RadteraCT Chest / Abdomen / Pelvis (Oncologic Staging)
CT+ ContrastWhole Body
Indications
- Initial staging of known malignancy (e.g. lymphoma, lung, breast, GI, GU, melanoma)
- Restaging and surveillance / treatment response (RECIST 1.1)
- Search for primary or metastatic disease
- Pre-treatment baseline for systemic therapy
Patient prep
- Screen eGFR/contrast allergy; premedicate if indicated
- NPO ~2-4 h; oral contrast per tumor type/site (often given for abdominopelvic bowel evaluation)
- IV access 18-20 G; supine, arms up
- Coach breath-holds (single inspiratory for chest)
Contrast
Agentiodinated (e.g. iohexol 350 or iopamidol 370)
RouteIV (+/- oral)
Dose≈100-150 mL at 2.5-3.5 mL/s (weight-based) with saline flush
TimingCombined acquisition: chest in late-arterial/early-portal as contrast bolus continues, abdomen/pelvis portal venous ~70 s; many sites split-bolus or single venous pass to cover C/A/P; add liver arterial phase if hypervascular primary
Technique
- Supine, arms up; coverage lung apices through pubic symphysis (and to ischial tuberosities)
- Chest in single inspiratory breath-hold then abdomen/pelvis; bolus tracking on aorta
- 120 kV; mAs per scanner with AEC; iterative reconstruction
- Reconstruct soft-tissue and lung kernels; thin source + coronal/sagittal reformats for measurements
- Maintain consistent technique/phase across follow-ups for RECIST comparability
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial chest (soft tissue + lung) | axial | 2.5-3 mm (lung 1-1.5 mm) | Nodes, lung mets; lung kernel images |
| 2 | Axial abdomen/pelvis portal venous | axial | 3-5 mm | Standard kernel; organ/nodal/peritoneal disease |
| 3 | Thin axial source | axial | 1.25-2 mm | Reformats, target lesion measurement |
| 4 | Coronal/sagittal reformat | coronal | 3 mm | Bone, nodes, survey |
Key points
- Report using RECIST 1.1 for solid tumors (or Lugano/Cheson for lymphoma); keep technique consistent across exams for reproducible target-lesion measurement
- Single contrast injection timed so chest opacifies on the early pass and abdomen at portal venous; add arterial liver phase for hypervascular primaries (HCC, NET, RCC, melanoma)
- Include lung kernel reconstructions for pulmonary metastases and bone windows for osseous disease
- Document all measurable target and non-target lesions and new sites of disease
References
• ACR–SAR–STR–SPR Practice Parameters for CT of the Chest, Abdomen and Pelvis
• RECIST 1.1 Criteria (Eisenhauer et al., Eur J Cancer 2009)
• Radiopaedia: CT chest abdomen pelvis (protocol) link
• ACR Appropriateness Criteria: Staging and Surveillance of relevant malignancies
• RECIST 1.1 Criteria (Eisenhauer et al., Eur J Cancer 2009)
• Radiopaedia: CT chest abdomen pelvis (protocol) link
• ACR Appropriateness Criteria: Staging and Surveillance of relevant malignancies
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.