Provider CT Ordering Guide

Abdomen for Stones

• No prep needed.

Abdomen and/or Pelvis

• Nothing by mouth (NPO) for 4 hours prior to scan.
• Patient can have all regular medications.
• Oral contrast needs to be consumed starting 1 hour before appointment.
• If area of interest is in the pelvis, a longer delay may be needed (diverticular abscess or appendicitis).
• See contrast policy in notes section below.

Biopsy or Abscess Drainage/Catheter Placement

• Nothing by mouth (NPO) after midnight.
• Patient will receive conscious sedation or anesthesia during procedure.
• When procedure is scheduled, also schedule a pre- op visit. A PT and PTT will be drawn at that time. Patient must bring any imaging studies that were not performed at Spartanburg Regional Healthcare System to pre-op visit so the radiologist can review them the day before the procedure.

Brain/Head

• No prep needed.

Brain/Head with Contrast

• See contrast policy in notes section below.

CTA Abdomen

• Nothing by mouth (NPO) for 4 hours prior to scan
• Patient may have all regular medications.
• See contrast policy in notes section below.
• Do not give oral contrast.

Chest (routine)

• See contrast policy in notes section below.

Chest High Resolution

• No prep needed.
• Chest for Pulmonary Embolism
• See contrast policy in notes section below.

Extremities

• No prep needed for visualization of bones.
• For visualization of soft tissue contrast may be needed; see contrast policy in notes section below.

Low Dose CT Lung Screening (appropriate for patients without symptoms of lung cancer)
Patients must meet the following criteria:

• Age 55-74 years AND >/=30 pack history of smoking
• Smoking cessation < 15 years OR
• Age >50 years AND >/=20 pack year history of smoking AND 1 additional risk factor.
• Documented high radon exposure.
• History of lymphomas, head and neck cancer, lung cancer, or other smoking related cancers.
• COPD or pulmonary fibrosis.
• Occupational exposure 
  • Silica
  • Cadmium
  • Asbestos
  • Arsenic
  • Beryllium
  • Chromium
  • Diesel fumes
  • Nickel

Orbits/Facial Bones

• No prep needed for visualization of bones.
• For visualization of soft tissue, contrast may be needed; see contrast policy in notes section below.

Pelvis

• No prep needed for visualization of bone.
• For other indications, follow the instructions given for abdomen.

Sinuses

• No prep needed.

Soft Tissue Neck

• See contrast policy in notes section below.

Spine

• No prep needed.

Notes/Miscellaneous Information

• Patients requiring IV contrast that are age 55 or older with no history of renal problems require a BUN and creatinine to be performed within the last 12 months. Patients with diabetes or a history of renal failure must have BUN and creatinine within the last 3 months.
• The oral contrast most often used is barium sulfate (Redi-Cat). An iodine-based contrast (gastroview) is given in place of barium sulfate when the patient is unable to tolerate the barium. The patient can pick up the oral contrast at the registration desk in the Regional Outpatient Center or at North Grove Medical Park prior to their appointment date. Please instruct the patient to begin drinking the contrast 1 or 2 hours before scheduled appointment time (depending on the ordering diagnosis).
• If the physician is looking for something specific, please include that information on the order. Instructions should include, for example, kidney or liver lesion, with or without contrast. The order needs to be as specific as possible.
• Diabetic patients taking Metformin® should be consulted about alternate glucose control. This is due to possible counteractions of the 2 medicines. The Metformin should be stopped for 48 hours after contrast injection.