. Orbit non circular

• Mode step/shoot
• Patient position: supine
• Orientation: head out

1. Camera preset: Tc99m-MNG

1. Scanning protocol
   1. Planar Imaging

1. Patient will be injected with radiotracer intravenously
2. Patient will wait 20 minutes before scanning to begin

• Immediately prior to placing patient on scanning table the patient should be asked to void.

1. All metal objects should be removed from patient prior to scan start
2. Patient will lay supine on the table with the head facing out.
3. Patient will be scanned with liver and spleen centered under the camera

• The static images to be taken are Anterior, Anterior with liver markers, posterior, right lateral, left lateral, LAO, RPO
• Additional static views will be acquired for areas of interest or at the request of the radiologist supervising the exam.

1. 1. SPECT Imaging

1. Patient will be injected with radiotracer intravenously
2. Patient will wait 20 minutes before scanning to begin

• Immediately prior to placing patient on scanning table the patient should be asked to void.

1. All metal objects should be removed from patient prior to scan start
2. Patient will lay supine on the table with the head facing out.
3. Patient will be scanned with liver and spleen centered under the camera

• 1 bed SPECT imaging with CT imaging for attenuation correction.
• Additional imaging as requested by radiologist.

1. SPECT/CT Reconstruction
   1. Nuclear Medicine Parameters

1. Filtered backprojection
2. Butterworth cutoff of .45 and order of 5

• Chang’s Attenuation Coefficient 0.15

1. Automatic contours
2. Projection angel is 2
3. Edge strength of .5

• Background threshold of 5
• Kernel 3X3

1. 1. CT Parameters

1. Bone Window
2. Body 5.0 B30s Med Smooth

• 5 mm Slice

1. Post processing/Display/Achieve
   1. All acquired images will be adjusted for optimal viewing and appropriate labeling.
   2. Planar images will be sent to the PAC’s system
   3. All SPECT images will be displayed in coronal and sagittal planes with and without CT fusion and NM MIP, and sent to the PAC’s system and Syngo Via for archiving/physician review