SOM DIP Report
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SOMATOM Drive System Owner Manual – Dosimetry and imaging performance report
Table of contents
Dosimet metry ry and ima imagin ging g perfo performa rmance nce rep report ort 1 Dosi 1.1
1.2
1.3
Do D ose information 1.1.1 General information about dose indication 1.1.2 Phantoms and methods 1.1.3 Typical CT conditions of operation 1.1.4 CTDI100 for typical CT conditions of operation 1.1. 1. 1.5 5 Do Dose se fa fact ctor orss rel relat ated ed to th the e CTDI CTDI100 for typical CT conditions of operation (128-slice) 1.1 .1.6 .6 Ov Over ervvie iew w of CT CTD DI100 (mGy/100 mAs) 1.1.7 CTDIfree air 1.1.8 Stray radiation 1.1.9 Dose le levels ca causing de deterministic ra radiation ef effects 1.1.10 Tolerances for CTDI 1.1.11 1.1 .11 Con Conver versio sion n factor factor for CTDI CTDIvol from Ø 32 cm phantom to Ø 16 cm phantom 1.1.12 1.1 .12 Con Conver versio sion n factor factor for CTDI CTDIvol 1.1.13 CTD TDIIvol for topograms 1.1.14 Geometric efficiency in the z-direction 1.1.15 Dose profiles 1.1.16 1.1. 16 Nomin Nominal al values values and toler tolerances ances for accept acceptance ance testing 1.1.17 1.1. 17 Beam qualit quality, y, leakage leakage techni technique que facto factors rs and minimum filtration 1.1.18 1.1. 18 Perfo Performanc rmance e specifica specification tion of autom automatic atic exposu exposure re controls 1.1.19 1.1. 19 Use of radiati radiation on shields shields for for the purpose purpose of reducing reducing patient dose in CT scanning with Siemens Healthcare CT systems Image quality 1.2.1 Low-contrast detectability 1.2.2 CT number 1.2.3 Un U niformity 1.2.4 Image noise 1.2.5 1.2 .5 Hig High-C h-Cont ontras rast-R t-Reso esolut lution ion,, Modula Modulatio tion n Transfe Transferr Function (MTF) 1.2.6 Sensitivity profiles 1.2.7 HD FOV: Advanced extended FOV reconstruction 1.2.8 Nominal tomographic section thicknesses Information about quality assurance 1.3.1 Test methods for the constancy tests
Index
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5 5 5 6 8 9 9 12 19 19 21 23 23 24 24 25 26 27 28 28
35 36 36 36 37 37 37 38 40 40 42 44
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Table of contents
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Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
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Dosimetr try y and imaging 1 Dosime performance report This chapter provides dose and imaging performance data. The data are in accordance with the US code of federal regulations 21 CFR 1020.33 (c) and the International Electrotechnical Commission IEC 60601-2-44 standard. This chapter provides the following information: ◾ CTDI100 for typical CT conditions of operation with regard to typical modes ◾ Dose factors showing the relative changes in CTDI 100 compared to the CTDI 100 of the typical mode, in varying a scan parameter ◾ Dosimetry data, such as beam quality, dose profiles, and stray radiation tables ◾ Image noise and High-Contrast-Resolution (HCR) of the typical modes ◾ Homogeneity of CT values and low-contrast resolution ◾ Reconstructab Reconstructable le slice thicknesses
1.1 Dose information 1.1.1
General information about dose indication The CT system provides information about the CTDIvol and Dose Length Product (DLP) as defined by the IEC 60601-2-44 standard. Both values are displayed on the user interface of the scanner before and after each scan range. In addition, these values are stored in the Patient Protocol and the DICOM Structured Dose Report. The CTDIvol represents the average energy dose (expressed as Air KERMA) within a cylindrical PMMA phantom, aligned with the scanner axis and centered in the scan plane. The phantom diameter to which the displayed CTDI vol refers depends on the default application of the used protocol; see ( Page 9 CTDI100 for typical CT conditions of operation). The reported and displayed CTDIvol and DLP refers to the 16 cm CTDI-phantom for head scans and to the 32 cm CTDI phantom for body scans, whereby the classification to 'head' or 'body' depends on the class of the original protocol delivered with the system. Neck protocols are classified as 'body'. CTDI vol and DLP of protocols originally intended for pediatric body examination and for neck examination refer to the 32 cm phantom. Factors for conversion of the displayed CTDIvol and DLP for the 32 cm phantom to equivalent CTDIvol and DLP for the 16 cm phantom are stated in ( Page 23 Conversion factor for CTDIvol from Ø 32 cm phantom to Ø 16 cm phantom ) (child protocols are recommended for pediatric patients under the age of 12 years and with a normal body size). The CTDI values given in this manual are valid for deactivated CARE Dose 4D and CARE kV, as both features are not adapted to phantom measurements. measurements. Dynamic Dose which dosereported of spiral overscan collimation is taken into(Adaptive account for theShield) reported DLPreduces but not the for the CTDIvol.
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Dosimetry an and im imaging pe performance re report
Further information regarding dose reduction functions is provided in the SOMATOM Instructions for Use. The reported DLP for spiral scans is calculated from the CTDIvol multiplied with a length L. The length L represents the table travel during the exposure and is corrected fordose effects of theoverscan. dynamic The collimation (Adaptive Dose which reduces the of spiral reduction of DLP by theShield) dynamic collimation is calculated as the time weighted average of collimator during the scan, divided by the nominal collimator opening for the scan. The effect of the dynamic collimation therefore is taken into account for the reported DLP but not for the reported CTDIvol. If the tube current varies during a scan, e.g. when using CARE Dose 4D, the CTDIvol and DLP displayed is the time-weighted average over the scan range.
1.1.2
Phantoms and methods According to: 21 CFR 1020.33 This chapter describes both, phantoms and methods used to establish the dose values reported below, and an instruction how to measure and determine CTDIvol, in order to verify against the value displayed at the scanner. The phantoms used to measure the CTDI values are circular cylinders of PMMA of diameter 16 cm (for head applications) or 32 cm (for all body applications), and with a length of at least 14 cm. They contain holes parallel to the axis of the phantom (A – E) to hold 100 mm dose chambers. Phantoms are aligned with the scanner axis and centered in the scan field. A dose chamber with an active length of 100 mm is used for the dose measurements. All dose values are given in Air KERMA. CTDI100 is measured in the center (A) and peripheral drillings at the 3 o‘clock, 6 o‘clock, 9 o‘clock and 12 o‘clock positions (B – E).
CTDI100 locations in dosimetry phantoms with the line of sight towards the front side of the gantry
To ensure correct dose measurements, it is recommended that a dosimeter conforming to IEC 61674 be used. The dosimeter has to be calibrated with beam qualities suitable for the CT energy spectrum examined, e.g. CT beam qualities "RQT" according IEC 61267. For dose measurements at 70 kV tube voltage or with tin filtration, an additional calibration with suitable beam qualities (for example RQR 5 acc. IEC 61267 and N150 acc. ISO 4037) is recommended to ensure that the energy dependance of the dosimeter does not distort the results of the dose measurements.
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Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
Dosimetry an and im imaging pe performance re report
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The dose is measured in single axial scans, so that the dose chamber measures the integrated dose profile along the z-direction over 10 cm, in the center of the scan plane. The measured values should be large compared to the accuracy of the dosemeter. As a result, it might be necessary to select either a large tube current and exposure time or to average the dosimeter readings over several scans. For measurements with the dose chamber in one of the peripheral positions it is recommended to average the results over several scans. Otherwise the scan start angle of the individual scans may influence the result.
IEC 61674: 2012
IEC 61267: 2005
ISO 4037-4: 2004
'Medical electrical equipment – Dosimeters with ionization chambers and/or semiconductorr detectors as used in X-ray diagnostic imaging' semiconducto
'Radiation conditions for use in the determination of characteristics'
'X and gamma reference radiation for calibrating dosemeters and doserate meters and for determining their response as a function of photon energy' To calculate the CTDI100 from the dosimeter readings (usually displayed as dose integrated over z-direction, i.e. as Dose Length Product (DLP), e.g. in mGy · cm) the value has to be divided by the nominal beam collimation. For scan modes without a z-flying focal spot, the nominal beam collimation is equal to the acquisition displayed at the scanner's console (e.g. 'Acquisition 32×0.6 mm' = 1.92 cm). For scan modes with a z-flying focal spot, the nominal beam collimation is equal to half of the acquisition displayed on the on the scanner's console (e.g. 'Acquisition 128×0.6 mm' · 0.5 = 64×0.6 mm = 3.84 cm). ( Page 40 Nominal tomographic section thicknesses)
LDP – measured Length-Dose-Product [mGy∙cm] Note that the reading may also be displayed as dose averaged over the chamber length, e.g. in mGy. NxT – Nominal Beam Collimation [cm] This is valid for all nominal beam collimations ≤ 4 cm. The CTDIw is the sum of a third of the CTDI 100 measured in the phantom's central chamber position (CTDI100c) and two third of the average of CTDI100 measured in the phantom's four peripheral chamber position (CTDI 100p).
According to it's definition, CTDI w has to be derived from CTDI100 measured in single axial scans. In this situation the CTDI vol is equal to the CTDIw. In general the CTDIvol displayed is derived from the CTDI w by multiplication with a factor that takes into account the table feed during scanning:
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Dosimetry an and im imaging pe performance re report
For spiral scanning
For axial scanning
For axial scanning without table feed
For scanning with periodic back and forth table movement p – Pitch factor NxT – Nominal collimation n – Number of scans vf – Table feed per scan R – Table range
Typical CT conditions of operation
1.1.3
According to: 21 CFR 1020.33 The following table provides scan parameter settings for typical modes of operation based on default setting of the Siemens scan protocols (with deactivated CARE Dose 4D and CARE kV). Protocol descriptions are provided by the Workflow Assistant. The system provides two shaped Xray beam filter settings (narrow, standard). These are set depending on the protocol type selected. The scan parameter settings provided here, although typical, may slightly deviate from the default protocols provided with the scanner software. Application type
Typical head
Typical head perfusion
Typical body
Typical cardiac
Typical body
Patient type
Adult
Adult
Adult
Adult
Child
Scan type
Sequence
Multiscan
Spiral
Sequence
Spiral
Protocol name
HeadNeuroSeq
NeuroPCT
Abdomen Routine_IR
DS_Coronary CTA_Adapt_Seq_IR*
Abdomen Routine_IR
Tube voltage
120 kV
80 kV
120 kV
A, B: 100 kV, 100 kV
100 kV
Tube mode
Single Tube (A)
Single Tube (A)
Single Tube (A)
Dual Tube (AB)
Single Tube (A)
Shaped filter
A: Standard
A: Standard
A: Standard
A, B: Narrow
A: Narrow
Tube current time product 390 mAs
200 mAs
147 eff. mAs
250 mAs/rot
98 eff. mAs
Tube current (per tube)
195 mA
200 mA
176 mA
439 mA
274 mA
Rotation time
1.00 s
1.00 s
0.50 s
0.285 s
0.50 s
Number of scans
9
1
1
4
1
Scan time
2.0 s
40 s
5.2 s
0.16 s
2.5 s
Table range
112 mm
0 mm
237 mm
104 mm
268 mm
Pitch factor or table feed
14.0 mm feed
0 mm feed
0.6 pitch
34.5 mm feed
1.4 pitch
Collimation
12 × 1.2 mm
32 × 1.2 mm
64 × 0.6 mm
64 × 0.6 mm
32 × 1.2 mm
Data acquisition
12 × 1.2 mm
32 × 1.2 mm
128 × 0.6 mm
128 × 0.6 mm
32 × 1.2 mm
Total collimation
14.4 mm
38.4 mm
38.4 mm
38.4 mm
38.4 mm
z-sharp
of f
off
on
on
off
Reconstructed slice width
4.8 mm
5.0 mm
5.0 mm
3.0 mm
5.0 mm
*) Flex 0.28 s, trigger: scan 70 to 70, pulsing off, 60 bpm, best phase manual, phase start 70 %
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Application type
Typical head
Typical head perfusion
Typical body
Typical cardiac
Typical body
Patient type
Adult
Adult
Adult
Adult
Child
Scan type
Sequence
Multiscan
Spiral
Sequence
Spiral
Kernel
H31s
H30s
B30f
B30f
B30f
1
*) Flex 0.28 s, trigger: scan 70 to 70, pulsing off, 60 bpm, best phase manual, phase start 70 %
Typical CT conditions of operation
1.1.4
CTDI100 for typical CT conditions of operation According to: 21 CFR 1020.33 The following table indicates the CTDI for the protocols specified . There is no significant difference in the exposure of the peripheral chamber positions. The stated dose chamber positions are B - E according to their positions in the phantom (up, down, left, and right). ( Page 8 Typical CT conditions of operation)
Application type
Typical Head
Typical Head
Typical Body
Typical Cardiac
Typical Body
Perfusion Patient size
Adult
Adult
Adult
Adult
Child
CTDI phantom
Ø 16 cm
Ø 16 cm
Ø 32 cm
Ø 32 cm
Ø 32 cm
CTDI100 ( (m mGy)
per scan
per scan
per rotation
per scan*
per rotation
Chamber position A (central)
62.8 mGy
331 mGy
3.66 mGy
3.76 mGy
2.90 mGy
Chamber position B (Up)
64.0 mGy
347 mGy
6.76 mGy
6.3 mGy**
4.92 mGy
Chamber position C (down)
65.4 mGy
354 mGy
6.41 mGy
6.1 mGy**
4.73 mGy
Chamber position D (left)
63.5 mGy
342 mGy
6.64 mGy
6.2 mGy**
4.85 mGy
Chamber position E (right)
63.3 mGy
341 mGy
6.67 mGy
6.3 mGy**
4.87 mGy
Average peripheral
64.0 mGy
346 mGy
6.6 mGy
6.2 mGy
4.85 mGy
CTDIW
63.6 mGy
341 mGy
5.63 mGy
5.4 mGy
4.20 mGy
CTDIvol
65.5 mGy
341 mGy
9.4 mGy
6.01 mGy
3.00 mGy
*) 0.33s full scan without pulsing **) Average over several partial scans CTDI100 for typical CT conditions of operation
1.1.5 General information
CTDIvol and CTDIw are calculated values based on the measured CTDI 100, where the CTDI100 has to be measured in axial scans (according to their definition in IEC 60601-2-44). As typical modes may be spiral scans, the values of CTDI100 stated above are measured in axial scans with the same scan parameters (kV, mA, collimation, rotation time and filter) as used in the spiral mode.
Dose factors related to the CTDI 100 for typical CT conditions of operation (128-slice) According to: 21 CFR 1020.33
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The CTDI100 is influenced by the following selectable scan parameters: ◾ kV ◾ Acquisition ◾ Shaped filter ◾ mAs values (mAs, eff. mAs, mAs/rot, ref. mAs, ref. mAs/rot) The CTDI100 is not influenced by the rotation time or recon parameters, such as Kernel or FoV. In the following tables, the CTDI 100 for the typical mode is represented by the value 1.00, shown in bold. CTDI100 for varying scan parameters are given as a proportion of the CTDI100 for the typical mode. Dose factors are presented for a wide range of scan parameter combinations that influence dose. However, depending on system configuration, licences and available scan protocols, not all of the combinations shown may be selectable. CTDI100 dose factors for varying tube voltage and shaped filter e g a t l o v e b u T
Typical Head
Values are given for central and peripheral CTDI 100 and are expressed as a proportion of the CTDI100 for the typical mode, shown in bold. Typical Head Perfusion
Typical Body
CTDI Phantom Ø 16 cm
CTDI Phantom Ø 16 cm
CTDI Phantom Ø 32cm
Shaped filter
Shaped filter
Shaped filter
Narrow
Standard
Narrow
Standard
Narrow
Standard
0,17
0,18
n.a.
0,63
0,12
0,14
0,16
0,19
n.a.
0,64
0,13
0,17
Weighted
0,16
0,19
n.a.
0,63
0,13
0,16
Central
0,27
0,29
n.a.
1,00
0,22
0,25
0,25
0,30
n.a.
1,00
0,21
0,28
Weighted
0,26
0,30
n.a.
1,00
0,21
0,27
Central
0,40
0,43
n.a.
1,47
0,35
0,39
0,38
0,44
n.a.
1,46
0,33
0,42
Weighted
0,38
0,44
n.a.
1,46
0,33
0,42
Central
0,55
0,60
n.a.
2,03
0,50
0,56
0,52
0,60
n.a.
1,99
0,45
0,59
Weighted
0,53
0,60
n.a.
2,00
0,46
0,58
V Central k 0 Peripheral 1 1
0,74
0,80
n.a.
2,72
0,69
0,78
0,70
0,80
n.a.
2,66
0,61
0,79
Weighted
0,71
0,80
n.a.
2,68
0,63
0,79
Central
0,92
1,00
n.a.
3,40
0,89
1,00
0,87
1,00
n.a.
3,32
0,78
1,00
Weighted
0,89
1,00
n.a.
3,34
0,80
1,00
Central
1,12
1,21
n.a.
4,12
1,12
1,26
1,06
1,21
n.a.
4,02
0,97
1,24
Weighted
1,08
1,21
n.a.
4,05
1,00
1,24
Central
1,35
1,45
n.a.
4,93
1,38
1,54
1,28
1,45
n.a.
4,80
1,18
1,50
Weighted
1,30
1,45
n.a.
4,85
1,22
1,51
V Central k 0 0 Peripheral 1 n S Weighted
0,10
0,11
n.a.
0,37
0,11
0,13
0,10
0,11
n.a.
0,36
0,09
0,12
0,10
0,11
n.a.
0,36
0,10
0,12
Central
* V k Peripheral 0 7
V k Peripheral 0 8
V k Peripheral 0 9
V k 0 Peripheral 0 1
V k 0 Peripheral 2 1
V k 0 Peripheral 3 1
V k 0 Peripheral 4 1
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Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
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e g a t l o v e b u T
Typical Head
Typical Head Perfusion
Narrow
Standard
Narrow
Standard
Narrow
Standard
V Central k 0 4 Peripheral 1 n S Weighted
0,44 0,42
0,46 0,46
n.a. n.a.
1,58 1,53
0,53 0,42
0,58 0,52
0,43
0,46
n.a.
1,54
0,44
0,53
1
Typical Body
CTDI Phantom Ø 16 cm
CTDI Phantom Ø 16 cm
CTDI Phantom Ø 32cm
Shaped filter
Shaped filter
Shaped filter
Dose Factors of CTDI100 for variation of tube voltage and shaped filter for central / peripheral /weighted CTDI100; each related to typical mode (bold) Typical Cardiac
e g a t l o v e b u T
Typical Pediatric Body CTDI Phantom Ø 32 cm
CTDI Phantom Ø 32cm
Shaped filter
Shaped filter
Narrow
Standard
Narrow
Standard
Central
0,24
n.a.
0,24
n.a.
Peripheral
0,28
n.a.
0,28
n.a.
Weighted
0,27
n.a.
0,27
n.a.
Central
0,44
n.a.
0,43
n.a.
Peripheral
0,47
n.a.
0,47
n.a.
Weighted
0,46
n.a.
0,46
n.a.
Central
0,69
n.a.
0,70
n.a.
Peripheral
0,72
n.a.
0,72
n.a.
Weighted
0,71
n.a.
0,71
n.a.
Central
1,00
n.a.
1,00
n.a.
Peripheral
1,00
n.a.
1,00
n.a.
Weighted
1,00
n.a.
1,00
n.a.
Central
1,39
n.a.
1,39
n.a.
Peripheral
1,35
n.a.
1,35
n.a.
Weighted
1,36
n.a.
1,36
n.a.
Central
1,79
n.a.
1,79
n.a.
Peripheral
1,71
n.a.
1,71
n.a.
Weighted
1,73
n.a.
1,73
n.a.
Central
2,25
n.a.
2,25
n.a.
Peripheral
2,13
n.a.
2,13
n.a.
Weighted
2,16
n.a.
2,15
n.a.
Central
2,77
n.a.
2,77
n.a.
Peripheral
2,59
n.a.
2,59
n.a.
Weighted
2,63
n.a.
2,63
n.a.
V k 0 0 1 n S
Central
0,23
n.a.
0,23
n.a.
Peripheral
0,20
n.a.
0,20
n.a.
Weighted
0,21
n.a.
0,21
n.a.
* V k 0 4 1 n S
Central
1,07
n.a.
1,06
n.a.
Peripheral
0,93
n.a.
0,92
n.a.
Weighted
0,96
n.a.
0,95
n.a.
* V k 0 7
V k 0 8
V k 0 9
V k 0 0 1
V k 0 1 1
V k 0 2 1
V k 0 3 1
V k 0 4 1
Dose Factors of CTDI100 for variation of tube voltage and shaped filter for central / peripheral /weighted CTDI100; each related to typical mode (bold)
Dose factors for varying acquisition type
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Values are given for central and peripheral CTDI 100 and are expressed as a proportion of the typical mode CTDI100, shown in bold.
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Acquisition
Collimation
Typical Head
n o i s u f r e P d a e H l a c i p y T
y d o B l a c i p y T
c a i d r a C l a c i p y T
y d o B c i r t a i d e P l a c i p y T
2 x 1 mm
2 x 1 mm
n.a.
n.a.
1.01
n.a.
1.00
1 x 5 mm
1 x 5 mm
0.78
n.a.
0.91
n.a.
0.89
20 x 0.6 mm
10 x 0.6 mm
1.03
n.a.
1.21
n.a.
1.18
16 x 0.6 mm
8 x 0.6 mm
1.49
n.a.
1.74
n.a.
1.70
16 x 0.3 mm
8 x 0.6 mm
1.49
n.a.
1.74
n.a.
1.70
1 x 10 mm
1 x 10 mm
0.78
n.a.
0.91
n.a.
0.89
40 x 0.6 mm
20 x 0.6 mm
1.05
n.a.
1.23
n.a.
1.20
12 x 1.2 mm
12 x 1.2 mm
1.00
n.a.
1.16
n.a.
1.15
32 x 0.6 mm
32 x 0.6 mm
0.96
n.a.
1.11
1.12
1.10
64 x 0.6 mm
32 x 0.6 mm
0.98
n.a.
1.14
1.14
1.12
32 x 1.2 mm
32 x 1.2 mm
0.87
1.00
1.02
1.02
1.00
128 x 0.6 mm
64 x 0.6 mm
0.86
n.a.
1.00
1.00
0.98
Dose factors for varying acquisition type
Dose factors for varying mAs
Values are given for central and peripheral CTDI 100 and are expressed as a proportion of the typical mode CTDI100, shown in bold. Dose factors are valid for deactivated CARE Dose 4D.
Current*
Typical Head
Typical Head Perfusion
Typical Body
Typical Cardiac
Typical Pediatric Body
mAs
factor
mAs
factor
eff. mAs
factor
mAs/rot
factor
eff. mAs
factor
20 mA
40
0.10
20
0.10
17
0.11
11
0.05
7
0.07
176 mA
352
0.90
176
0.88
147
1.00
100
0.40
63
0.64
195 mA
390
1.00
195
0.98
163
1.11
111
0.44
70
0.71
200 mA
400
1.03
200
1.00
167
1.14
114
0.46
72
0.73
274 mA
548
1.41
274
1.37
229
1.56
156
0.62
98
1.00
439 mA
878
2.25
439
2.20
367
2.49
250
1.00
157
1.60
683 mA
1366
3,50
683
3,42
570
3,88
389
1,56
244
2,49
736 mA
1472
3,77
n.a.
n.a.
615
4,18
419
1,68
263
2,69
797 mA
n.a.
n.a.
n.a.
n.a.
666
4,53
454
1,82
285
2,91
800 mA
n.a.
n.a.
n.a.
n.a.
n.a.
n.a.
456
1,82
n.a.
n.a.
*) per tube
Dose Factors for variation of mAs central and peripheral CTDI 100, related to typical mode (bold)
1.1.6
Overview of CTDI100 (mGy/100 mAs) Not all combinations of mode parameters shown are selectable. For dual-source modes, separate calculations have to be done for Tube A and B.
12
Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
Dosimetry an and im imaging pe performance re report
6 . 0 x 4 6
6 . 0 x 8 2 1
) p r a h 2 7 2 4 0 5 7 2 7 2 7 2 0 2 1 8 9 9 7 9 8 0 3 2 2 1 1 2 8 6 , , , , , , , , , , , , s - 5 , 6 , 6 , 0 , 2 , 1 , 9 , 1 , 0 , 2 , 3 , 3 , 1 1 1 3 3 3 6 6 6 0 0 0 5 , 5 , 5 , 4 , 4 , 4 , z 2 ( 2 2 4 4 4 5 6 6 8 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 6 6 6
2 . 1 x 2 3
9 5 0 3 2 6 9 9 2 8 1 3 3 4 2 1 8 , 5 , 4 , 1 , 3 , 2 , 0 , 4 , 3 , 4 , 8 , 6 , 5 4 5 , 1 , 0 , 3 , 1 1 1 4 4 4 7 7 7 0 0 0 5 , 5 , , 7 , 7 , 3 , 2 , 2 , 2 , 6 , 5 , 5 , 5 , 6 , 5 2 2 2 4 4 4 6 6 6 8 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 6 6 6
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a h 6 4 8 8 7 1 5 5 9 0 1 4 5 7 6 6 8 8 9 2 1 6 0 9 2 1 1 5 3 0 x x s , , , , , , , , , , , , - 8 2 4 z , 0 , 9 , 5 , 7 , 7 , 7 , 9 , 8 , 3 , 5 , 4 , 2 2 2 5 5 5 8 9 9 2 3 2 7 , 7 , 7 , 2 , 3 , 3 , 3 6 ( 2 3 2 4 4 4 6 6 6 9 9 9 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 7 7 7
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h 0 8 2 7 6 0 3 2 6 1 3 2 6 8 7 4 , 5 , 9 , 5 , 6 , 7 5 s , , , 7 , 7 , 1 , 1 , 8 , 7 , 9 , 8 - 1 , 2 , 2 , 9 , 1 , 1 , 3 , 5 , 4 , 0 0 0 3 3 3 6 7 7 0 0 0 4 4 4 8 , 8 , 8 , 8 , 9 , 9 , z 3 ( 3 3 4 5 5 7 7 7 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 1 1 1 7 7 7
2 . 1 x 2 1
6 6 9 4 5 8 7 1 3 0 6 7 9 2 1 1 4 3 5 9 8 4 8 6 7 6 7 7 7 4 9 , 3 , 3 , 6 , 6 , 9 , 9 , 3 , 3 , 1 , 0 , 7 , 9 , 8 , 9 , 2 , 1 , 6 , 8 , 7 , 2 , 6 , 9 , 3 , 7 , 7 , 7 , 4 , 5 , 5 , 2 3 3 4 4 4 6 7 7 9 9 9 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 7 7 7
0 1 x 1
1 6 1 9 6 0 4 2 6 9 9 2 1 8 2 0 7 , 3 , 2 , 6 , 8 , 7 , 2 , 5 , 4 , 2 , 5 , 4 , 8 8 3 , 6 , 4 , 4 , 0 0 0 2 2 2 5 5 5 8 8 8 3 , 8 , , 4 , 4 , 8 , 8 , 6 , 5 , 6 , 6 , 3 , 3 , 9 , 8 2 2 2 3 3 3 5 5 5 7 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 5 5
6 . 0 x 0 1
6 . 0 x 0 2
) p r a h 4 2 6 7 6 0 9 8 2 1 1 0 3 5 4 6 8 7 1 4 3 1 4 3 4 2 2 4 1 9 , , , , , , , , , , , , , , s - 0 , 2 , 1 , 8 , 0 , 0 , 1 , 3 , 3 , 9 , 0 0 3 3 3 6 6 6 0 0 0 4 4 4 8 , 8 , 8 , 7 , 8 , 7 , z 3 ( 3 3 4 5 5 7 7 7 9 1 1 1 1 1 1 1 1 2 2 2 2 2 2 1 1 1 7 7 7
5 x 1
0
1 I D T C
1 6 1 9 6 0 4 2 6 9 9 2 1 8 2 0 7 , 3 , 2 , 6 , 8 , 7 , 2 , 5 , 4 , 2 , 5 , 4 , 8 8 3 , 6 , 4 , 4 , 0 0 0 2 2 2 5 5 5 8 8 8 3 , 8 , , 4 , 4 , 8 , 8 , 6 , 5 , 6 , 6 , 3 , 3 , 9 , 8 2 2 2 3 3 3 5 5 5 7 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 5 5
) d p r a a e h 9 4 6 3 0 1 4 6 6 3 6 5 2 5 4 9 3 1 0 4 3 8 2 1 5 2 3 2 3 2 H s , , , , , , , , , , , , , , , , , , 6 6 6 , , , : 6 5 0 3 2 - 3 , , , , , , 0 0 0 4 4 4 9 9 9 3 4 4 9 9 9 4 5 5 , , , 1 1 1 n z ( 4 4 4 7 7 7 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 2 2 2 1 1 1 o i t a c i l p p A l 6 a . c 0 7 4 5 6 7 7 1 1 0 5 9 8 1 5 4 7 1 0 4 0 8 9 5 3 0 8 9 5 6 6 , , , , , , , , , , , , , , , , , 5 4 4 , , , i 3 8 1 4 6 9 8 x , , , 0 0 0 p , , , , , 0 0 3 3 3 8 8 8 2 3 3 7 8 7 2 3 3 , , y 6 4 4 4 6 6 6 9 1 1 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 2 2 2 1 1 1 T ; d r a d n a t S : r 1 7 4 9 2 0 4 6 6 0 5 7 9 2 4 4 0 3 2 9 3 2 3 7 5 4 3 4 9 8 5 , , , , , , , , , , , , 5 5 5 4 5 5 e 5 7 6 1 3 2 0 2 2 3 5 4 x l , , , , , , , , , , , , 1 1 1 4 4 4 6 7 7 0 0 0 , , , , , , t i 2 2 2 2 4 4 4 6 6 6 8 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 6 6 6 F d e p a l l l l l l l l l l h ] ] a a a a a a a a a a S r r r r r r r r r r m m ; l e l e l e l e l e l e l e l e l e l e m m a h a h a h a h a h a h a h a h a h a h m r r r r r r r r r r [ [ p p p p p p p p p p c t i t i t i t i t i t i t i t i t i t i n n n r n r n r n r n r n r n r n r n r n r 6 e e e e e e e e e e e e e e e e e e e e o o 1 i i c p c p c p c p c p c p c p c p c p c p t t , , , , , , , , , , , , , , , , , , , , i a s 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Ø 0 0 i w 0 0 w 0 0 w 0 0 w 0 0 w 0 0 w 0 0 w 0 0 w 0 0 w 0 0 w : 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I I I I I I I I I I I I I I I I I m q i u r e I I I I I I I I I I m l D D D D D D D D D D t D D D D D D D D D D D D D D D D D D D D l o c i T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T o C A F C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C t n V k 0 7 V k 0 8 V k 0 0 1 V k 0 2 1 V k 0 4 1 V e g a t l o V e b u T V k 0 9 V k 0 1 1 V k 0 3 1 k 0 0 1 n S V k 0 4 1 n S a h P 6 . 0 x 8
) s A m 0 0 1 / y G m (
1
6 . 0 x 6 1
SOMATOM Drive Print No. C2-047.660.01.02. C2-047.660.01.02.02 02
13
1
6 . 0 x 4 6
6 . 0 x 8 2 1
Dosimetry an and im imaging pe performance re report
) p r a h 7 1 3 7 4 8 5 1 9 3 9 1 1 8 3 7 1 3 4 8 0 5 8 0 3 5 8 9 1 7 , , , , , , , , , , s - 2 , 2 , 2 , 6 , 5 , 5 , 4 , 2 , 2 , 5 , 1 , 3 , 0 6 , 8 , 2 2 2 5 4 5 8 7 8 4 , 3 , 3 , 0 , 9 , 9 , z 2 ( 2 2 3 3 3 5 5 5 7 7 7 1 9 9 1 1 1 1 1 1 1 1 1 1 1 1 6 5 5
2 . 1 x 2 3
3 9 0 6 5 8 6 8 4 9 2 1 4 1 9 3 8 , 9 1 , 0 , 5 , 7 , 8 , 3 , 4 , 9 , 3 , 5 , 6 8 3 , 7 , 5 , 6 , 0 9 , 1 , , 2 , 3 , 6 , 6 , 3 , 4 , 4 , 5 , 0 3 2 2 5 5 5 8 8 8 4 , 3 , 4 , 0 , 0 2 2 2 3 3 3 5 5 5 7 7 7 1 9 1 1 1 1 1 1 1 1 1 1 1 1 1 6 6 6
6 . 0 x 2 3
, m m m m ) p 6 . 6 . r 0 0 a 6 8 9 5 8 2 4 6 2 7 7 3 1 3 8 0 5 x x h , 0 , 2 , 4 , 8 , 0 , 5 , 8 , 1 , 0 , 2 , 5 , 2 3 s - 5 2 4 z , 5 , 5 , 1 , 0 , 0 , 1 , 9 , 0 , 5 , 1 , 3 , 1 1 1 4 3 4 7 6 7 1 0 0 6 , 5 , 5 , 8 , 6 , 7 , 3 6 ( 2 2 2 4 4 4 6 5 6 8 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 6 6 6
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h 9 2 4 1 4 0 9 1 0 5 4 8 5 9 1 9 9 6 4 , 6 , 0 , 8 , 6 6 s , , , 9 , 1 , 2 , 5 , 9 , 2 - 7 , 7 , 7 , 5 , 3 , 4 , 6 , 4 , 5 , 2 , 8 , 9 , 2 1 2 5 4 5 9 8 8 2 1 2 7 , 6 , 6 , 4 , 2 , 3 , z 2 ( 2 2 4 4 4 6 6 6 9 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 7 7 7
2 . 1 x 2 1
7 2 4 0 8 2 8 7 4 1 0 0 9 4 6 9 3 5 1 5 7 7 0 2 7 9 1 9 1 7 6 , 1 , 1 , 4 , 4 , 7 , 7 , 1 , 1 , 4 , 8 , 1 , 6 , 6 , 6 , 3 , 1 , 2 , 3 , 1 , 2 , 8 , 5 , 6 , 1 , 5 , 6 , 0 , 9 , 9 , 2 2 2 4 4 4 6 6 6 8 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 7 6 6
0 1 x 1
8 5 6 5 6 9 7 1 6 7 3 1 6 2 3 6 6 2 9 3 , 2 , 3 , 1 , 6 , 8 , 9 , 3 , 5 , 0 4 0 , 3 , 9 , 8 , 2 , 1 1 1 4 3 3 6 6 6 3 , 5 , , 0 , 0 , 2 , 2 , 8 , 8 , 6 , 7 , 9 , 0 , 2 , 2 , 3 , 4 2 2 2 3 3 3 4 4 4 6 6 6 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 5 5 5
6 . 0 x 0 1
6 . 0 x 0 2
) p r a h 4 7 9 3 6 2 7 8 8 8 7 1 2 7 9 3 6 9 6 9 1 4 5 8 3 3 6 5 2 0 , , , , , , , , , , , , s - 7 , 6 , 6 , 4 , 2 , 3 , 5 , 2 , 3 , 0 , 6 , 8 , 2 1 1 5 4 4 8 7 8 2 1 1 7 , 6 , 6 , 3 , 1 , 2 , z 2 ( 2 2 4 4 4 6 6 6 9 8 8 1 1 1 1 1 1 1 1 1 2 2 2 1 1 1 7 7 7
5 x 1
6 . 0 x 8
8 5 6 5 6 9 7 1 6 7 3 1 6 2 3 6 6 2 9 3 , 2 , 3 , 1 , 6 , 8 , 9 , 3 , 5 , 0 4 0 , 3 , 9 , 8 , 2 , 1 1 1 4 3 3 6 6 6 3 , 5 , , 0 , 0 , 2 , 2 , 8 , 8 , 6 , 7 , 9 , 0 , 2 , 2 , 3 , 4 2 2 2 3 3 3 4 4 4 6 6 6 9 8 9 1 1 1 1 1 1 1 1 1 1 1 1 5 5 5
6 . 0 x 6 1
6 . 0 x 6
5 9 1 5 8 4 7 8 7 4 , 0 , 1 , 7 , 1 , 3 , 9 , 2 , 4 , 4 , 6 , 9 , 5 , 7 , 0 , 9 , 2 2 2 6 6 6 0 0 0 5 4 4 0 , 6 , 7 , 8 , 9 , 6 , 7 3 3 3 6 5 5 8 8 8 1 1 1 1 1 1 2 2 2 2 2 2 3
1 x 2
2 8 9 4 3 7 4 6 2 6 9 8 3 , 4 1 , 9 , 5 , 6 , 7 , 2 , 4 , 8 , 3 , 2 , 2 , 7 , 6 , 6 , 5 , 3 , 4 , 6 , 3 , 4 , 0 9 , 0 2 2 2 5 5 5 8 2 2 2 3 3 3 5 5 5 7 7 7 1 9 1 1 1 1 1 1 1 1
] ] m m m m [ [ n n o i o i t t a i s i m u i l q o c C A
l a r t n e c , 0 0
r e t l i F
e g a t l o V e b u T
14
r a E r e n n I : n o i t a c i l p p A l 5 8 5 3 7 7 2 0 , , 3 2 2 9 7 8 a c , , i 9 9 , , , , 2 2 2 2 2 9 9 9 p y T ; w o r r a N : r 2 4 5 8 0 6 0 6 , , 4 3 4 1 0 0 e l 8 8 , , , , , , t i 1 1 1 1 1 6 6 6 F d e p a l l l h a a a S r r r ; e l e l e a a h h h m r p r p p c t t i i i r n r n r 6 e e e e e 1 p c p c p , , , , , 0 0 0 0 0 Ø 0 0 0 0 0 : 1 1 1 1 1 I I I I I w I w I w I D D D D D D D D m o T T T T T T T T t C C C C C C C C n V k 0 4 1 V k 0 0 1 n S V k 0 4 1 n S a h P
) p r a h 5 5 8 8 5 3 7 6 0 1 5 7 6 8 1 1 1 4 8 8 1 3 0 4 9 5 0 6 3 4 s , , , , , , , , , , , , , , , , , , - 9 , 8 , 8 , 3 , 1 , 2 , 4 , 0 , 2 , 3 2 2 7 6 7 2 1 1 6 5 6 2 1 1 4 , 3 , 4 , 0 0 0 z 3 ( 3 3 6 6 6 9 9 9 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 2 2 2 1 1 1
1 I D T C
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 7
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 8
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 9
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 0 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 1 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 2 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w D I D I D T T T C C C V k 0 3 1
Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
Dosimetry an and im imaging pe performance re report
6 . 0 x 4 6
6 . 0 x 8 2 1
1
) p r a h 7 6 3 3 1 5 3 9 7 4 2 3 3 5 4 6 0 9 2 8 2 0 2 3 3 7 6 2 1 2 , s - 5 , 2 , 0 , 0 , 1 , 7 , 6 , 1 , 6 , 3 , 4 , 7 , 2 , 9 , 0 , 1 , 5 , 3 , 2 , 2 , 9 , 4 , 1 6 , 5 , 8 , 7 , 4 , 9 , 4 , z 0 ( 1 1 1 2 1 1 3 2 2 4 3 3 5 5 4 7 6 5 9 7 6 1 9 0 0 0 2 3 3
2 . 1 x 2 3
8 9 5 5 7 0 6 9 4 9 5 3 9 3 8 4 2 6 1 4 3 2 6 9 8 6 0 9 , 9 4 5 , 0 , 6 , 3 , 2 , 2 , 3 , 5 , 5 , 4 , , 2 , 0 , 1 , 8 , 2 , 7 , 5 , 8 , 1 , 1 , 7 , 5 , 5 , 1 , 1 8 , 8 , 7 , 0 , 4 0 1 1 1 2 1 1 3 2 2 4 3 3 6 5 4 7 6 5 9 8 6 1 9 0 0 0 2 4 3
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a 6 3 4 7 4 3 7 6 0 9 5 3 3 5 3 3 6 7 3 0 3 5 0 5 8 x x h , 9 4 , 9 , 0 9 s - 6 2 4 z , 4 , 1 , 1 , 4 , 9 , 8 , 6 , 0 , 6 , 0 , 2 , 6 , 7 , 7 , 7 , 5 , 2 , 9 , 0 9 , 2 , 2 0 6 , 9 , 8 , 7 , 4 , 8 , 3 6 ( 0 1 1 1 2 1 1 3 3 2 5 4 3 6 5 4 8 7 5 1 8 7 1 1 0 0 0 2 4 3
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h 0 5 7 6 9 5 0 2 8 8 3 8 7 1 0 1 2 5 1 4 4 6 8 8 3 7 1 0 , 5 7 s , , - 7 , 5 , 2 , 2 , 5 , 1 , 0 , 9 , 2 , 8 , 4 , 5 , 9 , 3 , 2 , 1 , 2 , 8 , 4 , 1 7 , 8 , 3 1 6 , 0 , 9 , 9 , 8 , 2 , z 0 ( 1 1 1 2 2 2 3 3 2 5 4 3 7 6 5 9 7 6 1 9 7 1 1 0 1 0 2 4 4
2 . 1 x 2 1
6 8 0 9 1 6 3 1 2 6 5 9 , 3 7 , 3 2 2 2 9 1 6 4 9 4 2 2 , 6 9 , 4 , 2 , 2 , 4 , 0 , 9 , 7 , 1 , 7 , 2 , 3 , 7 , 0 , 9 , 8 , 8 , 5 , 0 , 9 0 , 4 , 3 1 , 0 , 8 , 8 , 5 , 0 , 0 1 1 1 2 2 1 3 3 2 5 4 3 7 5 4 8 7 6 1 9 7 1 1 0 1 0 2 4 4
0 1 x 1
2 5 4 4 4 0 9 3 5 3 6 2 4 7 3 9 0 6 5 2 6 2 3 0 9 0 7 2 , 3 8 5 , 9 , 4 , 1 , 9 , 7 , 7 , 8 , 4 , 2 , , 1 , 9 , 9 , 6 , 9 , 4 , 0 , 4 , 4 , 6 , 9 , 8 , 5 , 2 , 0 8 , 8 , 6 , 5 , 1 0 1 0 0 1 1 1 2 2 2 4 3 2 5 4 3 6 5 4 8 7 5 1 8 0 0 0 2 3 3
6 . 0 x 0 1
6 . 0 x 0 2
) p r a h 9 2 4 4 5 1 7 5 2 2 3 0 0 7 8 1 5 0 9 2 5 2 6 6 4 5 1 2 2 2 , , , s - 6 , 5 , 2 , 2 , 5 , 1 , 9 , 8 , 2 , 8 , 3 , 5 , 9 , 1 , 0 , 0 , 0 , 7 , 2 , 1 5 , 7 , 3 1 6 , 0 , 9 , 9 , 7 , 1 , z 0 ( 1 1 1 2 2 1 3 3 2 5 4 3 7 6 5 9 7 6 1 9 7 1 1 0 1 0 2 4 4
5 x 1
6 . 0 x 8
2 5 4 4 4 0 9 3 5 3 6 2 4 7 3 9 0 6 5 2 6 2 3 0 9 0 7 2 , 3 8 5 , 9 , 4 , 1 , 9 , 7 , 7 , 8 , 4 , 2 , , 1 , 9 , 9 , 6 , 9 , 4 , 0 , 4 , 4 , 6 , 9 , 8 , 5 , 2 , 0 8 , 8 , 6 , 5 , 1 0 1 0 0 1 1 1 2 2 2 4 3 2 5 4 3 6 5 4 8 7 5 1 8 0 0 0 2 3 3
6 . 0 x 6 1
) p r a h 9 0 9 9 7 4 4 5 4 7 9 8 2 s - 9 , 2 , 7 , 7 , 6 , 0 , 8 , 5 , 6 , 0 , 6 , 4 , 6 , z 0 ( 2 1 1 3 3 2 5 4 4 7 6 5
5 3 1 , 7 3 , 1 , 7 1 , 8 , 1 , 0 7 , 2 , 3 1 0 , 6 3 1 1 8 7 1 1 9 1 1 1
6 . 0 x 6
4 8 0 9 0 0 8 0 2 5 4 7 1 8 6 4 4 , 6 , 7 4 , 1 , 5 , 9 , 6 , 6 , 8 , 3 , 8 , 0 , 7 , 5 , 9 , 3 , 4 , 3 , 1 , 8 , 3 , 2 0 5 , 5 3 0 0 2 1 1 3 2 2 5 4 3 7 6 5 9 8 6 1 1 8 1 1 1
1 x 2
8 9 5 4 6 9 6 7 3 8 3 1 8 0 6 2 9 3 9 0 0 9 5 , 2 , 0 , 0 , 1 , 7 , 6 , 2 , 7 , 3 , 5 , 8 , 2 , 1 , 1 , 2 , 6 , 5 , 2 , 5 , 1 , 4 , 0 1 1 1 2 1 1 3 2 2 4 3 3 6 5 4 7 6 5 9 8 6
] ] m m m m [ [ n n o o i i t t a i s i m q i u l o c C A
l a r t n e c , 0 0
r e t l i F
1 I D T C
e g a t l o V e b u T
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 7
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 8
SOMATOM Drive Print No. C2-047.660.01.02. C2-047.660.01.02.02 02
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 9
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 0 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 1 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 2 1
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 I w I I D D D T T T C C C V k 0 3 1
y d o B t l u d 6 2 2 1 1 4 A , 7 , 2 9 6 9 , 5 , 3 , 2 , 8 , 9 , : 1 1 0 1 1 4 6 5 n o i t a c i l p p A l a c 6 9 7 4 5 7 5 2 , , 8 4 2 9 4 6 i , , p 8 5 , , , , y 1 1 0 1 1 3 6 5 T ; d r a d n a t S : r 5 4 4 9 7 5 8 7 e , l 1 8 , 5 , 8 , 7 , 4 , 9 , 4 , t i 1 9 0 0 0 2 3 3 F d e p a l l l h a a a S r r r ; e l e l e a a h h h m r p r p p c t t i i i r n r n r 2 e e e e e 3 p c p c p , , , , , 0 0 0 0 0 Ø 0 0 0 0 0 : 1 1 1 1 1 I w I I w I I w m I D D D I D D D I D D o T T T T T T T T t C C C C C C C C n V k 0 4 1 V k 0 0 1 n S V k 0 4 1 n S a h P
15
1
6 . 0 x 4 6
6 . 0 x 8 2 1
Dosimetry an and im imaging pe performance re report
) p r a h 9 5 0 0 1 7 3 5 1 7 1 6 6 1 3 9 4 3 5 7 9 2 4 0 7 9 2 0 6 4 s - 4 , 9 , 8 , 9 , 6 , 3 , 4 , 4 , 1 , 0 , 4 , 9 , 8 , 6 , 0 , 6 , 8 , 1 , 6 , 2 , 3 , 7 , 8 , 8 , 4 , 6 , 6 , 2 , 1 , 8 , z 0 ( 0 0 0 1 1 1 2 2 2 3 2 2 4 4 3 5 5 4 7 6 5 8 7 0 0 0 2 3 2
2 . 1 x 2 3
0 8 2 2 6 1 7 3 8 1 3 6 3 7 6 8 5 9 5 1 9 4 4 4 8 1 4 4 5 2 5 , 9 , 4 , 1 , 9 , 7 , 7 , 8 , 4 , 2 , , 9 , 8 , 6 , 4 , 5 , 1 , 5 , 0 , 7 , 1 , 0 , 2 , 5 , 5 , 1 , 0 , 7 , 6 , 2 , 9 0 0 0 0 1 1 1 2 2 2 3 3 2 4 4 3 6 5 4 7 6 5 9 8 0 0 0 2 3 2
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a 6 8 1 2 3 6 2 9 0 4 9 7 4 6 9 8 6 4 6 8 7 8 1 9 0 9 9 2 x x h , 7 4 s - 5 2 4 z , 0 , 9 , 0 , 8 , 5 , 6 , 7 , 4 , 3 , 8 , 3 , 2 , 2 , 5 , 1 , 6 , 8 , 2 , 2 , 2 , 4 , 0 8 , 5 , 7 , 7 , 4 , 5 , 2 , 3 6 ( 0 1 0 1 1 1 1 2 2 2 3 3 3 5 4 4 6 5 5 8 7 6 1 8 0 0 0 2 3 3
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h 1 7 8 1 7 8 6 1 9 4 9 4 2 7 5 4 8 0 1 3 6 4 9 8 8 5 6 1 8 9 s , - 6 , 1 , 9 , 1 , 9 , 6 , 7 , 0 , 5 , 5 , 1 , 6 , 5 , 6 , 9 , 5 , 1 , 3 , 7 , 9 , 8 , 0 , 0 5 , 5 , 8 , 7 , 7 , 8 , 4 , z 0 ( 1 0 1 1 1 1 3 2 2 4 3 3 5 4 4 7 6 5 8 7 7 1 9 0 0 0 2 3 3
2 . 1 x 2 1
8 5 3 5 0 8 0 2 5 5 7 3 0 9 , 2 2 7 3 4 2 0 0 6 6 1 3 4 , 1 , 9 , 0 , 9 , 6 , 6 , 9 , 5 , 4 , 0 , 5 , 3 , 4 , 7 , 3 , 9 , 0 , 4 , 6 , 5 , 6 , 5 0 , 5 , 8 , 7 , 5 , 7 , 3 , 0 1 0 1 1 1 1 2 2 2 4 3 3 5 4 4 6 6 5 8 7 6 1 9 0 0 0 2 3 3
0 1 x 1
5 8 4 2 8 6 1 6 5 9 5 3 1 6 1 7 1 3 4 1 8 1 6 8 3 4 7 0 0 0 4 , 8 , 3 , 8 , 6 , 3 , 2 , 2 , 4 , 0 , ) , 8 , 7 , 4 , 2 , 2 , 9 , 1 , 7 , 2 , 7 , 4 , 7 , 7 , 8 , 1 , 1 , 6 , 5 , 9 , 6 0 0 0 0 1 1 1 2 1 1 3 2 2 4 3 3 5 4 4 6 5 5 8 7 0 0 0 2 2 2 a
6 . 0 x 0 1
6 . 0 x 0 2
) p r a h 0 5 7 8 4 5 3 5 4 9 1 7 5 6 6 5 5 8 0 6 1 0 s - 6 , 1 , 9 , 0 , 9 , 6 , 7 , 9 , 5 , 4 , 1 , 5 , 4 , 5 , 8 , 4 , 0 , 1 , 6 , 7 , 7 , 9 , z 0 ( 1 0 1 1 1 1 2 2 2 4 3 3 5 4 4 7 6 5 8 7 6
5 x 1
6 . 0 x 8
5 8 4 2 8 6 1 6 5 9 5 3 1 6 1 7 1 3 4 1 8 1 4 , 8 , 3 , 8 , 6 , 3 , 2 , 2 , 8 , 7 , 4 , 2 , 2 , 9 , 1 , 7 , 2 , 7 , 4 , 7 , 7 , 8 , 0 0 0 0 1 1 1 2 1 1 3 2 2 4 3 3 5 4 4 6 5 5
6 . 0 x 6 1
) p r a h 6 6 9 6 9 8 9 6 7 9 3 5 8 2 1 2 2 2 8 6 1 6 s , , , - 8 , 6 , 3 , 5 , 7 , 3 , 4 , 2 , 6 , 5 , 9 , 1 , 9 , 0 , 0 , 4 , 0 9 , 0 , 2 1 9 , z 0 ( 1 1 1 2 2 2 4 3 3 5 5 4 8 7 6 1 8 8 1 1 9
6 . 0 x 6
1 8 3 8 8 8 6 9 1 0 9 3 2 9 0 9 6 3 5 1 , 6 , 1 8 , 4 , 3 , 4 , 7 , 0 , 6 , 5 , 3 , 6 , 2 , 0 , 5 , 6 , 9 , 6 , 7 , 7 , 5 , 2 0 4 , 0 1 1 1 2 2 2 4 3 3 5 4 4 7 6 6 9 8 7 1 1 9
1 x 2
0 8 2 1 5 1 6 2 7 0 2 4 1 5 4 6 3 7 3 8 6 1 5 , 9 , 8 , 9 , 6 , 4 , 4 , 5 , 1 , 1 , 5 , 0 , 9 , 7 , 1 , 7 , 0 , 2 , 7 , 4 , 5 , 8 , 0 0 0 0 1 1 1 2 2 2 3 3 2 4 4 3 6 5 4 7 6 5
] ] m m m m [ [ n n o o i t i t a i s i m q i u l o c C A
l a r t n e c , 0 0
0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
l a r e h p i r e p , 0 0
l a r t n e c , 0 0
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I I I I I I I I I I I I r D e w D I w D I w D I w D I w D I w D I w D I D D D D D D D t D D D D D D l T D T T T T T T T T T T T T T T T T T T T T T i F C C C C C C C C C C C C C C C C C C C C C C
e g a t l o V e b u T
16
l a r e h p i r e p , 0
V k 0 7
V k 0 8
V k 0 9
V k 0 0 1
V k 0 1 1
V k 0 2 1
V k 0 3 1
m u a r T h s a l F 0 5 3 t 7 3 6 1 , 4 7 0 , 5 , 8 , 7 , 6 , 8 , 4 , p 1 9 0 0 0 2 3 3 e c x e ( h s a l F , y d 6 8 3 4 7 0 0 0 o 1 , 4 , 0 , B , 1 , 6 , 5 , 9 , 6 c 8 7 0 0 0 2 2 2 i r t a i d e P , o i d r 8 3 0 4 a 4 , 6 , 2 0 5 3 8 , 2 , 0 , 8 , 5 , 9 , C 1 1 0 1 1 3 5 4 : n o i t a c i l p p A l 7 5 2 1 4 0 a , 0 , 8 c , 6 , i 4 3 7 , 1 , 0 , 2 , 7 1 1 0 1 1 3 5 4 p y T ; w o r r a N : r 0 0 8 1 3 3 4 0 e t 1 , 0 , 4 , 7 , 6 , 2 , 2 , 9 , l i 9 8 0 0 0 2 3 2 F d e p a l l l h a a a S r r r ; e l e l e a a h h h m r r p p p c t i t i i r n r n r 2 e e e e e 3 p c p c p , , , , , 0 0 0 0 0 Ø 0 0 0 0 0 : 1 1 1 1 1 I I I I I w D I w D I w m I D D D D D D T T T T T T T T o C C C C C C C C t n V k 0 4 1 V k 0 0 1 n S V k 0 4 1 n S a h P
Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
Dosimetry an and im imaging pe performance re report
6 . 0 x 4 6
6 . 0 x 8 2 1
) p r a h s z (
2 . 1 x 2 3
0 4 , 4
0 5 , 4
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a x x h s 2 4 z 3 6 (
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h s z (
8 9 , 4
0 4 , 5
8 6 , 6
2 8 , 6
6 5 , 7
1 2 , 8
6 3 , 9
5 5 , 9
6 , 0 1
5 , 1 1
4 , 2 1
6 , 2 1
0 , 4 1
2 , 5 1
0 , 6 1
3 , 6 1
1 , 8 1
7 , 9 1
7 , 9 1
1 , 0 2
3 , 2 2
3 , 4 2
9 , 3 2
3 , 4 2
0 , 7 2
3 , 9 2
5 , 8 2
0 , 9 2
2 , 2 3
0 , 5 3
8 9 , 1
1 0 , 2
3 2 , 2
3 4 , 2
3 5 , 8
6 . 0 x 4 6
4 6 , 8
2 . 1 x 2 3
6 . 0 x 8 2 1
) p r a h s z (
1
6 0 , 4
0 2 , 6
4 7 , 8
6 , 1 1
1 , 5 1
4 1 , 4
2 3 , 6
1 9 , 8
8 , 1 1
3 , 5 1
2 6 , 9
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a x x h s 2 4 z 3 6 (
9 5 , 4
1 0 , 7
9 , 9
1 , 3 1
0 , 7 1
5 , 0 1
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h s z (
8 9 , 4
2 6 , 7
7 , 0 1
2 , 4 1
5 , 8 1
2 . 1
2 . 1
x 2 1
6 1 , 5
2 8 , 7
9 , 0 1
4 , 1
7 , 8 1
0 , 3 2
9 , 7 2
2 , 3 3
0 3 , 2
0 9 , 9
x 2 1
5 7 , 4
4 2 , 7
2 , 0 1
5 , 3 1
6 , 7 1
0 1 x 1
2 0 , 4
9 0 , 6
3 5 , 8
3 , 1 1
6 , 4 1
0 , 8 1
7 , 1 2
9 , 5 2
9 7 , 1
2 7 , 7
0 1 x 1
0 7 , 3
4 6 , 5
6 9 , 7
6 , 0 1
7 , 3 1
9 8 , 4
8 4 , 7
5 , 0 1
0 , 4 1
2 , 8 1
0 7 , 3
4 6 , 5
6 9 , 7
6 , 0 1
7 , 3 1
5 0 , 7
8 , 0 1
2 , 5 1
1 , 0 2
2 , 6 2
6 . 0 x 0 1
6 . 0 x 0 2
) p r a h s z (
5 x 1
6 . 0 x 8
6 . 0 x 6 1
) p r a h s z (
0 3 , 5
6 0 , 8
3 , 1 1
9 , 4 1
3 , 9 1
8 , 3 2
8 , 8 2
3 , 4 3
9 3 , 2
3 , 0 1
6 . 0 x 0 1
2 0 , 4
9 0 , 6
3 5 , 8
3 , 1 1
6 , 4 1
0 , 8 1
7 , 1 2
9 , 5 2
9 7 , 1
2 7 , 7
5 x 1
8 , 4 1
6 . 0 x 8
5 6 , 7
6 , 1 1
3 , 6 1
5 , 1 2
8 , 7 2
3 , 4 3
5 , 1 4
5 , 9 4
4 4 , 3
6 . 0 x 0 2
6 . 0 x 6 1
) p r a h s z (
) p r a h s z (
. a . . a n . : n n : 6 6 o . . n i 0 t 0 o 5 0 4 3 3 4 2 7 3 9 8 2 4 0 7 i , , , , , , , , , , , , a t 2 2 6 x x c , 1 5 0 6 2 9 6 , 3 , 0 4 9 4 i a l 6 6 7 1 1 2 2 3 3 4 3 1 6 1 1 1 2 c i p l p p A p ; A d ; r a w d o r n r a a t 1 1 8 9 0 5 3 0 2 9 0 0 2 9 7 8 3 S N , , , , , , , 4 7 5 0 6 1 2 8 x x : : , , , 2 6 0 4 8 , , , , , 1 5 r r 2 2 4 6 9 1 1 2 2 2 2 8 4 6 8 1 1 e e t t l l i i F F d d e e ] ] p ] ] p m m m m a a r r r r r r r r r r r r r r r h h i i i i i i i i i i i i i i i m m m m a a a a a a a a a a S [ [ a a a a a S [ [ ; ; e e e e e e e e e e e e e e e n n n n e e e e e e e e e e e e e e e e e o o r r r r r r r r r r r r r r r o o n n i i i i f f f f f f f f f f f f f f f t t o o t t , , , , , , , , , , , , , , , i i a s a s 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 n n 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 i i : : 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I I I I I I I I I I I I I I I m q i u r D e m q i u r e m l m l t D D D D D D D D D t D D D D D l l o o c o c o T T T T T T T T T T T T T T T i i t t C A F C C C C C C C C C C C A F C C C C C n n a k 0 7 V k 0 7 V e g a t l o V e b u e g a t l o V e b u T V T V k 0 8 V k 0 9 V k 0 0 1 V k 0 1 1 V k 0 2 1 V k 0 3 1 V k 0 4 1 V k 0 0 1 n S V k 0 4 1 N S h k 0 8 V k 0 9 V k 0 0 1 V k 0 1 1 a h P P
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Dosimetry an and im imaging pe performance re report
) p r a h 6 , s z 8 ( 1
5 , 2 2
0 , 7 2
1 9 , 1
7 2 , 8
2 . 1 x 2 3
0 , 9 1
0 , 3 2
5 , 7 2
3 9 , 1
8 3 , 8
6 . 0 x 2 3
, m m m m ) 6 . 6 . p r 0 0 a h 1 x x s , - 1 2 4 z 3 6 ( 2
5 , 5 2
5 , 0 3
5 1 , 2
2 3 , 9
6 . 0 x 0 2
6 . 0 x 0 4
) p r a h 9 , s z 2 ( 2
7 , 7 2
2 , 3 3
4 3 , 2
2 , 0 1
x 2 1
7 , 1 2
3 , 6 2
5 , 1 3
1 2 , 2
0 6 , 9
0 1 x 1
9 , 6 1
5 , 0 2
5 , 4 2
2 7 , 1
8 4 , 7
) p r a h 5 , s z 2 ( 2
2 , 7 2
5 , 2 3
0 3 , 2
0 , 0 1
9 , 6 1
5 , 0 2
5 , 4 2
2 7 , 1
8 4 , 7
) p r a h 4 , s z 2 ( 3
2 , 9 3
9 , 6 4
1 3 , 3
4 , 4 1
6 . 0 x 4 6
6 . 0 x 8 2 1
2 . 1
6 . 0 x 0 1
6 . 0 x 0 2
5 x 1
6 . 0 x 8
6 . 0 x 6 1
. a . n : 6 . n 0 o 6 0 3 1 5 i , , , , t 1 x 0 7 4 , 3 a 6 3 3 4 3 1 c i l p p A ; w o r r a 1 9 9 4 2 4 N , , , 9 3 x : 8 2 7 , , r 2 1 2 2 1 8 e t l i F d e ] ] p m m a r r r r r h i i i i i m m a a a a a S [ [ ; e e e e e n n e e e e e e o r r r r r o n i i f f f f f t i o t , , , , , a s 0 0 0 0 0 n 0 0 0 0 0 i : 1 1 1 1 1 I I I I I m q i l u r e m l t D D D D D l o c o T T T T i T t C A F C C C C C n e g a t l o V e b u T V k 0 2 1 V k 0 3 1 V k 0 4 1 V k 0 0 1 n S V k 0 4 1 N S a h P
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1.1.7
1
CTDIfree air The CTDIfree air is stated in the following table based on the typical body mode (shown in bold type) for varying collimation, kV, and filter setting. Additionally, the CTDIfree air for the typical head mode is stated.
Acquisition [mm]
2 . 1 × 2 3
6 . 0 × 8 2 1
19.2 mm
38.4 mm
38.4 mm
7,3
7,4
6,6
6,5
11,5
11,0
11,2
10,0
9,8
16,9
16,1
15,4
15,8
14,0
13,8
16,5
22,3
21,2
20,3
20,8
18,5
18,2
28,4
21,4
28,9
27,5
26,3
26,9
24,0
23,5
26,4
35,0
26,4
35,7
33,9
32,4
33,2
29,6
29,0
61,0
31,9
42,3
31,9
43,1
41,0
39,2
40,2
35,7
35,1
72,8
38,1
50,5
38,1
51,4
48,8
46,7
47,9
42,6
41,9
4,8
5,1
2,6
3,5
2,6
3,6
3,4
3,2
3,3
2,9
2,9
12,6
20,5
21,8
11,3
15,1
11,3
15,4
14,6
13,9
14,4
12,7
12,5
70 kV
6,1
9,8
10,4
5,4
7,2
5,4
7,3
7,0
6,7
6,8
6,1
6,0
80 kV
9,2
15,0
15,9
8,3
11,0
8,3
11,2
10,6
10,2
10,4
9,3
9,1
90 kV
13,0
21,1
22,3
11,7
15,5
11,7
15,8
15,0
14,4
14,7
13,1
12,8
100 kV
17,3
28,0
29,6
15,5
20,5
15,5
20,9
19,9
19,0
19,5
17,4
17,0
110 kV
22,5
36,4
38,5
20,2
26,7
20,2
27,2
25,8
24,7
25,3
22,6
22,1
120 kV
27,7
44,9
47,7
24,9
33,0
24,9
33,7
31,9
30,6
31,4
27,9
27,4
130 kV
33,6
54,4
57,6
30,1
40,0
30,1
40,7
38,7
37,0
38,0
33,8
33,1
140 kV
40,2
65,1
69,0
36,1
47,8
36,1
48,7
46,3
44,3
45,4
40,4
39,7
Sn 100 kV
2,8
4,6
4,9
2,5
3,4
2,5
3,4
3,3
3,1
3,2
2,8
2,8
Sn 140 kV
12,3
19,8
21,1
11,0
14,7
11,0
14,9
14,1
13,5
13,9
12,3
12,2
1 × 2
6 . 0 x 6
6 . 0 × 6 1
5 x 1
6 . 0 x 0 2
0 1 × 1
6 . 0 × 0 4
2 . 1 × 2 1
6 . 0 × 2 3
6 . 0 × 4 6
2.0 mm
3.6 mm
4.8 mm
5.0 mm
6.0 mm
10.0 mm
12.0 mm
14.4 mm
19.2 mm
70 kV
6,6
10,7
11,2
5,9
7,8
5,9
7,9
7,6
80 kV
10,0
16,2
17,1
9,0
11,8
9,0
12,1
90 kV
14,0
22,6
23,9
12,5
16,6
12,5
100 kV
18,4
29,9
31,6
16,5
21,9
110 kV
23,9
38,7
40,9
21,4
120 kV (typical)
29,4
47,6
50,5
130 kV
35,6
57,6
140 kV
42,4
68,7
Sn 100 kV
2,9
Sn 140 kV
Total collimation [mm]
: r e t l i f d e p a h S
: r e t l i f d e p a h S
d r a d n a t s
w o r r a n
Variation of the collimation 3 . 0 x 6 1
) l a c i p y t (
CTDIfree air in mGy for typical body mode (bold type) with variation of collimation, kV, and filter setting Acquisition [mm]
12 × 1.2
Total collimation [mm]
14.4
Shaped Filter Wide 120 kV (typical)
89,8
CTDIfree air in mGy for setting of typical head mode
1.1.8
Stray radiation Stray radiation is indicated for the horizontal and vertical planes based on the scanner coordinate system (intersection (intersection of scanner axis with scan plane) for maximum tube voltage (140 kV) and maximum collimation width (64 × 0.6 mm). A cylindrical PMMA phantom with a diameter of 32 cm and a length of 15 cm is centered in the scan plane for the stray radiation measurement. A 500 cm3 dose chamber is used for the measurements.
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The accuracy of stated values is determined by the accuracy of chamber positioning (± 5 cm in each direction) and by the accuracy of the dosemeter (± 5% or 0.0013 µGy/mAs, whichever is more). Backscatter from cabin walls or similar surfaces may cause additional variation in the radiation measurement. The data below represent the maximum scatter radiation for that system type. Depending on the system configuration, i.e. shaped filter or gantry cover, lower values may result. Data in the tables below are derived from measured values. Stray radiation in microGray (µGy) per mAs
Stray radiation (vertical)
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1
Stray radiation (horizontal)
1.1.9
Dose levels causing deterministic radiation effects Certain modes of operation allow selections of scan parameters that may lead to an accumulated peripheral CTDI100 of more than 1 Gy. This dose may exceed the threshold for deterministic radiation effects on the patient's skin or eye lenses (see IEC 60601-1-3: 60601-1-3:2008, 2008, Annex A.2, 5.2.4.5).
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The accumulated peripheral CTDI100 may serve as a very rough estimation of skin or eye lens dose. However, other factors may influence the dose to cause deterministic radiation effects, for example:
◾ A deviation of may the patient's diameter fromthat the is standard CTDIhigher phantom size lead to abody patient's skin dose noticeably than indicated by the accumulated peripheral CTDI100. Such a deviation may occur, for example, if a body perfusion examination is performed with a very thin patient. ◾ Repeating examinations within a short time period (compared to the biological recovery time for deterministic radiation effects) may lead to deterministic radiation damages, even if the accumulated peripheral CTDI100 of the single examinations was below 1 Gy. By using the default Siemens scan protocols for patients with a standard patient size, without changing the default settings of the scan parameters, and without repeating the scans, the accumulated peripheral CTDI 100 will be kept reasonably below 1 Gy. The following list gives examples of situations that may lead to an accumulated peripheral CTDI100 of 1.0 Gy and above (numbers are approximations). Thewith list refers to default Siemens scan protocols and concentrates on scan modes relatively high radiation exposure. This list is not exhaustive. ◾ Use of perfusion protocols with changes in kV, scan times, or mAs, for example: – Neuro PCT with with tube voltage changed from 80 kV to 120 kV (≈ 1.2 Gy) – Neuro PCT with with mAs increased from 200 mAs to ≈ 580 mAs ◾ Use of interventional protocols, for example: – Head Intervention i-Fluoro with an accumulated scan time of ≈ 21 s – Head Intervention i-Fluoro with 10 s scan time and mAs increased from 100 mAs to ≈ 220 mAs – Head Intervention i-Fluoro with 15 s scan time and tube voltage increased from 120 kV to 140 kV ◾ Scanning of sequence protocols without table feed, for example: – Approximately 16 scans of Head Neuro Seq without table feed ◾ Repeating standard sequences or spiral scans within an examination, for example: – Repeated application of the default protocol Head Neuro Seq (approximately 16 times) – Repeated application of the default protocol Abdomen Seq (approximately 93 times) – Repeated application of the default protocol Abdomen Routine (approximately 89 times)
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1
To prevent unintended, excessive exposure, the CT system provides tools for Dose Notification and Dose Alert according NEMA XR-25 and IEC 60601-2-44 (Ed. 3.1). The default threshold value for Dose Alert is an accumulated CTDIvol of 1.0 Gy for adult patients and 1.0 Gy for pediatric patients.
Ratio of peripheral CTDI100 to displayed CTDIvol
In general, the accumulated peripheral CTDI 100 for a scan can be derived from the displayed CTDIvol by multiplying the CTDIvol with a given factor that depends on the tube voltage and shaped filter used: Shaped Filter: Na N arrow CTDI phantom size: Ø 16 cm
e g a t l o V e b u T
Standard Ø 32 cm
Ø 16 cm
Ø 3 2 cm
70 kV
1.0
1.2
1.0
1.2
80 kV
1.0
1.2
1.0
1.2
90 KV
1.0
1.2
1.0
1.2
100 kV
1.0
1.2
1.0
1.2
110 kV
1.0
1.1
1.0
1.2
120 kV
1.0
1.1
1.0
1.2
130 kV
1.0
1.1
1.0
1.2
140 kV Sn 100 kV
1.0 1.0
1.1 1.1
1.0 1.0
1.2 1.2
Sn 140 kV
1.0
1.1
1.0
1.1
Ratio of peripheral CTDI100 to displayed CTDIvol
1.1.10
Tolerances for CTDI According to: 21 CFR 1020.33
The actual exposure values, such as CTDI 100, CTDIw, CTDIvol and DLP, may deviate from the values displayed at the scanner and may deviate from the values stated in this manual within the following tolerances: Typical deviation*
within ± 10%
Max. tolerance*
± 20%
*) Not including the dosemeter's tolerance; verified with dosemeter according IEC 61674 Tolerances for CTDI values
Linearity of the radiation output (linearity of measured dose related to displayed mAs): ± 10%
1.1.11
Conversion factor for CTDIvol from Ø 32 cm phantom to Ø 16 cm phantom The displayed and reported CTDIvol and DLP refer to cylindrical PMMA phantoms with a diameter of 16 cm for head protocols and with a diameter of 32 cm for all body protocols (adult and pediatric protocols) according to IEC 60601-2-44. Neck protocols refer to the 32 cm phantom, too. The table below lists factors for the conversion of the CTDIvol and the DLP from the CTDI phantom size of Ø 32 cm to the CTDI phantom size of Ø 16 cm.
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The table below provides conversion factors to calculate the CTDIvol and DLP for the 16 cm phantom from the values of a 32 cm phantom. The factors are stated separately for each setting of shaped filter. Please note that for adult neck protocols the standard shaped filter is used and for pediatric body and pediatric neck protocols the narrow shaped filter is used.
1.1.12
Conversion factor for CTDIvol Conversion factor from Ø 32 cm to Ø 16 cm Tube Voltage
Shaped filter Standard
Shaped filter Narrow
70 kV
2.5
2.8
80 kV
2.4
2.6
90 kV
2.3
2.5
100 kV
2.2
2.5
110 kV
2.2
2.4
120 kV
2.2
2.4
130 kV
2.1
2.3
140 kV
2.1
2.3
Sn 100 kV
2.0
2.2
Sn 140 kV
1.9
2.1
Conversion factor for CTDIvolfrom Ø 32 cm to Ø 16 cm
Example For a typical pediatric body protocol at 100 kV, the displayed CTDIvol (related to the Ø 32 cm CTDI-phantom) is 3.00 mGy × cm; see ( Page 8 Typical CT conditions of operation). For the same protocol, the CTDI CTD Ivol of a Ø 16 cm CTDIphantom is 2.5 times higher than the CTDI vol of a Ø 32 cm CTDI-phantom, resulting in 7.50 mGy.
1.1.13
CTDIvol for topograms The CTDIvol for topogram scans may be estimated according to IEC 60601-2-44. Since the collimation (6 × 0.6 mm) and table speed (100 mm/s) for the topogram is fixed, the CTDIvol for topograms is stated in the following table depending on the kV and mA values:
24
Protocol type
Head
Adult body
Child body
Shaped filter
Standard
Standard
Narrow
Phantom size
Ø 16 cm
Ø 32 cm
Ø 32 cm
CTDIvol
CTDIvol
CTDIvol
µGy/mA
µGy/mA
µGy/mA
70 kV
1.6
0.6
0.5
80 kV
2.5
1.0
0.8
90 kV
3.6
1.6
1.3
100 kV
5.0
2.2
1.8
Dosimetry and imaging performance report | System Owner Manual Print No. C2-047.660.01.0 C2-047.660.01.02.02 2.02
Dosimetry an and im imaging pe performance re report
Protocol type
Head
Adult body
Child body
Shaped filter
Standard
Standard
Narrow
Phantom size
Ø 16 cm
Ø 32 cm
Ø 32 cm
CTDIvol
CTDIvol
CTDIvol
µGy/mA
µGy/mA
µGy/mA
110 kV
6.6
3.0
2.4
120 kV
8.3
3.8
3.1
130 kV
10.0
4.7
3.8
140 kV
11.9
5.7
4.7
1
CTDIvol for topograms
1.1.14
Geometric efficiency in the z-direction The dose efficiency is defined by IEC 60601-2-44 as the integral of the “free in air” dose profile in the isocenter i socenter along the z-axis over the acquisition range in the z-direction. It is expressed as percentage of the total integral of the dose profile in the z-direction. The acquisition range is the distance spanned by the selected detector elements along the z-axis. The displayed CTDIvol and DLP reflect the dose efficiency of a collimation according to the definition of CTDIvol.
Correlation of dose profile and collimation with regards to dose efficiency
y
Dose
z
z-axis
(1)) Tot (1 Total al dos dose e pro profil file e widt width h (2)) Do (2 Dose se pr prof ofil ile e (3) Detector (4)) Ac (4 Acqu quis isit itio ion n ran range ge Dose efficiency values for the various collimation types
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Acquisition
Total collimation
Dose efficiency
2 × 1 mm
2.0 mm
79%
1 × 5 mm 20 × 0.6 mm
5.0 mm 6.0 mm
84% 70%
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Dosimetry an and im imaging pe performance re report
Acquisition
Total collimation
Dose efficiency
16 × 0.6 mm
4.8 mm
50%
16 × 0.3 mm
4.8 mm
50%
1 × 10 mm
10.0 mm
92%
40 × 0.6 mm
12.0 mm
71%
12 × 1.2 mm
14.4 mm
78%
32 × 0.6 mm
19.2 mm
82%
64 × 0.6 mm
19.2 mm
76%
32 × 1.2 mm
38.4 mm
90%
128 × 0.6 mm
38.4 mm
87%
Dose efficiency values of CT scans
For CT scans with a dose efficiency lower than 70%, a message containing information about the dose efficiency is displayed after a scan range is loaded. The user has to confirm the message before starting the scan.
1.1.15
Dose profiles According to: 21 CFR 1020.33
Dose profiles for single axial scans have been measured for the narrowest and widest collimations, as well as for a mid-range collimation. For each of these collimations, the dose profiles have been measured without any phantom (free air), at the center of the Ø 16 cm CTDI phantom (head) and at the center of the Ø 32 cm CTDI phantom (body). The phantoms were centered in the isocenter and aligned with the scanner axes. For the measurements, a semiconductor diode sensor was moved through the phantom. Dose profile diagrams In the diagrams below, dose profiles (thick lines) are presented as a percentage of their maximum value. Sensitivity profiles for the detector slices used in these collimations are plotted as thin lines (sum of single-slice sensitivity profiles). The dotted lines indicate the nominal collimation. Nominal values and tolerances for acceptance testing The stated tolerances are determined by the accuracy of the measurement method. For acceptance testing, dose profile widths are measured using film (GAFCHROMIC XR-QA / XR-QA2) and without any phantom. The tube is fixed and positioned at 12 o'clock. The exposure parameters are chosen to overexpose the film (120 kV, 160 mA, 10 s). Using this method, no densitometry is needed to evaluate the film. The width of the blackened range is a measure of the base width of the profile. Nominal values and tolerances are defined accordingly.
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Dose profile diagrams no phantom
phantom 16 cm
phantom 32 cm
2 × 1 mm
12 × 1.2 mm
64 × 0.6 mm
x-Axis: z-position [mm] y-Axis: rel. dose & ssp[%] Dose profiles
Full Width at Half Maximum (FWHM) of dose profiles Collimation
No phantom
Ø 16 cm phantom
Ø 32 cm phantom
Tolerance
2 × 1 mm
2.5 mm
2.7 mm
2.9 mm
± 1.5 mm
12 × 1.2 mm
18 mm
22 mm
55 mm
± 4.0 mm
64 × 0.6 mm
43 mm
45 mm
88 mm
± 4.0 mm
Full Width at Half Maximum (FWHM) of dose profiles
1.1.16
Nominal values and tolerances for acceptance testing Collimation
Nominal blackening width
Tolerance
2 × 1 mm
3.5 mm
± 1.0 mm
12 × 1.2 mm
19.4 mm
± 1.5 mm
64 × 0.6 mm
45.5 mm
± 2.0 mm
Nominal values and tolerances for acceptance testing
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1.1.17
Beam quality, leakage technique factors and minimum filtration According to: 21 CFR 1020.33 Tube voltage
Half Value Layer (HVL)
70 kV
≥ 4.0 mm Al
(typical 5.2 – 5.4 mm*)
80 kV
≥ 4.5 mm Al
(typical 6.0 – 6.1 mm*)
90 kV
≥ 5.0 mm Al
(typical 6.6 – 6.8 mm*)
100 kV
≥ 5.0 mm Al
(typical 7.2 – 7.4 mm*)
110 kV
≥ 5.0 mm Al
(typical 7.8 – 8.0 mm*)
120 kV
≥ 5.0 mm Al
(typical 8.3 – 8.5 mm*)
130 kV
≥ 5.0 mm Al
(typical 8.8 – 9.0 mm*)
140 kV
≥ 5.0 mm Al
(typical 9.3 – 9.5 mm*)
Sn 100 kV
≥ 5.0 mm Al
(typical 11.3 – 11.4 mm*)
Sn 140 kV
≥ 5.0 mm Al
(typical 13.8 – 13.9 mm*)
*) Depending on shaped filter Beam quality ≤ 0.8 0.88 8 mGy mGy/h /h
Leakag Leak age e rad radia iati tion on of XX-ra rayy tub tube e hou housi sing ng as asse semb mbly ly at at 1 m di dist stan ance ce to focal spot with 145 kV, 4600 W
Leakage technique factors Minimum filtration, permanent in the useful beam (tube housing assembly)
Quality equivalent filtration ≥ 6.8 mm Al at 145 kV
CARE filter
Minimum filtration, permanent in the useful beam (beam limiting device)
0.3 mm Ti + 1 mm C,
CARE filter
(2.9 mm Al 140 kV/HVL 8.4 mm Al)
Tube A and tube B
Tube A and tube B
Setting of shaped filter: standard (e.g. head and standard body protocols) Additional filtration, conditional conditional in the useful
0.5 mm Al
CARE filter
beam (beam limiting device)
(0.5 mm Al 140 kV/HVL 9.4 mm Al)
Tube A and tube B Setting of shaped filter: narrow (e.g. cardiac and pediatric body protocols)
0.4 mm Sn
(protocols with setting
(47 mm Al 140 kV/HVL 9.4 mm Al)
Sn 100 kV or Sn 140 kV)
Minimum filtration
1.1.18
Performance specification of automatic exposure controls The CT scanner offers different types of automatic exposure controls for adaptation of the exposure to the indvidual patient. ◾ CARE Dose 4D: mAs adaptation to patient size, longitudinal, and angular tube current modulation ◾ ECG-Pulsing: Adaptation of tube current to the patient's ECG signal
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◾ X-CARE: Control of the angular tube current to reduce dose for an angular segment with radiation sensitive organs, such as eye lenses and breast tissue ◾ CARE kV: Optimization of kV to minimize patient dose but maintaining image quality The modulation type applied depends on the protocol selected and the individual setting: Prot Pr oto oco coll ty type pes, s, org rga an ch cha ara ract cte eri rissti ticcs
Modu dula lati tion on ty typ pe
Abdomen
XYZ exposure control
AngioBody
(CARE Dose 4D)
Pediatric Head Pediatric Angio Head
The tube current is adapted to the patient size. It is varied along the z-axis according to the patient’s attenuation profile and modulated angularily according to the patient's angular attenuation profile that has been measured online.
Neck Pelvis Runoff Shoulder Spine Thorax Adult Head
Z exposure control
Adult Angio Head
(CARE Dose 4D)
The tube current is adapted to the patient size and varied along the z-axis according to the patient’s attenuation profile.
Respiratory Body-Perfusion
XY exposure control
Extremities
(CARE Dose)
Osteo
Fixed exposure control (CARE Dose 4D)
Cardio
ECG-Pulsing
(Z exposure control for chest pain protocols only)
(possibly combined with fixed exposure control or Z exposure control)
X-CARE protocols
Angular modulated exposure control (X-CARE) (possibly combined with fixed exposure control, Z exposure control or XY exposure control)
The tube current is modulated angularily according to the patient's angular attenuation profile that has been measured online and is based on the user-selected mAs. The tube current is adapted to an average patient size and kept constant. The tube current is pulsed according to the patient's ECG signal.
The tube current is modulated angularly relatively to the patient's orientation to reduce dose in certain body ranges (eye lenses, breast tissue).
Modulation types of automatic exposure control, related to the selected protocols
CARE Dose 4D
CARE Dose 4D automatically adapts the tube current to the patient's body size and shape. Using the patient's topogram, Care Dose 4D evaluates two profiles of the patient's body size in the a.p. and lateral directions, related to the X-ray attenuation of the patient's body. Based on these profiles, the mAs value is adapted to the patient during the subsequent CT scans. The adaptation follows a curve, which determines the correlation between patient size and tube current. The adaptation curve has been derived from clinical optimization for constant diagnostic image quality.
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Dosimetry an and im imaging pe performance re report
The adaptation curve is based on three parameters: ◾ A reference body size, related to a typical adult patient size of approximately 70 to 80 kg, which is internally stored in the CT system for the considered organ characteristic and depending on the selected protocol. This patient size refers to a typical tissue-bone-mixture-equivalent tissue-bone-mixture-equivalent X-ray attenuation coefficient and is not the physical diameter of the patient's body (in particular in the lung and pelvis regions). Reference thickness for automatic exposure control (for specific organ characteristics) – Head, Angio Head 19.2 cm – Neck 22.6 cm – Shoulder 34.8 cm – Thorax, Respiratory 31.4 cm – Cardio 29.4 cm – Abdomen, AngioBody, BodyPerfusion, Runoff 33.9 cm – Pelvis, Osteo 35.8 cm – Spine 32.8 cm ◾ A reference mAs value “ref. mAs” (or “ref. mAs/rot”), which is adjustable by the operator on the Scan Card to modify the overall dose and image quality of the scan range. ◾ An individual adjustment of the adaptation strength, which can be selected in five steps (very weak, weak, average, strong, very strong), and which is separated for body sizes smaller or larger than the reference body size. The curve below shows the theoretical adaptation curve for a cylindrical body shape. Depending on the individual patient geometry, the curve may deviate from this theoretical function. Moreover, the curve may be cut depending on the system's power limits.
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Adaptation of mAs to patient size for standard protocols (adult and child)
x
Devi De viat atio ion n fro from m ref refer eren ence ce th thic ickn knes esss (d (d - dref) [cm]
y
(eff.) mA mAs / ref. mA mAs
(1)) co (1 cons nsta tant nt noi noise se (2) ver eryy str stro ong (3) strong (4) average (5) weak (6) very we weak Depending on the modulation type of the protocol, the patient size adapted tube current can be fixed, modulated along the z-axis according to the adaptation curve, modulated according to the patient's online measured angular attenuation profile, or a combination of these. For certain organ characteristics (obese, runoff, neck), special adaptation curves are applied.
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Automatic Exposure Control - adaptation curves for neck protocols
x
Devi De viat atio ion n fro from m ref refer eren ence ce th thic ickn knes esss (d (d - dref) [cm]
y
(eff.) mA mAs / ref. mA mAs
(1)) co (1 cons nsta tant nt noi noise se (2) ve very ry str tro ong (3) strong (4) average (5) weak (6) very we weak
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Automatic Exposure Control - adaptation curves for obese protocols
x
Devi De viat atio ion n fro from m ref refer eren ence ce th thic ickn knes esss (d (d - dref) [cm]
y
(eff.) mA mAs / ref. mA mAs
(1)) co (1 cons nsta tant nt noi noise se (2) ver eryy str stro ong (3) strong (4) average (5) weak (6) very we weak
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Automatic Exposure Control - adaptation curves for runoff protocols
x
Devi De viat atio ion n fro from m ref refer eren ence ce th thic ickn knes esss (d (d - dref) [cm]
y
(eff.) mA mAs / ref. mA mAs
(1)) co (1 cons nsta tant nt noi noise se (2) ve very ry str tro ong (3) strong (4) average (5) weak (6) very we weak ECG Gating
X-CARE
CARE kV
The tube current is synchronized to the patient's ECG signal and gated depending on the user-defined setting for the image time window, which is set as a percentage range of the RR interval (e.g., 70% to 70%). Depending on the data range needed for the particular image reconstruction, the width of the tube current gating varies between a minimum of a 260° rotation angle and a maximum of full rotation. Outside the tube current gating window, the tube current is reduced to 20% (or 4% with MinDose) of the value inside the gating window. The tube current is reduced over an angle segment of 80°, with respect to the anterior position of the patient, to reduce the organ dose for radiation-sensitive peripheral organs such as eye lenses or female breast tissue. Depending on the system's power limits, the tube current reduction is by up to 80%. The reduction is compensated for by an increased tube current over the rest of the rotation, keeping the average CTDIvol constant. The kV is optimized to minimize the CTDIvol but maintaining image quality (contrast-to-noise ratio). CARE kV evaluates the body diameter using the patient's topogram. Based on the user-defined image quality and tissue of interest, a kV setting is determined that minimizes the CTDIvol, keeping the contrast-to-noise ratio constant.
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1.1.19
1
Use of radiation shields for the purpose of reducing patient dose in CT scanning with Siemens Healthcare CT systems In general, the effects of radiation shields used in CT examinations on patient dose and image quality depend on several factors, in particular, the material and shape of the radiation shield, its placement and the patient’s body shape. Since these factors vary with each individual examination setup a generalized and scientifically validated statement is not feasible. However, the following statements may provide a better understanding of the situation. ◾ Radiation shield positioned outside of the directly exposed range of a CT scan and the corresponding topogram scan: No negative influence on image quality and patient dose is expected, therefore no concerns in using radiation shields in this situation exist. ◾ Radiation shield positioned within the directly exposed range of a CT scan or the corresponding topogram scan: Shielding may affect image quality and patient dose: ◾ Image reconstruction algorithms widely suppress artifacts caused by metals in or on the patient's body but artifacts cannot generally be excluded. ◾ Siemens' automatic exposure control, CARE Dose 4D, can be substantially affected by external shields on the patient’s body. To minimize a potential negative effect of Radiation Shields it is recommended to scan the topogram without shields and use the shields only during the succeeding CT examination. ◾ While patient dose is reduced in areas protected by the radiation shield, consequently the image noise may increase (in addition to the presence of artifacts) and affect diagnosis. ◾ An alternative to shielding that also only locally reduces the radiation dose in the patient is a dedicated scan mode like X-CARE that is offered on most of the CT systems manufactured by Siemens Healthcare. In summary, the use of radiation shields positioned within the directly exposed range of a CT scan cannot generally be recommended. A careful consideration of patient dose and image quality by the user is mandatory. For further information, see also the following publications: ◾ Vollmar SV, Kalender WA: Reduction of dose to the female breast in thoracic CT: a comparison of standard-protocol, bismuth-shielded, bismuth-shielded, partial and tubecurrent-modulated current-modulat ed CT examinations. Eur Radiol 2008, 18(8):1674-1682. 18(8):1674-1682. ◾ Geleijns J, Salvado Artells M, Veldkamp WJ, Lopez Tortosa M, Calzado Cantera A: Quantitative assessment of selective in-plane shielding of tissues in computed tomography tomography through evaluation of absorbed dose and image quality. Eur Radiol 2006, 16 (10):2334-2340. ◾ Geleijns J, Wang J, McCollough C: The use of breast shielding for dose reduction in pediatric CT: arguments against the proposition. Pediatric Radiology 2010, 40(11):1744-1747
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◾ Halliburton SS, Abbara S, Chen MY, Gentry R, Mahesh M, Raff GL, Shaw LJ, Hausleiter J: SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr 2011, 5(4): 198-224. ◾ AAPM Position Statement on the Use of Bismuth Shielding for the Purpose of Dose Reduction in CT scanning (http://www.aapm.org/publicgeneral/ (http://www.aapm.org/publicgeneral/ BismuthShielding.pdf)
1.2 Image quality 1.2.1
Low-contrast detectability Low-contrast detectability detectability has been measured in a spiral body mode at 120 kV with the following parameter settings: 10 mm slice, kernel I31s, ADMIRE strength 5, FoV 160 mm with a 20 cm Catphan (CTP 515) consisting of a plastic disc with rod inserts of different sizes and contrast values. The phantom is positioned at approximately 3.5 cm of the plane to avoid the ring suppression algorithm diminishing the contrast of the concentrically positioned inserts. The low-contrast detectability is determined by a visual inspection of the images. The specified low contrast is the smallest diameter that can be visualized for a certain contrast at the specified dose with a specified images slice thickness. This method is subjective and depends on the viewer's visual acuity and on statistical fluctuations of the image noise. Therefore, the stated diameter combines the evaluation of several human observers and several images independently scanned with the same scan parameters.* Due to the high variability of these results, it is difficult to objectively measure low contrast detectability. Hence, this visual method is not recommended for an acceptance test. * Specification for detectability by single observers within single scans: ◾ 5 mm / 3 HU at CTDI vol (32 cm) ≤ 12 mGy, Body Mode ◾ 5 mm / 3 HU at CTDI vol (16 cm) ≤ 26 mGy, Head Mode
CTDIvol (32 cm) for low-contrast detectability
1.2.2
Low-contrast detectability detectability in a 20 cm CATPhan CTP 515 for a reconstructed slicewidth of 10 mm: Object Size / Contrast
CTDIvol (32 cm)
5 mm / 3 HU
8 mGy
4 mm / 3 HU
10 mGy
3 mm / 3 HU
13 mGy
CT number The CT number is specified for air (-1000 ± 4 HU) and water (0 ± 4 HU) only. The specification is not valid for other materials in the beam. The specified CT number of air according to the YY 0310 testing method is -1000 ± 10 HU. The T he CT number for water is valid for a cylindrical phantom with a diameter ranging from 20 cm to 30 cm which is centered and aligned with the scanner axis for both, typical head modes and typical body modes.
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The CT numbers for other materials depend on the kV settings and the shaped filter.
1.2.3
Uniformity The uniformity of the CT values is specified for a typical scan mode within a cylindrical 20 cm water phantom that has been centered in the scan plane without any other objects in the scan field.
Cross-field uniformity (maximum)
≤ 4 HU
(Typical head mode, Ø20 cm water phantom, typical body mode, Ø20 cm and Ø30 cm water phantom)
Cross-field uniformity (typical)
≤ 2 HU
(Typical head and body mode, Ø20 cm water phantom)
1.2.4
Image noise According to: 21 CFR 1020.33
A circular Region of Interest (ROI) with a diameter of approximately 40% of the phantom diameter was used to measure the noise in images of a 20 cm and 30 cm water phantom using the following typical head and typical adult body conditions of operation. Ø 20 cm water phantom
Ø 30 cm water phantom
Typical head
3.2 HU ± 10%
n.a.
Typical adult body
4.7 HU ± 10%
12.0 HU ± 10%
Image noise
1.2.5
High-Contrast-Resolution, Modulation Transfer Function (MTF) According to: 21 CFR 1020.33
The Point Spread Function (PSF) image is obtained by scanning a 0.2 mm tungsten wire placed in air. The two-dimensional Fourier transformation of the PSF generates a Modulation Transfer Function (MTF) of the system. Nominal values for wires placed in plastics are specified for quality assurance. Refer to the automatically generated software reports.
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Measured MTF from image of wire placed in air
x
Spa pattia iall Fre Freq quen enccy [LP [LP/c /cm m]
y
MTF [%]
(1)) Ty (1 Typi pica call Head Head (H (H30 30s) s) (2)) Ty (2 Typi pica call Body Body (B3 (B30f 0f)) (3)) Sha (3 Sharpe rpest st with without out UHR (H7 (H70h) 0h) (4)) Sha (4 Sharpe rpest st wit with h UHR UHR (U9 (U95u) 5u) MTF
Typical Head (H30s)
Typical Body (B30f)
Sharpest without UHR (H70h)
Sharpest with UHR (U95u)
50%
3.5 LP/cm ± 10%
3.5 LP/cm ± 10%
11.4 LP/cm ± 10%
18.7 LP/cm ± 10%
10%
5.9 LP/cm ± 10%
5.9 LP/cm ± 10%
14.0 LP/cm ± 10%
23.3 LP/cm ± 10%
Nominal MTF values of a wire placed in air
1.2.6
Sensitivity profiles Slice Sensitivity Profiles (SSP) are measured in the standard mode on the basis of images of a thin gold disk that is i s moved through the scan plane along the z-axis in very small steps and imaged after each scan in a single axial scan. The sensitivity profile is the profile of HU values measured along the z-direction at the location of the gold disc in the image. Sensitivity profiles are valid for the head mode and the body mode.
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Nominal slice thickness 0.6 mm
Thinnest axial slice 0.6 mm
x
z [mm]
y
SSP [%]
Nominal slice thickness 5 mm
Midrange axial slice 5 mm
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z [mm]
y
SSP [%]
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Nominal slice thickness: 14.4 mm
Maximum axial slice 14.4 mm
1.2.7
x
z [mm]
y
SSP [%]
HD FOV: Advanced extended FOV reconstruction HD FOV was designed to substantially improve the accuracy of previous extended FOV methods. Whereas previous extended FOV algorithms seek to fulfill consistency conditions at the edges of measured raw data, the new HD FOV approach uses prior knowledge in the image domain. The contour of the patient outside the Scan Field of View (SFOV) is estimated using a standard eFOV reconstruction. Afterwards, Afterwards, the area inside is filled with constant attenuation values (typically water). Using this information about the patient, the corresponding image volume is forward projected. This step provides a stream of synthetic raw data, which is combined with the measured raw data. This approach gives a rough estimate of patient geometry outside the SFOV and a good stability of attenuation values. In typical clinical situations, an HU stability of ± 50 HU is maintained. The accuracy of the contour estimate depends on the patient geometry.
1.2.8
Nominal tomographic section thicknesses According to: 21 CFR 1020.33
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Application
Mode
Acquisition (mm)
Reconstructable Slice Width (mm) 4 . 0
Routine
Spiral
128 × 0.6
5 . 0
6 . 0
5 7 . 0
0 . 1
x1)
x
x
x
2 . 1
32 × 1.2 Sequence
x1)
128 × 0.6
x
x
x
5 . 1
0 . 2
0 . 3
0 . 4
x
x
x
x
x
x
32 × 1.2
4 . 2
8 . 4
0 . 8
0 . 0 1
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
0 . 5
0 . 6
0 . 7
x
x
x
x
x
x
x
x
x
x
x
x
2 . 7
1 × 10
Neuro
Sprial Spiral
Sequence
x
x
x
x
x
x
x
x
x
x
x
x
40 × 0.6
1)
x
x
x
x
x
x
x
x
x
x
x
x
x
20 × 0.6
x1)
x
x
x
x
x
x
x
x
x
x
x
x
128 × 0.6
x
12 × 1.2
x
x
x
x x
1×5 32 × 0.6
Thorax HR
Sequence
2×1
UHR
Spiral Sequence
0 . 0 2
x
1 × 10
Spiral
0 . 5 1
x 1)
Obese
4 . 4 1
x
1×5 Flash
1
x 1)
x
x
x
x
x
x
16 × 0.6
x
x
x
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
x
x x
x x
x x
x x
x x
x x
x x
x x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
16 × 0.6
x
x
1)
z UHR Chest Pain
Spiral Spiral
16 × 0.3 128 × 0.6
x
x x1)
32 × 1.2 Cardio
Spiral
128 × 0.6
1)
x
x
x
x
32 × 1.2 Sequence
128 × 0.6
1)
x
x
x
x
32 × 1.2 Cardiac Shuttle
Sequence
Respiratory
Spiral
128 × 0.6
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
32 × 1.2 128 × 0.6
x1)
32 × 1.2 Sequence
128 × 0.6
x1)
x
x
x
32 × 1.2 i-Fluoro
Multiscan
12 × 1.2
x
x
x
1 × 10
i-Sequence
Sequence
x
1×5 32 × 1.2
x
x
x
12 × 1.2
x
x
x
x x
x
x
x
1 × 10
x
1×5 i-spiral
Spiral
32 × 1.2
Perfusion
Multiscan
128 × 0.6
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
32 × 1.2 1 × 10 Adaptive 4D Spiral
128 × 0.6 32 × 1.2
x x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
1) With Stellar detector
Some of the listed configurations are optional.
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Application
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Mode
Acquisition (mm)
Reconstructable Slice Width (mm) 4 . 0
Dual Energy
Spiral
128 × 0.6
5 . 0
6 . 0
5 7 . 0
0 . 1
x1)
x
x
64 × 0.6
Sequence
Spiral
Sequence
5 . 1
0 . 2
x
x
4 . 2
0 . 3
0 . 4
x
x
8 . 4
0 . 8
0 . 0 1
x
x
x
0 . 5
0 . 6
0 . 7
x
x
x
2 . 7
x
x
x
x
x
x
x
x
x
x
x
x
40 × 0.6
1)
x
x
x
x
x
x
x
x
x
x
x
x
x
32 × 0.6
x1)
x
x
x
x
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
64 × 0.6
1)
x
x
x
x
x
x
x
x
x
128 × 0.6
x1)
x
x
x
x
x
x
x
x
64 × 0.6
x1)
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
1)
x
x
x
x
x
x
x
x
128 × 0.6
x
32 × 0.6
Dual Energy Cardio
2 . 1
x
128 × 0.6
x
64 × 0.6
x
4 . 4 1
0 . 5 1
0 . 0 2
1) With Stellar detector
Some of the listed configurations are optional.
Nominal tomographic section thicknesses
Tolerances of slice thickness According to: 21 CFR 1020.33
< 1mm
Tolerance: ± 0.5 mm
≥ 1 mm and ≤ 2 mm
Tolerance: ± 50%
> 2 mm
Tolerance: ± 1 mm
1.3 Information about quality assurance The CT system offers a software-based tool for quality assurance which fulfills the requirements of IEC 61223-2-6 for constancy testing of imaging performance in CT. With this software tool, dose and imaging performance factors such as CTDI, slice thickness, image noise, homogeneity and light marker accuracy, can be tested. See SOMATOM Instructions for use. For each test, the tool checks the following two criteria: ◾ the constancy of the system, i.e. whether the deviation of the currently measured values from previously recorded reference values for this individual system is within the tolerance for the constancy of a system. ◾ if the same testing methodology was used in the acceptance test: Whether the measured values meet the nominal values specified for this type of system within the specified tolerances. To establish the reference values, the tests can be configured as a reference measurement. The tolerances for the tests consist of the tolerances related to the nominal value and the tolerances related to the reference value.
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Relationship between reference measurement and actual measureme measurement nt
(1) Nomin Nominal al value(∙) value(∙) and toleran tolerance ce (↔) for for reference reference measurem measurement ent (2) Refer Reference ence value value (ο) and and tolerance tolerance (↔) (↔) for actual actual measureme measurement nt The upper indicates specified around nominal valuefor (black dot)arrow specified for thethe scanner typetolerance concerned. This the tolerance is valid the initial constancy measurement ( Constancy Reference) where the baseline values for the individual system (black circle) are established and stored for comparison with the succeeding constancy tests. The lower arrow indicates the specific tolerance around the baseline value established in the Constancy Reference measurement. This tolerance is valid for the periodical constancy measurement (Constancy Normal). It indicates the allowed deviation from the baseline value cut to the additional valid tolerances for the nominal value indicated by the upper arrow. New reference values must be recorded in the following situations: ◾ When a new CT scanner is brought into use ◾ After installation of a new software version, the reference test is required by the manufacturer ◾ After changing any component relevant to image quality and dose (exchange of tube, tube collimator or detector) or its accessories (detector module) ◾ Whenever changes in test equipment may cause a variation After installation or relocation of the CT scanner or after major modifications (other than normal maintenance or repair), a repetition of partial acceptance testing according to IEC 61223-3-5 may be necessary. The test tool offers a routine test plan according to the requirements of the standard. In addition, constancy tests must be done in the following situations: ◾ Whenever malfunction is expected ◾ Immediately after the CT scanner has undergone maintenance that could affect the performance parameter under test ◾ Whenever the constancy test fails, in order to confirm the test result Reports for the quality tests with measured values and their tolerance range can be extracted as pdf files for the configured language.
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The function “Quality Daily” is a subset of Constancy tests consisting of “Homogeneity and Water value” and “Image Noise” only. The measured values here are checked to be within the nominal tolerance only. The test methods of the constancy tests are described below. Tests defined by IEC 61223-2-6 as mandatory are marked in bold type. Other tests are not selected as default or are only optionally available after configuration of the test menu (service function).
1.3.1
Test methods for the constancy tests
Test
Content
Slice thickness
The tomographic section thickness is evaluated by measuring the width of the image of an inclined aluminium ramp at the intersection of the ramp with the slice. The width is defined as the Full Width at Half-Maximum (FWHM) of the baseline corrected CT-value profile. The influence of the reconstruction kernel and the influence of the cone angle on the measured width are taken into account. The measurement is performed for two sets of scan parameters, representing a typical head mode and a typical body mode. The evaluation is performed for at least both outer and one central slice. The measurement and evaluation is performed separately for system A and B.
Homo Ho moge gene neit ityy an and d wa wate terr val value ue
The mea The measu sure reme ment nt is pe perf rfor orme med d fo forr thr three ee se sets ts of sc scan an pa para rame mete ters rs,, rep repre rese sent ntin ing g a typical head mode, a typical body mode and a body dual-source mode. For the dual-source mode the evaluation is performed separately for system A and B. The water value and homogeneity is evaluated by measuring the mean CT number in five Regions Of Interest (ROI) in the image of a cylindrical water phantom with diameter 20 cm. The ROI are located in the center and near the edge of the water phantom at 12 o'clock, 3 o'clock, 6 o'clock and 9 o'clock. The water value is the CT number of the central ROI, the homogeneity is the difference between the outer ROI and the central ROI each.
Image noise
The measurement is performed for three sets of scan parameters, representing a typical head mode, a typical body mode and a body dual-source mode. For the dual-source mode the evaluation is performed separately for system A and B. The image noise is evaluated by measuring the standard deviation of CT numbers in a Region Of Interest (ROI) in the image of a cylindrical water phantom with a diameter of 20 cm. The ROI is located in the phantom center. To suppress any influences of image inhomogeneity or ring artifacts, the evaluation is performed for the difference image of two succeeding scans.
Contrast scale
Contrast scale is evaluated from the mean CT numbers in a central Region Of Interest (ROI), measured from a scan of a cylindrical water phantom with a 20 cm diameter and a scan without a phantom. Attenuation Attenuation coefficients of -1 -1 0 cm for air and 0.192 cm for water are taken for the evaluation. Evaluation is performed for two scans, representing a typical body-mode and a dualsource-mode.
Low-contrast re resolution
The lo low-c -co ontrast re resolution is is te tested fo for th the AA-system by by vi visual as asssessment of of low contrast rods of 5 mm diameter embedded in a plastic disc providing a contrast of approximately 6 HU. An image with a 10 mm slice thickness, taken with a CTDI freeAir of approximately 50 mGy, is evaluated.
*) CTDIair and CTDIw are alternative methods for the mandatory dose constancy test. Siemens offers CTDI air by default; CTDIw can be configured.
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Test
Content
High Hi gh-C -Con ontr tras astt-Re Reso solu luti tion on (MT (MTF) F)
The high The high-c -con ontr tras astt reso resolu luti tion on is is dete determ rmin ined ed by by eval evalua uati ting ng the the ima image ge of of a thi thin n tungsten wire placed in a plastic rod, centered in the scan plane and aligned
1
along the scanner axis. The point spread function is obtained from the images of the wire and the Modulation Transfer Function (MTF) is calculated as the Fourier transformation of the point spread function. The 50% and 10% values of the MTF are evaluated. The measurement is performed for four to five sets of scan parameters, representing a typical head mode, a typical body mode, a dual-source mode, the sharpest mode without UHR comb and, if available, the sharpest mode with UHR comb. For the dual-source mode the evaluation is performed separately for system A and B. CTDIw*
The CTDIw is evaluated from the measured Dose-Length-Product (over 10 cm) for three sets of scan parameters, representing a typical head mode, a typical body mode and a dual-source mode. For the head mode, a 16 cm PMMA phantom is used and for the body mode and dual-source mode, a 32 cm CTDI phantom is used. The dose is measured in the central and upper borehole only, as the differences of the four peripheral positions are known as small compared to the tolerances. The dual-source-mode is like the typical body mode, but with both tubes contributing half of the dose each.
CTDIfree air*
The CTDIfree air is evaluated from the measured Dose-Length-Product (over 10 cm) in a typical head mode, a typical body-mode (A-System) (A-System) and a scan with the typical body mode parameter in the B-system.
Tube voltage
The tube voltage is measured with an internal voltage divider for scans with all nominal tube voltages. The test is performed separately for system A and B.
Light marker
For the test of the light markers, the system phantom is centered and aligned, so that the lightmarkers hit the engraved notches on the phantom. From the image of the phantom, scanned with narrow collimation, the congruence of the engraved notches with the scan plane, as well as the saggital and coronal planes, are tested.
Topogram position
In the topogram image of the system phantom, the position of an tomogram scan with narrow collimation is selected for the engraved notches in the phantom. From the recorded tomogram image of the phantom, the congruence of the engraved notches with the scan plane is inspected.
Table position
The patient table is automatically moved forward and backward over 30 cm in continuous movement and stepwise movement. After each series of movements, the distance is measured with a ruler.
*) CTDIair and CTDIw are alternative methods for the mandatory dose constancy test. Siemens offers CTDI air by default; CTDIw can be configured. Test methods for the constancy tests
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Index
A
causing deterministic radiation effects 21
Advanced extended FOV reconstructio reconstruction n 40
Dosimetry and Imaging performance 5
Peripheral CTDI100 Ratio of peripheral CTDI100 to displayed CTDIvol 23
B
E
Phantoms and methods 6
Beam quality 28
ECG Gating 34
C
exposure controls performance specification of automatic 28
automatic exposure controls performance specification 28
CARE Dose 4D 5, 29
Dose profiles 26
Conversion factor Ø32 to Ø16 phantom 23, 24
Q quality assurance 42
Extended FOV reconstruction 40
R
Collimation types Dose efficiency values 25
G
Radiation Stray radiation 19
contrast 36
geometric efficiency z-direction 25
Radiation effects Dose levels causing deterministic radiation effects 21
H
radiation shields 35
HD FOV 40
Ratio of peripheral CTDI100 to displayed CTDIvol 23
CARE kV 5, 34
Contrast CTDIvol low-contrast detectability (Ø32 phantom) 36 High-Contrast-Resolution High-Contra st-Resolution 37 Conversion factor Conversion factor CTDIvol Ø32 to Ø16 23, 24 CT conditions (CTDI100) typical (128-slice) 9 typical 8 CT number 36 CTDI 5 tolerances 23 CTDI free air 19 CTDI100 dose factors for varying tube voltage voltage and shaped filter (128-slice) 10 mGy/100 mAs (128-slice) 13 Ratio of peripheral CTDI100 to displayed CTDIvol 23 related dose factors 9, 9 Typical CT conditions of ope operation ration (128-slice) 9 CTDIvol Conversion factor Ø32 to Ø16 phantom 23, 24 for topograms 24 low-contrastt detectability (Ø32 low-contras phantom) 36 Ratio of peripheral CTDI1 CTDI10 00 to to displayed CTDIvol 23
D Dose efficiency values for various collimation types 25 dose factors related to CTDI100 9, 9 Dose factors (CTDI100) for varying tube voltage and shaped filter (128-slic (128-slice) 10 10 for varying acquisition type type (128 (128-slice) 11 for varying mAs 12 Dose levels
SOMATOM Drive
High-Contrast-Resolution High-Contra st-Resolution 37
I
image noise 37
L Leakage technique factors 28
Resolution High-Contrast-Resolution High-Contra st-Resolution 37
S Sensitivity profiles 38 Stray radiation 19
low-contrast low-contra st detectability 36
T
Low-contrast detectability Low-contrast CTDIvol (Ø32 phantom) 36
tolerances for CTD 23
M
Typical CT conditions of operation 8
Methods and Phantoms 6 Minimum filtration 28 Modulation Transfer Function 37 MTF 37
N Nominal tomographic section section thicknesses 40
O
Tomographic section thicknesses 40
U uniformity 37
X X-CARE 34
Z z-direction geometric efficiency 25
Ø16 phantom Conversion factor CTDIvol Ø32 to Ø16 23, 24 Ø32 phantom Conversion factor CTDIvol Ø32 Ø32 to to Ø16 23, 24 CTDIvol low-contrast detectability 36 Operation (CTDI100) Typical CT conditions (128slice) 9 Typical CT conditions 8
P patient safety use of radiation shield 35 pediatric protocols
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Federal law restricts this device to sale by or on the order of a physician (21 CFR 801.109(b)(1)). The original language of this document is English. Manufacturer’s note: This device bears a CE mark in accordance with the provisions of Council Directive 93/42/EEC of June 14, 1993 concerning medical devices and the Council Directive 2011/65/EU of June 08, 2011 on the restriction of the use of certain hazardous substances substances in electrical and electronic equipment. The CE marking applies only to Medical Devices which have been put on the market according to the above-mentioned EC Directives. Unauthorized changes changes to this product are not covered by the CE mark and the related Declaration of Conformity.
Siemens Healthcare Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen Germany Phone: +49 9131 84-0 siemens.com/healthcare
Legal Manufacturer Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen Germany
Print No. C2-047.660.01.02.02 C2-047.660.01.02.02 | © Siemens Healthcare GmbH, 2016 – 2016
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