CT3300 Access CT – Operation Lab

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 Objectives
When you have successfully completed this lab, you will be able to:
 Explain the user interface layout
 Power up the system
 Warm up the X-ray tube
 Perform air calibrations
 Conduct a surview scan
 Plan a study and conduct Axial scans
 Conduct a Helix (Spiral) scan
 Verify operation of the ACS/DOM function
 Find, view and delete images from the home page
 Manipulate the images
 Perform a post-reconstruction
 Power down the system

Prerequisite Lessons
 System Introduction Lecture
 Safety Lecture
 System Layout Lecture

Tools/Reference Materials
 Access CT Instruction For Use Manual

Time
3 hours

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 Introduction
The purpose of this module is to make the student familiar with the basic operation of the
Access CT system. Refer to the Access CT “Instructions for Use” throughout this entire lab.

The student will properly apply power, warm up the x-ray tube, perform air calibrations, and
remove power from the system.

The basic system functionality is verified by performing scans to created surview and helical
images. This lab allows the student to become familiar with the methods of image selection
and manipulation on the Access CT.

During each of the following labs the students will properly power up and power down the
system with a functional scan at the start and end of lab to ensure the scanner is working.

Procedure Preview
In this lab exercise, the learner will perform,
 Power up and down the system
 Basic functional scan
 Image manipulation

Special Instructions/Precautions
<CAUTION:
When performing a scan, make sure no one in the scanner room and the door is closed during
exposure and the x-ray warning light is working>

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 Instructions
Button Exercise
1. Power up the system
2. Login as CT
3. Perform CT Box button function exercise and fill in the table provided

a.

b.

c.

d.

e.

h.

i.

j.

k.

l.

m.

n.

o.

p.

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 4. Perform Gantry Control Panel button function exercise and fill in the table provided

3
7 4

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 Question:
How does the gantry reacts when button 4 is pressed?

______________________________________________________________________________

What happen if you use the button 3 at different horizontal position?

_____________________________________________________________________________

What is the different between button 5 and 6?

Tube Warm Up

For Access CT, tube warm up is mandatory. To warm up the tube,

1. Go to the processing screen by clicking the “Processing” button in the upper right of the
screen.
2. Select the “Service” button.
3. In the upper left, under the Tube Heat Caution box, on the “Daily” tab select “Tube Warm
Up” and click “Start”.
4. Exit the warm up when complete.

Question:
What is the tube heat after warm up?

______________________________________________________________________________

Can you change this heat percentage when logged on as user CT? (Non-Service Mode)

______________________________________________________________________________

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 Air Calibration

At least once a week, Air Calibrations need to be performed at the average room operating
temperature, like the middle of the day. Air calibrations are used to compensate for different
amplifications of the pre-amplifiers.

1. Follow the operator’s manual to perform all of the air calibrations.

Question:
Under which menu can you start the air calibration?

______________________________________________________________________________

Which menu can be used to select the 80kV and 120kV air calibrations?

______________________________________________________________________________

Can you perform specific calibrations for one protocol only?

______________________________________________________________________________

Surview Scan

The purpose of this step is to learn how to make a surview scan and plan a study using the
surview image.

1. Ask your instructor for a “Mystery Box” and put it on the patient table. Push the laser
ON/OFF button to switch ON the laser.
2. Unlock the patient table, position the mystery box just before the laser light and lock the
patient table again. The patient table can also be moved using the buttons on gantry control
panel.
3. Make a surview scan of the mystery box. The position of the patient table can now be read
from the gantry control panels.

Question:
What is the position of the patient table according to the gantry control panel?

______________________________________________________________________________

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 Do not manually change the table position during this part of the lab.

4. Go to the “Start Study” page and set up a study. Use the following information:
Patient ID: 111-Axial
Last Name: Box
First Name: Mystery
Gender: Male (check box)
The fields with the * are mandatory.

Question:
Why do we have to indicate how the patient is positioned on the table?

______________________________________________________________________________

5. After you filled in all the mandatory fields, the arrow in the lower right corner will be
highlighted. Select this arrow to go to the next screen.

6. In this screen you can select different protocols. Before we make an axial or helical scan, we
will first make a surview scan. The surview scan will then be used to plan an axial or helical
scan. For this exercise we use the head protocols. To select the head protocols, click the
appropriate examination graphic. Next select the surview tab.

Question:
What is the difference between the EXAM, SURVIEW, AXIAL and HELICAL tab?

______________________________________________________________________________

7. Select the “Surview 90” protocol and go to the next screen.

8. On the left of the screen you can see the parameters for the surview scan. The settings are
default and can be changed. The “View Angle” can be used to change the position of THE
tube and also used to select Dual Surview scan. Check if “Direction- in” is selected and also
set the “Length” parameter to 400 (Do not change anything else).
9. Press the green GO button in the lower left corner.
10. When prompted to press the Scan Button on the CT Box to take the Surview scan.

Questions
What is the position of the X-ray tube during a 90 surview?

______________________________________________________________________________

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 Look at the image, what do you think is inside the black box?

______________________________________________________________________________

What is the couch position according to the gantry control panel?

______________________________________________________________________________

11. Access Dual CT systems allow us to make more than one surview scan for one examination.
To make a new surview scan of the “mystery box”, first we have to “end” the study. To do
this click the “End Study” button in the upper right corner and confirm. DO NOT MOVE THE
COUCH.
12. Go to the start study page and select “Current” (upper left corner).
13. Select the “Surview 90” protocol for Heads and go to the next screen. Change the view
angle from 90 to 180. Make sure that “Direction - out” is selected and length is set to 400.
14. Execute the surview, look carefully at the couch movement. (You will notice that the couch
moves before the X-ray starts)

Questions
Why does the couch move before the start of the surview?

______________________________________________________________________________

15. DO NOT leave the Plan Scan tab and continue with Axial scan lab.

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 Axial Scan

The purpose of this step is to learn how to plan and execute an axial scan. After the scan we will
also view the images.

1. In the upper left corner, find and press the “Insert Protocol” button. Select the “Brain
Exam–10mm. (Ax)” protocol and continue to the next screen. You will now see that the
selected protocol is added to the “Procedure” list.
2. Click on the added protocol. The screen now shows the default settings for the selected
protocol. On the surview image there will appear a blue box / window which can be used to
plan the scan.

Question
What is the default slice thickness for this protocol?

______________________________________________________________________________

What is the default collimation for this protocol?

______________________________________________________________________________

What is the meaning of the increment (mm) parameter and how much will the couch move
after the first axial scan?

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 Planning a Scan

1. Click on the blue box / window displayed on the surview image.

2. Change the size and position of the box / window until the “Mystery Box” is completely
covered.

Question
How many images will be made to cover the complete “Mystery Box”?

______________________________________________________________________________

What will change if you change the size of the blue box / window in vertical direction?

______________________________________________________________________________

And what if it is changed in horizontal direction?

______________________________________________________________________________

3. Change the default mAs value to 46 and execute the plan by pressing the green “GO”
button.

Questions:
How many images are made?

______________________________________________________________________________

Did you discover any other items inside the “Mystery Box”?

______________________________________________________________________________

4. We will now plan a second series of axial scans on the mystery box. The same surview will
be used. Press the “Plan Scan Button” then the “Insert Protocol” Button and then select the
“Exam protocols” tab.

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 5. Select the “Brain Exam-10mm. (Ax)” protocol. Continue to the next screen, change the slice
thickness to 5mm and increment to 10.

Question
What’s the meaning of the different colors used for the different protocols?

______________________________________________________________________________

How many different slice thicknesses can be selected in this protocol?

At which couch position will the first scan be made?

______________________________________________________________________________

How many images will be made to cover the mystery box?

______________________________________________________________________________

What is the couch position for the last axial scan (calculate)?

6. Press “GO” and perform the scan.

Question:
What is the scan position after the scan series?

Is this the same as your calculation?

______________________________________________________________________________

7. After the scan has finished, end the study.

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 Helical (Spiral) Scan

The purpose of this step is to learn how to make a helical scan and to understand the meaning
of the different parameters used.

Make use of the Access Dual CT Instructions for Use manual to make an abdomen helical scan.

1. Position the mystery box.

2. Register a patient using the following data:

Patient ID: Training_Spiral

Last name: Mystery
First name: Box
Gender: Female

3. On the next screen select the “Abdomen Protocol Group” and the Abdomen Exam Protocol.

Question:
How many procedures are in this examination?

______________________________________________________________________________

4. Go to the next screen.

5. Make sure that the length = 400 and the couch direction is in line with the positioning of the
black box.
6. Change the mA to 30.
7. Execute the Surview scan. After the scan the image will be displayed and the blue box to
plan the helical scan is also shown.

Question:
What is the difference between a helical and an axial scan?

______________________________________________________________________________

8. Adjust the blue box so that the complete mystery box is covered.

Question:
In this protocol what is the default setting for the pitch? What is the meaning of pitch?

______________________________________________________________________________

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 How many images will be made?

______________________________________________________________________________

9. Go back and decrease the pitch.

Question:
Did the number of images change, and why?

10. Increase the pitch to default again.

11. Change the current setting to 34mAs.
12. Change the “Collimation” to 2*5, “Thickness” to 3mm. Under ‘Increment’ select
‘Continuous’.

Question:
Did the number of images change and why?

______________________________________________________________________________

13. Change the thickness to 4mm and change the “increment” to 4mm.

Question:

Did the number of images change and why?

14. Leave the increment parameter on 3mm. If you change the length to 300mm the scan time
will also change.
15. Check your helical plan and see if it still covers the mystery box. Execute the scan as planned
and wait until all images are reconstructed. Later we will use this data for post
reconstructions and volume reconstructions. After all images are reconstructed, end the
study.

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14
 Find, View and Delete image

1. After closing the helical study you will see the Patient register page. Click the “Home”
button.

The following screen is used to find, retrieve and delete patient images and raw data. The right
side of screen shows a window which is split up into three parts.

The first session allows you to see and choose different data storage devices available on the
system (1).
The second session contains the patient examinations (2).
The third session shows the series that were made during the exam (3). There are three tabs:
Series, Images and Reports. Selecting a series and then clicking on the image tab will show all the
images in that series.
Preview of the images can be seen in the lower right corner. Explore the directory page and
perform the following operations:

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 2. Ask your instructor for a blank CDR and copy 1 exam you made to this disk.

Question:
Which data sources are available on your system?

______________________________________________________________________________

Which data (Images, Raw, or Both) was copied to the CD?

______________________________________________________________________________

Can the CD be used again to add additional images?

______________________________________________________________________________

3. Select an image series (not a surview) and press the ‘viewer’ button under the ‘Data
options’. This action will load the series to the viewer and will show the review screen. The
viewer can be used to diagnose the images.
4. Look at the image and try to adjust the Window Width (WW) and the Window Level (WL).

Question:
How did you change the WW and the WL?

5. On the lower left of the screen there is a ‘Windowing’ section. Click on the ‘Modified>>’
button and select the ‘lung’ window.

Question:
How can you apply the ‘Lung’ Window on all the images?

______________________________________________________________________________

6. Locate the Image Parameters button and view the Image information.
7. Exercise other options in the viewer.
8. Click on the ‘Exit’ button and exit the review window.

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 ACS & DOM Functionality

ACS (Automatic Current Selection) is a volume-based function that helps clinicians get
consistent noise characteristics for different sized patients.

C-DOM (Combined Dose Modulation) is a prospective scanning mode in which the X-ray tube
current is modulated according to patient’s size in both the rotation and Z directions, this
reduces streaking artifacts, and improves image noise consistency along the Z direction.

This exercise demonstrates how to verify the modulations functions are working properly.

1. Put the 7 Inch water phantom on the table top.

2. Begin a study and select the Lung protocol. (Both a surview and helical)
3. Perform the surview scan and make sure to capture the whole 7 inch phantom.
4. Plan the helical scan making sure of the whole phantom will be scanned.
5. Under the MAIN tab (for selecting scan options), if the bottom of selections mAs/Slice area
was filled with Blue, it means the DOM is applied to the protocol.
6. Execute the scan. When the images are previewed pay attention to the mA values, the mA
value should change as the phantom size goes on different position of the 7 inch phantom.

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 Archiving Images

Archiving images is done from the home page of the application software. The images together
with the raw data (and some calibration data) are stored on the D and E drive of the host
computer. There is no automatic deletion (FIFO) of images from the host computer. Of course
the images shall only be deleted from the host computer after they are archived. Archiving can
be done to a PACS system, CD-R, DVD or any other (correctly configured) device. For now we will
archive the images to a CD-R.

1. Go to the home page.

2. Right click on the mouse on a patient exam in the study list. It will bring up a menu as in the
picture below.

Question:
What is the function of the “lock” button and can you lock individual series?

______________________________________________________________________________

What is the function of the “Modify” button and which patient data can still be modified?

______________________________________________________________________________

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18
 Will the original data still be available after you modified the patient data?

______________________________________________________________________________

Is it possible to delete only the raw data and keep the images? How can you do this?

______________________________________________________________________________

3. Use the “copy to” button to copy the images you made to CD-R.

Question:
How can you hide the patient information from the images being written to CD?

______________________________________________________________________________

4. You can export the raw data by “Home” page. Right click on the series list and select “Export
Rawdata” to service directory D:\Service\

5. Copy the raw data to a CD, DVD or any external storage device.

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19
 Post Reconstruction

The purpose of this step is to learn how you can make a post reconstruction from RAW data
available on the host computer.

1. Navigate to the IRS data storage device. Before you can make a post reconstruction you
must have RAW data available on the host computer.

Question:
How can you check if you have raw data of an examination available?

______________________________________________________________________________

2. Select the Raw data for ‘training Spiral’ study. Click on the Recon button on left side of the
screen under ‘Recon’ section.
3. Change the following parameters:
Slices Thickness: 5mm
Increment: 5mm
FOV: 250mm
Metal Artifact Reduction: ON
4. Perform the reconstruction. After the reconstruction is finished, click ‘Exit’. This will bring
you back to the home page.

Changing Users/ Logging Out

The purpose of these steps are to make you aware of how to change the user mode, and how
to leave the system at the correct point for the technician to log in and NOT have access to
service desktop functions.
From being logged in as SERVICE, Log out from the HOME screen. Notice the system logs out
and leaves you at the service desktop, with multiple shortcuts to different tools, i.e. my
computer, backup/restore…
We DO NOT want to return the system to the customer in this state, with access to the desktop
icons. To leave the system at the correct point:
1. Launch the host application from the Icon on the desktop.
2. Log in as: philips_service, pwd: service_only
3. Navigate to Processing > Service and use the “Switch User” button under the Service folder
4. Change users by logging back in as: CT
5. Navigate to the Home screen and logout from the application.

Notice on the desktop, only the START button in the lower left corner and an Access
Dual/Access CT Icon is available, other desktop Icons are removed.
After every service call, leave the system in this state before you turn it over to the customer.

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 Additional Information
<For further information about the topic, read/do….>

Revision History

Revision # Modified By Effected Content

(yyyymmdd)
20150729 Cheow Yong Lim Initial Release

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21