RadteraCT Chest Without Contrast (Routine)
CTNo contrastChest
Indications
- Evaluation/follow-up of pulmonary nodule or lung mass
- Characterization of pulmonary parenchymal disease, calcified granulomas
- Hemoptysis (when contrast not needed/contraindicated)
- Follow-up of known findings, infection, when contrast contraindicated (renal failure, allergy)
- Pleural disease, pneumothorax assessment
Patient prep
- No prep required for non-contrast
- Arms raised above head; supine, head or feet first per scanner
- Coach breath-hold at end-inspiration
Contrast
None / non-contrast
Technique
- Supine, arms up; helical volume from lung apices through posterior costophrenic sulci/adrenals
- Single end-inspiratory breath-hold
- 120 kV (or 100 kV in smaller patients); mAs per scanner with AEC; iterative reconstruction
- Reconstruct soft-tissue (standard) kernel and lung (sharp) kernel; thin sections for nodule evaluation and reformats
- Reformat coronal and sagittal
Series / Sequences
| # | Series / Sequence | Plane | Thickness | Notes |
|---|---|---|---|---|
| 1 | Axial soft tissue/mediastinal | axial | 2.5-3 mm (thin 1-1.25 mm available) | Standard kernel, mediastinal window |
| 2 | Axial lung | axial | 1-1.5 mm | Sharp/lung kernel, lung window; nodule assessment |
| 3 | Coronal reformat | coronal | 2-3 mm | Lung and soft-tissue windows |
| 4 | Sagittal reformat | sagittal | 2-3 mm |
Key points
- Non-contrast is adequate for nodule follow-up, parenchymal disease, and when contrast is contraindicated
- Use Fleischner Society guidelines for incidental nodule follow-up; thin sections + MIP improve nodule detection
- Add expiratory or prone HRCT if air trapping/ILD suspected (see HRCT protocol)
- Contrast required to characterize mediastinal/hilar nodes and vascular structures
References
• ACR–STR Practice Parameter for the Performance of Thoracic CT
• Fleischner Society Guidelines for Pulmonary Nodules (2017)
• Radiopaedia: CT chest (protocol) link
• ACR Appropriateness Criteria: Incidentally Detected Lung Nodule
• Fleischner Society Guidelines for Pulmonary Nodules (2017)
• Radiopaedia: CT chest (protocol) link
• ACR Appropriateness Criteria: Incidentally Detected Lung Nodule
Source: Researched — verify against your institution
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Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.