User Guide

MX 16-slice
459800820424_A
Philips Healthcare MX 16-slice User Guide
May 2021

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 Table of Contents

System Startup and Shutdown ................................................................................................................................ 1

System Startup .................................................................................................................................................... 1
Tube Warm-up .................................................................................................................................................... 1
System Shutdown................................................................................................................................................ 2
Air Calibration ..................................................................................................................................................... 2
Maintenance Recommendation.......................................................................................................................... 3
QA-Daily Quality Assurance ................................................................................................................................ 3
Set Protocol Parameters ......................................................................................................................................... 7
Main Tab ............................................................................................................................................................. 7
Dose Tab .............................................................................................................................................................. 9
Contrast Tab ........................................................................................................................................................ 9
Voice Tab ........................................................................................................................................................... 10
Auto Storage Tab ............................................................................................................................................... 10
Advanced ........................................................................................................................................................... 11
Dose Check ........................................................................................................................................................ 12
Voice Recording .................................................................................................................................................... 15
Voice Manager .................................................................................................................................................. 15
Adding Breathing Lights .................................................................................................................................... 15
Generate Protocols ............................................................................................................................................... 17
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Protocol Edit ...................................................................................................................................................... 17

Delete a Protocol ............................................................................................................................................... 17
Create a New Protocol ...................................................................................................................................... 17
Building a Protocol with MPR............................................................................................................................ 18
Executed Surview .................................................................................................................................................. 19
How to Create an Executed Surview ................................................................................................................. 19
Understanding How DoseRight Works .................................................................................................................. 21
Use DoseRight ACS ............................................................................................................................................ 22
Absolute Minimum and Maximum mAs ........................................................................................................... 22
Consider the Following When Using DoseRight ACS......................................................................................... 23
Dose Right Level Settings for ACS ..................................................................................................................... 23

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Table of Contents

iDose4 .................................................................................................................................................................... 25
Getting started with iDose4 ............................................................................................................................... 25
Creating an iDose4 Protocol .............................................................................................................................. 25
Use Dose Check ..................................................................................................................................................... 27
What is Dose Check? ......................................................................................................................................... 27
Dose Notification Details ............................................................................................................................... 27
Dose Alert Details .......................................................................................................................................... 28
MAR (Metal Artifact Reduction)............................................................................................................................ 31
MAR Use ............................................................................................................................................................ 31
Contraindications for MAR ................................................................................................................................ 32
Performing a Routine Scan .................................................................................................................................... 33
Performing a Routine Scan ................................................................................................................................ 33
Raw Data Reconstruction ...................................................................................................................................... 35
Planning Reconstructions on the Surview......................................................................................................... 35
Reconstructing Raw Data after Ending the Study ............................................................................................. 35
Bolus Tracking ....................................................................................................................................................... 37
Use Bolus Tracking ............................................................................................................................................ 37
TIBT........................................................................................................................................................................ 41
Test Injection Bolus Timing ............................................................................................................................... 41
Creating a Batch in Viewer .................................................................................................................................... 43
Creating a Batch in MPR Viewer ....................................................................................................................... 43
iBatch..................................................................................................................................................................... 45
Creating an iBatch of Lumbar disc in MPR ........................................................................................................ 45
AVA ........................................................................................................................................................................ 47
Bone Removal Volume Tools ............................................................................................................................ 47
Vessel Extraction ............................................................................................................................................... 47
Measurements .................................................................................................................................................. 48
Brain Perfusion ...................................................................................................................................................... 49
Plan .................................................................................................................................................................... 49
Measurements .................................................................................................................................................. 49
View ................................................................................................................................................................... 49
Parameters ........................................................................................................................................................ 49
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 Table of Contents

Perfusion Scanning ............................................................................................................................................ 50

Lung Nodule Assessment ...................................................................................................................................... 51
Nodule Detection .............................................................................................................................................. 51
Follow up ........................................................................................................................................................... 51
Virtual Colonoscopy .............................................................................................................................................. 53
Definition ........................................................................................................................................................... 53
Navigation ......................................................................................................................................................... 54
Create landmarks ............................................................................................. Error! Bookmark not defined.
Comparison ....................................................................................................................................................... 55
Compare Procedure ......................................................................................... Error! Bookmark not defined.
Dental Planning ..................................................................................................................................................... 57
Dental Planning ................................................................................................................................................. 57
Calibration ......................................................................................................................................................... 57

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 System Startup and Shutdown

System Startup
1. Turn system power ON (if gantry power is off).
2. If your system includes an Uninterruptable Power Source (UPS), turn
it on.
3. Locate the power switch on the side of the gantry, turn it on.
4. Turn on power to the computer and monitor.
5. At the Windows log-in screen, type CT. Click OK, or press Enter.
No password is required.
6. Click OK to begin the initialization.
7. Double click the MX 16 host icon to activate the software.
8. Type the desired User name and password.
9. Perform a tube warm-up by performing short tube conditioning. For
instructions see “Tube Warm-up” on below.

Tube Warm-up
Short tube conditioning must be performed each day before scanning the
first patient and if the tube heat storage is less than 10%.
1. Make sure no one is in the scan room.
2. Check that the table is up and within 10 to 20 mm from the Out
position.
3. Click Service to access the service options.
4. Click Tube Warm Up. The Tube warm-up dialog box opens.
5. Click Start. The system displays information regarding the progress in
the message box.
6. When the warm-up is complete, click Exit to return to the Home
window. Your system is now ready to scan.

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System Startup and Shutdown

System Shutdown

Before shutting down the system, complete the following:

■ Make sure all Reconstructions are complete.
■ Click End Study to ensure no study is in process.
■ Make sure Tube heat storage is below 25%.
When these tasks are complete, proceed to the shutdown procedure.
1. Click Logout.
2. Click Start.
3. Click Power Off.
The system displays the Shutdown Windows dialog box.
4. Locate the power switch on the side of the gantry.
5. Turn off the gantry power.

Air Calibration
For more detail about air calibration, refer to the Philips Instructions for
Use.
▪ Air calibration is part of normal system maintenance.
▪ To ensure proper operations of the scanner, conduct this
procedure at least once per week.
▪ Because this procedure must be done at stable, operating
temperature, perform at midday after a number of patients have been
scanned.
▪ Ensure that no objects are in the scan field (in the gantry).

To perform the air calibration:

1. Make sure the table is not in the gantry. Raise the table to 300
mm or higher.
2. Click Service to access the service options.
3. Click Air calibration. The system displays a box containing a checklist
for performing the calibration.
4. Click Confirm to continue.
The system displays a box containing Speed, Collimation, Resolution, and
Voltage parameters to be included. You can select specific parameters, or
you can select them all.
5. Click Confirm to continue.
6. Click Start to begin the calibration.

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 Table of Contents

Note: If tube heat is less than 10%, the system

automatically performs a tube warm-up before
conducting any air calibrations. Also, depending on
the amount of time the system has been idle, a
message may appear informing you of the last time
air calibration was performed.

Maintenance Recommendation
1. Log out/Log in to the computer (Dell) once per day.
2. Reboot computer (Dell) every two days
3. Cycle power to the entire CT scanner once per week, including
computer, gantry, and wall. Do not turn off wall power switch unless
the tube heat storage is below 25%.
4. Perform a Short Tube Conditioning daily.
5. Perform Air Calibrations weekly.
6. Make sure that the system has been powered on for at least one hour
before performing air calibrations.
7. To ensure high availability and good image quality of the imaging
system, Philips recommends that the Image Performance Quality
Assurance checks found in the Operators Manual be performed as
listed.

QA-Daily Quality Assurance

Daily Quality Assurance checks should be done to ensure best possible
image quality from your scanner. It is recommended that the body
phantom be done daily in conjunction with the Quick IQ Check.
1. Align the body phantom in the center of the gantry.
a. Place the lateral laser light on the lateral screw on the
body phantom. (A)
a. Place the internal laser light on the white line on top of the
body phantom. (B)
b. It is not necessary to zero the table.

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System Startup and Shutdown

2. At the top of the screen, click Processing.

3. Click Service.
4. Click QA.
5. Click Next in the QA Window.
6. Click OK in the Adjust Phantom Note.
7. Click Start in the Notes Dialog box.
8. Click OK in the Scan Note.
9. Record the readings on the Daily/Monthly QA Worksheet.

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System Startup and Shutdown

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 Set Protocol Parameters
You can set parameters on the following tabs of the protocol:

Icon Tab name

Main tab

DoseRight tab

Injection tab

Auto voice tab

Automatic options tab

CCT tab

Advanced tab

Dose Check tab

Main Tab
You can adjust the following parameters on the Main tab.
Parameter Description
Series This parameter is used to insert a label that will appear
Description on all the images of the series. Up to sixteen
characters can be used.
Start and Usually these fields will be copied from the Plan on
End Surview, but you can type any desired value in the
correct resolution and range.
Length The length parameter gives the region covered by the
Helix. This is displayed in millimeters.
Direction The direction the couch will move during the scan.
Thickness The tomographic Thickness is the spatial resolution in
the Z direction. This discrete parameter that can be
selected from the dropdown menu. Certain
collimations provide certain obtainable slice
thicknesses. This is displayed in millimeters.

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Set Protocol Parameters

Parameter Description
Increment The increment parameter is used to set the distance
between two consecutive reconstructed slices. The
value can be entered by typing or electing an option
from the dropdown menu. If the Contiguous option is
selected, the increment will be set as equal to the Slice
Thickness. If the Overlap option is selected the
Increment will be equal to half the Slice Thickness. This
is displayed in millimeters.
Evolving The images are displayed in a separate window, and
are dynamically refreshed. You may adjust the window
center and width for optimal viewing of the image, to
monitor the proper execution of the scanning process.
◼ Zoom in/out to enlarge or reduce the series of
images.
◼ Pan image to center the series of images or the
region of interest.
◼ Adjust the window setting.
◼ Click Start to complete the reconstruction.
kV The Voltage parameter is used to set the voltage
according to the absorption characteristics of the
scanned body part.
◼ Infant scans can only be performed with medium
(120 kV) or low (90 kV) voltage.
◼ Low or medium voltages improve contrast
resolution in small and medium objects or bodies,
and therefore are preferred for scanning infants
and normal size patients respectively.
A high voltage (140 kV) scan provides greater
penetration in large objects and reduces the noise of
the images.
mAs/Slice The mAs/slice parameter sets the exposure during the
scan. Its range of values is determined by the Tube
Current (linearly), the Rotation Time (linearly), and the
Pitch (inversely proportional).
◼ To change the mAs/slice, select a value from the
Dropdown menu or type a value within the range
displayed there. If you type a value for mAs/slice
that is not within the allowed range, the nearest
value (maximum or minimum, respectively) from
the list in the dropdown menu is set.
◼ If the desired value is higher than the maximum
displayed, then decrease the pitch or increase the
rotation time.
If the desired value is lower than the minimum
displayed, then increase the pitch or decrease the
rotation time.

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 Dose Tab
The Dose tab contains all relevant dose tools and dose
information including DoseRight.
Refer to the Use DoseRight for Scanning section for more
information on these tools.

Parameter Description
ACS Optimizes the dose for each patient based on the
planned scan by suggesting the lowest possible mAs
settings to maintain constant image quality at low
dose throughout the exam.
ACS+DOM System recommended ACS value, plus angular and
longitudinal modulation.
DOM only DOM is a scanner function which modulates the tube
current in two ways simultaneously. First, the tube
current is modulated during each rotation based on
patient body symmetry change using specially
developed hardware and software algorithms.
Second, the tube current is modulated longitudinally
according to the attenuation of the patient.
Absolute This setting allows you to define the maximum mAs
Min/Max and minimum mAs values per protocol when using
mAs the DoseRight function.

Contrast Tab
You can adjust the following parameters on the Contrast tab.

Parameter Description
Non-Timed In this mode the contrast is injected and when ready
the user presses the Scan button on the CT
control box to start the clinical scan.
Timed This mode allows for the injection to start and then
start the scanner by pressing the Scan button on the
CT control box. The scan starts after the Post
Injection delay.
Bolus Refer to page 37, Bolus Tracking of the User Guide.
Tracking
Post This is the time from injection to the start of the
Injection scan.
Delay
Automatic This allows the system to update the minimum Post
Minimum Injection Delay.
delay

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Set Protocol Parameters

Parameter Description
Spiral Auto This is an optional method for timed scans. This
Start (SAS) feature is for use with only Philips approved
injectors.
◼ The scanner waits for the start signal from the
contrast injector before beginning the scan.
◼ When SAS is activated, the user initiates the
scan by starting the injector.
Note: When using SAS, if there is an issue that will
require you to stop the scan, pushing the stop
bottom, on the injector only stops the injection. The
user will have to push the pause, estop on the
scanner, or move the couch out of the gantry to stop
the scan.

Voice Tab
The following parameters can be adjusted on the Voice tab:

Parameter Description
Auto phrase The auto voice parameter is used to select a
prerecorded message set: before the scan (for
example, “hold your breath”) and after it (for
example, “you can relax now”).
Preview This allows the patient to hear the selected
message set.

Note: The language used must be chosen on the start study

window.

Auto Storage Tab

You can adjust the following parameters on the Automatic
Options tab:

Parameter Description
Auto storing The storage parameter is used to select the
archive devices for storing the reconstructed
image.
To Change the archiving media (Add/Remove),
select the Storage Devices button and the
Select Devices dialog box will appear.

The local device cannot be deselected. Any listed devices can be

optionally selected.
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 Parameter Description
Apply to All This will apply any changes made to that series
Series to all series.
Auto Filming Reconstructed images can be sent immediately
after the display to the filming application. To
set the parameters, click “Auto Filming.” The
film protocol dialog box appears.
Merge Sets the option to merge the scan with the
previous scan. The image numbers will be
contiguous with the previous scan.

Advanced
The following parameters can be adjusted on the Advanced tab:

Parameter Description
Resolution ◼ Standard is available at all rotation times,
uses the large focal spot and normal angular
sampling, and has no FOV restrictions.
◼ High uses the small focal spot and normal
angular sampling. There are no FOV
restrictions.
Collimation Tailored to different applications, several
collimation apertures are available. The
minimum available thickness is always larger
than the basic collimation. For example if the
user chose 0.75 the minimum slice thickness will
be 0.8.
Pitch The parameter represents the value of the
patient table speed (this is a normalized speed:
the motion of the table relative to the total
collimation for one rotation of the Gantry) A
larger pitch enables a longer total coverage for a
given scan time but can sometimes produce a
lower quality image, in terms of image noise.
Rotation Time The rotation time parameter defines the
duration of one rotation of the gantry.
FOV [mm] (Field The FOV parameter denotes the diameter of
of View) the reconstructed image. The FOV value is
usually copied from Plan on Surview, where it is
interactively set by the FOV function. The FOV
value can be selected from the dropdown box
or typed directly in its text box.
Planning Type Lung, Brain, and Axial Spine scan types have
Planning type. This is designed to place the
scan box over the anatomy of interest.
Adjustments to the plan scan box may be

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Set Protocol Parameters

Parameter Description
necessary.
iDose Please see iDose Section of the User Guide.
Filter There are a variety of reconstruction filters
available for different clinical applications. Some
specifically enhance detail, primarily in the lung
and bone. Please see table in IFU for full list of
Filters and their description and intended use.
Window Center Window Center and Width are used to set the
and Window gray levels of the reconstructed image.
Width
Center X [mm], Center X and Center Y set the Horizontal (X)
Center Y [mm] and Vertical (Y) displacements, in millimeters
(with resolution of 1.0 mm) of the
reconstructed image relative to the center of
the gantry opening. They are used to center the
region-of-interest in the image frame. Usually,
the Center X and Center Y values are copied
from Plan on Surview where it is interactively
set by the Move function. Values within the
range of +/- FOV/2 may also be typed.
Matrix The image matrix parameter sets the number of
pixels that the reconstructed image will contain.
The matrix sizes are 512 x512, 768 x 768, and
1024 x 1024.
Adaptive Filter This parameter automatically reduces the noise
through the thick tissue areas of the patient.
MAR This parameter uses an algorithm to modify the
metal projection data, resulting in reduced
streaking when scanning metal in a patient.
It is recommended that you provide
reconstructions with and without Metal Artifact
Reduction enabled. You can perform this in
Offline Recon if desired.

Dose Check

Parameter Description
Dose Check Th is t ab di spl ays r eal -tim e upd at ed
in fo rm ati on r el at ed to d o se v alu es.
No t all inf or m ati on i s di spl aye d in all
sc an m o de s.
Th e CTDI an d DLP v alue s are
c alcu lat e d sep ar ate ly for He ad an d

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 Parameter Description
B o dy , an d ac c o rdin g t o p ar am et er s set
in Do se Che c k Sett ing.

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 Voice Recording

Voice Manager
1. Select Service Tab.
2. Select System Setting.
3. Select Voice Manager.
4. Click Add under Language to create new language.
Note: The new language is given a generic name. To
rename, enter name in the field box and click enter.
5. Click Add under Action Sets to add a Phrase. The Add
Voice dialog box appears.
6. Type the Pre-Scan and Post-Scan commands onto the box and
click OK.
7. Click Record to record either the Pre-Scan or Post-Scan
commands.
Note: A microphone is needed to record.

Adding Breathing Lights

1. Click the Breathing Lights radio button.

2. Click Add.
Note: Breathing light phrases will be added in order
they appear in GUI. Delete unwanted phrases by
highlighting the phrase and click Delete.

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 Generate Protocols
From the Service tab you can perform access the Protocol
Edit button:

Protocol Edit
1. Select the Service tab.
2. Select Protocol Edit.
3. Select the desired protocol from within the Protocol groups.
4. Make the desired changes to the protocol parameters.
5. Click OK.
6. Save the Protocol.
a. Save overwrites the existing protocol.
b. Save As creates a new protocol with a new
Protocol name.

Delete a Protocol
1. Select the Service tab.
2. Select Protocol Edit.
3. Open the desired Protocol.
4. Select Delete.
Note: Factory Protocols cannot be deleted. User
protocols cannot be recovered when deleted.

Create a New Protocol

1. Select the Service tab.
2. Select Protocol Edit.
3. Select the desired Protocol Group.
4. Select the factory protocol from the Protocol Group that
most closely resembles the desired scan. Factory protocols can
be identified with the Philip’s logo in the bottom right corner.
5. Adjust scan type and parameters as needed.

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Generate Protocols

6. Click OK.
7. Save the Protocol.
a. Save overwrites the existing protocol.
b. Save As creates a new protocol with a new
Protocol name.

Building a Protocol with MPR

1. Select the Service tab.
2. Select Protocol Edit.
3. Select the desired Protocol Group.
4. Select the factory protocol from the Protocol Group that
most closely resembles the desired scan. Factory protocols can
be identified with the Philip’s logo in the bottom right corner.
5. Adjust scan type and parameters as needed.
6. Click Insert MPR.
7. Select Orientation.
8. Click OK.
9. Save the Protocol.
■ Save overwrites the existing protocol.
■ Save As creates a new protocol with a new
Protocol name.

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 Executed Surview

How to Create an Executed Surview

■ Utilizing the 2D Viewer, it is possible to save a Surview with
Line’s as a secondary capture. Follow these steps:
1. Load series and Surview into the viewer (2D).
2. Compare series is on by default.
3. Click Series button.
4. The Surview will be displayed with lines.
5. To save, click Save Display.

■ If you right click the Surview and select Surview, and then
then Set as Surview, a small reference Surview will be
displayed on each axial image. The red reference line moves as
you scroll through the images.

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 Understanding How DoseRight
Works
The DoseRight function automatically suggests the mAs for each
patient based on a comparison to a pre-stored Water Equivalent
Diameter (WED) reference depending on size. The WED
reference sizes are below.

Reference Size Patient Size

40 cm Large Adult
33 cm Average Adult
24 cm 30-50 kg
(pediatric)
16 cm 10-30 kg
(pediatric)
12 cm >10 kg (pediatric)

■ The system compares the absorption coefficients of the

Surview to the reference size and the system suggests an
optimal mAs.

Comparison to Suggested
Surview
reference optimal mAs

■ For every ~5cm above/below the reference size the mAs is

increased/decreased by a factor of 1.67 using 120 kVp.
■ The mAs is cut in half for each ~7cm below the reference size.
■ The user will get the following message when the difference
between the protocol reference size and the calculated Water
Equivalent Diameter (WED) for the current Surview is +/-
10cm for an adult and +/- 5cm for a child.

ACS+Dom unavailable. The patient is significantly different than the WED for
this protocol. This could lead to recommended mAs values that are different
than expected. Please verify the mAs and change if needed.

OK

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Understanding How DoseRight Works

Use DoseRight ACS

1. In the Dose tab of the protocol in Protocol Edit click the
DoseRight dropdown menu.
On active scanning, when DoseRight ACS is selected,
mAs/Slice the window containing the mAs will be blue
indicating that DoseRight has made a mAs
recommendation.
2. You must build your user-defined protocols based on the
Philips factory protocols to utilize the pre-calculated
attenuation curves.
3. Beside the DoseRight checkbox is a dropdown menu where
DOM can be selected.
4. At least 70% of planned scan region should be located within
the Surview or DOM function will be disabled.
5. ACS and DOM are available for selection in the User Interface
after a Surview is acquired.
6. If you manually change the protocol mAs, ACS will be disabled
but DOM will modulate if it is selected.
7. If you manually change the protocol default kV, the mAs value
will automatically adjust.

Absolute Minimum and Maximum mAs

This setting allows you to define the maximum mAs and minimum
mAs values per protocol when using the DoseRight function. This
setting can be defined:
■ Built into the protocol
■ Added from the DoseRight tab

To enable this feature, click Service > System Settings>

Scanner options> Customize DoseRight max/min mAs.

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 Consider the Following When Using
DoseRight ACS
■ DoseRight should not be used for Head, Calibrations, QA
Protocols, Brain Perfusion, CCT, and Bolus Tracking
■ Verify the DoseRight mAs prior to every scan. The mAs is
adjusted for each patient after comparison is made to the
selected protocol’s WED.
■ If the patient is smaller than the WED, the mAs will
decrease.
■ If the patient is larger than the WED, the mAs will
increase.

Dose Right Level Settings for ACS

The DoseRight Factor choices are labeled from 0.3 to 1.7. Each
DoseRight Factor choice correlates to a DoseRight Level. Level 0.3
uses the least amount of radiation dose and results in the highest
image noise. Level 1.7 uses the highest amount of radiation dose
and results in the lowest image noise.

1.7 Low Noise

1.3

1.0 Standard

0.7

0.3 Low Dose

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 iDose4

Getting started with iDose4

iDose4 is an Iterative Reconstruction Technique designed to
remove noise from images. iDose4 provides the ability to create
diagnostic images using lower mAs or kVp factors, thus reducing
radiation to the patient. It can also be used to improve image
quality of routine acquisitions, or in some cases do both; combining
improved image quality with lower mAs or kVp.

iDose4 is designed to provide the same look as the Filtered back

Projection image.

Some types of CT acquisitions are naturally noisy. For example a

bariatric or cardiac scan may have noisy images. iDose4 can reduce
the level of noise on those images and improve image quality
without changing the mAs or kVp.
iDose4 is very easy to use. Just choose a pre-created iDose4
Protocol, then plan normally.

Creating an iDose4 Protocol

1. Select a series group then select an existing protocol while in
Protocol Edit.
2. Navigate to the Advanced tab in each axial or helical series.
3. Place a checkmark beside iDose.
4. Select the appropriate iDose Level from the drop down
menu.
Note: iDose Level 1 decreases the image noise the least,
while each higher level removes more noise.
5. Adjust the kVp and /or mAs, on the Main tab, to match the
selected iDose level, if desired after the iDose level is set.
Note that you can use the iDose4 mAs Guide to assist
in adjusting mAs. You'll find the iDose4 mAs Guide at the
end of this section. Remember that CTDI must always
be considered, when changing kVp or mAs and using
iDose4.
6. Click the green OK button.
7. Click the Save As button to save your changes.

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iDose4

8. Select a name for the new protocol that indicates that the
protocol is using iDose. Additional iDose4 protocols can be
created as needed.

Important Considerations with iDose4

■ iDose4 can be used with or without changing the mAs or kVp.
■ When mAs or kVp are reduced, additional noise is added to
the images. This additional noise can decrease the image quality.
■ iDose4 reconstruction can be done as an online or offline
reconstruction.
■ An iDose reconstruction can be done anytime that raw data is
available.
■ Reducing mAs reduces the CTDI in a linear fashion.
■ For each step kVp is reduced, the CTDI is reduced 20-30%.

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 Use Dose Check

What is Dose Check?

There are three parts to the Dose Check feature:

Part Description

Dose Alerts the user that a pre-defined CTDIvol or

Notification DLP value will be exceeded on a scan by scan
basis.
Dose Alert Alerts the user that a pre-defined CTDIvol or DLP
value from a combination of all planned scans will
be exceeded.
Dose Check Records any study where Dose Notification or
Record Dose Alert values were exceeded.

Dose Notification Details

■ The system computes the CTDIvol and DLP for each planned
series and checks this against the Dose Notification Value for
that series.
■ If the CTDIvol and/or DLP of a scan exceed the set limit, the
operator is notified with a pop-up message:

Series 2: Planned CTDIvol is 21.88 mGy which exceeds the

recommended limit of 20 mGy.

■ The scan cannot continue until you select one of the following
options:
Notification Action
Message
Proceed If you click Proceed you are accepting the
current CTDIvol and/or DLP, which is
above the notification value. A Dose Log
Entry will be created.
Cancel If you adjust the parameters below the
notification value, no Dose Check
Report entry will be created.

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Use Dose Check

■ Entering the Diagnostic Reason is optional.

■ In Plan scan, the limits are displayed but cannot be edited.
■ Notifications values have not been set in the factory
reference protocols.
■ The Dose Notification values may be left empty; however,
this negates the purpose of this safety feature.
■ Populate your Dose Notification values on your user
protocols if you wish to use this feature.
■ When scan parameters that affect the CTDIvol and/or DLP are
changed, the system checks the updated values against the
Dose Notification values again.
■ For multi-cycle scans (like Trackers, Perfusion, CCT etc.) the
calculation assumes the maximum number of cycles in the
protocol will be performed.

Dose Alert Details

■ The system computes the accumulated CTDIvol and DLP values
for all planned series at each anatomic position throughout the
exam. If the cumulative CTDIvol or DLP at any anatomic
position is expected to exceed the alert value when the next
scan is performed, the Dose Alert pop-up will be displayed as
shown here:

Dose Alert
Information:
Series 2: Accumulated CTDIvol is
65.91 mGy which exceeds the
recommended limit of 30 mGy

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 • The scan will not proceed until you choose to either:
If you choose… This will happen:
Proceed You will continue a scan that is over
the alert value.
◼ A Dose Check Report entry will
be created.
◼ To proceed, you MUST enter
your name.
◼ If the password option is enabled,
you must enter a name and
password.

Cancel You can modify the dose to a level

below the alert limit.
◼ Modify the dose to a level below
the alert.
◼ If you modify the dose below the
alert value, a Dose Log Entry will
not be made.
◼ If the CTDIvol or DLP values are
still above the notification setting,
a Dose Notification may still be
triggered.

■ Dose Alerts are associated with complete studies, not

individual series, and are enabled in Service > System
Settings > Dose Check settings > Dose Limit Setting.
Note: To edit Dose Limit Setting, User must be logged in as an
administrator or higher.
■ Use the Factory default values, or enter values instituted for
your site:
■ Default CTDIvol values have been set at 1000mGy,
which is consistent with FDA suggested values.
■ No DLP values are included in the factory settings.
■ An alert warrants more stringent review before proceeding
and requires a higher level of action by the user. For example
the FDA has suggested an alert value for CTDIvol of 1000 mGy,
which would deliver approximately half the dose associated
with the onset of skin injury.
■ Additional information is available at the following website:
http://www.fda.gov/Radiation-
EmittingProducts/RadiationSafety/RadiationDoseRedu
ction/ucm232551.htm

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 MAR (Metal Artifact Reduction)

MAR Use
The Metal Artifact Reduction for Orthopedic Implants algorithm
reduces artifacts induced by metal objects. MAR is applied when
metal artifacts are present in the image. Metal objects attenuate
more X-rays than soft tissue and bone, so fewer photons can reach
the detectors. This causes severe beam hardening, which results in
bright or dark streaks or star like patterns on the images. Artifact
free images with metal cannot be obtained using standard
reconstruction. MAR improves image quality for patients with large
orthopedic implants.
MAR can be selected while planning study, and Offline
reconstruction. A second reconstruction is recommended to
review with and without MAR by the physician.

Examples of MAR images- Hip Prosthesis

Original Image MAR image

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MAR (Metal Artifact Reduction)

Using MAR
1. Select Start Study from the Main Menu, and enter patient
data.
2. Go to Age Group and select Appropriate Age Group.
3. Select a position from the Position drop down menu.
4. Click the Exam Protocols button at the bottom right of the
screen. This opens the Exam Protocol Groups page.
5. Select one of the Exam Groups, and then select a protocol.
6. Click the green GO button to start the Surview.
7. After completing the Surview, plan study. If the Surview shows
some type of large orthopedic implant, MAR can be activated.
8. Select MAR on the Advanced tab.

Contraindications for MAR

■ External metals including bismuth shields.
■ Implanted devices near skin surfaces (such as pacemaker, etc.).
■ Metal in or near intra-body air spaces.
■ Metal in or near spine.

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459800820424_A 32 Philips Healthcare
 Performing a Routine Scan

Performing a Routine Scan

1. From the Home screen, select Start Study.
2. Input the patient’s data into the Patient Data fields.
a. Pull information from the HIS/RIS if your facility has
this option.
b. If your Facility does not have the HIS/RIS option
manually input the patient’s data from the
Schedule tab.
If HIS/RIS is used, the patient’s data will populate the
Patient Data Fields.
Note: All mandatory fields are in yellow and have a red
asterisk. Mandatory fields must be completed to
conduct a scan procedure.
3. Click the dropdown arrow to select the patient position.
4. On the menu at the top of the screen, click Protocols.
The Exam Protocols Groups will now display.
5. Select the correct Exam Protocol Group for your exam.
The Exam Protocols will display.
6. After selecting the correct Exam Protocol Group the Exam
Protocols will be displayed.
Note: If you select the wrong Exam Protocol Group,
click Exam Protocol Groups to return to the previous
screen and select another Exam Protocol Group.
Note: The tabs located on the left side of the screen
represent different types of scans, i.e., Exam Protocols
have Surview and an axial or helical acquisition. The
Surview tab will only display Surview Scans; Axial Scans
will only contain axial images, and so on.
7. Select the desired Exam Protocol.
The Plan Scan window will appear.
Note: If desired, the protocol can be edited at this stage.
Either the Surview or acquisition can be selected by
clicking on the desired series.
8. Click GO to continue the study.
The system will display a message in the lower right
corner of the screen to indicate that it is initializing. This
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Performing a Routine Scan

indicates the system is preparing to scan.

The system will instruct you to push the correct button
on the Scan Control box.
9. Push the desired button as described below.
MX 16 Scanner Control Box
Button Button Action
name
Enable Moves the table into correct
Button starting position

Scan Button Allows the scanner to perform

individual scans

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 Raw Data Reconstruction
Using Raw Data, you can manipulate the data in two ways:
■ Planning reconstructions on the Surview
■ Reconstructing raw data after ending the study

Planning Reconstructions on the Surview

1. Select the Add Recon button, after the Surview has been
taken and the scan has been planned. An additional series will
appear in the flow window and on the Surview.
2. Use the protocol parameter menu to make the required
changes to the recon series. The series can be manipulated on
the Surview as well.
3. Scan the patient once all the planning has been completed. The
system will acquire the scan, reconstruct the initial acquisition,
and then reconstruct the additional added reconstructions.
The images from the additional reconstruction will
appear in the Directory as a separate series.

Reconstructing Raw Data after Ending the

Study
1. Select the Selected Device button and select the IRS device
from the Directory window. The patient list will now reflect
and display the raw data files.
2. Select the name of the patient to be reconstructed and select
the proper raw data series from the Series list.
3. Click Offline Recon button from the left-sided work area.
4. Make the necessary change, and then click select one of the
following:
■ If you click Start, the Reconstruction Manager
displays.
■ If you click Exit, select from these options:
Stop allows you to temporarily stop the reconstruction.
Click Y to confirm. The system displays options to
resume or delete reconstruction.
Delete to delete the selected reconstruction.
Start to continue with current reconstruction.

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Raw Data Reconstruction

Delete All to delete all pending reconstructions.

Task FW to move a selected reconstruction up in the
queue (one line at a time).
Task BW to move a selected reconstruction down in
the queue (one line at a time).

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 Bolus Tracking

Use Bolus Tracking

The Bolus Tracking function maximizes the efficiency of the CT
scans that are enhanced through the use of a contrast agent.
Bolus Tracking is designed to help the user time the clinical scan
with precision. This is done by preceding the clinical scan with
locator and tracker scans.
1. To use Bolus Tracking, it must first be activated while building
protocols. It can be activated during active planning as well. To
activate, click the Contrast Parameter tab and select Bolus
Tracking.
Parameters for Bolus Tracking are as follows:

Parameter Description
Threshold The Hounsfield number
that the contrast must
reach to automatically start
the clinical scan. The
contrast level threshold is
operator defined; the
system default threshold is
150HU.
Post The time interval between
Threshold the threshold being met
delay and the start of the clinical
scan.
Automatic Enables the Post Threshold
Minimum delay to keep the lowest
delay time interval between
cessation of tracker images
and start of clinical scan.
The Contrast agent, route, concentration, volume and
flow rate can also be entered.
2. When Bolus Tracking is activated, two additional steps will be
added to the protocol: a Locator and Tracker.
The following items are available:

Parameter Description
Suggest Locator If selected will display an image on the Locator
Position main tab that provides a location suggestion for
the locator scan placement.
Post Injection Located on the Tracker main tab and is the

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Bolus Tracking

Parameter Description
Delay delay from the start of the injection until the
start of the tracker scans.
Automatic Keeps the post injection delay to a minimum.
Minimum delay
SAS An interface between the injector and the
scanner that allows the scanner to be initiated
with the injector. Pressing pause on the injector
will not stop the scanner, nor will pressing the
e-stop button on the scanner stop the injector.
3. Click GO to complete the exam.

GO
The first scan will be a single
locator image.
Note: If the user has a question as to where to place the
ROI, the information icon will show a graphical
representation of a Suggested ROI Location.

Selection Action
Manual To place a Manual ROI:
a . Icon is activated automatically.
b . Draw a ROI in the vessel of choice
appropriate to the scan.
c . Resize and move the ROI as needed.
ROI cannot compensate for patient
motion.
4. If you do not like the location of the image displayed, Replan
the locator by selecting the Rescan Locator button.
This will take the user back to the Surview image and
allow the locator/tracker line to be moved.
5. Repeat step 3 above. When the user is satisfied with the
placement of the ROI and ready to begin the scan, proceed to
step 6.
6. Click Go Once the user is satisfied with the ROI placement.

GO
Depending on whether the system
has the optional Spiral Auto Start (SAS), Auto start or
manual start may be initiated.

Start method Instructions

Auto Start When the system prompts, press the Injector
Mode using Start button.

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 SAS The tracker scan starts with the delay defined in
the tracker scan protocol after the injection
start.
Manual Start Simultaneously press the Manual button (to
Mode start the tracker scans) and the Injector Start
button. The scan starts after a lapse of time
equal to that defined as delay in the tracker scan.

7. Observe the contrast on the updated images as the tracker

scans start. The graph tracks the progress of the ROI
measurements.
Note: The user can override Bolus Tracking by clicking
on the Start Clinical Scan button.

BOLUS TRACKING
To stop tracking and skip to clinical scan press START CLINICAL SCAN

START CLINICAL SCAN

Note: If the scan has to be aborted for any reason, the

user will have to return to the protocol and re-enable
Bolus Tracking.

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 TIBT

Test Injection Bolus Timing

■ The TIBT application analyzes time dependent processes, in
particular the update and dispersion of contrast material with
relation to time.
■ Information measured via the application is then used to
identify the delay time to inject for a clinical scan.
■ ROIs are drawn over the regions whose changes are to be
measured. The average pixel values of the ROIs are plotted
over time for a graphical description of the time variations.
■ TIBT on the MX 16-slice is an online application. Meaning that
it happens while in the active viewer only.
To generate a protocol with TIBT scan follow these steps in
Generate Protocol.
1. Select the Insert icon with the Surview selected (series 1).
2. Locate the TIBT scan under the axial tab in Exam Protocols.
3. Click the TIBT scan so that it is inserted into the protocol as
series 2.
Note: SAS is not available so the user must start the
contrast and scanner at the same time.
4. Place the TIBT plan over the vessel of interest. Start injector
using 15-20 ml of contrast and scanner Scan button at the
same time.
■ Contrast may be followed with 15-20ml of saline if
a dual head injector is used.
■ For accurate results, keep the injection rate for the
TIBT the same as the injection rate for the clinical
scan.
5. Monitor enhancement of the desired vessel on the screen. If
desired, the user can stop the scan when the enhancement
fades by selecting the pause button.
■ You can allow the scanner to complete the planned
number of cycles.
6. After the scan is completed, two icons will become available on
the active viewport.
7. The first icon, when pressed, automatically, activates the ROI
function and allows you to draw an ROI over the area of
interest.

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TIBT

8. Use the following tools to edit the ROI:

Icon Description
Activates the ROI function and allows you to
draw an ROI over the area of interest

Graphs the HU values over time.

9. The second button graphs the HU values over time.

10. Select the Contrast Tab on the clinical exam and place the
start time from the TIBT series in the Post Injection Delay
and continue with the scan.

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 Creating a Batch in Viewer

Creating a Batch in MPR Viewer

1. In the Home Directory, select patient and series needed.
2. Click Viewer.
3. Click MPR tab.
4. Change to the desired orientation.
5. Click Batch Tab
6. Scroll image in Main Viewport to desired location.
7. Click From button.
8. Scroll image in Main Viewport to the end of the dataset.
9. Click To button.
10. Set the desired thickness and increment
11. Click the triangle to the right of the Save button to display the
Save Batch button.
12. Click Save Batch.
13. Type desired Description.
14. Select destination.
15. Click Save.
Note: Image Parameters Page, Mini Image, and or
Reference Image can be added prior to saving the batch.

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 iBatch

Creating an iBatch of Lumbar disc in MPR

1. Select an iBatch protocol for Lumbar anatomy in the
drop-down list of iBatch.
2. Add, delete or adjust the batch range and/or degree of
tilt displayed in the user interface.
3. Reference, Mini image, and Parameter page can be added
to iBatch images.
4. Save or send the disc batch to local or remote devices.
To edit the Protocol, click Show/Hide Protocol.
Parameters that can be changed are Slice Thickness, Slice
Incrementation, Image Number, and Name of Protocol.

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459800820424_A 45 MX 16-slice User Guide
 AVA
The Advanced Vessel Analysis (AVA) application offers a set of
tools for general vascular analysis for body and skull (head and neck)
studies. AVA workflow consists of three stages, described below:
■ Bone Removal
■ Vessel Extraction
■ Measurements

Bone Removal Volume Tools

1. From the Directory, choose the patient and thin dataset for
use in AVA.
2. Click the AVA on the Home Screen
3. Click Bone Removal icon.
4. You may want to orient the image to an axial or sagittal plane
before clicking on the bone for removal.
5. Set the appropriate thresholds then click the bone to be
removed. If all of the bone did not remove, the thresholds can
be adjusted and the seed re-deposited.
If there are remaining unattached particles, click
Residuals – The point placed will remove residuals
created from the last click used for bone removal.
Include brings back all removed bones and tissues.

Vessel Extraction
1. Under the Guided Workflow, click Vessel Extraction.
2. If desired, enter the maximum and minimum threshold values.
3. Click the Add Seed button.
4. Place a start point by clicking in the vessel. You can place the
seed in either the main volume rendered image or the
reference images.
5. Place a second point (the end point) in the vessel.
Note: After two points are marked, the system enables
the Auto Track button.
6. Click Auto Track to have the system generate the path.

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AVA

The system asks if you would like to name the vessel.

Select an option:
■ Click Yes to select a name from the list or define a
new name for the vessel.
■ Click No to extract the vessel without assigning a
name Measurements.
The Centerline is created, vessel named, and orthogonal
images of the vessel are displayed.

Measurements
1. Select Measurements under Guided Workflow.
2. Select Display Contours to edit the vessel contours as
needed.
■ Incorrect contours can be corrected using the Q-
CTA tools.
■ The characteristic and reference lines can then
be moved to the appropriate points using the
sMPR or scrolling the reference image to the
desired location.

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 Brain Perfusion
The Brain Perfusion application analyzes the uptake of injected
contrast over one or more regions of interest. The Hounsfield
unit contrast enhancement is tracked for each voxel over time to
produce tissue specific time-density curves. Brain scan as to have a
minimum of 20 cycles and up to 4 images per cycle.

Plan
1. In the Home Directory, select patient and series needed.
2. Click Brain Perfusion.
3. Scroll through images in Z Axis to desired location.
4. Click Reference Artery and draw ROI on tMIP image.
5. Click Calculate.
6. Enter the Relative Value in the Define Vessels dialog box if
parameters for Define Vessel is selected.
Note: The default value is 25%.

Measurements
1. Click OK for Perfusion Maps.
2. Click Mirror Line button and draw mirror line on tMIP image.
3. Draw ROI on areas of interest. The ROI is present throughout
the Z axis and the table updates for that Z location.

View
Perfusion Maps can be viewed all together or individually by
choosing the corresponding radio button.

Parameters
Please see IFU for detailed information on Perfusion Parameters.

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Brain Perfusion

Perfusion Scanning

Suggested Routine Brain Perfusion

for MX 16-slice Scanners only
Thickness 6.0
Increment 0.0
kV 90
mAs 96
Cycle Time 1.5
Cycles 40
Resolution Standard
Collimation 16 x 1.5
RT 0.6
FOV 250
Filter SA
WC/WL 350/80
Matrix 512

Suggested Contrast values

Note: Consult your Radiologist prior to setting up or changing any
injection protocols in your department. Jog is not available on MX 16-
slice scanner.
For Non-Jog scans 40-50mL contrast, followed by 20-40mL saline
For All scans ◼ Injection rate of 4-6mL per second
◼ 18-20 gauge IV placed in right antecubital vein

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 Lung Nodule Assessment
The Lung Nodule Assessment (LNA) application assists with the
diagnosis of pulmonary nodules and lesions.

Nodule Detection
1. In the Home Directory, select patient and series needed.
Initial and Follow-up studies can be loaded into application
together by holding the CTRL key and selecting both series.
2. Click Lung Nodule Assessment.
Note: If two studies were loaded, click the Series tab
to toggle between series.
3. Scroll through axial images until nodules are found.
4. When a nodule is found, click Mark Nodule and then click
the inside of the nodule. A numbered contour will appear
around the nodule.
5. To check this, click Edit Contour and check to make sure
that the blue area encompasses only the nodule. To correct
any inaccuracies, use Edit Contour and/or Draw Contour
to modify the segmentation borders.
6. Repeat steps 3-5 for all nodules.
7. Initial and Follow up studies need have nodules marked in the
Detection Stage.

Follow up
1. After all nodules have been segmented and marked in the
Detection Stage, click the drop-down menu and select
Follow Up.
Note: In the Nodule List the nodules will be displayed
for both studies. Nodule 1 is selected by default on both
studies but may not correspond. The lesion will appear
on the axial slice as well as the coronal and sagittal
reference images.
2. Click the nodule under Follow Up to find the lesion that
matches. When a matching lesion is found, click the Match
Nodule button. Continue until all of the lesions have been
matched.

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Lung Nodule Assessment

If any lesions have been matched in error, use Unmatch

Nodule to separate them.
3. Click the Summary Table button to see a table that includes
Growth Rate and Doubling Time.
4. Click Save or Save Display to save the results to a
destination.

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 CT Colonoscopy
The CT Colonoscopy (CTC) application enables fast and easy
visualization of colon scans, using acquired CT images. The virtual
colonoscopy workflow consists of three stages, described below:
■ Definition
■ Navigation
■ Comparison

Definition
1. Select the patient from the Directory window.
More than one acquisition may be loaded at the same time for
comparison; however the steps below will need to be
performed on both acquisitions. The maximum case load is two.
2. Load to CT Colonoscopy.
When the package is launched, there will be a delay while the
software automatically extracts the air-filled components from
the volume and completes the rendering.
During the Definition Stage, the software defaults to defining
the most prominent segment with an S and E, start and end
point. These points generate from rectum to cecum.

Note

Color coding as described below will help you to

determine the action needed for each component.
If the centerline or segments need editing, open the Center Line
Edit Tool.
3. Click Redo Segmentation.
4. Click Connect Colon.
5. Click Next Colon Segment or Previous Colon Segment to get
to the starting location.
6. Click Connect Colon or Remove Current Colon to reject that
segment of colon.
7. Repeat Steps until entire Colon Centerline is created and click
Confirm Segmentation.
8. Move to the second acquisition by selecting either Supine or
Prone in the Select Series area and repeat steps above.

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CT Colonoscopy

Color Description

Green Active component that must be accepted or rejected

Gray Component is inactive

Brown Component that has been accepted

Navigation
In the Navigate stage, various image types and display
arrangements (layouts) are available for viewing and playing. The
available layouts are described below.

Layout Display Color

2+3 Layout Endo view, Volume of path, axial image, cross-sectional

images, and Sagittal images

1+3 Layout Long filet segment, Volume of path images, cross-sectional

image and endo view

2*2 Layout Volume of Path Image, Endo view, Cross-sectional,

and axial images

Note

The filet view gives a projection that is, in effect, like

cutting a section of the colon open longitudinally and
spreading it so the whole colon wall can be seen at once.
With a 20°overlap, this technique provides superior
visualization over Endo.

Play Trajectory controls the fly-through. When you are at the

start of the fly-through, you can only go forward. Use Reverse to
reverse the camera fly through direction.

Polyps
1. Click the Mark Polyp button.
2. Place mouse cursor over the area of interest.
3. Click to mark the area.
4. This area is automatically located on all viewports.
5. Save Images or Save Display.

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 Comparison
The Comparison stage allows you to view two cases of the same
patient, prone and supine, and perform comparison analyses
between them.
• The two cases must be loaded at the same time when opening
the CT Colonoscopy application.
• The segments and centerline must be created in Define stage
for both acquisitions before going to Comparison.

Compare Procedure

The image area of the opening window will display one case on the
left and one on the right.

1. Select the desired layout.

2. Place both series in the same anatomical location.
3. Use the Navigation tools to navigate through the data sets
simultaneously.

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 Dental Planning

Dental Planning
Note: Before the study is filmed, calibrations must be done to
assure the accuracy of measurements. See “Calibration” on page 58.
1. Click the correct patient and series from the Directory.
2. Click the Dental Planning application.
The Dental Planning package will open with the
Panoramic mode selected.
3. Click the Define Curve button in the Plan section.
4. Draw a curved path through the mandible or maxilla by clicking
and depositing points along the anatomy using the reference
image. Define the path along the root of the teeth. To finish
the curve, press the Esc button on the keyboard.
The Number and Space fields define how many
panoramic images are created and how far apart they are
from each other.
5. Click the Sectional images icon to view and edit the number
and spacing of the cross- sectional images using the number
and space fields.
Note: The orientation of the cross-sectional images is
marked by a B-Buccal for cheek side and an L-Lingual
for tongue side.
Once a section has been defined, it can be moved along
the path. Additional sections can be added or deleted.
6. Once sections have been created they can be printed in one of
two ways:
■ Film Pair allows printing of a section paired with its
panoramic and reference image. Sections 1 through
12 will be sent to the Filming preview window. These
images appear in Filming as a display. No editing is
permitted.
■ Print Preview allows a protocol for a film layout to
be created. The images will not appear in Filming.
They will go directly to the printer.

Calibration
Note: To calibrate the MX 16-slice for life-size images, follow the
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Dental Planning

steps below.
1. Load the series images and print dental images.
2. Measure the real size of the scale using a ruler. X1
represents the horizontal scale measurement, and Y1
represents the vertical scale measurement. X
represents the displayed length of the horizontal
scale, and Y represents the displayed length of the
vertical scale.
3. Use the factor = (x/x1 +y/y1)/2.
4. Click Calibration to open the Calibration dialog box.
5. Use f = 1; (f represents the previous factor).
6. Type the desired calibration factor * f and Click the
OK button.
7. Repeat these steps until the Factor is close to 1.

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 MX 16-slice CT scanner
V2.0

The following checklist is designed to serve as a reference point for Philips

Clinical Education while training customers on Philips equipment. After on-site
training and completion of this checklist, the technologist will demonstrate
workflow, to include but not limited to Brain imaging, Cardiac, CTA exams and
Perfusion Studies. If any sections are not completed, please provide a brief
explanation. One copy of the checklist should remain at the site, and the Clinical
Education Specialist will keep one copy.

1
459800820424_A
Safety Notifications
User1 User2 User3 User4

1. The X-ray unit may be dangerous to patient and operator

unless safe exposure factors, operating instructions and
maintenance schedules are observed.

2. Do not use the MX 16 slice CT scanner for any application

until you are sure that the image Performance QA has been
completed and that the PM program is up to date.

3. Do not use the MX 16-slice CT scanner for any application

until you have received adequate and proper training in its
safe and effective use.

4. Never attempt to remove, modify, over-ride or forcibly move

any safety device on the equipment.

5. Do not use the MX 16-slice CT scanner for any purpose

other than those for which it is intended.

6. Gantry Emergency Stops and Locations

7. Resetting from an Emergency Stop

8. During all movements of the gantry and patient table, keep

the patient under constant observation.

9. Location of the Emergency patient releases

10. Do not remove covers or cables from the equipment.

11. Do not use explosive disinfecting sprays while cleaning the

MX 16-slice CT CT Scanner.

12. Portable radio transmitting devices such as mobile phones

should not be used around the CT scanner as they can
interfere with proper functioning of the system.

13. Exposing an implanted medical device such as a pacemaker

or neurostimulator to medical radiation has the potential to
cause the device to malfunction.

14. Are you familiar with the regulations for radiation safety for
your state, province or country?

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15. Location of the Radiation warning lamps on the scanner.

16. Do not stare into the laser beam. Instruct patients not to
stare into the beam.

17. Make sure to use radiation protection devices and dedicated

pediatric protocols to reduce radiation dose. Make sure to
enter the patients’ age correctly when using pediatric
protocols.

18. When lowering the patient couch, please check to make sure
that nothing is under the table in order to avoid collision and
to ensure patient safety.

19. Philipsrecommends that when HU measurements are

needed, reconstruct the raw data using filters which do not
affect the HU numbers, such as the SA, SB or SC filters.
Absolute Hounsfield Units should never be used as the sole
basis for any diagnosis.

20. Do NOT use MAR in the following instances:

• External metals
• Bismuth shields
• Metal in or near intra-body air spaces
• Small surgical implanted devices, i.e. screws, pins, clips,
etc.

Gantry/Couch Operations
21. GantryPanel Control - Up/Down, In/Out, Tilt, Patient
Unload Button

22. Gantry Panel - Laser Lights

23. Gantry Panel- Couch Zero Button

24. Gantry Panel- Index In / Index Out

25. Gantry Panel – Tilt/ Table Position/ Height Range

26. Gantry Panel – Tale Release (Rear and Foot)

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27. Accessories – Head holder, Foot Extension, Restraints

Operators Console Overview

28. System Start-up/Shutdown

29. Air Calibrations (Full vs. Partial)

30. Tube Warm Up

31. Protocol Edit

32. System Setting

Voice Manager
Window Setting
CCT monitor setting
Image Information setting
Annotation
Patient Registration setting
Age-Based Protocol Classification
Scanner Option
Dose Check Setting (Administrator login required)

33. Dose Check Report (Administrator login required)

34. Constancy

35. Quality Assurance (QA) – Daily/Monthly

36. Bug Reports

37. Disk Cleanup

38. Virus Scan

39. Logout (User)

Scan Control Box

40. Pause – Enable - Scan

41. Gantry Controls - Up/Down - In/Out

42. Control Panel Accelerate Button

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43. Gantry Panel – Tilt Button

44. Volume Controls - Console and Gantry Speakers

45. Patient Intercom

Patient Directory

46. Mouse Functionality

47. Right Click Functions

Copy To…
Delete
Film
Lock
Modify

48. Folder/Device Selection

49. Sub-Selection
Right Mouse options

50. Find or Search

Filter - Remove Filter

51. Refresh

52. Sort

53. Recon/ Recon Manager

54. Copy To

55. Delete

56. Film

57. Modify

58. Lock

59. Viewer

60. Combine

61. Queue Manager

Transfer/Print

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62. Image Viewport

63. View a CD
Load CD - Copy to Local - View

64. Burn a CD (CDR)

CD Record - Clear

65. DVD-RAM

66. Logout

Patient Entry / Protocol Selection

67. New - Current – Anonymous

68. Schedule

Scheduled – All Scanned

Worklist – Search (Searched Item)

69. Mandatory Fields (*Red Asterisk)

70. Voice Language Selection

71. Patient Position

72. Select Protocol

Protocol Edit

73. User vs. Factory Exam Protocols

74. Hide Factory Protocols

75. Change Protocol Order

76. Export Protocols

77. Adult – Pediatric – Infant Protocols

Age based classification for infant and pediatric

78. Surview
View Angle -180, 90, 180-90, 90-180
Direction

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 Side by Side planning for Dual surviews

79. Main Parameters

Scan Types – Brain, Abdomen Routine etc.
Unrestricted Scan Types- Head/Body
Default Series Label
Thickness and increment
kV-mAs/Slice
Evolving

80. Dose Parameters

DoseRightMode ACS, ACS+DOM, DOM only
Dose Right Level
Absolute Min/Max mAs

81. Injection Parameters

Non-Timed
82. Timed
SAS – Spiral Auto Start
Post Injection Delay
Automatic Minimum Delay

83. Bolus Tracking

Locator
Suggest locator Position
Tracker
Cycle Time
Post Injection Delay
Automatic Minimum Delay
SAS- Spiral Auto Start
Threshold
Post Threshold Delay
Automatic Minimum Delay
Set Manual ROI
Suggested ROI Location
Redraw ROI
Repeat locator

84. Voice Selection

Auto Voice Enabled
Pre Scan/Post Scan -Preview

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85. Automatic Options
Storage Devices
Auto Filming
Merge
Auto vs. Manual Archive

86. Advanced Parameters

Resolution- Standard / High
Collimation
Pitch
Rotation Time
FOV
iDose
Filter Selection
Matrix
Planning Type(Protocol Edit only)
Window Button
Adaptive Filter
Metal Artifact Reduction

87. Dose Check Parameters

Dose Notification CTDIvol Limit
Dose Notification DLP Limit

88. Copy and Paste Plans

89. Set Protocol Age Group

Infant 0-18 months (pink)
Child 18 months-18years (blue)
Adult 18+ (yellow)

90. Save vs. Save As

91. Insert Protocol/ Copy Series/ Add Recon/Insert MPR

92. User vs. Factory Exam Cards

Scan Setup and Review

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93. Move the Scan Plan

94. Change Start/ End

95. Change FOV

96. User Previous Surview

97. Concurrent Reconstruction vs. Evolving

98. Repeat Last Series

99. Next Series

100. Continue Current Series

101. Protocols

102. Plan Scan

103. View Scan

Dose Management

104. Dose Info

105. CTDIvol

106. Total DLP (saved with ES Surview)

107. Estimated Dose Savings

Filming

108. Multi-Format

109. Change Film Format

110. Reverse Series

111. Print Surview Options

Display Mini Image
Display Location Line

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 Location Line Form

112. Print

113. Select Printer (if more than one)

114. Set Number of Copies

115. All Films button

116. Right Mouse Options

Insert Blank Image
Insert Parameters Page
Duplicate
Paste
Select Current Film
Set as Surview
Hide Location Lines

117. File
Print Preview
Auto Print clear
Print Test- SMPTE pattern

118. Do Not Mix Patients

119. Delete/ Swap/Image Click and Drag

Scanner Workstation Applications

120. Viewer

121. Batch & Cine

122. 2D/Planar/Volume/Endo

123. 2D
Compare Mode

124. Planar
Curved Mode

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125. Volume
Clipping Tools
Bone Removal

126. Dental

127. VA
Bone Removal -Volume Tracing
Vessel Extraction
Measurement

128. Lung Nodule Assessment

129. Virtual Colon

130. Brain Perfusion

Exam Workflows

131. Brain Imaging

132. CTA (Bolus Tracking vs TIBT)

133. CCT (option)

3 Image Display
Display Order- Switch Head/ Foot
Horizontal or Vertical Flip

134. MAR (Metal Artifact Reduction)

135. Other

136. Procedure to Place Helpdesk and Service Calls

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MX 16-slice CT

OA#: Site#:
Site name:
Training dates:
Addendum to system configuration:
Attendees (Name/ARRT#/ASRT#):

Yes No
Off-site training packet received and reviewed?
Attended off-site training?
CEU criteria met?
Continuing Education information supplied to the customer?
Clinical Education line discussed with customer?
Service call procedure discussed with customer?
Do you feel the training objections were met?

Customer signature/title:
Date:
Customer comments:

CES signature:
CES comments:

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This page is optional. Please delete if not using:

Optional Sign-In Sheet

System:

Hospital:

Date: OA#: Site#:

Name (please print) ASRT# ARRT#

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© Koninklijke Philips N.V 2021
All rights are reserved. Reproduction or
transmission in whole or in part, in any form
or by any means electronic, mechanical or
otherwise, is prohibited without the prior
written consent of the copyright owner.
Dell is a U.S. registered trademark of Dell
Computer Corp.
Microsoft is a U.S. registered trademark of
Microsoft Corp.

459800820424_A*5/2021