Technical Reference Manual

5507106-1EN
Rev. 1

This manual supports the following products:

• Revolution™ Discovery™ CT 
with Revolution™ GSI and Revolution™ HD configurations
• Discovery™ CT750 HD

This product is certified as a LightSpeed™ Multislice CT Scanner.

The MHLW certified number is 21100BZY00104000

0459

Revolution™ Discovery™ CT
Technical Reference Manual, English
5507106-1EN
Revision: 1
© 2014 General Electric Company. All rights
reserved.
 Table of Contents
i Revision History . . . . . . . . . . . . . . . . . . . . . . . . . . . . .i-1
Revision History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . i-2

1 Before You Start . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2

User Information Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

Applications Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4

iLinq . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5

2 X-ray Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

Radiation Protection (Reference 21CFR 1020.30 (h)(1)(i)) . . . . . . . . . . . . . 2-2

3 Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

What Do I Need to Know About... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3

Warning Labels and Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4

Equipment Warning Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7

General Safety Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

Implantable Device Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-15

Recommendations Prior to Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-15

Recommendations After Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-15

Radiation Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

Authorized Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16

General Radiation Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17

Scans Acquired at the Same Tomographic Plane . . . . . . . . . . . . . . . . . . . 3-18

mA Mode Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-22

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-1

 Organ Dose Modulation (ODM) Mode Changes . . . . . . . . . . . . . . . . . . . . . 3-24

kV Mode Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-25

GSI Mode Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-27

CTDIvol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30

Pediatric and Small Patient Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-31

X-ray Tubes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-32

Electrical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-32

Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-34

General Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-34

Patient Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-36

VolumeShuttle™ (Axial) and Volume Helical Shuttle . . . . . . . . . . . . . . . . 3-42

Emergency Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-44

Cardiac Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-45

Laser Safety (Reference 21CFR 1040.10 (h)) . . . . . . . . . . . . . . . . . . . . . . . 3-48

Reconstructed Image Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-49

Data Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-51

Application Software Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-53

Application Specific Safety Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-53

Helical Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-53
Lung Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-54
Auto Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-54
SmartStep and SmartView Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-54
Table Float . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-56
SmartStep and SmartView Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-56
Interventional / Biopsy Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-57
Organ Dose Modulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-58
Dynamic Transition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-59
Image Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-60
Advanced Applications Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-60
Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-61
Segment Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-62
Filming and Saving Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-62
Image reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-62
Window Width and Level (W/L) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-63
Volume Rendering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-63
Image quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-63

TOC-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 Gemstone Spectral Imaging (GSI) Viewer . . . . . . . . . . . . . . . . . . . . . . . . . . 3-64
Image Reliability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-64
Image Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-65
Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-65
Film and save . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-66
Window Width and Window Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-66

Accuracy of Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-67

Measure Distance for Axial, Helical, and Cine Images . . . . . . . . . . . . . . 3-67
Measure Distance for Scout Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-67
Measure Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-68
ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-68
Reformat Plane Thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-68

Operator Console Ergonomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-69

Posture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-69

Equipment Adjustments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70

Chair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70
Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70
Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70
Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70
Other considerations: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-70

Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-71

GE Approved Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-72

IV Pole Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-73

Table Tray Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-74

Systems With Metal-Free Cradles and Accessories . . . . . . . . . . . . . . . . . 3-74

Xtream/Enhanced Xtream Injector Safety . . . . . . . . . . . . . . . . . . . . . . . . . 3-75

Limited Access Room Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-75

Emergency Devices and Emergency Egress . . . . . . . . . . . . . . . . . . . . . . . 3-76

Emergency Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-76
Emergency Stop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-76
Emergency Stop Button Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-78
System Emergency OFF Buttons using Main Disconnect Control . . . . . 3-78
Reset the Emergency OFF Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-78
Emergency Patient Care During X-ray ON: . . . . . . . . . . . . . . . . . . . . . . . 3-79
Emergency Egress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-79
To Safely Remove the Patient: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-80

Maintenance and Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-80

Cleaning Equipment (Bio Hazard) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-81

Environmental Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-81

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-3

 Name and Concentration of Hazardous Substances . . . . . . . . . . . . . . . . . 3-82
Explanation of Pollution Control Label . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-82

Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-84

4 Operator Documentation . . . . . . . . . . . . . . . . . . . . . 4-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

5 Tube Warmup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Tube Warmup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Perform Tube Warmup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5

6 Daily Fast Cal Procedure . . . . . . . . . . . . . . . . . . . . . 6-1

Fast Cal. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
Beam Quality Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
Fast Cal Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

7 Prepare the System . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2

8 Check Disk Space . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

Check Image Space . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

9 Reset the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

System Shutdown/Reset Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

10 Stop/Start the Operating System . . . . . . . . . . . . . . 10-1

Shutdown System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

If You Turn OFF the MDC at the End of the Scan Day: . . . . . . . . . . . . . . . 10-5

For Systems with UPS (Uninterrupted Power Supply) . . . . . . . . . . . . . . . 10-6

TOC-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 11 General Information . . . . . . . . . . . . . . . . . . . . . . . . 11-1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

System components: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

Emergency Stop: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

CT Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

CT Operation Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

X-ray Source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

CT Detector and DAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

Power Distribution Unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

Operator's Console . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

DICOM Print . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

X-ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

Tube Warmup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Beam Quality Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Theory of Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
System Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Performix HD X-ray Tube . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Gemstone Detector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Scaleable Data Acquisition Sub-System (Volara HD DAS) . . . . . . . . . . . 11-6

General Information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7

Patient Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
EMI/EMC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7

Network. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7
Purpose of Revolution Discovery CT Scanner Connection to Network . . 11-7
Network Interface Technical Specifications . . . . . . . . . . . . . . . . . . . . . . . 11-8
Network Information Flows Specifications . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Required Characteristics and Configuration for Network Support of 
Revolution Discovery CT Scanner Specifications . . . . . . . . . . . . . . . . . 11-11
Remote Host Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-11
Network Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-11
System Data and Control Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-14

X-ray Generation and Detection Details . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15
Gantry Coordinate System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-15

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-5

 Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-16

Collimator Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-17

Z-Axis Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-17

Dynamic Z-Axis Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-19

Automatic Exposure Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-20

How AEC Works . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-20
Adaptation to Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-20
When to Use AEC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-21
When NOT to Use AEC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-21
AEC Does Not Guarantee Reduction of Radiation Doses in 
All Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-21
Effect of AEC Control Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-22
AEC Considerations of Patient Size, Shape, Composition, and Age . . 11-22
Dynamic AEC Scanning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-22
How to tell if the dose has changed . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-22
Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-22

Scout Based Attenuation Characterization . . . . . . . . . . . . . . . . . . . . . . . 11-23

AutomA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-28
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-28
AutomA Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-30
AutomA FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-31

kV Assist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-34
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-34
Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-35
Image Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-38
kV Assist FAQs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-41

ECG-Modulated MA Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-44

Electrocardiograph Tube Current Modulation . . . . . . . . . . . . . . . . . . . . 11-44
ECG-modulated mA Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-44
Organ Dose Modulation (ODM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-45

System Operational Modes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-47

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-47
Scout (Reference YY0310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-47
Pediatric Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-47
Axial and Cine Scans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-48

VolumeShuttle (Axial) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-48

Helical Scans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-49

Image Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-49

Volume Helical Shuttle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-50

Cardiac Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-51

TOC-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 Gemstone Spectral Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-52

High Resolution Scanning Capability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-54

Adaptive Statistical Iterative Reconstruction (ASiR) . . . . . . . . . . . . . . . 11-57

Overlapped Recon (Axial) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-57

SmartView . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-58

Image Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-58

System Image Quality Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-59

Calibration Scans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-59

Tube Capacity and ISD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-59

Focal Spot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-60

Focal Spot Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-60

Focal Spot Selection Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-60

Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-61

Reconstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-61

Conjugate Cone-Beam Backprojection . . . . . . . . . . . . . . . . . . . . . . . . . . 11-62

Helical Scan Data Usage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-63

Calibration Scans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-63

Warmup Required . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-63

Data Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-63

Image Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-64

Gray Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-64

CT Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-65

Variables You Cannot Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-66

Pixels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-66

Pixel Coordinates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-66

RAS Coordinates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-68

Pixels and CT Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-70

Window Width . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-70

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-7

 Window Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-70

12 Quality Assurance . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2

QA Phantom (Reference 21CFR 1020.33(d)(1)) . . . . . . . . . . . . . . . . . . . . . 12-2

QA Schedule (Reference 21CFR 1020.33 (d)(2)) . . . . . . . . . . . . . . . . . . . . 12-4

System Performance (Reference 21CFR 1020.33 (d)(2)) . . . . . . . . . . . . . . 12-5

Maintain Image Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
Handling the QA Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
Position the QA Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6
Prescribe the QA Series for the Resolution, Low Contrast Detectability, 
and Noise and Uniformity Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6
Analyze the QA Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Contrast Scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8
High Contrast Spatial Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-9
MTF (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
Low Contrast Detectability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
Noise and Uniformity (Reference 21CFR 1020.33(j)) . . . . . . . . . . . 12-13
Prescribe the QA Series for the Slice Thickness Test - Phantom 
Section #1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-15
Slice Thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-17
Prescribe the QA Series for Alignment Light Accuracy - Phantom 
Section #1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-17
Alignment Light Accuracy (Reference 21CFR 1020.33(g)(2)). . . . . 12-20
Typical Results and Allowable Variations. . . . . . . . . . . . . . . . . . . . . . . . 12-20
Contrast Scale. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-20
High Contrast Spatial Resolution . . . . . . . . . . . . . . . . . . . . . . . . . . 12-20
Axial Scan Slice Thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-20
Noise & CT Number of Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-21
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-21
Low Contrast Detectability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-21
QA Master Data Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-22
QA Phantom - Representative Images (Reference 21CFR 
1020.33 (d)(3)(i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-23
Digital Representative Images (Reference 1020.33 (d)(3)(ii)) . . . . . . . . 12-23
Gemstone Spectral Imaging (GSI) Quality Assurance - Optional. . . . . . 12-27
QA Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-27
Position the QA Phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-27
Prescribe the GSI QA Series for the CT Number Accuracy and 
Noise and Uniformity Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-27
Analyze the GSI QA Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-28
GSI QA Data Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-29
QA Phantom - Representative Image for GSI QA. . . . . . . . . . . . . . 12-29

Dosimetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-29
General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-29
CTDIw (Reference IEC 60601-2-44 and 21 CFR 1020.33 (c)) . . . . . . . 12-31
Measuring Method for CTDI100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-35
CTDIvol (Reference IEC 60601-2-44) . . . . . . . . . . . . . . . . . . . . . . . . . . 12-43

TOC-8 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 CTDI Dose Calculations (Reference 21CFR 1020.33 (c)(2)) . . . . . . . . 12-47
Scanning Mode Specific Dosimetry Information. . . . . . . . . . . . . . . . . . . 12-47
Volume Helical Shuttle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-47
Peak Skin Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-48
Other Dosimetry Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-50
Dose Length Product (DLP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-50
Max Z Location CTDIvol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-50
Dose Efficiency (Reference IEC 60601-2-44) . . . . . . . . . . . . . . . . . 12-51
Dose Profile (Reference IEC 60601-2-44, IEC 60601-2-44: 2002 
clause 29.1.103.1/2 and 2009 clause 203.110/111 and 
21CFR 1020.33 (c)(2)(iv) and (c)(3)(iv)) . . . . . . . . . . . . . . . . . . . . . 12-51
Dose Deterministic Effects (IEC 60601-2-44:2009 
Clause 203.5.2.4.5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-55
Scout Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-56
Phantoms for Performance Testing (Reference 21CFR 
1020.33(c)(3)(v)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-56
Noise (Reference 21CFR 1020.33 (c)(3)(i)) . . . . . . . . . . . . . . . . . . . . . 12-56
Nominal Slice Thickness and Sensitivity Profile (Reference 21CFR 
1020.33 (c)(3)(iii) and (c)(3)(iv)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-58
Modulation Transfer Function (MTF) (Reference 
21CFR 1020.33 (c)(3)(ii)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-61
Maximum Deviation (Reference IEC 60601-2-44 and 
21CFR 1020.33 (c)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-61
Typical Dose (Reference IEC 60601-2-44 and 
21CFR 1020.33 (c)(2)(v)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-62
Dose Profile (Reference 21CFR 1020.33 (c)(2)(v)). . . . . . . . . . . . . 12-62
Performance (Reference 21CFR 1020.33 (c)(3)(v)) . . . . . . . . . . . . 12-62
Frequency of Constancy Tests (Refer to Section 4.7 
of IEC 61223-2-6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-62
Stray Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-63
Radiation Field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-64

13 Performix™ HD X-ray Tube Specifications . . . . . . 13-1

X-ray Tube Model Numbers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2

Beam Limiting Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2

Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2

Non-Operating Environment (Reference IEC 60601-1 and IEC 
60601-2-28) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2
Operating Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2

X-ray Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3

Leakage Technique Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3
Quality Equivalent Filtration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3
(Reference IEC 60601-1-3 and 21CFR 1020.30(h)(2)(i) and 
21CFR 1020.30(h)(4)(i)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-3
Half Value Layer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-4
CT Scan Ratings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-4
Performix HD X-ray Tube Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5
Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5
Marking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-5

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-9

 Reference Axis for Target Angle and Focal Track . . . . . . . . . . . . . . . . . . 13-6
Focal Spot Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-6
High Voltage (HV) Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-7
Nominal Tube Voltage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-8
Maximum High Voltage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-8
Envelope Voltage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-9
Principal Dimensions (with mounting bracket) . . . . . . . . . . . . . . . . . . . . . 13-9
Construction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-9
Performix HD X-ray Tube Assembly Heating and Cooling Curves . . . . . 13-9
Thermal characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-10
Heat Storage Capacity and Continuous Dissipation (Reference YY310 
and IEC 60613) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-10
Maximum Continuous Dissipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-10
Nominal Continuous Input Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-11
Pressure and Thermal Management . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-11
Beam Limiting Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-11

Performix HD X-ray Tube Insert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12

Target Material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Nominal Anode Input Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Nominal CT Anode Input Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Nominal CT Scan Power Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Maximum Anode Heat Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Focal Spots . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Small Focal Spot: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Large Focal Spot: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
GSI Focal Spot: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Zero Bias Focal Spot: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Reference Axis: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Target Angle with Respect to Reference Axis . . . . . . . . . . . . . . . . . . . . 13-13
Anode Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Minimum Inherent Filtration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Anode Heating and Cooling Curve . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-13
Single Load Rating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-14
Serial Load Rating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-16
Highest Constant Load at 4s (Reference IEC 60601-2-44) . . . . . . . . . . 13-16
Maximum Filament Current . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-16
Cathode Emission Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-17

14 Regulatory Information . . . . . . . . . . . . . . . . . . . . . . 14-1

Applicable Regulations and Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-2

Intended Use of the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-3

Indications for Use of the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14-3

TOC-10 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 15 Electromagnetic Compatibility . . . . . . . . . . . . . . . . 15-1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-2

General Scope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-3

Electromagnetic Emission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-3

Electromagnetic Immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-4

Limitations Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-7

Use Limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-7

External Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-7

Installation Requirements & Environment Control . . . . . . . . . . . . . . . . . . 15-7

Cable Shielding & Grounding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-7
This Product Complies with the Radiated Emission as per CISPR11 
Group1 Class A Standard Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-7
Subsystem & Accessories Power Supply Distribution . . . . . . . . . . . . . . . 15-7
Stacked Components & Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-8
Low Frequency Magnetic Field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-8
Static Magnetic Field Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-8
Electrostatic Discharge Environment & Recommendations . . . . . . . . . . 15-8

16 System Specifications . . . . . . . . . . . . . . . . . . . . . . 16-1

System Component Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-2

Component Rating Plates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-3

Purchasable Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-7

Purchasable Option Descriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-8

Helical High-Contrast Spatial Resolution . . . . . . . . . . . . . . . . . . . . . . . . . 16-10

3D MTF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-10
Axial High Contrast Spatial Resolution . . . . . . . . . . . . . . . . . . . . . . . . . 16-11
Helical Low-Contrast Detectability - Statistical (Reference YY310) . . . 16-12
Axial Low-Contrast Detectability - Statistical (Reference YY310) . . . . . 16-14
Helical Image Noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-15
Axial Image Noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-15
CT Number Linearity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-16
CT Number Uniformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-16
Dose Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-17

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-11

 Subsystem Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
Operator Console . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
Console . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
Host Computer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
PC Based System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
Image Processor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
Image Reconstruction Engine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-18
The Revolution Discovery CT Operator Console User Interface . . . . . . 16-19

Data Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19

64-Row Detector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19

Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19
Load Capacity (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-19
Maximum Cradle Travel (Reference YY310) . . . . . . . . . . . . . . . . . . . . . 16-20
Cradle Speeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-20
Scan Location Accuracy (Reference YY310 and 21CFR 1020.33 (i)) . . 16-20
Elevation Travel Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-20
Full Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-20
Elevation Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-20
Elevation Range (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . 16-20

Gantry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Tilt Limits (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Tilt Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Gantry Opening Diameter (Reference YY310) . . . . . . . . . . . . . . . . . . . 16-21
Isocenter to Tube Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Tube Focus to Detector Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Running Noise (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Rotational Speeds (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Scout Orientation (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Rotational Freedom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-21
Laser Alignment Lights (Reference 21CFR 1040.10 (h)) . . . . . . . . . . . . 16-22
Maximum Output Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Laser Alignment Light Accuracy (Reference YY310 and 
21CFR 1020.33 (g)(3)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Gantry LCD Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22

X-ray Tube: Performix™ HD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22

Heat Storage (Reference YY310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Focal Spots (Reference YY310). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Small Focal Spot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Large Focal Spot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
GSI Focal Spot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Anode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-22
Main Power Supply (Reference IEC 60601-2-44) . . . . . . . . . . . . . . . . . 16-23
Line Voltage (Reference 21CFR 1020.30 (h)(3)(i)) . . . . . . . . . . . . . 16-23
3-Phase 50/60 Hz ± 3Hz (Reference 21CFR 1020.30 (h)(3)(i)) . . . 16-23
Maximum 3-Phase Power Demand at Full Rated Output . . . . . . . . 16-23
Continuous 3-Phase Power Demand . . . . . . . . . . . . . . . . . . . . . . . 16-23
Maximum Line Current Demand (Reference 21CFR 
1020.30 (h)(3)(ii) and (h)(3)(iii)). . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-23

TOC-12 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 Generator Subsystem Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-23
Maximum Output Power (Reference IEC 60601-2-44) . . . . . . . . . . 16-23
kV Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-23
Maximum mA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-23
Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-23
Rise Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
Fall Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
Generator Duty Cycle (Reference 21CFR 1020.30 (h)(3)(v)) . . . . . . . . 16-24

kV, mA, Linearity, and Time Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24

Kilovolts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
kV Selections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
Basic kV Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
(Reference 21CFR 1020.30 (h)(3)(vi)) . . . . . . . . . . . . . . . . . . . . . . 16-24
(Reference YY0310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
kV Accuracy for GSI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-24
(21CFR 1020.30 (h)(3)(vi) and YY310) . . . . . . . . . . . . . . . . . . . . . . 16-24
kV Accuracy for GSI SnapShot Pulse / GSI Cardiac presets . . . . . . . . . 16-25
(21CFR 1020.30 (h)(3)(vi) and YY310) . . . . . . . . . . . . . . . . . . . . . . 16-25
Milliamperes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-25
Selections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-25
mA Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-25
(Reference 21CFR 1020.30 (h)(3)(vi)) . . . . . . . . . . . . . . . . . . . . . . 16-25
(Reference YY0310) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-25
mA Accuracy for GSI Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-25
mA Accuracy for Enhanced GSI Modes* . . . . . . . . . . . . . . . . . . . . 16-25
mA Accuracy for GSI SnapShot Pulse / GSI Cardiac Presets** . . . 16-25
Linearity of X-ray Output (Reference IEC 60601-2-44) . . . . . . . . . . 16-25
Exposure Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-26
X-ray Exposure Time Accuracy (Reference 21CFR 
1020.30 (h)(3)(vi) and YY310). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-26
Normal Axial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-26
Cine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-26
Helical (Continuous scans) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-26
Cardiac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
Volume Shuttle (Axial). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
SmartView/SmartStep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
Volume Helical Shuttle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
Scout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
Measuring Tool Variance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
kV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
mA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-27
Exposure Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28
Accuracy Subject to Following Conditions . . . . . . . . . . . . . . . . . . . . . . . 16-28
Line Voltages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28
Line Regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28
Transient Voltage Variations Caused by External Loads 
Must Not: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28

Measurement Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28

(Reference 21CFR 1020.30 (h)(3)(viii)) . . . . . . . . . . . . . . . . . . . . . . . . . 16-28
Kilovolts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-28
Milliamperes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-29
Exposure Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-29

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT TOC-13

 Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-29
System Cooling Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-30
Temperature and Humidity Specifications . . . . . . . . . . . . . . . . . . . . . . . 16-30
Ambient Temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-30
Scan Room (Recommended for Patient Comfort) . . . . . . . . . . . . . . . . . 16-30
Control Room (including Console/Computer) . . . . . . . . . . . . . . . . . . . . 16-30
Table and Gantry In Exam Room (when room is unoccupied) . . . . . . . 16-30
Equipment Room (if separate room to hold PDU) . . . . . . . . . . . . . . . . . 16-30
Rate of Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-30
Room Temperature Uniformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Media (disks/tapes) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Relative Humidity (All Areas) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Electromagnetic Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Pollution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Carpeting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-31
Lighting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-32
Patient Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-32
Control Room . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-32
Equipment Room. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-32
Altitude . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16-32

17 Planned Maintenance . . . . . . . . . . . . . . . . . . . . . . . 17-1

Planned Maintenance (Reference 21CFR 1020.30 (h)(1)(ii) and
IEC 60601-1 6.8.2)) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17-2

18 Product Manufacturer . . . . . . . . . . . . . . . . . . . . . . . 18-1

Product Manufacturer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-2

19 CT Acceptance Testing . . . . . . . . . . . . . . . . . . . . . . 19-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-2

Positioning of The Patient Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3

(Reference IEC 61223-3-5 Clause 5.1) . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3
Patient Positioning Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3
(Reference IEC 61223-3-5 Clause 5.2). . . . . . . . . . . . . . . . . . . . . . . 19-3
Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-3
Test Procedure for Internal/external Laser Light Accuracy . . . . . . . . 19-4
Test Procedure for Sagittal and Coronal Light Accuracy . . . . . . . . . 19-4
Data Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-4
Preview Image Accuracy Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-6
(Reference IEC 61223-3-5 Clause 5.2.1.3.3) . . . . . . . . . . . . . . . . . . 19-6
Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-6
Test Procedure for Preview Image Accuracy Test . . . . . . . . . . . . . . 19-6
Data Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-7
Tomographic Section Thickness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-9
(Reference IEC 61223-3-5 Clause 5.3). . . . . . . . . . . . . . . . . . . . . . . 19-9
Tomographic Section Thickness for Axial Scan . . . . . . . . . . . . . . . . 19-9

TOC-14 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 Dose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-15
(Reference IEC 61223-3-5 Clause 5.4 and IEC 60601-2-44: 2009 
Clause 203.6.3.2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-15
Scan Protocols and Dose Specifications for CTDIw . . . . . . . . . . . . 19-16
Scan Protocols and Dose Specifications for CTDIfree air. . . . . . . . 19-16
Noise, Mean CT Number and Uniformity . . . . . . . . . . . . . . . . . . . . . . . . 19-17
(Reference IEC 61223-3-5 Clause 5.5). . . . . . . . . . . . . . . . . . . . . . 19-17
Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-17
Test Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-18
Expected Results and Variations . . . . . . . . . . . . . . . . . . . . . . . . . . 19-18
Spatial Resolution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-18
(Reference IEC 61223-3-5 Clause 5.6). . . . . . . . . . . . . . . . . . . . . . 19-18
Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-19
Test Procedure and Data Evaluation . . . . . . . . . . . . . . . . . . . . . . . 19-19
Expected Results and Tolerance . . . . . . . . . . . . . . . . . . . . . . . . . . 19-20
Low Contrast Resolution (or low contrast detectability (LCD)) . . . . . . . . 19-21
(Reference IEC 61223-3-5 Clause Optional) . . . . . . . . . . . . . . . . . 19-21
Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19-21
Test Procedure and Data Evaluation Using Catphan® 600 . . . . . . 19-21
Test Procedure and Data Evaluation Using GE QA Phantom . . . . 19-23
Expected Results and Variations . . . . . . . . . . . . . . . . . . . . . . . . . . 19-24

20 Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-1
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20-2

A Dose Information Reference . . . . . . . . . . . . . . . . . . . A-1

Dose Information References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2

B Reference Noise Index . . . . . . . . . . . . . . . . . . . . . . . B-1

Reference Noise Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

Index

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 
Chapter i
Revision History

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT i-1

Revision History

Revision History

Revision Date Reason For Change

1 May 2014 Release for HD3.0 - 14MW24.xx.

i-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 1
Before You Start

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Before You Start

Introduction
Anyone who operates this system should have received prior training before they attempt to scan
or diagnose patients. This training should include medical and X-ray education, in addition to GE
applications training. This guide does not provide medical explanations, but it does suggest
potential applications for some of the software features. It describes potential Safety problems,
and how to avoid them.

Everyone who uses this equipment must read and understand all instructions, precautions and
warnings. This manual should be kept near the equipment. Procedures and safety precautions
should be viewed periodically.

This manual is originally written in English.

This Guide addresses three safety classifications:

DANGER The most severe label describes conditions or actions which result in a specific
hazard. You will cause severe or fatal personal injury, or substantial property
damage, if you ignore these instructions.

WARNING This label identifies conditions or actions for which result in a specific hazard.
You may cause severe personal injury, or substantial property damage, if you
ignore these instructions.

CAUTION This label applies to conditions or actions that have potential hazard. You can
cause minor injury or property damage if you ignore these instructions.

This Manual uses pictures, or icons, to reinforce the printed message. It uses the corresponding
international symbol or icon next to the danger, warning or caution message. For example, the
upright hand with the lightning bolt across it warns of electrical hazards.

Federal law restricts this device to sale by or on the order of a physician.

Do not use the equipment if a known safety problem exists. Call your local service provider
and have the system repaired.

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Before You Start

User Information Description

We have divided the current User Information into three parts:·

User Manual: The User Manual contains all the user information required to operate the scanner
in a safe and proper manner. The User Manual can be displayed on Display monitor by clicking on
the Learning Solutions icon in the desktop control area.

The User Manual can be viewed on a PC with Adobe Reader® version 6 or higher.

Technical Reference Manual: This manual details safety information and specification of the
system and includes power off and on procedures.

Application Tips and Workarounds: This manual details workaround information for software
and system information.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 1-3

Before You Start

Applications Help
Although we try to make this guide complete and accurate, undocumented changes or unexpected
results do occur.

If you can't find the answer to your application question, you may call the Customer Center. Use
this phone number for non emergency purposes only, because you may not receive an immediate
response.

1. Dial 1-800-682-5327.

2. Select 1 for Applications Answer line.

3. Select 3 for CT Application assistance.

If your system fails, or you have an emergency, call GE Cares at 1-800-437-1171.

CAUTION This system was designed for use by individuals trained in CT system
operation. Study the Safety Tab of this Manual before you scan the first patient.
Use the Index to find the section and page number of an item of interest.
Periodically review the User Manual and the Technical Reference Manual.

CAUTION There are no user-serviceable parts on the system. In order to obtain training or
technical information on the system, please contact GE Service.

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Before You Start

iLinq
If your system has broadband connectivity to GE and a contract, you can click [iLinq] to receive
help.

iLinq delivers tools to the console that help address the challenge of keeping you up to date and
improving productivity.

 The Contact GE feature puts technologists in touch with GE's technical experts at the Online
Center for a fast response to maintenance and application questions. These calls receive top
priority.
 Request GE service without picking up the phone.
 Auto-sends key status info to speed up the resolution process.
 Fastest response time available from GE.
Figure 1-1 Contact GE Window

 The Messages feature provides a record of previous Contact GE requests and resolution
searches, and other valuable information that GE has sent.
 Keep track of your Contact GE service history.
 Reference past questions for quicker answers.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 1-5

Before You Start

Figure 1-2 Message Window

Please keep User Information readily available.

Send your comments to:

GE

CT Application (W1120)

3000 N. Grandview Blvd.

Waukesha, WI 53188

U.S.A.

1-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 2
X-ray Protection

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 2-1

X-ray Protection

Radiation Protection (Reference 21CFR 1020.30

(h)(1)(i))

CAUTION Improperly used X-ray equipment may cause injury. Read and understand the
instructions in this book before you attempt to operate this equipment. The
General Electric Company will gladly assist and cooperate in placing this
equipment into use.

Although this equipment incorporates a high degree of protection against X-ray outside the useful
beam, no practical design can provide complete protection. Nor can any practical design compel a
user to take adequate precautions to prevent the possibility of any person carelessly, unwisely, or
unknowingly exposing themselves or others to radiation.

Everyone having anything to do with X-ray must receive proper training and become fully
acquainted with the recommendations of the National Council on Radiation Protection and
Measurements, and the International Commission on Radiation Protection.

NCRP reports are available from:

NCRP Publications

7910 Woodmont Avenue

Room 1016

Bethesda, Maryland 20814

CAUTION Everyone having anything to do with X-ray must take adequate steps to ensure
protection against injury.

All persons authorized to use the equipment must understand the dangers posed by excessive X-
ray exposure. We sell the equipment with the understanding that the General Electric Company, its
agents and representatives have no responsibility for injury or damage which may result from
exposure to X-ray.

GE urges you to use protective materials and devices.

2-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 3
Safety

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Safety

Introduction
This chapter provides information about safety precautions and procedures. It is important for you
to read and understand the contents of this chapter so the correct precautions and procedures are
followed.

This manual should be kept near the console for easy access.

CAUTION This system was designed for use by individuals trained in CT system
operation. Study the Safety Chapter of this Manual before you scan the first
patient. Use the Index to find the section and page number of an item of interest.
Periodically review the User Manual, Applications Tips and Workarounds, and
the Technical Reference Manual.

If necessary, additional training is available from a GE Applications Specialist. Contact your

institution’s GE sales representative for additional information about further safety and operational
training.

WARNING Modification of any existing patient data on the system must follow the
guidelines specified in the User Manual.

Watch for electromagnetic compatibility from other hardware. Detailed information concerning
Electromagnetic Compatibility can be found in the Technical Reference Manual.

United States Federal Regulation 21CFR 801.109

CAUTION Federal law restricts this device to sale by or on the order of a physician.

CAUTION Improper system usage could void your warranty. More importantly, you could
endanger your patients and yourself if you don't follow the correct procedures.

3-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

What Do I Need to Know About...

The User Manual and Technical Reference Manual include information required for the safe and
proper use of the equipment. This chapter summarizes the most important safety issues. Some of
the concepts you need to understand:

 Warning Labels and Symbols on page 3-4

 General Safety Guidelines on page 3-13
 Radiation Safety on page 3-16
 Electrical Safety on page 3-32
 General Mechanical Safety on page 3-34
 VolumeShuttle™ (Axial) and Volume Helical Shuttle on page 3-42
 Emergency Patient on page 3-44
 Cardiac Safety on page 3-45
 Laser Safety (Reference 21CFR 1040.10 (h)) on page 3-48
 Reconstructed Image Orientation on page 3-49
 Data Safety on page 3-51
 Application Software Safety on page 3-53
 Application Specific Safety Topics on page 3-53
 Gemstone Spectral Imaging (GSI) Viewer on page 3-64
 Accuracy of Measurements on page 3-67
 Operator Console Ergonomics on page 3-69
 Accessories on page 3-71
 Emergency Devices and Emergency Egress on page 3-76
 Maintenance and Cleaning on page 3-80
 Cleaning Equipment (Bio Hazard) on page 3-81
 Environmental Concerns on page 3-81
 Name and Concentration of Hazardous Substances on page 3-82

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 3-3

Safety

Warning Labels and Symbols

This chapter addresses three safety classifications:

DANGER The most severe label describes conditions or actions which result in a specific
hazard. You will cause severe or fatal personal injury, or substantial property
damage if you ignore these instructions.

WARNING This label identifies conditions or actions which result in a specific hazard. You
will cause severe personal injury, or substantial property damage if you ignore
these instructions.

CAUTION This label applies to conditions or actions that have potential hazard. You may
cause minor injury or property damage if you ignore these instructions.

This chapter uses the international symbol or icon along with the danger, warning or caution
message.

Table 3-1 Symbols used in Labeling

Symbol Description
Alternating current

Protective earthing point

ON / Power ON

OFF / Power OFF

Input Power

3-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

Symbol Description
Output Power

Type B Applied Part

Functional Earth Ground

Caution, consult accompanying documents

General Warning symbol

Electrical Shock Hazard

Table 3-2 Symbols used in Labeling

Symbol Description
Made for Indicates the Manufacturer (responsible design owner)
by (Made by) Indicates the Manufacturing Location
Refer to instruction manual/booklet

Pushing prohibited

Manufacturer (responsible design owner)

Model Number

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Safety

Symbol Description
Serial Number

Date of Manufacture

X-Ray Filtration (Al Equivalent Filtration)

Minimum Filtration

Radiation of Laser Apparatus

GSI Focal Spot

Large Focal Spot

Small Focal Spot

3-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

Equipment Warning Labels

The following Warning Labels are used on the equipment:

Figure 3-1 Warning labels located at the bottom of the gantry cover (Reference 21CFR 1040.10
(h))

CAUTION LASER RADIATION

DO NOT STARE INTO BEAM

CLASS 2 LASER PRODUCT

Figure 3-2 Labels on the front of the gantry (Reference 21CFR 1040.10 (h))

CAUTION LASER APERTURE

Do not stare into beam

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 3-7

Safety

Figure 3-3 Warning labels located on the table

CAUTION Finger pinching can cause physical injury.

To prevent pinching of fingers, keep fingers away from this area before
operating the switch for Elevation Down and IMS IN.

Figure 3-4 Warning labels located on the table

CAUTION Finger Pinching Can Cause physical injury.

To Prevent pinching of fingers, keep fingers away from this area before
operating the switch for cradle OUT.

3-8 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

Figure 3-5 Label on the side of the table

CAUTION Do not grasp the side of the cradle.

Figure 3-6 Label located on the operators console for systems manufactured after June 10, 2006
(Reference 21CFR 1020.30 (j))

WARNING This X-ray unit may be dangerous to patient and operator unless safe exposure
factors, operating instructions and maintenance schedules are observed. To be
used by authorized personnel only.

The following Warning Labels are on the equipment if the equipment is in compliance with
IEC60601-1:2005.

Figure 3-7 Warning label on lower left side and lower right of front and rear covers of gantry

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 3-9

Safety

CAUTION PINCH POINT. Keep hands clear when tilting.

WARNING Do not place your hands inside the gantry opening when tilting the gantry. The
gantry can pinch or crush your hands.

Figure 3-8 Warning label on gantry front cover, table, operator console and PDU

CAUTION AVOID INJURY. Read and understand information in manuals before operating
product.

Figure 3-9 Warning label located on PDU

CAUTION PDU CAN MOVE AND DAMAGE CABLES. Do not lean on or move when
connected to power.

3-10 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

Figure 3-10 Warning label on the table

CAUTION AVOID INJURY. Do not exceed table maximum capacity of 227 kg (500 lb).

WARNING Do not exceed table maximum capacity of 227 kg (500 pounds). This could
cause the table to fail and the patient could fall.

Figure 3-11 Warning label on the table

CAUTION AVOID INJURY. Do not exceed table maximum capacity of 306 kg (675 lb).

WARNING Do not exceed table maximum capacity of 306 kg (675 pounds). This could
cause the table to fail and the patient could fall.

Figure 3-12 Load Limit Caution

CAUTION Excessive weight can break accessory and cause injury. Do not load more than
34 kg or 75 pounds.

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Safety

Figure 3-13 Accessory Caution

CAUTION Do not hit the accessory against the gantry. Patient injury or equipment damage
could result.

Figure 3-14 IV Pole Load Limit Caution

CAUTION Do not load more than 4,5 kg or 10 pounds. Verify that extension collar is
securely tightened before use.

Figure 3-15 Tray Load Limits Caution

CAUTION Do not load more than 9 kg or 20 pounds.

Figure 3-16 Accessory Load Limit Caution

CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that
accessory is latched to underside of cradle.

3-12 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

General Safety Guidelines

 This product was designed and manufactured to ensure maximum safety of operation. It
should be operated and maintained in strict compliance with the safety precautions, warnings
and operating instructions contained herein, and in any other documentation specific to the
product.
 The system has been designed to meet all the safety requirements applicable to medical
equipment. However, anyone attempting to operate the system must be fully aware of
potential safety hazards.
 The manufacturer or vendor of the equipment makes no representation, however, that the act
of reading this manual renders the reader qualified to operate, test or calibrate the system.
 The owner should make certain that only properly trained, fully qualified personnel are
authorized to operate the equipment. A list of authorized operators should be maintained.
 This manual should be kept at hand, studied carefully and reviewed periodically by the
authorized operators.
 Unauthorized personnel should not be allowed access to the system.
 Do not leave the patient unobserved at any time.
 Always assist the patient on and off the table to avoid potential injury.
 Become familiar with the functional hardware so that you can recognize serious problems. Do
not use the system if it appears damaged or fails. Wait for qualified personnel to correct the
problem.
 Abbreviations used in the operator manuals can be found in this manual.
 If the product does not operate properly or if it fails to respond to the controls as described in
this manual, the operator should:
 First ensure the safety of the patient.
 Next ensure the protection of the equipment.
 Evacuate the area as quickly as possible in any potentially unsafe situation.
 Follow the safety precautions and procedures as specified in this manual.
 Immediately contact the local service office, report the incident and await further
instructions.
 The images and calculations provided by this system are intended as tools for the competent
user. They are explicitly not to be regarded as a sole incontrovertible basis for clinical
diagnosis. Users are encouraged to study the literature and reach their own professional
conclusions regarding the clinical utility of the system.
 Understand the product specifications, system accuracy, and stability limitations. These
limitations must be considered before making any decision based on quantitative values. In
case of doubt, please consult your sales representative.
 Do not block the ventilation ports of the electronic equipment. Always maintain at least 6
inches (15 cm) clearance around the ventilation ports to prevent overheating and damage to
the electronic hardware.

CAUTION Prior to powering on the system, the room environmental operating conditions
found in the System Specification chapter must be maintained for at least 24
hours. These conditions must be constantly maintained when the system is
energized and/or in use.

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Safety

CAUTION Do not load any non-GE approved software onto the computer.

DANGER Make sure all covers are in place before you use the equipment. The covers
protect you and your patient from moving parts or electrical shock. The covers
also protect the equipment.

NOTE Only qualified Service personnel should service the system with the covers off.

DANGER Information on internal gantry components is provided for user education. The
gantry contains dangerous voltages and moving parts. TO PREVENT
ELECTRICAL SHOCK OR CRUSHING INJURIES, DO NOT REMOVE COVERS OR
ENTER THE GANTRY. ONLY TRAINED, QUALIFIED SERVICE PERSONEL MAY
REMOVE GANTRY OR OTHER EQUIPMENT COVERS.

WARNING This system is intended for use by healthcare professionals only. This system
may cause radio interference or may disrupt the operation of nearby equipment.
It may be necessary to take mitigation measures, such as reorienting or
relocating the system or shielding the location.

WARNING Imaging functions may be lost without warning. Emergency procedures should
be developed to prepare for such an occurrence.

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Safety

Implantable Device Safety

WARNING CT Scans may cause interference with implanted or externally worn electronic
medical devices such as pacemakers, defibrillators, neurostimulators and drug
infusion pumps. The interference could cause operational changes or
malfunction of the electronic medical device.

Recommendations Prior to Scanning

 If practical, try to move external devices out of the scan range.
 Ask patients with neurostimulators to shut off the device temporarily while the scan is
performed.
 Minimize the X-ray exposure to the electronic medical device.
 Use the lowest possible X-ray tube current consistent with obtaining the required image
quality.
 Do not scan directly over the electronic device for more than a few seconds.
NOTE For procedures such as CT Perfusion or CT Interventional scans that require scanning
over the electronic medical device for more than a few seconds, attending staff should be
ready to take emergency measures to treat adverse reactions if they occur.

Recommendations After Scanning

 Have the patient turn the device back on if it had been turned off prior to scanning.
 Have the patient check the device for proper functioning, regardless of whether or it was
turned on or off.
 Advise patients to contact their healthcare provider as soon as possible if they suspect their
device is not functioning properly after a CT scan.
NOTE Recommendations from FDA Preliminary Public Health Notification: Possible Malfunction
of Electronic Medical Devices Caused by Computed Tomography (CT) Scanning date July
14, 2008.

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Safety

Radiation Safety
(Reference 21CFR 1020.30 (h)(1)(i))

WARNING Improperly used X-ray equipment may cause injury. Read and understand the
instructions in this book before you attempt to operate this equipment. If you
fail to follow safe X-ray practices or ignore the advice presented in the manual,
you and your patient risk exposure to hazardous radiation.

Authorized Users
This equipment incorporates a high degree of protection against X-ray radiation outside the useful
beam. But this equipment cannot substitute the essential requirement that every user must take
adequate precautions to prevent the possibility of any person carelessly, unwisely, or unknowingly
exposing themselves or others to radiation.

Everyone having anything to do with X-ray equipment must receive proper training and become
fully acquainted with the recommendations of the National Council on Radiation Protection and
Measurements and the International Commission on Radiation Protection.

NCRP reports are available from:

NCRP Publications
7910 Woodmont Avenue
Room 1016
Bethesda, Maryland 20814

WARNING Everyone having anything to do with X-ray equipment must take adequate steps
to ensure protection against injury.

All persons authorized to use the equipment must understand the dangers posed by X-ray
exposure so that they can prevent any injury or damage that may result from such exposure. GE
Medical Systems urges you to use protective materials and devices to prevent any injury or
damage from X-ray exposure.

3-16 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Safety

General Radiation Safety

WARNING Never scan a patient with unauthorized personnel in the scan room. Warn
visitors and patients about potential for harm if they fail to follow instructions.

WARNING Never calibrate, test the system, or warm the tube with patients or personnel
present in the scan room without adequate radiation safety precautions being
utilized.

 Stay behind a lead screen or lead glass shield during each X-ray exposure.
 Use technique factors prescribed by the radiologist or diagnostician. Use a dose that produces
the best diagnostic results with the least X-ray exposure.
 Amber indicator lights on the gantry display panel, and rear of the gantry, illuminate during X-
ray exposure.

WARNING Use of controls or adjustments, or performance of procedures other than those

specified herein, may result in hazardous radiation exposure.

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Safety

Scans Acquired at the Same Tomographic Plane

IEC standard 60601-2-44:2001 clause 29.1.105 and 60601-2-44:2009 clause 203.107 states that
you must be warned when scans are acquired at the same tomographic plane, i.e. same scan
location. The need for the warning is to make users aware of the potential dose that can be given
to the patient when acquiring scans at the same table location.

When acquiring scans in this mode:

 Utilize the dose information displayed on the ViewEdit screen. The dose information displayed
is covered in the next section, CTDIvol.
 An optional DICOM Structured Report (SR) Dose Report is saved in Series 997.
 Use proper techniques for the application and anatomy you are scanning.
A warning message (Figure 3-17) is posted when [Confirm] is selected for the following scan
types:

 SmartStep or SmartView
 SmartPrep Baseline and Monitor scans
 Cine scans
 Axial scans with zero table increment (interval)
 VolumeShuttle (Axial)
 Volume Helical Shuttle
Figure 3-17 Warning Message when scanning on the same tomographic plane: Axial,
Cine, Helical, SmartStep/SmartView, SmartPrep baseline, and SmartPrep monitor scans

WARNING This series contains one or more groups with multiple scans at the same
tomographic plane, i.e. same location.

Do you wish to continue?

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Safety

Figure 3-18 Warning message when scanning on the same tomographic plane for
SmartPrep with Organ Dose Modulation

WARNING This series contains one or more groups with multiple scans at the same
tomographic plane. i.e. same location.

Minimum diagnostic delay is x.x seconds +/- the time of the monitor scan.

ODM enabled. Diagnostic Delay may be increased up to x.x seconds.

Do you wish to continue?

CAUTION Prolonged exposure to X-ray in one spot may cause reddening or radiation
burns. Users must be aware of the techniques used and exposure time to
ensure safe operation.

A warning message is posted when the Geometric Efficiency in the Z-direction is less than 70%.
Geometric Efficiency is a measure of how much of the X-ray beam in the Z-direction is used by the
system.

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Safety

Figure 3-19 Warning message when dose efficiency is less than 70%

WARNING The following groups in this series contains GEOMETRIC EFFICIENCY IN THE Z
DIRECTION of less than 70%: Images 1-12,13-28.

NOTE Images 1-12, 13-28 is an example of a location where Geometric Efficiency in Z is less
than 70%.

Figure 3-20 Warning Message when scanning on the same tomographic plane: Volume Helical
Shuttle

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Safety

WARNING This series contains one or more groups with multiple scans at the same
tomographic plane, i.e. same location.

Temporal interval for some of the images exceeds 3.2 seconds. Use of this data
for processing of CT Perfusion maps may contain errors in the functional
information.

Since Volume Helical Shuttle Scan gives repeated scans over the same region,
careful attention should be made when scanning sensitive organs like the lens
of the eyes.

Do you wish to continue?

Figure 3-21 Warning Message when scanning on the same tomographic plane: VolumeShuttle
(Axial)

WARNING This series contains one or more groups with multiple scans at the same
tomographic plane, i.e. same location.

Temporal interval for some of the images exceeds 3.2 seconds. Use of this data
for processing of CT Perfusion maps may contain errors in the functional
information.

Do you wish to continue?

After reading the message, if you wish to continue with the scan, click [Continue].

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mA Mode Changes
Figure 3-22 Attention Message when mA Mode is changed: Manual mA to AutomA

CAUTION An automatic exposure control mode has been enabled. Verify the Noise Index,
Min mA/Max mA values and resultant CTDIvol and DLP meet the clinical goal for
the acquisition and follow the radiation exposure guidelines for your
department.

Figure 3-23 Attention Message when mA Mode is changed: AutomA to Manual mA

CAUTION Manual mA mode has been enabled. Verify the prescribe mA and resultant
CTDIvol and DLP meet the clinical goal and follow the radiation exposure
guidelines for your department.

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Figure 3-24 Attention Message when mA Mode is changed: Manual mA to ECG

Modulation

CAUTION ECG Modulation has been enabled. Verify the Min mA and Max mA values,
phase range and resultant CTDIvol and DLP meet the clinical goal for the
acquisition and follow the radiation exposure guidelines for your department.

Figure 3-25 Attention Message when mA Mode is changed: ECG Modulation to Manual
mA

CAUTION ECG Modulation has been disabled. Verify the Manual mA and resultant CTDIvol
and DLP meet the clinical goal for the acquisition and follow the radiation
exposure guidelines for your department.

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Organ Dose Modulation (ODM) Mode Changes

Figure 3-26 Attention Message when mA mode is changed: Organ Dose Modulation is
enabled

CAUTION ODM has been enabled. Verify the Noise Index, Min mA/Max mA, and ODM range
and the resultant CTDIvol and DLP meet the clinical goal for the acquisition and
follow the radiation exposure guidelines for your department.

Figure 3-27 Attention Message when mA mode is changed: Organ Dose Modulation is
disabled

CAUTION ODM has been disabled. Verify, 1) Noise Index, Min mA/Max mA or 2) Manual mA
values and resultant CTDIvol and DLP meet the clinical goal of the acquisition
and the radiation exposure guidelines for your department.

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kV Mode Changes
Figure 3-28 Attention Message when kV Assist mode is enabled

CAUTION kV Assist mode has been enabled.

Verify,

1) kV, Noise Index, Min mA/Max mA, or

2) kV, Manual mA values

and resultant CTDIvol and DLP meet the clinical goal for the acquisition and
follow the radiation exposure guidelines for your department.

Figure 3-29 Attention Message when Manual kV mode is enabled

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Safety

CAUTION Manual kV mode has been enabled.

Verify,

1) kV, Noise Index, Min mA/Max mA, or

2) kV, Manual mA values

and resultant CTDIvol and DLP meet the clinical goal for the acquisition and
follow the radiation exposure guidelines for your department.

Figure 3-30 Attention Message when kV Mode is changed: kV Assist to Cardiac

CAUTION Manual kV mode has been enabled.

Verify,

1) kV, Min mA/Max mA, Phase Range or

2) kV, Manual mA values

and resultant CTDIvol and DLP meet the clinical goal for the acquisition and
follow the radiation exposure guidelines for your department.

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GSI Mode Changes

Figure 3-31 Attention Message when GSI mode is enabled

CAUTION GSI mode has been enabled. Verify the selected GSI Preset and resultant CTDIvol
and DLP meet the clinical goal for the acquisition and follow the radiation
exposure guidelines for your department.

Figure 3-32 Attention Message when GSI mode is disabled

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Safety

CAUTION GSI mode has been disabled.

Verify,

1) kV, rotation time, Noise Index, Min mA/Max mA, or

2) kV, rotation time, Manual mA values

and resultant CTDIvol and DLP meet the clinical goal for the acquisition and
radiation exposure guidelines for your department.

Figure 3-33 Attention Message when GSI Assist mode is enabled

CAUTION GSI Assist mode has been enabled. Verify the selected GSI Preset and resultant
CTDIvol and DLP meet the clinical goal for the acquisition and follow the
radiation exposure guidelines for your department.

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Figure 3-34 Attention Message when both GSI and GSI Assist mode are enabled

CAUTION GSI mode has been enabled.

GSI Assist mode has been enabled.

Verify the selected GSI Preset and resultant CTDIvol and DLP meet the clinical
goal for the acquisition and follow the radiation exposure guidelines for your
department.

Figure 3-35 Attention Message when Manual GSI Preset selection mode is enabled

CAUTION Manual GSI Preset selection mode has been enabled. Verify the selected GSI
Preset and resultant CTDIvol and DLP meet the clinical goal for the acquisition
and follow the radiation exposure guidelines for your department.

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Safety

Figure 3-36 Scan parameter update after Confirm

CAUTION Scan parameters have changed since settings were confirmed.

Please verify scan parameter settings on View Edit screen.
Press Confirm to proceed with scanning.

CTDIvol
As you setup the scan parameters from the ViewEdit screen, the Dose Information area at the
upper right of the scan monitor contains updated dose information. This dose information is based
on a measurement of the CTDI or CT Dose Index, which is the current standard for CT dosimetry
and performance. By using a measurement called CTDIvol, a single value is provided to estimate
the relative dose for an exam.

The CTDIvol is a weighted average measurement in a reference phantom. This dose is expressed
in milliGrays. For additional information on specific CTDIvol doses and their calculations, refer to
your Technical Reference manual.

The DLP or Dose Length Product is the product of the CTDIvol and the scan length for a group of
scans. This number can be summed over the entire exam to give an estimate of the total dose.
The value is expressed in milliGray centimeters.

The Projected Series DLP shows the DLP that would result from scanning the current group or
groups.

The Accumulated Exam DLP displays the total exam DLP up to the current point in time. Scout
dose is not included in the DLP totals since standards for reporting scout dose are not yet defined.
Scout dose is generally a very small part of the exam.

The dose information updates when technique values such as kV, mA, scan time, slice thickness,
and scan field of view are changed.

Dose information is saved as a screen save image in Series 999 upon selecting End Exam. Series
997 contains the DICOM Dose Structured Report.

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Pediatric and Small Patient Imaging

Adult techniques and protocols should not be used on pediatric patients (under 2 years of age).
The National Cancer Institute and The Society for Pediatric Radiology developed a brochure, http:/
/www.cancer.gov/cancertopics/causes/radiation-risks-pediatric-CT and the FDA issued a Public
Health Notification, Reducing Radiation Risk from Computed Tomography for Pediatric and Small
Adult Patients, that discuss the value of CT and the importance of minimizing the radiation dose,
especially in children. More information can also be obtained at http://www.fda.gov/Radiation-
EmittingProducts/default.htm.

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X-ray Tubes
The system uses cooling and reconstruction algorithms specifically designed for GE X-ray tubes.

You risk three dangers when you do not use GE X-ray tubes.

 A non-GE tube could cause destructive component failure if the cooling delays do not meet its
design requirements.
 The images could exhibit reduced performance or artifacts if your X-ray tube fails to conform
with GE tube performance specifications.
 Radiation leakage may exceed GE specifications when a non-GE X-ray tube is installed in the
system.

CAUTION We cannot guarantee performance or safety if you use a non-GE X-ray tube
because the cooling and reconstruction algorithms depend upon the tube
design. Radiation leakage may exceed GE specifications when a non-GE X-ray
tube is installed in the system.

Electrical Safety

DANGER ELECTRICAL SHOCK HAZARD. Avoid all contact with any electrical conductor.
Do not remove or open system covers or plugs. Internal circuits use high voltage
capable of causing serious injury.

To guarantee safe, reliable equipment performance, prepare the site according

to GE Medical Systems requirements. This includes making sure the equipment
is connected to a power supply main with a protective earth. If you have any
questions about these requirements, contact GE Medical Systems.

An electrical hazard may exist if any light, monitor, or visual indicator stays on
after the system is shut down. To prevent possible injury, turn off the main power
supply wall switch, and contact your service office immediately.

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DANGER NO USER SERVICEABLE PARTS. Refer service to qualified service personnel.

Only allow people who know the proper procedures, and use of the proper tools,
to install, adjust, repair, or modify the equipment.

To guarantee safe, reliable equipment performance, prepare the site according

to GE Medical Systems requirements. If you have any questions about these
requirements, contact GE Medical Systems.

Fuses blown within 36 hours of being replaced may indicate malfunctioning

electrical circuits within the system. Have the system checked by qualified
service personnel, and do not attempt to replace any fuse.

DANGER ELECTRICAL FIRE. Conductive fluids that seep into the active circuit
components of the system may cause short circuits that can result in electrical
fires. Therefore, do not place any liquid or food on any part of the system.

To avoid electrical shocks or burns caused by the use of the wrong type of fire
extinguisher, make sure that only fire extinguishers approved for use on
electrical fires are used.

CAUTION Surplus lengths of power cords or other cables from mobile accessory units
that may be used during patient scanning should be stored in safe and isolated
areas. For example: Excess cable may be wound in a figure eight and stored at
the base of the stationary equipment. This minimizes signal interference and
protects cables from damage due to traffic.

CAUTION The accessory receptacles located on the gantry are not for general use. Verify
that accessory requirements do not exceed 3.0 A (~120 VAC) per receptacle.

CAUTION The accessory receptacles located on the operator console are not for general
use. The combined power consumption of the accessories should not exceed
960 watts.

CAUTION Included power cord is only to be used when connecting GE approved

accessories to the gantry or operator console.

A CT System combined with GE approved accessories complies with the IEC60601-1 standards
related to safety and performance of medical electrical systems. Refer to the standard for more
information.

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Safety

 Do not connect electric devices to the CT System that are not approved by GE. It may create
increased electrical leakage current and there is possibility of electric shock.
 The GE console monitors, modem, video amp, MOD, and media tower are intended to be
powered by the CT System using cables provided. Do not connect these devices to power
sources other than the CT system (for example, wall outlets, or other electrical equipment). It
may create increased electrical leakage current and there is possibility of electric shock.
 Note that some powered equipment may only be connected by a signal cable to GE
equipment (for example, a network hub). A separation device is required for equipment that is
powered by a different power source.

Mechanical Safety
General Mechanical Safety
 Check for any obstruction around the equipment before attempting to move the table and
gantry. When performing table or gantry motions, always monitor the progress of the motion.
 Be especially careful when tilting the gantry or when moving the table with the cradle or head
holder in place, to avoid driving these accessories into the gantry covers.
 The (Cradle Unlatch Indicator) is illuminated in green when the cradle is unlocked. An
unlocked cradle could potentially move unexpectedly.
The (Interference) light illuminates when the cradle has reached a travel limit or
encountered interference.
 If the table reaches one of the limits while you are actively pressing the controls, the
limit light will turn off when the controls are released.
 Clear an interference by changing the gantry tilt, moving the cradle, or adjusting the table
height.

WARNING Do not use the table base as a foot rest. You could entrap and injure your foot
while lowering the table. Do not place your hands between the table base and
the table side panels.

WARNING Be sure that the gantry will not touch the patient during Remote Tilt operation.
Pinching or crushing may happen if the gantry touches the patient.

 Avoid any patient contact with the gantry during tilt or cradle movement (manually or software
driven).

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Figure 3-37 System label on all four corners of gantry

CAUTION Pinch Point. Keeps hands clear when tilting.

WARNING Do not place your hands inside the gantry opening when tilting the gantry. The
gantry can pinch or crush your hands!

Figure 3-38 Gantry strap locations

CAUTION Gantry straps should only be used for Cardiac Monitor, SmartView/SmartStep
cables. Placing injector lines through the gantry straps could cause interference
issue and patient harm.

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Safety

CAUTION Gantry straps are designed to hold cables for accessories. Do not use for lifting
or support.

CAUTION Do not attach accessories to the cradle that are damaged or broken such as the
table extender, head holder, and patient positioning straps.

CAUTION Ensure that all cables attached to the gantry or hung in the gantry strap do not
present a trip hazard or loop, which could be caught when moving past the
cables.

Patient Positioning

CAUTION Improper centering of patient when using AutomA/SmartmA can lead to higher
or lower dose than expected.

CAUTION AutomA, kV Assist, GSI Assist and SnapShot Assist all use attenuation
information from the scout to set scan parameters. Poor patient centering will
impact the results in these scanning modes.

CAUTION Keep the patient in view at all times.

 Never leave the patient unattended.

CAUTION If the head is poorly positioned in the head holder and a gantry tilt is used,
images with different CT numbers and intensities may be seen at the edges of
two rotational interfaces. Make sure the patient is properly positioned in the
head holder, and not positioned so that the head is at the junction of the head
holder attachment to the cradle. If a repeat scan is needed, make sure the
locations with different intensities are in the middle of the beam collimation. Do
not repeat using exactly the same prescription.

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Figure 3-39 Warning label located on table

CAUTION Avoid Injury. Do not exceed table maximum capacity of 227 kg (500 lb).

WARNING Do not exceed table maximum capacity of 227kg (500 pounds). This could cause
the table to fail and the patient could fall.

Figure 3-40 Warning label located on heavy patient table

CAUTION Avoid Injury. Do not exceed table maximum capacity of 306 kg (675 lb).

WARNING Do not exceed table maximum capacity of 306kg (675 pounds). This could cause
the table to fail and the patient could fall.

 The concentrated weight of short, heavy patients can cause the cradle to make contact with
the gantry.
 Make sure you do not drive the cradle into the gantry cover.
 Make sure you do not pinch the patient's skin or extremities between the cradle and the
gantry.

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Safety

CAUTION When using the external laser alignment light for patient positioning purposes,
be aware that the patient's elevation may be slightly lower with the cradle
extended than with the cradle fully retracted. This is because the cradle may
bend slightly under a patient's weight. This difference should be taken into
consideration for applications where patient position information is critical,
such as Treatment Planning. To minimize these effects, after using the external
laser alignment system to position the patient, advance the patient to the CT
scan plane. Turn on the CT alignment lights to determine if they line up with the
markers on the patient. If necessary, compensate for the bend in the cradle by
elevating the table. When the CT alignment lights line up with the markers, set
the landmark for the scan using the Internal laser alignment light.

Please refer to the X-Y Table Accuracy for Flat Table Top in the User Manual to assess the X-Y
accuracy of your system.

CAUTION When using patient positioning accessories, make sure there are no areas
which might cause a pinch point or interfere with patient tubing or IV.

CAUTION Check to make sure the power injector has enough IV tubing to allow free
movement of the cradle. Make sure the unit itself does not interfere with table
travel.

Ensure excess tubing length is secured to the table top. DO NOT loop additional
IV tubing in the patient's fingers.

 Check the length of all patient health lines (IV tubing, oxygen line, etc.) and make sure they
accommodate cradle travel. Position these lines so they cannot catch on anything within the
patient vicinity or between the table and gantry during cradle travel or gantry tilt.

CAUTION The patient positioning straps provided with the system do not support the full
weight of the patient. Patient positioning straps should be used to aid in patient
positioning and are not meant to fully restrain the patient.

CAUTION Care should be taken to ensure the patient positioning straps, patient clothing,
or other material will not be caught during table motion.

 The scannable range is not indicated by the black mark on the table. The scannable range is
indicated by the tilt and travel limits button on the gantry controls.

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Figure 3-41 Table

Discovery CT750 HD Revolution Discovery CT

CAUTION If the table is lowered with anything in the red X area as indicated above, the
table could be damaged along with the equipment or object under the table.

CAUTION Physically assist all patients on and off the table and into position on the cradle.

CAUTION The foot pedals at the base of the table for loading and unloading patients are
always active. Care should be taken not to activate the foot pedals once the
patient has been positioned on the cradle and an exam started.

 Return the gantry tilt to the 0-degree upright position, latch the cradle, and adjust the table to a
comfortable height for patient loading and unloading.
 Latch the cradle before you load or unload the patient (the Cradle Unlatch indicator illuminates
when the cradle is unlatched).

WARNING To prevent pinching or crushing of the patient's extremities, keep the patient's
hands and feet away from the edge of the moving table top/cradle and its
surrounding equipment, or between table base and side panels of the table.
Take special care when positioning physically large patients.

WARNING To prevent pinching or crushing of the patient, watch the patient and equipment
carefully at all times during gantry tilt or table movement. If unwanted motion
occurs or motion does not stop, press the emergency stop switch on the
console or gantry.

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Figure 3-42 Load Limit Caution

CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that
accessory is latched to underside of cradle.

CAUTION Excessive weight can break accessory and cause injury. Do not load more than
34 kg or 75 pounds.

WARNING The head holder may crack, possibly injuring the patient's head or neck, if the
patient tries to brace himself or herself on the head holder during positioning.
The head holder and cradle extender are only designed to support 75 pounds
(34kg). Ask the patient to move up into the head holder or manually help the
patient into position.

CAUTION The patient head holder or table extender should be adequately secured to
ensure stability. If they are not secured properly, degradation of image quality
may result due to introduced motion of the head holder or table extender.

CAUTION Use of any cradle extension accessories such as the table extension, head
holder, coronal head holder, and phantom holder are not accounted for in the
table gantry interference matrix. Therefore, additional care needs to be taken to
closely monitor any table up/down, in/out or gantry tilt movement to avoid
contact of the extended accessory with the gantry.

Figure 3-43 Accessory caution

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CAUTION Do not hit the accessory against the gantry. Patient injury or equipment damage
could result.

NOTE Collision sensors are placed under the table surfaces to stop downward motion and
minimize the effects of a collision in most cases. Upward motion is still allowed if a collision
sensor has been activated.

CAUTION Do not attach accessories to the cradle that are damaged or broken such as the
table extender, head holder, and patient positioning straps.

 Check the accessory attachment plate fixed to the end of the cradle. Repair or replace if loose
or damaged.
 Use the cradle extender to support the patient's head or feet during a scan.
For VT1700 and VT2000 tables, to move the patient out of the gantry in an emergency, the cradle
can be manually withdrawn by applying a minimum of 60 lb (267 N) of force.

For the VT2000x table, to move the patient out of the gantry in an emergency, the cradle can be
manually withdrawn by applying a minimum of 80 lb (357 N) of force.

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VolumeShuttle™ (Axial) and Volume Helical Shuttle

This section contains VolumeShuttle (Axial) and Volume Helical Shuttle warnings.

NOTE For Volume Helical Shuttle a message will be posted in the Real Time Information Area
and an Attention pop-up will be posted with the following messages:

“Table travel did not meet expected time for pass(es) during acquisition.”

Additional information on the errors seen can be found in the GE System Log.

CAUTION Temporal sampling may be degraded due to changes in timing for the table to
move from location to location if proper positioning methods are not followed.
Make sure that the patient is securely positioned on the table and that their arms
are not allowed to drag on the table or allow clothing, sheets or blankets to get
caught causing a table move problem.

WARNING Temporal interval for images exceeds 3.2 seconds. Use of this data for
processing of CT Perfusion maps may contain errors in the functional
information.

Temporal sampling for data acquired for use in CT Perfusion should not exceed 3.2 seconds
between data points for optimal results. As the temporal resolution increases, an error in the
statistical accuracy of the information may be introduced.

This section contains VolumeShuttle (Axial) warnings.

CAUTION VolumeShuttle (Axial) is intended for the neuro application of CT Perfusion.

CAUTION VolumeShuttle (Axial) acquisition for head imaging should be performed with
the patient positioned head first into the gantry in the head holder, or with the
top of the head positioned 200 mm from the end of the cradle. Degraded image
quality may result if alternate positions are used due to excessive body mass on
an extended table.

CAUTION VolumeShuttle (Axial) for the acquisition of perfusion data should not be used
for patients whose weight is greater than 400 lb (181 kgs). The possibility exists
of a scan abort due to the system being unable to move the table within the
specified time. Use a Cine or Axial protocol for a single 40 mm location and
repeat for a second location if additional coverage is needed.

This section contains Volume Helical Shuttle warnings.

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WARNING Prospective reconstruction only allows a preview series to be reconstructed at

5 mm image thickness with 5 mm, 10 mm, 20 mm or 30 mm interval. All
additional reconstructions need to be done in Retro Recon.

Figure 3-44 Message at End Exam for exams containing Volume Helical Shuttle

WARNING Helical Shuttle Scan: Generate Retro Recon images, or reserve scan files
immediately.

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Emergency Patient
This section contains Emergency Patient warnings.

Figure 3-45 Warning Message: Emergency Patient

CAUTION No Emergency Patient protocol default has been set. Please use Emergency
Patient Protocol in Protocol Management to set Emergency Patient protocol
defaults.

Verify the Emergency protocol link.

 Check that the Protocol content and protocol icon are referenced
correctly.
 Check the parameters for each link.
 Patient Orientation
 Patient position
 Anatomical reference
 Anatomical coverage

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Cardiac Safety

CAUTION If, during the scan, the heart rate drops significantly lower than the prescribed
heart rate, there is a potential for gaps in the gated image location. To avoid
image location gaps, a non-gated image is reconstructed for the period where
the patient heart rate dropped below the expected or confirmed heart rate at the
start of the exam. A non-gated image may have more motion and may not be
reconstructed at the prescribed phase.

CAUTION ECG signal clarity and integrity must be confirmed prior to performing ECG-
gated acquisitions. Items which may require adjustments of equipment settings
or positioning, or patient set-up include:

- External Interference

- Atypical Patient ECG (e.g. elevated T-Waves, low ECG amplitude or signal
strength)

- Suboptimal Patient Connection

ECG lead placement should follow recommended guidelines to optimize results.

If the ECG lead becomes disconnected during the scan, or the heart rate drops
below 30 BPM, the images will be reconstructed as non-gated segment images.
This is done to avoid inaccuracy of the z-location of images where necessary.

CAUTION Ensure the ECG patches are not past expiration date and that the gel on the
pads is still moist for proper conduction of the ECG signal for successful gating.

 It is important to explain to the patient the events that will occur during the acquisition of the
contrast enhanced cardiac data. Make sure to explain the warm feeling that may occur during
the injection of the contrast material.
 Use consistent breathing technique for all the series in a cardiac exam. Practice the consistent
breathing instructions with the patient prior to scanning.
 During the practice breath hold, make sure to watch the ECG trigger monitor to determine the
average heart rate, minimum heart rate, and ECG pattern during the breath hold.
 Position the patient's arms over the patient's head so they are comfortable and will not move
during the acquisition of data.

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CAUTION A patient with any of the conditions listed below may require additional
attention. If patients are scanned with these conditions, the software may not be
able to detect the R-Peaks and the images therefore may be produced as
ungated segment images.

- Patients with multiple pre-contractions or extra systole (e.g. PVC, PAC).

- Patients with persistent or extreme arrhythmia.

- Patients with bi-ventricular lead (dual chamber) pacemakers.

CAUTION Patient motion, respiration, beat-to-beat variability of heart rate, heart motion, or
significant change in heart rate over the scan duration could cause an ECG
gated acquisition to have degraded image quality. It is important to explain to
the patient the pattern of breathing instructions to expect, the warm feeling that
can be felt from the contrast injection, and to position the patient comfortably
such that the arms will not move with respect to the body during the scan.

CAUTION There is a possibility that the ECG signal may not be detected by the system due
to improper lead placements, or a lead falling off during the scan. It is important
to place new leads on the patient before the scan. Make sure the leads are
attached properly, and use only GE recommended ECG leads.

It is important to confirm ECG trace clarity before the scan.

CAUTION Avoid scanning patients with known arrhythmias. If arrhythmias (including pre-
ventricular contractions, or extra systole), are seen when reviewing the ECG
trace prior to scanning, attempt to regulate the heart rhythm (e.g. practice
breathing instructions, calm the patient, or follow procedure established by your
institution). It is not advised to scan a patient with arrhythmias as image quality
may be degraded.

CAUTION If you do not see the RED line on the R-Peak, but somewhere else, it is advised
to make the appropriate adjustments to the electrode placement, monitor
settings, and equipment to ensure proper gating on the R-Peak.

CAUTION The heart rate displayed on CT console is a 3-cycle average. You must review
the actual waveform pattern to determine ECG trace clarity, trigger location, and
if any cycle-to-cycle variability or masked arrhythmias may be present in order
to adapt set up and conditions prior to proceeding with the scan acquisition.

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CAUTION Cardiac helical scan modes of SnapShot Segment, Burst, and Burst Plus are
optimized for specific heart rate ranges. Select the appropriate scan mode for
each patient's heart rate pattern. If the incorrect mode is selected, temporal
resolution may be insufficient and degraded image quality could result.

CAUTION SnapShot Segment Plus is an alternate reconstruction mode which applies a

different weighting to data in the area of cardiac cycle transitions compared to
SnapShot Segment reconstruction mode. Image quality in these transition areas
should be reviewed carefully.

CAUTION SnapShot Pulse or GSI SnapShot Pulse should not be used for studies where
function or full multiphase analysis is needed. Settings may limit the cardiac
phases available to one or a few neighboring phases impacting the ability to
analyze heart motion or review cardiac phase locations outside the prescribed
phase.

WARNING When using SnapShot Pulse or GSI SnapShot Pulse scan mode for coronary
artery imaging, SnapShot Pulse or GSI SnapShot Pulse should only be used for
patients with stable heart rates of 65 beats per minute (BPM) or less. Heart rates
that are unstable or above 65 BPM inherently exhibit higher heart motion and
increase the interscan delay, which could lead to suboptimal image quality.
Alternate imaging modes such as cardiac helical should be considered if the
optimal conditions for SnapShot Pulse or GSI SnapShot Pulse are not met.

CAUTION AutomA and ECG Modulation are not valid with SnapShot Pulse or GSI
SnapShot Pulse acquisitions due to prospective control of X-ray over the scan
volume. Only Manual mA values for SnapShot Pulse or Cardiac GSI Presets for
GSI SnapShot Pulse can be prescribed.

CAUTION Manual edits of the ECG gating R-Peak triggers may be performed
retrospectively in some ECG-gated exams as long as scan data exists on the
console. Images can be reconstructed with user modified gating triggers and
the original gating information can be retrieved after edits have been made.

CAUTION Heart rate information and phase location will be updated to indicate any
movement of trigger locations since heart rate and phase values are calculated
based on time between consecutive triggers and are not diagnostic values.

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CAUTION The ECG waveform on the console, the gantry display and ECG Monitor
provided for cardiac imaging should not be used for monitoring patient status.
The monitor and waveform are intended for clinical imaging and may not show
the accurate status of the patient due to system interference and operation that
may occur during imaging.

Laser Safety (Reference 21CFR 1040.10 (h))

A laser alignment light system is available in order to accurately define the patient scan region.

WARNING THE LASER BEAM CAN CAUSE EYE INJURY.

- Tell all patients to close their eyes before you switch ON the alignment lights.

- Instruct your patients to keep their eyes closed until you turn OFF the
alignment lights.

NOTE Closely monitor infants and infirm patients, and prevent them from accidentally staring into
the beam.

CAUTION The detector and DAS rotate to position the alignment lights over the laser
ports.

- Keep your hands away from the gantry opening.

- Make sure the gantry side covers are in place.

WARNING Use of controls or adjustments, or performance of procedures other than those

specified herein, may result in hazardous radiation exposure.

 The indicator on the gantry display panel lights when you turn ON the alignment lights.
 Warning labels regarding laser safety are provided on the gantry, as described in the Warning
Labels and Symbols section.

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Reconstructed Image Orientation

CAUTION GE CT image reconstruction is in an orientation viewing from the patient's feet.

The reconstruction orientation is the orientation in which the image is installed
in the image database, and is the orientation with which images are networked
to a remote viewing station.

Figure 3-46 Image reconstruction orientation

A P

R L L R

P A
1. 2.
A P

R L L R

P A
3. 4.

Table 3-3 Image reconstruction orientation

Number Description
1 Head First Supine
2 Head First Prone
3 Feet First Supine
4 Feet First Prone

The patient position information stored in the image header correctly reflects the orientation (RAS)
information for the patient. Viewing applications will correctly reflect Right (R), Left (L), Anterior (A)
and Posterior (P) of the patient.

The reconstructed image orientation may differ from preferred anatomical viewing presentation in
which the patient's Right is on the viewers Left and patient's Left is on the viewers Right. For
example, when the patient is scanned Head First and Prone the patients’s Left is on the viewer’s
Left and the patient’s Right is on the viewer’s Right. The image presentation will need to be
modified to display preferred anatomical viewing. Some viewing stations may not have the
capability to flip the image presentation, but if the capability exists, you must use display tools such
as Flip to change the presentation of the image.

Some remote viewing stations may have the capability to set default viewing protocols. This is
another tool that can be used to set an anatomical viewing presentation.

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Post processing applications such as Direct MPR, Reformat and Volume Viewer automatically
orient images in anatomical viewing orientation. These applications create axial images in
anatomical viewing presentation. Please see Auto Applications (Option) for more information. The
system also provides the capability to create Gray Scale Presentation State Objects (GSPS) to flip
the image orientation.

Flip/Rotate in recon can be used to generate images where right/left or anterior/posterior are
flipped or where both R/L and A/P have been flipped to meet desired image display preference. An
Attention pop-up is displayed at Confirm for series where Flip/Rotate in recon is selected.
Attention: This scan prescription utilizes one of the reconstruction-based image flip or rotate
options. Please ensure that this prescribed image orientation is displayed appropriately on all
remote viewing devices.

Figure 3-47 Flip Warning Message

CAUTION The scan prescription utilizes one of the reconstruction based image flip and/or
rotate options. Please ensure the prescribed image orientation is displayed
correctly on all remote viewing devices.

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Data Safety
To ensure data safety:

 Verify and record the patient's identification before starting a scan.

 Observe and record the patient's orientation, position, and anatomical landmarks before
starting a scan. Ensure that the patient is positioned within the scan parameters.
 Maintain system image quality by performing Daily QA and other maintenance.
Connectivity - Always verify that the data transferred to another system has been correctly
received.

CAUTION Do not remove images while scanning. Always remove images when the system
is idle. Removing images while the system is acquiring and reconstructing data
could cause the system to lock up and require a reboot and/or force the system
to go into data base recovery.

CAUTION Saving images in Interchange (CD/DVD) while scanning may cause long
interscan delays (ISD) to be missed or may cause Auto Voice to fail to play. Do
not copy or restore images using CD-R or DVD-R while scanning.

CAUTION When comparing GE CT images with other images, consult the DICOM
Conformance Statement for the details on the DICOM Image Position, Frame of
Reference UID, and Slice Location values stored.

CAUTION Some annotations values are stored in private DICOM elements. When viewing
images on a remote station, these annotations values may not be visible on the
image. Consult the DICOM Conformance Statement for information on private
DICOM data fields.

CAUTION If you plan to reconstruct images, you must use files that reside in the disk.
Either reserve the scan files you plan to retrospectively reconstruct, or
reconstruct unsaved scan files before the system overwrites the files with new
scan data. The system refuses to overwrite reserved scan files. Remember to
release the reserved scan files when you finish retrospective reconstruction.

CAUTION Incorrect data entries or procedures could result in misinterpretation or

misdiagnosis.

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CAUTION When entering Patient ID information, the system may contain multiple
instances of the same Patient ID. Multiple schedule records can be due to
multiple procedures being ordered under separate accession numbers or New
and Completed records in the Patient schedule for the same Patient ID.

When entering the Patient ID, verify that the correct Accession number and
Exam Description selected is what is desired. Scanning with an incorrect
Accession number may cause problems reconciling exams on a PACS system.
Please see the Schedule Patients chapter for more information.

CAUTION The system posts a warning message when expected disk space required to
store scan data from the prescribed exam is insufficient.

CAUTION The system posts a warning message when expected image space required to
store images from prescribed reconstruction is insufficient.

CAUTION The system posts a warning message when data was interpolated to generate
images.

CAUTION The system posts a warning message if there is a failure during the archive of
patient data.

CAUTION The system posts a warning message if there is a failure during the network of
patient image data.

CAUTION The system posts a warning message when a scan is aborted due to a failure in
the acquisition chain.

CAUTION The system posts a warning message when the system has low disk space. This
is due to a partition on the system disk getting too full. Removing images will
not help. Contact service to help with recovery. If you reboot the system and see
the message asking if you want to run storelog, select the option to remove the
logs.

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CAUTION The system posts a warning message if patient orientation has been changed or
does not match after start of exam.

Application Software Safety

CAUTION Do not initiate a QuickSnap if the system is actively collecting data with X-ray
on.

CAUTION Do not initiate an IQ Snap while the system is actively scanning or

reconstructing data.

Application Specific Safety Topics

Helical Scanning

WARNING Helical scanning has the inherent ability to produce artifacts when scanning
highly sloped anatomy (e.g. pediatric or adult heads). Factors which worsen
this effect are: faster table speeds, thicker image thickness, and gantry tilt. In
some cases these artifacts could be mistaken for a hemorrhage near the
cranium, or a thickening of the skull.

To reduce the occurrence of these artifacts, you may prescribe slower table
speeds or thinner slices (such as 2.5 mm) during helical scans near the vertex
of a pediatric or adult head.

WARNING It has been documented in radiology literature that an artifact may occur in the
chest that bears the double margin of the great vessels, which emulates a
dissection of the vessel during 0.4 - 1.0 second scans. This can occur in axial or
helical scans. If you have scanned axially with a 0. 4 observe this phenomenon,
re-scan the area with a 2 second axial scan to verify if it is artifact or patient
pathology. Segment Recon mode for helical and cine acquisitions may be used
in Retro Recon to also assess if the area is artifact or pathology.

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Lung Algorithm
 The Lung algorithm setting provides edge enhancement between structures with large density
differences, such as calcium and air, resulting in a sharper lung field when compared to
Standard algorithm.
 For best image quality, prescribe a 5 mm scan thickness when you plan to use the Lung
algorithm. If you plan to prescribe a High Resolution Lung study with 3.75, 2.5, or 1.25 mm,
use the Bone algorithm.
 The Lung setting enhances the contrast of small objects. For best viewing and film quality,
select a window width of 1000 to 1500 and a window level of -500 to -600.
 The Lung algorithm setting increases the CT number values at the edge of high contrast
objects. If you plan to take CT number measurements of vessels or nodules in the lung, please
check and compare your results with Standard algorithm images. ROI and Histogram
functions use CT numbers.
 Remember: The edge enhancement provided by the Lung setting may not be appropriate in
some clinical cases. Please take individual viewing preferences into account when you choose
the Lung setting.

Auto Scan
 Press and release Move to Scan on the console to advance the cradle.
 If Auto Scan is disabled, Move to Scan must be pressed for every scan before Start Scan will
become ready.
 If you select Auto Scan during one group Rx, it remains ON for every group in that series.

SmartStep and SmartView Safety

The SmartStep and SmartView options add several components to the scan room. These are the
In-Room Monitor, Hand Held Control for table movement as well as image review, and the X-ray
Control Foot pedal.

Each of the SmartStep/SmartView components is connected to the system by a cable. When using
the system, ensure that the cables cannot catch on anything when the gantry or table is moved
and that the cables are out of the way while loading and unloading the patient.

CAUTION The cabling provided for the integrated Hand-Held Controller (HHC) and Foot
Pedal with the SmartView and SmartStep options may present a trip hazard.

Ensure that the cabling can not catch on anything when the gantry or table is
moved and that the cables are out of the way while loading and unloading the
patient.

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Figure 3-48 AutomA is active when starting a SmartStep/SmartView series

CAUTION Interventional scan type has disabled AutomA.

Please verify or change the mA as needed.

Figure 3-49 kV Assist is active when starting a SmartStep/SmartView series

CAUTION Interventional scan type has disabled kV Assist.

Please verify or change the kV as needed.

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Figure 3-50 kV Assist and AutomA are active when starting a SmartStep/SmartView
series

CAUTION Interventional scan type has disabled kV Assist and AutomA.

Please verify or change the kV and mA as needed.

Table Float
During the scan, the clinician has the option to float the table between scans. When the Table Float
mode is selected, the table is unlatched and can be moved freely by anyone at the bedside.

WARNING Unintended table motion may cause a serious injury. Table may be bumped or
jarred during an interventional procedure. Care must be taken when performing
interventional procedures in the float mode. It is the clinician's responsibility to
ensure that they have control of the table when in this mode of operation. Table
must not be left unattended when in the float mode. Ensure that the table is
latched before leaving the table side.

SmartStep and SmartView Scanning

SmartStep and SmartView scanning allow multiple scans at one location for interventional
procedures. The system allows up to 90 seconds of scanning in one place. After 90 seconds, the
operator must prescribe a new scan to continue. The accumulated scan time from a procedure is
displayed on the In-Room Monitor.

CAUTION Exposure time to the patient can be up to 90 seconds per Confirm compared to
60 seconds for all other scan modes.

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CAUTION Prolonged exposure to X-ray in one spot may cause reddening or radiation
burns. User must be aware of the techniques used and exposure time to ensure
safe operation.

CAUTION The foot pedal is active if the system is in the “Prepped” state. Care should be
taken not to step on the foot pedal and make an unwanted exposure.

CAUTION The foot pedal should not be detached or attached to the gantry when the
system is in the Ready to Scan state. Always make sure the system is not in the
prepped or ready state when manipulating the foot pedal connection to the
gantry.

In SmartView, if the image latency exceeds the expected timing for the selected rotation speed,
the following warning message will be displayed in the SmartView display area. Once the image
latency returns to the expected rate, the warning message will be removed.

WARNING Average Latency

xxxxx - xxxxx ms

(where xxxxx represents the image latency time in ms)

Clinicians working in the scan room should wear appropriate protective clothing. Lead aprons,
groin and thyroid protection, as well as protective eye wear are available through the GE
Accessories Catalog.

Interventional / Biopsy Scanning

CAUTION The continuous AutoView layout format should not be used for display of
images during an interventional study because it does not allow for quick
review of images in a free viewport.

WARNING When scanning for interventional (biopsy) studies, the scan mode, image
thickness, number of images per rotation, and the display layout used affect the
display of the images. It is recommended to use the Biopsy Mode provided on
the system. If manually prescribing biopsy scans, Axial 1i scan mode or Helical
scan mode with a slice thickness greater than 2.5 mm must be used. Do not use
Cine scan mode for interventional (Biopsy) imaging. Do not use an Auto View
layout with more than one Auto View image viewport.

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Refer to Select a Multiple Image Display in the Viewing Images chapter of the User Manual for
more information on how to set up the desired viewing options.

Choose one of the following for the best Auto View layouts.

Figure 3-51 Auto View Layouts

Organ Dose Modulation

Figure 3-52 Warning message when ODM prescription is valid but SmartmA is off

WARNING One or more ODM regions will not be applied to prescribed scan groups. Check
ODM prescriptions, ensure SmartmA is enabled and Scan Types are valid.

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Figure 3-53 Warning message when ODM prescription is disabled

WARNING ODM has been disabled.

It can be enabled again once patient orientation and patient position match the
last scout series.

Dynamic Transition
Figure 3-54 Warning Messages when Dynamic Transition is turned off in Scan Progress
screen

WARNING Dynamic Transition in SmartPrep was turned off. Please start Scan Phase
manually when enhancement level for target ROI reaches an appropriate HU
value.

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Figure 3-55 Warning Messages when Dynamic Transition is turned on in Scan Progress
screen

WARNING Dynamic Transition in SmartPrep is ON. System will automatically transition to

Scan Phase when enhancement level for Transition ROI reaches the HU value
set for threshold.

Please confirm that the Transition ROI is set correctly.

Image Check

CAUTION Images are not for diagnostic use.

Advanced Applications Safety

CAUTION 3D or slab reconstructions provide additional supplemental information,

complementing diagnosis that should be based on classical techniques.

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WARNING Non-GE acquired images can be loaded in Volume Viewer but GE does not
guarantee the quality or reliability of any reconstruction, segmentation or
measurements performed on these images. Non-GE images can easily be
identified by the corresponding image annotation.

Follow the DICOM acquisition parameter guidelines listed in each application

user guide. Consult GE-published DICOM conformance statement of Volume
Viewer which is available on the GE website at http://www.gehealthcare.com/
usen/interoperability/dicom/products/workstation_dicom.html

Measurements

WARNING Do not use 3D or slab views only to perform any measurements (distance,
angle, Region of Interest, Report Cursor, Area, Volume…). Always check that
the position of measurement points, and refer to 2D baseline views (acquisition
images or reformatted images of minimal thickness) to confirm measurements.

CAUTION The software calculates and displays measurements with a resolution of one
decimal (such as 0.1 mm, 0.1 degree, etc.). You should be aware that the real
measurement accuracy is generally less for a number of different reasons
(image resolution, acquisition conditions…).

Distance, angle and area measurements are valid only if all trace segments are
longer than the inter-slice distance.

WARNING Depending on WW/WL settings, objects may display differently. Check WW/WL
before depositing measurement points.

CAUTION When filming or saving images for diagnostic purposes, always make sure the
patient name and geometry information is displayed on all views, and that they
match information on the reference view.

CAUTION When saving images with a new series description, make sure this description
matches the saved images.

WARNING Check with original datasets the reliability of segmentations and measurements
performed in Saved objects after post processing and reloading.

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Segment Tools

WARNING Before using any segmentation tool (threshold, scalpel, remove & keep object,
AutoSelect, “floater” filters…), always make sure that it will not remove
pathologies or other essential anatomical structures.

WARNING When using any Segmentation tools (AutoSelect, threshold, Paint on slice,
Quick Paint…), check contours to check the reliability of the segmentation.
Make sure the contours match the correct segmentation and volumes. Check
that the segments volumes match the contours.

Filming and Saving Images

CAUTION When filming or saving images for diagnostic purposes, always make sure the
patient name and geometry information is displayed on all views, and that they
match the information on the reference view.

CAUTION When saving images with a new series description, make sure this description
matches the saved images.

CAUTION Check with original datasets the reliability of segmentations and measurements
performed in Saved objects after post processing and reloading.

Image reliability

CAUTION 3D or slab reconstructions provide additional supplemental information,

complementing diagnosis that should be based on classical techniques

WARNING Always correlate any information (cursor position, image orientation,

measurements, image quality…) in any 3D reconstruction (reformatted plane,
oblique, MPVR, MIP, Volume Rendering, Navigator endoluminal views, Curved,
segmentations, measurements, tracking, saved images…) with the original data
(acquisition or baseline images).

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WARNING A 3D view is a two-dimensional projection on the screen of the 3D Volume.

There is no indication on a 3D view of how “deep “inside the 3D volume a 3D
cursor is. Always check the accuracy and consistency of 3D coordinates by
checking cursor position on original data (acquisition images).

Window Width and Level (W/L)

WARNING The window width and level (W/L) determine how clearly pathologies and other
anatomical structures can be discerned. Incorrect W/L settings may result in
pathologies and other essential anatomical structures not being displayed
correctly. As a single W/L cannot display all features present in an exam, use
several different settings when necessary, to explore all exam data.

Volume Rendering

WARNING When using Volume Rendering, incorrect setting of opacity curve, opacity
threshold, transparency setting when merging VR objects, can result in
pathology or essential anatomies not being visible. Always correlate Volume
Rendering images with original images.

Image quality

WARNING At all times, it remains the responsibility of the physician to determine whether
the inter-slice distance used for a particular exam is acceptable.

WARNING Loading non-square pixels will result in bad image quality.

WARNING Default Plaque Color Map preset is provided for information. You must check
and adjust Values and segment names.

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Gemstone Spectral Imaging (GSI) Viewer

Image Reliability

WARNING Monochromatic, Material Density, and Effective-Z transformations are based on

data with in the GSI Data file. Although the application checks that Exam ID and
other DICOM parameters are the same to ensure the pairs are matching, good
clinical practices should be put in place to avoid mixing patient data.

CAUTION Several material attenuation curves from the National Institute of Standards and
Technology (NIST) are included with the GSI Viewer to be used for material
decomposition images. The GSI Viewer allows for the addition of non-validated
material attenuation curves, but it is the user’s responsibility to verify the
authenticity of the material attenuation curves. GE is not responsible for the use
of new materials that have not been through formal validation procedures, and
care should be exercised in their use for creating additional diagnostic
information.

CAUTION The GSI Viewer allows for the addition of non-validated material attenuation
curves. Utilizing suboptimal combination of these custom material pairs or
inadequate tuning of material attenuation curves may result in suboptimal
image quality of MD images or unexpected values.

WARNING The saved MD series should not be used in other software applications that rely
on Hounsfield values.

Figure 3-56 Saved MD Series warning

MD images can be generated prospectively and retrospectively in recon, and in the GSI Viewer.

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WARNING Curved and Lumen reformation can introduce distortions in the shape of
objects. To avoid misinterpretation, you should always correlate the cursor
position in curved reformation views with the original and reformatted images.

Image Quality

CAUTION For a two-monitor configuration, check the monitor calibration regularly to

ensure images are displayed identically on both monitors.

CAUTION The general assumption for material separation and monochromatic image
generation is that the materials do not have a k-edge in between 40 and 140 keV.

CAUTION The ability to separate materials into the corresponding material basis pair is a
function of the material itself as well as the attenuation characteristics of the
basis pairs. If the basis pairs chosen have attenuation characteristics that are
similar or close to each other, the resulting MD images will not produce
adequate separation and may result in images that have less than optimal image
quality.

Measurements

CAUTION The report cursor shows the voxel value nearest to the center location of the
report cursor in the original loaded slices.

CAUTION Material Density images, unlike conventional CT images and Monochromatic

images, use units of milligrams per cc (mg/cm3) for pixel data instead of HU.
Therefore density image series should not be used under any circumstance with
software applications that use HU values. Always check units of statistical
measure within the application to confirm expected units.

CAUTION Effective-Z images, unlike conventional CT images and Monochromatic images,

use units of mean atomic number (Z) for pixel data instead of HU. Always check
units of statistical measure within the application to confirm expected units.

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Film and save

CAUTION The formats and image quality of exported electronic films are not suitable for
diagnostic purposes. Additionally, the image quality may be degraded by the
data compression techniques (depending on the compression settings).
Diagnosis shall only be performed on the original images in DICOM format.

CAUTION Although images saved with the Enable MD Save option are DICOM compliant,
they are scaled differently and do not rely on HU. As such, they should not be
used in any application other than GSI Viewer without first confirming accuracy
and compatibility.

Window Width and Window Level

CAUTION The Window Width and Window Level for GSI images will vary depending on the
keV selected compared to non-GSI images. Place an ROI on an anatomical area
and note the mean value. Set the Window Level to mean value and adjust the
Window Width to the desired viewing level.

CAUTION The MD data values have been appropriately scaled to provide better dynamic
range for visualization on different viewing platforms. This scaling is reflected in
the units that are reported next to the W/L.

Rescaling the values for visualization also changes the values reported or
displayed by quantitative tools, e.g., ROIs, Report Cursor, etc. To convert to
other units, you need to perform a multiplication. For example, if the scaling is
200 ug/cm3 then a reported value of 20 is actually 200 × 20 ug/cm3 = 4000 ug/
cm3 or 4 mg/cm3. The precision of the data can be refined for new materials,
which generates the pixel data at a different resolution (precision).

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Accuracy of Measurements
Measure Distance for Axial, Helical, and Cine Images
This section includes information on accuracy of measurements used when reviewing images.

CAUTION Measure error using the straight line distance graphic is less than two times the
image pixel size.

CAUTION Note that the measurements are accurate only if the trace segments are longer
than the slice interval.

Measure Distance for Scout Images

Accuracy of measurements for scout images in the “X” direction varies with object thickness and
distance from ISO center in the “Y” direction. Note the orientations of the “X” and “Y” in Figure 3-57
below assume a scout scan plane of 0 degrees. If the scout plane is rotated, then the “X” and “Y”
orientation changes accordingly.

 For measurements of anatomy in the “X” direction that are at ISO center (“Y”):
 The measure error using the straight line distance graphic is less than 5% of the
measured distance plus 2 mm.
 For measurements of anatomy in the “X” direction that are NOT at ISO (“Y”):
 The measure error using the straight line distance graphic is less than 5% of the
measured distance plus 2 mm plus 3% of measured distance per centimeter from ISO.
 For measurements of anatomy in the “Z” direction:
 Measure error using the straight line distance graphic is less than two times the image
pixel size.

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Figure 3-57 Scout Scan Plane

1 = ISO center, 2 = Y axis, 3 = X axis, 4 = Z axis, 5 = X-Ray tube focal spot, 6 = scan plane, 7 =
patient table.

Measure Angle

CAUTION Measurement accuracy using the angle graphic is equal to the displayed angle
value ± 10 degrees for an angle measured between segments which are five
times larger than the image pixel size. Accuracy improves as the length of the
segments increases.

ROI

CAUTION Area measurement accuracy using a region of interest graphic (rectangle,

smooth curve, ellipse or free draw) is equal to the displayed area ± the
circumference of the region multiplied by (image pixel size)2/2. Mean and
standard deviation values for the intensity of the pixels in the region are also
affected by this accuracy. If the ROI is rotated, the area measurement can vary
up to 5%. Region of interest statistics are based on the pixels INSIDE the
graphic defining the region.

Reformat Plane Thickness

Reformat plane thickness equals 1 pixel.

 If each axial pixel represents 0.5mm of anatomy, then the reformat plane thickness equals
0.5mm.

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 If pixel size equals 0.9766 mm (500 mm/512), then the reformat plane represents a slice of
anatomy about one millimeter thick.

CAUTION CT Numbers are NOT absolute; misdiagnosis is possible. System and patient
variables may affect CT Number accuracy. If you rely solely upon CT numbers
without taking variables into consideration, you could misdiagnose an image.

For more information refer to: CT Number on page 11-65.

CAUTION The limiting measurement resolution of the cursor is 1 mm, i.e., the distance
less than 1 mm but greater than 0.5 mm is rounded to 1 mm, therefore, the
accuracy of this testing is limited by the cursor measurement capability. This is
especially important for a thin slice measurement where the FWHM is close to
0.625 mm. The results for these thin slice images will not be as accurate as the
thick slice ones. This is the limitation of this testing method.

Operator Console Ergonomics

To optimally use the system and reduce the chance of physical strain and fatigue, the following
steps are recommended regarding how you use your operator console.

Posture
Correct posture is very important. To ensure correct posture while sitting at your operator console,
follow these basic steps:

1. Face the monitors and keyboard without twisting your body.

2. Sit comfortably erect with the small of your back well supported.

3. Position your forearms parallel to the floor, with your wrists straight.

4. Position the screen so that your eyes are nearly level with the top of the screen.

5. Keep both feet flat on the footrest, with your thighs parallel to the floor.

If you cannot comfortably maintain this position while working at your operator console, you should
make the necessary adjustments to your operator console environment.

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Equipment Adjustments
Chair
Adjusting the fit and height of your chair is very important for comfort. Follow these basic
guidelines:

1. Fit the backrest snugly against your back. People with shorter legs might need a back cushion.

2. Set your chair height to position your forearms parallel with the floor when your hands are
placed on the keyboard. If your feet dangle, you need a footrest.

Keyboard
Keyboard height is also important. When typing:

 Your wrists should be as straight as possible.

 Your forearms should be parallel to the floor.
 Your hands and fingers should float over the keys or mouse.

Screen
 The recommended viewing distance from the screen is 18 - 28 inches (45 - 70 centimeters).
 With your head straight, your eyes should be looking directly at the top of the screen.
 You should look at the screen straight-on, not at an angle from the side, top or bottom.
 Glare from the screen can disrupt your viewing and cause eyestrain. Do not face a window,
and position the screen at right angles to bright light sources.

Comfort
Comfort at your operator console indicates you've set up your work area correctly. However, even
a well-designed area needs frequent adjustment, especially for different users. Take the time when
positioning yourself at your operator console to ensure your comfort.

It is also recommended that if you use the operator console for extended periods (several hours at
a time), that you take short breaks to get away from your operator console and perform simple
stretching exercises to reduce the chance of fatigue.

Other considerations:
 Stay alert to your patient's condition.
 Use the speakers and microphones on the table, gantry, and console to stay in constant
communication with the patient, even while you sit at the console.
 Follow the exam procedures explained in the User Manual. Carefully enter patient information
and position before proceeding.

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Accessories

WARNING Pinching from installation of accessories, for example, head holder, phantom
holder, foot extender or using a cracked head/phantom holder etc. can cause
physical injury.

WARNING The use of accessories, transducers, and cables other than those specified may
result in degraded ELECTROMAGNETIC COMPATIBILITY of the EQUIPMENT
and/or SYSTEM.

WARNING Do not connect accessories that are not approved as part of the system. Do not
use accessories from other modalities.

WARNING None of the accessories support the full weight of a patient. If you sit, stand, or
otherwise apply excessive pressure to these devices, they break or come off
the cradle and may cause injury. If an accessory breaks, use caution when
picking it up and do not continue to use.

CAUTION When using patient positioning accessories that are not GE options, make sure
there are no areas that might cause a pinch point or interfere with patient tubing
or IV.

WARNING Accessories like arm boards and catheter bag holders are not secured to the
table and may interfere with the gantry if not positioned properly.

WARNING All non medical equipment connected to the USB port of the media tower on the
CT operator console must comply with IEC/EN/UL60950-1 and should be
approved by GE.

CAUTION Do not use the USB or Ethernet port on the front cover of the CT operator
console, it is intended for service use only.

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Figure 3-58 USB, Ethernet Port, and Power Switch

GE Approved Accessories
With each use, check all accessories for damage and remove them from service if damaged or
cracked. Use only GE approved equipment together with this system.

CAUTION Using accessories which are not GE approved accessories might affect dose
and image quality.

Table 3-4 GE Approved Accessories Types and Models

Type Manufacturer/Model
Cardiac Monitor IVY 3100 - B with ethernet
IVY 3150 - B
IVY 7800
Respiratory Monitor Varian 1.7
Partial UPS Eaton Powerware 9355
Eaton Powerware 9330
External Hard Drive Seagate FreeAgent 1TB USB 2.0
Seagate FreeAgent 2TB USB 2.0/3.0
Bar Code Reader Opticon 6125
Hand Held 3800
Honeywell 3800g
Honeywell 1300g
SmartStep Monitor (includes LCD monitor, video splitter
and mountings) GE 5115174-x*
SmartStep Handheld Control GE 2199947-x*
SmartStep Foot pedal GE 2199945-2
Modem Mult-Tech ZBA
Veo Reconstruction Server CT Blade Center / IBM_GE 5235082
Patient contrast injector: Nemoto Dual Shot Alpha (CiA425 Class I) / GE 5328194

For Xtream Injector option Nemoto Dual Shot Alpha (CiA425 Class IV) / GE 5328195

Nemoto Dual Shot GX (CiA425 Class IV)

Medrad ISI900 (for Stellant D) (CiA425 Class I and Class

IV) / GE 5335919

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Safety

Type Manufacturer/Model
Patient contrast injector: Nemoto Dual Shot Alpha (CiA425 Class IV) / GE 5328195

For Enhanced Xtream Injector option Nemoto Dual Shot GX (CiA425 Class IV)

Medrad ISI900 (for Stellant D) (CiA 425 Class I and Class

IV) / GE 5335919

*Model numbers may contain a "-x" (i.e. 2199947-x). In these instances "x" can be any numeric
character. For example, in 2199947-x, "-x" refers to 2199947, 2199947-2, 2199947-3, etc.

The following approved accessories were shipped with the system:

 Patient comfort and workflow accessories such as the cradle pad, cradle extender, patient arm
board, catheter bag holder, table tray, and IV pole attached to the cradle.
 Patient positioning accessories including Axial and Coronal head holders, positioning straps,
and pads.
 System quality assurance accessories including imaging phantoms and phantom holder.
Additional accessories and supplies approved for use with the system are available at
www.GEhealthcare.com.

The placement of the cardiac monitor should be on the monitor stand. The monitor should not be
placed on the table. It should be positioned so that it is not touching the table or gantry when it is in
use.

IV Pole Safety
Care should be taken in the amount of weight placed on the pole. Ensure that the pole is tightened
prior to use.

CAUTION The IV pole may bend when excessive weight is placed on the pole. Ensure no
more than 4.5 kg or 10 lb. is placed on the IV pole.

CAUTION Ensure that the IV pole extension collar is tightened prior to use to prevent the
pole height from collapsing.

Figure 3-59 IV Pole Load Limits

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Safety

CAUTION Do not load more than 4,5 kg or 10 pounds. Verify that extension collar is
securely tightened before use.

Table Tray Safety

Care should be taken in the total weight of objects that are placed on the tray.

Figure 3-60 Tray Load Limits

CAUTION Do not load more than 9 kg or 20 pounds.

CAUTION Objects that may be susceptible to tipping should be strapped down with the
Velcro™ strap provided.

Systems With Metal-Free Cradles and Accessories

CAUTION Prevent damage to metal-free accessories! Carefully examine the metal-free

clasp assembly on the accessory and the catch on the cradle before attempting
to attach the accessory for the first time.

Figure 3-61 Accessory Load Limit

CAUTION Accessory may fall and cause injury if not latched to cradle. Make sure that
accessory is latched to underside of cradle.

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 To Latch an accessory:
 Align the accessory tongue with the pocket at the end of the cradle.
 Keep fingers clear of the cradle.
 Push the tongue all the way into the pocket until it latches into place.
 Rubber shims may have been installed on the head holder or foot extender to give it a
tighter fit. Please take care when latching the accessory to make sure that it is completely
latched. Push the latch forward until you hear a click. Verify that the latch is fully latched.
 To Unlatch an accessory:
 Pinch the two L-shaped parts together and pull the accessory out of the cradle.
 An alternate method is to apply a light force to the catch towards the cradle, pinch the L-
shaped catch together, and pull accessory out of the cradle.
 Proper operation:
 Keep the accessory “tongue” and cradle pocket clean and free of fluids and debris.
 Keep the latch and cradle pocket area clear of sheets, drapes, pads or any item that could
interfere with proper latching and cause damage.
 Positioning
 Positioning patient anatomy over the area where the head holder or cradle extension
attaches to the cradle may produce images where contrast between two adjacent
rotations is different. Make sure the area of interest, especially the head, is properly
positioned in the head holder or the cradle extension.

Xtream/Enhanced Xtream Injector Safety

CAUTION The injector and the system are operated independently after the Start Scan
button is pressed. When you want to stop both the system and the injector, use
the Stop Scan button on the system SCIM and the stop injector function on the
injector.

CAUTION When you use Xtream Injector with SmartPrep, injection doesn't start at the
beginning of Baseline Phase. It starts at Monitor Phase. Going to Scan Phase
without Monitor Phase, injection will not start.

Limited Access Room Configuration

CAUTION Due to access limitations on the left side of the gantry, some procedures may be
affected when ancillary equipment is used. Assess the placement of the
equipment needed for the procedure before the placement of the patient on the
table. Access around the left side of the gantry may also be affected.

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Emergency Devices and Emergency Egress

(Reference 21CFR 1020.33 (f)(2)(ii))

Emergency Devices
The system has two types of Emergency buttons:

1. Emergency Stop- when pressed, all table and gantry motions are halted, generation of X-rays
is stopped, laser alignment lights are turned off. The system aborts any data acquisition in
progress, and attempts to save all data acquired prior to the abort. Use the Emergency Stop
button for patient related emergencies.

2. System Emergency Off Button- when pressed, the power to all system components is
removed, stopping all table and gantry motion and generation of X-rays. The system aborts
any acquisitions in progress, and data obtained prior to the abort can become corrupt or lost.
Use the System Emergency OFF button for catastrophic emergencies, such as fire or
earthquake.

CAUTION If you press the Emergency Stop or Emergency OFF buttons during a scan, the
system will abort the data acquisition.

Emergency Stop
NOTE Every operator should take a few minutes to locate the Emergency Stops on their system
before scanning the first patient.

The system has five Emergency Stop buttons:

 One on each control panel on the front of the gantry (Figure 3-62).

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Figure 3-62 Front of Gantry

1 1
1 1

2
Discovery CT750 HD Revolution Discovery CT
1 Emergency Stop Buttons
2 Cradle Handle
 Two on the rear cover of the gantry.
 One on the Scan Interface Control Module (SCIM). (Figure 3-63).
Figure 3-63 Scan Control Interface Module (SCIM) - Emergency Stop button

Press an Emergency Stop button in the event of a patient related emergency or if the cradle,
table or gantry starts to move unexpectedly.

 Once an Emergency Stop button is pressed, the Reset gantry key, on the gantry control
panel, flashes about once every two seconds.
 Press the Reset gantry key to restore power to the gantry and table.
When Emergency Stop is applied, the moving cradle and tilting gantry may overrun by less than 10
mm and less than 0.5 degrees respectively.

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Emergency Stop Button Symbols

Emergency Stop buttons may be accompanied by one of the symbols below.

System Emergency OFF Buttons using Main Disconnect Control

In the event of a fire, flood, earthquake, or any other catastrophic emergency, all power to the
system should be turned off. Pressing the System Emergency OFF button immediately removes
all power to the system by removing power to the Main Disconnect Control (MDC). Because the
system has no time to save data, or shutdown in an orderly fashion, pressing the System
Emergency OFF button can corrupt system files or result in loss of patient data.

The facility designer determines the quantity and locations of the Emergency OFF buttons. GE
recommends placing an Emergency OFF button near the doorway of every room in the system
scan suite. Ask your supervisor to show you the location of all the Emergency OFF buttons in the
system suite. Follow facility guidelines to report an emergency.

Press the System Emergency OFF button (red, circular button located on the wall) in the event of
a catastrophic emergency, such as fire or earthquake.

Reset the Emergency OFF Button

1. Press the Start button on the Main Disconnect Control.

a. Power to the Power Distribution Unit (PDU), operator console, and system electronics will
be restored.

2. Press the Reset gantry key on the gantry panel.

a. Power to the gantry drives, X-ray system, and table drive will be restored.

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Figure 3-64

CAUTION The Xray and Drive power is disabled.

Please walk into the scan room and press the Reset button on the Gantry
Control Panel.

Emergency Patient Care During X-ray ON:

 Press STOP SCAN to abort X-ray and stop gantry/table movement.
 Press PAUSE SCAN to pause scanning after the current scan completes.
 During an exam, the system pauses between scans if you Press any button on the control
panel other than the alignment lights. It stops X-ray if you Press the same button(s) during a
scan.
 Select Resume on the screen to continue the exam.

Emergency Egress
System operation may be stopped due to power failure or a safety event (something coming into
contact with the collision sensors), or the system may be halted by the operator in response to
emergency conditions.

The Cradle unlatch button should only be used in two situations.

1. In Emergency Egress situations.

2. When using the SmartStep scan type.

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To Safely Remove the Patient:

1. Press the Cradle Release gantry key or the Emergency Stop button (Figure 3-62) to
disengage the clutch.

2. Pull the cradle to its out position, using the Cradle Lip or Cradle Handle (Figure 3-62).

3. Assist the patient off the table.

Maintenance and Cleaning

 To guarantee safe, reliable equipment performance, the site must be prepared according to
GE Medical Systems requirements, as specified in the Pre-Installation Manual.
 There are no user serviceable parts in this system. The product should be installed,
maintained, and serviced by qualified service personnel according to procedures laid down in
the product service manuals.
 The system in whole or in part should not be modified in any way without prior written approval
by GE Medical Systems.
 Keep the equipment clean. Remove body fluids and/or IV spills to prevent a health risk and
damage to internal parts. Clean the equipment with any of the following Approved Cleaning
Agents. Follow Cleaning Agent Manufacturer instructions. Apply with cloth or supplied
Cleaning Agent wipes:
 Warm water and soap mixture or a mild antiseptic
 Common household bleach, diluted 10:1
 Sani-cloth HB
 Perasafe
 Incidin Plus
 Distel (formally known as Trigene)
 Also, use dry cleaning for electronic components.
 Do not clean the connectors on the cables for ECG, respiratory equipment, etc. If you need to
clean them contact GE Service.
 Planned maintenance must be carried out regularly to ensure safe operation of the equipment.
 For user maintenance of the system and performance tests, refer to the maintenance and
calibration information in the Technical Reference Manual.

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Cleaning Equipment (Bio Hazard)

CAUTION Blood Bourne Pathogens Procedure - Before any equipment is serviced or

returned to GE Medical Systems, the following criteria must be met:

 Equipment used in a clinical setting must be cleaned and free of any blood and other
infectious substances.
 Customers are responsible for the sanitary condition of the equipment. The suggested
equipment clean-up procedure for cleaning any fluids or matter discovered in accessible or
inside, under the direction of service, are as follows:
 Wear personal protective equipment.
 Wear proper Nitrile gloves.
 Before cleanup, take note of sharp corners or objects that could cut the gloves. If gloves
tear, remove, wash hands thoroughly, and re-glove.
 Use cloth or paper towels along with cleaner, taking care not to splash.
 Sanitize the area using common bleach diluted 10:1 or an Approved Cleaning Agent listed
in the Maintenance and Cleaning section. Clean any tools that come in contact with body
fluid.
 Since viruses require moisture to remain active, dry the entire area.
 When confident the area is clean and dry, place cleaning materials in a red biohazard bag.
 Remove gloves, turning them inside out, and put gloves in the biohazard plastic bag. Seal
and give the bag to appropriate personnel for disposal.

Environmental Concerns
This symbol indicates that the waste of electrical and electronic equipment must not
be disposed of as unsorted municipal waste and must be collected separately. Please
contact an authorized representative of the manufacturer for information concerning
the decommissioning of your equipment.

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Name and Concentration of Hazardous Substances

Explanation of Pollution Control Label
This symbol indicates the product contains hazardous materials in excess of the
limits established by the Chinese standard SJ/T11363-2006 Requirements for
Concentration Limits for Certain Hazardous Substances in Electronic Information
Products. The number in the symbol is the Environment-friendly Use Period
(EFUP), which indicates the period during which the toxic or hazardous
substances or elements contained in electronic information products will not leak
or mutate under normal operating conditions so that the use of such electronic information
products will not result in any severe environmental pollution, any bodily injury or damage to any
assets. The unit of the period is "Year".

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In order to maintain the declared EFUP, the product shall be operated normally according to the
instructions and environmental conditions as defined in the product manual, and periodic
maintenance schedules specified in Product Maintenance Procedures shall be followed strictly.

Consumables or certain parts may have their own label with an EFUP value less than the product.
Periodic replacement of those consumables or parts to maintain the declared EFUP shall be done
in accordance with the Product Maintenance Procedures.

This product must not be disposed of as unsorted municipal waste, and must be collected
separately and handled properly after decommissioning.

Table 3-5 Table of hazardous substances' name and concentration

Hazardous substances' name

Component Name
(Pb) (Hg) (Cd) (Cr(VI)) (PBB) (PBDE)
Operator Console X O O X O O
Gantry X O X X X X
LCD Monitor O X O O O O
ECG Cardiac Trigger X O O X X X
Power Distribution Unit X O X X X X
Patient Table X O X X X X
 O: Indicates that this toxic or hazardous substance contained in all of the homogeneous materials for this part is
below the limit requirement in SJ/T11363-2006.
 X: Indicates that this toxic or hazardous substance contained in at least one of the homogeneous materials used
for this part is above the limit requirement in SJ/T11363-2006.
 Data listed in the table represents best information available at the time of publication.
 Applications of hazardous substances in this medical device are required to achieve its intended clinical
uses, and/or to provide better protection to human beings and/or to environment, due to lack of reasonably
(economically or technically) available substitutes.

This product consists of devices that may contain mercury, which must be recycled or disposed of
in accordance with local, state, or country laws. (Within this system, the backlight lamps in the
monitor display contain mercury.)

The X-ray Collimator contains the following potentially hazardous materials:

 Lead: Lead salts are toxic and their ingestion may cause serious problems. The manipulation/
handling of lead is subject to regulations.
The X-ray Tube Assembly contains potentially dangerous materials but does not present any
danger as long as it is neither opened nor disassembled.

WARNING Do not discard the X-ray Tube Assembly among industrial waste or domestic
garbage.

WARNING A damaged X-ray Tube Assembly should not be dispatched through the national
postal service.

The X-ray Tube Assembly contains the following potentially hazardous materials:

 Lead: Lead salts are toxic and their ingestion may cause serious problems. The manipulation/
handling of lead is subject to regulations.

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 Oil: Univolt 54 and Crosstrans 206 mineral oil are not toxic, but the prevailing environmental
regulations should be observed for their disposal or recuperation. For example, it is forbidden
to dispose of these oils in the wastewater or sewage system or in the natural environment.
Your local GEMS field service will advise you on the suitable means of disposal of equipment.

 The X-ray Tube Assembly to be discarded should be forwarded to the GEMS Service network,
and it will be disposed of in a GEMS recycling center.

Precautions
Take all the necessary precautions for the personnel handling the recovery or destruction of X-ray
Tube Assemblies, and in particular against the risks due to lead.

These personnel must be informed of the danger involved and of the necessity to observe the
safety measures.

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Chapter 4
Operator Documentation

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Operator Documentation

Introduction
The system user information is designed to provide you with safety and operation information for
you to safely and effectively use the system.

To start the user information:

 Insert the disk you wish to view in the DVD-RW/DVD-RAM drive in the media tower.
 Select the [Learning Solutions] icon.
 Select the language you wish to review in.

To exit the user information:

 Click File>Quit to exit the user information.

 Click on another desktop such as Exam Rx.
NOTE Do not click on the iconify icon.

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 
Chapter 5
Tube Warmup

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Tube Warmup

Tube Warmup

The system operates most efficiently within certain parameters. These parameters are established
by warming up the tube using a preset group of exposures. When the operator performs a tube
warmup at least once per 24 hour period and at any system prompt, the tube warmup reduces the
possibility of artifacts and may aid in prolonging the life of the tube.

SmarTube™ warmup optimizes scanning performance by including an indication of the

temperature state of the tube. Operating the system in the green zone will maximize tube life.

The tube state will be indicated by 3 zones on the scan monitor above the New Patient icon.

 Green: Tube is at optimal operating state.

Figure 5-1

 Yellow: Tube warmup should be performed to move the tube to the optimal operating state.
There are no restrictions during scanning while in this zone.
Figure 5-2

 Blue: Tube warmup must be performed. Depending on system type, mA may be limited and
some scan types may not be available until warmup is performed.
Figure 5-3

For best care of your tube, never skip tube warmup. Perform the warmup when your tube reaches
yellow for faster warmup and maximum tube life. Time to warmup the tube is calculated to put the
system in the optimal operational state as quickly as possible for the system type. The interface is
provided so you are in control. Only Green means go.

NOTE GE recommends that you warmup the tube after two hours of non-use. Only the tube
warmup scans need to be done at this time. Tube Warmup scans from the blue zone are
completed within 72 seconds.

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Tube Warmup

Figure 5-4

CAUTION No scans have been taken since 08/26/2008, 02:20:44 PM.

Tube warmup must be run.

NOTE If the detectors are cold due to the A1 power being off, turn the system on and wait two
hours before performing a tube warmup. This allows the detectors to return to their
operating temperature.

NOTE Failure to run Tube Warmup when requested by the software can lead to serious damage
to the X-ray tube and decrease tube life.

NOTE Failure to perform requested tube warmup will result in reduction of the maximum mA
possible for the exam after a tube warmup has been cancelled or skipped.

Desired mAs can be achieved by changing rotation time (mAs = mA x rotation time).

NOTE If requested tube warmup is skipped, kV Assist will not be available. Select a Manual kV
value to continue or End exam and perform a tube warmup.

Figure 5-5

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Tube Warmup

CAUTION Tube Warm-up has been canceled or skipped.

Maximum mA allowed will be limited for this exam.

Small focal spot will be limited to 250 mA.

Large focal spot will be limited to 500 mA.

kV Assist acquisition is not possible until Tube Warm-up is completed.

Select End Exam and run Tube Warm-up from Daily Prep to enable the full mA
range capability.

NOTE If a requested tube warmup is skipped, kV Assist and GSI mode will not be available.
Change to Manual kV for series where kV Assist was enabled. Change to Axial, Helical or
Cine scan type for series where GSI was enabled, or End Exam and perform a tube
warmup.

Figure 5-6

CAUTION Tube Warm-up has been canceled or skipped.

Maximum mA allowed will be limited for this exam.

Small focal spot will be limited to 250 mA.

Large focal spot will be limited to 500 mA.

kV Assist acquisition is not possible until Tube Warm-up is completed.

GSI acquisition is not possible until Tube Warm-up is completed.

Select End Exam and run Tube Warm-up from Daily Prep to enable the full mA
range capability and/or GSI scanning.

NOTE If the state of the tube is yellow and about to transition to blue, and an exam is started
without running a tube warmup, the tube warmup message may be seen at End Exam. If
the state of the tube is green, click OK in the pop-up message and continue scanning as
needed, otherwise a tube warmup should be run.

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Tube Warmup

NOTE A non-GE tube could cause destructive component failure if the cooling delays do not meet
its design requirements.

Perform Tube Warmup

To perform a tube warmup:

1. Click the blue or yellow SmarTube warmup buttons (Figure 5-2 or Figure 5-3).

a. The following message will display before running a tube warmup.

Figure 5-7

WARNING Scans may have been taken within the last two hours.
Warmup scans may cause subsequent tube cooling delays.

Note: Tube warmup will run in Autoscan mode.

b. Click [Accept & Run Tube Warmup] to continue.

Or, alternately,

2. Select [Daily Prep] on the Scan Monitor screen.

3. Select [Tube Warmup] on the Daily Preparation screen.

a. Read the compatibility Warning.

The following message will display if an unrecognized tube has been installed.

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Tube Warmup

Figure 5-8

CAUTION Attention: An unrecognized tube has been installed on the system. Tube Cooling
algorithms are designed specifically for GE tubes and the performance of the
system cannot be guaranteed.

Warning: Scans may have been taken within last two hours. Warmup scans may
cause subsequent tube cooling delays.

Note: Tube warmup will run in Autoscan mode.

I have read and understood the implications of the above warning.

b. Position the gantry to 0° tilt.

4. Click [Accept] when you understand the implications.

a. Tube warmup runs a set of tube heating scans.

b. When finished, the system display returns to the daily prep screen.

A message that tube warmup has been completed will also be in the system message log.

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 
Chapter 6
Daily Fast Cal Procedure

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Daily Fast Cal Procedure

Fast Cal
To maintain image quality, complete the Fast Cal procedure once a day.

Beam Quality Check

Once every seven days a beam quality check will be performed when you run Fast Cal. A
message is displayed asking you to remove any obstructions from the beam. When you start the
scan, six air scans are taken before the Fast Cal procedure. This test adds an additional 90
seconds to the total time to run Fast Cal.

Figure 6-1 Beam Quality Check Message

WARNING Please remove any obstruction in the path of the beam.

If the Beam Quality check detects a degradation in the quality of the beam, the following message
is displayed:

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Daily Fast Cal Procedure

Figure 6-2 Beam Quality Check Problem Detected

CAUTION The Beam Quality Check has detected a problem. Image Quality may be
affected.
Scanning will not be disabled. Call GE SERVICE today to schedule service to
correct the problem.
Press OK to proceed at the risk of Image Artifacts.

Should the beam quality problem message be seen, contact GE Service and schedule service to
come correct the problem.

Fast Cal Procedure

1. Display the Scan Monitor screen.

a. Clear the gantry opening.

b. Raise the table above the patient loading level.

c. Set gantry tilt to zero.

2. Select [Daily Prep] and [Fast Cal].

a. Before the start of every scan day.

3. The system automatically selects the Auto Scan function.

a. The system automatically selects the following sequence of scans:

 Gantry Balance Check

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Daily Fast Cal Procedure

Figure 6-3 Gantry Balance Check will be done before the Fast Cal

Gantry Balance Check is executing. This process will take about 1 or 2 minutes.
 Mylar Window Check
 Warmup
 Interconnectivity Map Scan Test
 Fast Calibration Scan List
 If GSI is installed, GSI Fast Calibration Scan List is completed over two sessions: Half
completed during the first session; the other half completed during the second
session.
If Fast Cal is not run for 24 hours, the following message is posted:
Figure 6-4

WARNING FastCal may not have been performed within the last 24 hours.

If Fast Cal is not run for 48 hours, the following message is posted:

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Daily Fast Cal Procedure

Figure 6-5

It has been over 48 hours since the last Fast Cal was done. All techniques will be
updated.
b. Follow system instructions to initiate the first scan, and the system acquires the rest of the
scan set.

c. Remain near the console during auto scan acquisition, so you can stop X-ray if someone
enters the scanner room.

If an unrecognized tube is installed on the system, the following message is displayed:

Figure 6-6

An unrecognized tube has been installed on the system. Fast Calibration techniques are
designed specifically for GE tubes and GE cannot guarantee that the performance of the
system will meet specifications with an unrecognized tube.

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Daily Fast Cal Procedure

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 
Chapter 7
Prepare the System

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Prepare the System

Introduction
(Reference IEC 60601-1:2005 7.9.2.12, 16.2)
 Clean the Accessories and check for damage.
 Check and remove dried contrast agent from:
 Mylar ring (around the gantry opening)
 Detector window
 Table extension and cradle surfaces — especially the Patient Restraint plastic channels
on the table
 Accessories (Head holders, pads and cushions, etc.)
 Check supplies.

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 
Chapter 8
Check Disk Space

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Check Disk Space

Introduction
Maintain Image file space on the disk, because the system refuses to scan when it runs out of file
space.

Check Image Space

 Check the daily schedule, and multiply the list of patients by the estimated number of images
each study requires.
 Compare your estimate to the remaining 512 and 1024 images listed in the Feature Status
Date and Time area.
 If your estimate exceeds the available Image Space:
 Film any previously unfilmed studies. (Optional)
 Transfer designated images to another suite or console.
 Archive and remove the oldest images from the system disk.
Always follow the filming and archive routines established for your facility.

NOTE Do not remove images while actively scanning patients.

Do not reboot the system immediately after removing images, this can cause mismatch of
information in the patient list.

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 
Chapter 9
Reset the System

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Reset the System

System Shutdown/Reset Procedures

To prevent system software problems, restart your system once every 24 hours. (Recommended:
Shutdown and restart at the end of the last shift.) If the system has a persistent problem, record
the time, circumstances, and error messages, then call service.

Performing a QuickSnap and/or an IQ Snap provides additional information to aid the service
engineer in resolution of issues.

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Chapter 10
Stop/Start the Operating System

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Stop/Start the Operating System

Shutdown System
To turn off main disconnect control (MDC) or A1, Shutdown the system.

1. On Display Monitor, select the [Shutdown] icon.

a. Dialog is posted

2. Select Shutdown and click OK.

The system must be idle state; scan acquisition hardware cannot be active. This means New
Patient, Daily Prep, and Service Tools cannot be open/active. These functions use the scan
acquisition hardware.

System will display a dialog box if an exam is open, Daily Prep is open, or a Service Tool is
active.

CAUTION System shutdown cannot be accomplished when scan acquisition hardware is

in use. End Exam, exit Daily Prep menu or close any open Service Tool before
attempting Shutdown.

Click Confirm.

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Stop/Start the Operating System

Exit New Patient by selecting End Exam, exit Daily Prep menu to close Tube Warmup/Fast Cal
menus or close Service Tool to continue Shutdown.

Select [Shutdown] again to complete system shutdown.

3. If scan hardware is not in use, following dialog box will be posted.

CAUTION System shutting down. Please wait…

a. When the system is down, a prompt is posted stating System Halted.

b. Turn off power to the Operator Console.

4. Press the STOP button on the MDC or A1 connector panel.

5. To start operating system from System Halted prompt, power cycle the operator console.

NOTE If your system has been turned off overnight, it will take several hours to stabilize before
the system is ready for use.

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Stop/Start the Operating System

6. A dialog box is posted on the display monitor.

CAUTION Waiting for system startup…

7. A dialog box will be posted when OC is starting.

CAUTION OC initializing. Please wait…

8. When this dialog disappears and “System Reset Successful” message is seen in the feature
status area, the system is ready to use.

NOTE If your system has the HIPAA login enabled, you are required to login to the system.

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If You Turn OFF the MDC at the End of the Scan Day:
To start the system if main disconnect has been powered off:

1. Press the START button on the main disconnect control (A1) to restore power to the PDU,
console(s) and subsystem electronics.

2. Press the RESET button to turn on the Gantry Control panel to restore power to the
Gantry drives, X-ray system, and Table drive.

a. When this dialog disappears and “System Reset Successful” message is seen in the
feature status area, the system is ready to use.

3. Turn on power to the Operator Console.

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For Systems with UPS (Uninterrupted Power Supply)

The CT system may be installed with a GE approved “partial” UPS. A partial UPS is an accessory
that can provide temporary power to the system during hospital power failures. It is not intended to
support the x-ray power or gantry axial rotation for scanning. It is intended to provide 120V/208V
power to critical subsystems as explained below. Follow the UPS manufacturer’s manual for
recommended operating and servicing requirements (includes preventative maintenance,
specification summaries, and troubleshooting guidance).

The partial UPS provides the following features:

 For sites with a history of power quality problems, the UPS provides voltage conditioning and
regulation for the system electronics.
 During planned or unplanned power outages (storms, testing of backup systems, transfers of
power), the host computer and related electronics will continue to function, allowing the user to
save images and complete a controlled shutdown, if necessary.
 During planned or unplanned power outages (storms, testing of backup systems, transfers of
power), the patient table and gantry control subsystems will continue to function, allowing the
user to safely remove a patient from the scanner, if necessary.
 If the user hits the Emergency OFF button for system power, the GE approved partial UPS will
not try to provide backup power. “Emergency OFF” intends to remove all system power to
prevent a safety hazard.

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Chapter 11
General Information

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General Information

Introduction
This section provides a simple introduction to CT, or Computed Tomography, for people with no
detailed physics or medical diagnostic education.

System components:
 The system components are explained in the User Manual.

Emergency Stop:
 Emergency Stop procedures are described in the Safety chapter.

CT Description
Computed tomography (CT) is a medical imaging method employing tomography created by
computer processing. Digital geometry processing is used to generate a three-dimensional image
of the inside of an object from a large series of two-dimensional X-ray images taken around a
single axial of rotation. The word "tomography" is derived from the Greek tomos (slice) and
graphein (to write). Computed tomography is known as computed axial tomography (CAT or CT
scan).

CT produces a volume of data, which can be manipulated, through a process known as

windowing, in order to demonstrate various bodily structures based on their ability to block the X-
ray/Röntgen beam. Although historically the images generated were in the axial or transverse
plane, orthogonal to the long axis of the body, modern scanners allow this volume of data to be
reformatted in various planes or even as volumetric (3D) representations of structures.

CT Operation Theory
The CT Scanner consists of the following subcomponents:

 X-ray source
 CT Detector
 Rotating Gantry
 Power Distribution Unit
 Patient Table
 Operator's console

X-ray Source
The source and detector components are housed on a gantry with a cylindrical patient bore. An X-
ray tube that is part of the source subcomponent is housed on the rotating gantry, diametrically
opposite to the detector. The high voltage generator is the second part of the X-ray source. It
provides high voltage to the X-ray tube across the anode and the cathode, along with current to

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the filament, which is part of the cathode. The filament produces an electron beam that is
accelerated towards the tube's anode or target. The electron beam impinges on the anode and X-
rays are produced. The generator also supplies the X-ray tube with “bias voltages” that control the
width, length and position of the focal spot on the target.

The X-ray tube's heat capacity and dissipation determine the frequency and length of CT
exposures. A Helical and Cine exposure can last up to 60 seconds and axial exposures last from
0.4 to 2.0 seconds.

CT Detector and DAS

The CT Detector is a wide coverage cone beam detector with multiple detector rows along the
longitudinal plane. The Detector channels are arranged as an arc diametrically opposite to the X-
ray tube on the rotating CT gantry. The detector consists of a scintillator that converts X-rays into
light, diodes for light conversion into current and analog to digital converter that converts the
current into digital signal. The data acquisition system (DAS) samples each detector cell up to
about 2500 times per gantry rotation, amplifies and quantifies the current from the cells and
transmits the resultant data to the Operator's console.

Power Distribution Unit

The PDU (Power Distribution Unit) distributes power to the rotating gantry, patient table and the
operator's console.

Operator's Console
The Operator's Console (OC) contains the reconstruction engine that converts the data
transmitted from the DAS into a single matrix of pixel values, called an image. The display
processor takes a copy of the digital matrix data, and converts it into television shades of gray, and
sends the image to the LCD for display. The OC also contains and controls the computer, X-ray,
and cradle drives.

DICOM Print
The system can send a camera request to a camera that has DICOM print capabilities.

X-ray
The X-ray tube contains filaments, a cathode and an anode. The filament provides the electrons
that create X-rays. The X-ray system generates a current that heats the filament until electrons
start to “boil off” and break away from the filament. We refer to the filament current as “mA.”
Increasing the mA increases the number of electrons that become available to make X-ray. Higher
concentrations of electrons improve image resolution.

The X-ray system creates a high voltage, or kV, potential between the cathode and anode. The
negative charge on the cathode repels the electrons that boil off the filament. The positive charge
on the anode attracts the negatively charged electrons. The electrons strike the rotating anode
target and displace electrons in the target material. This interaction creates heat and X-ray

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General Information

photons. The target rotates to help spread the heat over a larger area. Increasing the kV increases
the electron strike speed, which in turn increases the intensity or “hardness” of the X-ray photon
beam.

Figure 11-1 CT System Illustration

Table 11-1 CT System Description

Number Description
1 X-ray must reach the detector’s reference channels at the edges of the Scan
Field of View (SFOV)
2 X-ray Tube
3 Centered Patient
4 Gantry Opening
5 Detector DAS

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Tube Warmup
Warmup provides an automated group of low technique exposures designed to safely bring the X-
ray tube to operating temperature before you start to scan for the day. Warmups increase tube life
and help produce more consistent, quality images.

NOTE If tube warmup is skipped or cancelled, the mA will be limited to 250 mA for small focal
spot and 500 mA for large spot for the first exam.

kV Assist mode is not allowed if tube warmup is skipped or cancelled.

GSI is not allowed if tube warmup is skipped or cancelled.

Beam Quality Check

Once every seven days a beam quality check will be performed when you run Fast Calibration. A
message will be displayed asking you to remove any obstructions from the beam. When you start
the beam quality check scan, six air scans will be conducted, followed by tube warmup scans. This
test adds an additional 90 seconds to the start of Fast Calibration.

If the system detects a beam quality issue, message will be posted to contact GE Service for
investigation of the issue.

Theory of Operation
System Overview
The system is a premium-tier, 3rd generation CT scanner. It will support all clinical applications
currently supported by the LightSpeed and Revolution Discovery CT product lines.

System Characteristics
 64 slice system.
 Variable rotation scan speeds (0.35, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, and 2.0 seconds per
rotation).
NOTE 0.425, 0.450 and 0.475 sec rotation speeds are available with CardIQ SnapShot option
and 0.35, 0.375 sec rotation speeds are available with CardIQ SnapShot option and 0.35
second option.

 Potential for new applications due to Higher Spatial Resolution, Gemstone Spectral Imaging
and Volume Helical Shuttle and no tube cooling delays.

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Performix HD X-ray Tube

 100.2 kW peak power (large spot, 5 second exposure, 120kV, Non-Hi Res Mode)
 68.6 kW peak power (small spot, 5 second exposure, 140kV, Non-Hi Res Mode)
 4.5 kW steady state capability
 0.35 second peak gantry speed capability
 107.1 kW peak power (GSI spot, 5 second exposure, 140kV, GSI mode)
Includes electron collector technology to remove off-focal electrons from the X-ray generating
path, resulting in lower patient dose and higher image contrast

Gemstone Detector
 64 rows = 64 unique physical cell locations in Z-axis
 Detector cell segregation in the Z-axis provides post-patient collimation.

Scaleable Data Acquisition Sub-System (Volara HD DAS)

 1024 input channels/converter card.
 Supports 7131 Hz sampling.
 Forward error correction applied to output data.
 Control functions:
 Error detection and reporting.
 Heater Control

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General Information
Patient Scanning
The system uses a similar geometry as the LightSpeed VCT.

Table 11-2 Geometry information

Parameter Revolution Discovery CT

ISO Height 1015 mm
Focal spot to ISO 539 mm
Focal spot to det 947 mm
SFOV 500 mm
Bore 700 mm

Table 11-3 Table configurations

Table Scan Range

VT1700 VT2000, VT2000x

Scout Scans 1600 mm 1900 mm
Axial Scans 1700 mm 2000 mm
Helical Scans > 1540 mm > 1870 mm
Cardiac Helical Scans > 1540 mm > 1870 mm

NOTE Helical scan range varies based on the helical pitch and gantry rotation speed selected.

 Patient weight capacity is 227 kg (VT1700, VT2000); 306 kg (VT2000x).

EMI/EMC
All systems built to global regulatory emissions (EMC) and immunity (EMI) compliance standards
to improve reliability, uptime and performance in its intended environment.

Network
Purpose of Revolution Discovery CT Scanner Connection to
Network
The Revolution Discovery CT Scanner is intended to be connected to a network in order to support
the following functionality:

 DICOM services to retrieve images from other DICOM-compliant machines

 DICOM services to push images to other DICOM-compliant machines
 DICOM services to query for images on other DICOM-compliant machines
 DICOM services to print images on DICOM complaint printers
 DICOM services to confirm that images have been permanently stored on a DICOM-compliant
machine

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 DICOM services to get DICOM modality worklist information from a remote hospital or
radiology department information system computer
 DICOM services to allow a Modality Performed Procedure Step to be communicated to the
Hospital/Radiology information system
 DICOM services to verify the remote DICOM system is connected properly to the HD scanner
device
 Services to provide authentication and authorization against Enterprise directory servers
All of the above features are optional on the Revolution Discovery CT Scanner.

Network Interface Technical Specifications

Connection Name: Hospital network port

Physical network connection type: IEEE 802.3-1998 1000/100/10 BaseT Ethernet
Speeds and duplex modes supported: 10Mbps, 100Mbps, and 1Gbps half and full duplex

Auto-negotiate
Default IP Address (from factory): IP Address – 192.9.101.1

Subnet Mask – 255.255.255.0

Gateway – empty
IP addressing: IPv4 static
QoS Support: n/a

Network Information Flows Specifications

Flow Name DICOM image retrieve

Network Connection on device Hospital network port
Usage Type/Function/Purpose Get a DICOM image or set of image from a network device
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding CT Image Storage

MR Image Storage

Enhanced SR

X-Ray Radiation Dose SR – CT Radiation Dose

RT Structure Set Storage

Positron Emission Tomography Image Storage

Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name DICOM image push

Network Connection on device Hospital network port
Usage Type/Function/Purpose Send a DICOM image or a set of images to a network device
Licensed/optional/required optional

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Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding CT Image Storage

MR Image Storage

Grayscale Softcopy Presentation Sate Storage

Enhanced SR

X-Ray Radiation Dose SR – CT Radiation Dose

RT Structure Set Storage

Positron Emission Tomography Image Storage

Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name DICOM image query

Network Connection on device Hospital network port
Usage Type/Function/Purpose Find a list of DICOM images from a network device
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding Study Root Query/Retrieve Information Model - FIND

Study Root Query/Retrieve Information Model - MOVE

Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name DICOM Storage Commit

Network Connection on device Hospital network port
Usage Type/Function/Purpose Used to confirm that local DICOM images have been permanently stored
on a remote DICOM device
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding Storage Commitment Push Model SOP Class
Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name DICOM modality worklist information

Network Connection on device Hospital network port
Usage Type/Function/Purpose Transfer patient information for HIS/RIS system to CT scanner
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP

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General Information

Application Layer Protocol and Encoding Basic Modality Worklist Information Model – FIND SOP Class
Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name Modality Performed Procedure Step

Network Connection on device Hospital network port
Usage Type/Function/Purpose Send a report about a performed patient exam to the HIS/RIS system
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding Modality Performed Procedure Step SOP Class
Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name DICOM Print

Network Connection on device Hospital network port
Usage Type/Function/Purpose Send a DICOM image to a DICOM printer
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding Basic Grayscale Print Management Meta SOP Class

Basic Color Print Management Meta SOP Class

Print Job SOP Class

Pinter SOP Class

Ports (default) 4006
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

Flow Name Enterprise Authentication / Authorization

Network Connection on device Hospital network port
Usage Type/Function/Purpose Authenticate local user against Enterprise Server
Licensed/optional/required optional
Communication Partner Device/IP Address/ Any network device supporting the DICOM application layer protocol(s)
Network listed below
Middle Layer Protocols TCP/IP
Application Layer Protocol and Encoding Microsoft Active Directory / Novell eDirectroy
Ports 3002, 3003, 3004, 6386
Traffic characterization and Bandwidth On demand, local user initiated. The bandwidth is dependent on the local
Requirements site.
Latency max n/a

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Required Characteristics and Configuration for Network Support of

Revolution Discovery CT Scanner Specifications
The network must meet the specific requirements above for all traffic flows associated with the
subset of features, use cases and workflow required by the responsible organization’s users.

In addition, the network must be “flat” (limited to a single IP broadcast domain).

Remote Host Parameters

The Network function has new enhancements to support DICOM networking. When adding or
updating a remote list, there are some new parameters needed. All of the following information,
except for Comments, needs to be provided in order to set up a remote host:

 The Host name to be entered is the name of the device. If the device is DICOM, the name
must match exactly to the name given to the device.
 The Network address of the device is provided by the institution's network administrator.
 The Network protocol is DICOM. If the Revolution Discovery CT will be sending to this device,
the device must be DICOM and the DICOM network protocol must be selected.
 The Port number is unique to the device. If the device is an Advantage Windows workstation
or HiSpeed CT/i, X/i, or NX/i system, the number will be 4006.
 The AE Title is unique to the device. If the device is an Advantage Windows workstation or
another GE Medical Systems system, the AE Title will be the same as the Host name.
 The Comment field allows you to input a comment.
 The Archive Node refers to the archiving responsibility of the device:
 If Auto is selected, the CT system will automatically check to see if the device is a Storage
Commitment Provider.
 If Yes is selected, the device will be responsible for archiving images. When the device
has received and saved the images, a notification message will be displayed on the
scanner console and the Archive status for the exam will be “A” for archived.
 If No is selected, the device will not be responsible for archiving.
NOTE The device must be a Storage Commitment Provider in order for remote archive node to
function.

 Access to the local host refers to the device's ability to access the Revolution Discovery CT.
Select Yes if you want the device to be able to send to and/or query the Revolution Discovery
CT.
 The Custom search feature enables the Custom search dialog box to be automatically
displayed when you select receive from the remote browser. If Yes is selected, the feature is
enabled. If No is selected, the Custom search dialog box will not automatically be displayed.
You can, however, get to the search feature once the remote browser is displayed, by simply
selecting Search, on the remote browser.

Network Compatibility
The BrightSpeed Series, LightSpeed QX/i, Plus, Ultra, RT, RT16, Xtra, Pro16, Pro32, VCT, Optima
CT660, Optima CT520, Optima CT540, Optima CT580, Discovery CT590, Discovery CT750 HD
and Revolution Discovery CT image formats are DICOM. This image format may only be

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General Information

transferred between systems using a DICOM network protocol. The receiving station must support
DICOM receive for LightSpeed images to be transferred (send or receive) to it.

Use the following table for network compatibility. The table lists the network protocol to use and the
features available for that system. The far left column lists the system the user is at (from).

Table 11-4 Network Compatibility

To

BrightSpeed Series,
BrightSpeed Select
Series, LightSpeed
QX/i, Plus, Ultra, RT,
RT16, Xtra, Pro16,
Pro32/VCT.
From
Discovery CT750 HiSpeed CT/i
HiSpeed NX/i, 3rd Party
HD, Revolution X/i, or QX/i DICOM Station
Discovery CT,
Optima CT660,
Optima CT520,
Optima CT540,
Optima CT580,
Discovery CT590
BrightSpeed Series, DICOM DICOM DICOM DICOM*
BrightSpeed Select
Series, LightSpeed Query Query Query Query**
QX/i, Plus, Ultra, RT,
Send Send Send Send
RT16, Xtra, Pro16,
Pro32/VCT. Revolution Receive Receive Receive Receive**
Discovery CT, Optima
CT660, Optima
CT520, Optima
CT540, Optima
CT580, Discovery
CT590
HiSpeed CT/i DICOM DICOM DICOM DICOM*

Query Query Query Query**

Send Send Send Send

Receive Receive Receive Receive**

HiSpeed DICOM DICOM DICOM DICOM*

FX/i, DX/I, LX/i Query Query Query Query**

Send Send Send Send

Receive Receive Receive Receive**

3rd Party DICOM DICOM DICOM DICOM DICOM*
Station
Query Query Query Query**

Send Send Send Send

Receive Receive Receive Receive**

* Some 3rd party stations use the ODINA network protocol. In this case use DICOM protocol and
port number 104.

** Query capability is only available only if station is a query retrieve provider.

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NOTE LightSpeed VCT, LightSpeed Pro32, BrightSpeed, based systems do not support
Advantage Network Protocol.

Table 11-5 Advantage Windows Network Compatibility

BrightSpeed Series,
BrightSpeed Select
Series, LightSpeed QX/i,
Plus, Ultra, RT, RT16,
Xtra, Pro16, Pro32/VCT
From
AW 1.X AW 2.X AW 3.X AW4.X Select, VCT/VCT XT or
Discovery CT750 HD,
Revolution Discovery
CT, Optima CT660,
Optima CT520, Optima
CT540, Optima CT580,
Discovery CT590
BrightSpeed Series, DICOM DICOM DICOM DICOM DICOM
BrightSpeed Select
Series, LightSpeed QX/i, Send Send Send Query Query
Plus, Ultra, RT, RT16, Send Send
Xtra, Pro16, Pro32/VCT
Select, VCT/VCT XT or Receive Receive
Revolution Discovery CT,
Optima CT660, Optima
CT520, Optima CT540,
Optima CT580, Discovery
CT590
AW 1.X SdC Net SdC Net SdC Net SdC Net DICOM

Query Query Query Query Query

Send Send Send Send Send

Receive Receive Receive Receive Receive

AW 2.X SdC Net SdC Net SdC Net SdC Net DICOM

Query Query Query Query Query

Send Send Send Send Send

Receive Receive Receive Receive Receive

AW 3.X SdC Net SdC Net SdC Net SdC Net DICOM

V1 V2 V3 Query Query

Query Query Query Send Send

Send Send Send Receive Receive

Receive Receive Receive

AW 4.X SdC Net SdC Net SdC Net SdC Net DICOM

Query Query Query Query Query

Send Send Send Send Send

Receive Receive Receive Receive Receive

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NOTE Advantage Windows systems do not support Query Retrieve provider. Send images from
the Advantage Windows to the BrightSpeed Series, LightSpeed QX/i, LightSpeed Plus,
LightSpeed Ultra, LightSpeed Pro16, LightSpeed Pro32/VCT Select, LightSpeed VCT/VCT
XT, Revolution Discovery CT, Optima CT660, Optima CT520, Optima CT540, Optima
CT580, Discovery CT590.

NOTE Optima CT660, Optima CT520, Optima CT540, Optima CT580, Discovery CT590,
Discovery CT750 HD, Revolution Discovery CT, LightSpeed Pro32/VCT Select, LightSpeed
VCT/VCT XT, LightSpeed Pro16, LightSpeed16, Ultra, Plus, QX/i, BrightSpeed Series, or
HiSpeed QX/i PC Based Systems do not support Advantage Network Protocol.

System Data and Control Flow

Figure 11-2 CT System Data and Control Flow Illustration

Table 11-6 System Components and Functions

Component Functions Data and Control Flows
Host Computer User interface, image display 1 Scan and recon prescription from operator
HDIP Scan and recon control and Image 2 Scan prescription to “master” controller
generation
Stationary Controller Stationary base real-time control and 3 Scan parameters distributed
“master” controller
On-Board Controller  table position
Rotating base real-time control  rotating parameters
Table Controller
Patient table real-time control  kV and mA selections
Slip-ring  X-ray beam collimation and filter selections
Signal and power transfer between
stationary and rotating components  detector slice thickness and SDAS gain
selections
4 Real-time control signals during scanning
X-ray Generator High voltage generation 5 High Voltage
X-ray Tube X-ray generation 6 Un-collimated X-ray beam
Collimator Formation of the X-ray beam 7 Collimated X-ray beam

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Detector Conversion of X-ray to analog signal 8 Analog scan data

data
DAS Conversion of analog signal data to 9 Digital scan data
digital data

X-ray Generation and Detection Details

Overview
The distinguishing feature of Revolution Discovery CT is the capability to simultaneously collect
multiple rows of scan data.

Gantry Coordinate System

X, Y, Z: Scanner gantry coordinate system:

 X = Tangent to circle of rotation.

 Y = Radial (from ISO toward tube focal spot).
 Z = Longitudinal (in/out of the scan plane).
Figure 11-3 Gantry Coordinate System

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Components
Figure 11-4 X-ray generation and detection components viewed from side of gantry

Table 11-7 Performix HD X-Ray Tube

Number Description
1 Uncollimated X-Ray Beam
2 Anode / Target
3 Cathode with Bias Voltages
4 Bowtie Filter
5 Tungsten Cams
6 Detector Collimator
7 Detector Pixels
8 Discovery Gemstone Detector - Continuous Collimator + 57 Detector
Modules (64 rows each)

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Collimator Theory
The X-ray tube collimator contains two cams that are used to control the width of the X-ray beam in
the Z-Axis.

The cams are used by the Z-Axis Tracking control system to maintain a narrow X-ray beam
aperture to ensure the optimal trade-off between dose and Image Quality is achieved. In helical
scan modes, the cams are used by the Dynamic Z-Axis Tracking control system to limit the x-ray
beam coverage to the area of the detector used in image reconstruction, reducing dose to the
patient while maintaining Image Quality.

Figure 11-5 Collimator CAM functionality illustration

Z-Axis Tracking
The purpose of tracking is to follow the focal spot so that we can keep the most uniform part of the
X-ray beam and the narrowest possible beam on the detector to reduce dose and still avoid
artifacts.

The focal spot moves in the Z-axis due to thermal changes in the tube and mechanical forces
during gantry rotation and tilt angle.

In order to maintain the narrowest possible beam, the system employs a closed loop control
system called as "Z-Axis Tracking". The closed loop control system uses measured beam position
data from the detector to position the collimator cams in real time. Each cam can be independently
adjusted for optimal beam performance1

1T.Toth,
et al., "A dose reduction X-ray beam positioning system for high-speed multi-slice CT scanners", Med. Phys., Vol 27,
No.12,Dec 2000).

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The schematic diagram in Figure 11-6 demonstrates the factors involved in collimation control in
the tracking architecture.

Figure 11-6 Z-Axis Tracking Architecture

5 6
3 4

8
9

10 12

11

Table 11-8 Z-Axis Tracking Architecture

Number Description
1 Z-Axis Tracking Architecture
2 Focal Spot
3 Stepper Motor Repositions

CAMs
4 Collimator
5 Tungsten CAMs
6 Closed Loop Control

The closed-loop control repositions collimator CAMs to hold the beam steady.

 Measure position of the X-ray beam on the detector

 Compute the optimal collimator position based on focal spot position
 Move the collimator to compensate for the focal spot position.
7 Compute new CAM position from Z-cell signal ratio.
8 Umbra
9 Detector
10 Detection of Beam Position
11 Beam position verses 2A/1A Ratio
12 Penumbra

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Dynamic Z-Axis Tracking

Beam tracking at the beginning and the end of helical scan acquisitions allows the system to
control the X-ray beam to target only the portion of the detector used by image reconstruction,
thereby limiting patient dose and maintaining image quality.

At the beginning of a helical scan, the lead cam will be closed to block the portion of the X-ray
beam that is not needed by image reconstruction. As the scan progresses, the lead cam will open
until the prescribed aperture width is achieved and normal Z-axis tracking begins. Near the end of
the scan, the trailing cam will begin to close to block the unused portion of the X-ray beam. Refer
to: Figure 11-7.

The amount of dose reduction achieved by this technique is a function of the aperture, pitch and
scan length prescribed by the user.

Figure 11-7 Dynamic Z-Axis Tracking Architecture

Table 11-9 Dynamic Z-Axis Tracking Architecture Descriptions

Number Description
1 Start of helical scan, lead cam closed and begin to open.
2 Middle of scan, cams open and normal Z-axis tracking
3 End of helical scan, trailing cam closes
4 Collimator
5 Leading Cam Opens
6 Tungsten Cams
7 Trailing Cam Closes
8 Blocked X-ray Region
9 Detector
10 Table Travel
11 Y axis
12 Z axis

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Automatic Exposure Control

Patients come in all shapes and sizes. For the purpose of achieving a desirable image quality with
a scan technique that reflects the patient’s size and shape, there are several approaches to
employing automatic and manual mA setting modes of CT operation. These approaches are
designed to adjust the X-ray output of the system according to the X-ray attenuation presented by
a patient’s anatomy. For example, the patient’s weight or body mass index may be used as a guide
to set a fixed mAs for the acquisition. Alternatively, some measure of patient thickness or girth,
such as anteriorposterior (AP) thickness, lateral width, or patient circumference can be used as a
basis to choose an appropriate fixed mAs value, i.e., a value that yields an image adequate for
diagnosis with a patient dose as low as reasonably achievable. However, these methods have at
least two inherent limitations. First, as they produce a fixed mA value, they do not adjust for
differences in body-region thickness and associated variation in X-ray attenuation along the
patient length and/or around the patient circumference. Second, the use of weight, thickness or
circumference is an incomplete surrogate for X-ray attenuation, which is one of the most relevant
physical parameters affecting image quality and which depends on the elemental composition and
density of human tissue as well as on its shape and thickness.

Automatic Exposure Control (AEC), on the other hand, is designed to adjust the scanner radiation
output to meet a desired, pre-set level of image quality/noise criterion by empirically assessing the
patient’s attenuation and automatically modulating the mA accordingly. AEC can provide a desired
level of image quality/noise at a lower patient dose than would be possible with a fixed scanner
radiation output. In general, CT systems may accomplish AEC in two ways:

 Modulating the mA dynamically during scanning in the X-Y and/or Z dimensions to adapt to
variations in the patient’s attenuation.
 Adjusting the mAs to a fixed value based on measurement and calculation of the patient’s
overall attenuation: the mAs is constant during scanning, but its value has been quantitatively
determined so as to yield an average pre-set level of image noise.
Most AEC systems operate as described in the first bullet above. Discussion of AEC hereafter
applies to these types of systems, unless otherwise indicated.

How AEC Works

On the basis of a patient’s attenuation, AEC sets mA values as the X-ray tube rotates around the
patient. The technology uses knowledge about the scanner’s imaging chain and the measured
attenuation of the patient to appropriately adjust mA values in order to achieve the desired,
constant image noise/quality criterion.

Larger patients typically require scanning at a higher mAs than the mAs used for smaller patients.
Similarly, thicker projections (e.g., laterally through the shoulders vs. AP through the shoulders)
typically require more mAs to achieve the same resultant image noise/quality criterion. Finally,
anatomy with greater attenuation (e.g., abdomen or pelvis compared to the lungs) requires more
mAs to achieve the same image noise/quality criterion.

Adaptation to Anatomy
As patient attenuation changes throughout the course of the scan, either rotationally around the
patient or along the length of the patient, AEC is designed to adjust dynamically the mA for each
body part and projection. If the attenuation does not change, AEC sets the mA at a constant value

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that is appropriate for the overall patient thickness and that achieves the desired image noise/
quality criterion.

When to Use AEC

AEC technology has the greatest impact when the portion of the patient being scanned has non-
uniform size, shape, or density. In these cases, AEC adjusts scanner radiation output to the
changing anatomy and modulates the mA in the Z-direction (along the patient) and/or in the XY-
direction (around the patient). Even though AEC is used, before scanning the operator must still
select scan parameters, including AEC parameters, which provide a desired image noise/quality
criterion. Scan parameters including AEC parameters must be chosen to carefully balance patient
radiation dose and image performance.

Even when the patient’s anatomy has consistent size, shape, and density throughout the planned
scan range, AEC technology chooses the appropriate exposure settings to achieve the image
noise/quality criterion requested by the user.

When bismuth or other shields are considered for use in the planned scanned range, consult the
system user manual for specific information.

When NOT to Use AEC

AEC might not be available for all scanning modes or on all scanners. When AEC is available, if
users do not understand the relationship between AEC parameters, image noise, and dose, AEC
should not be used. Also, if the patient cannot be centered in the scanner, AEC is not
recommended because the attenuation calculations used for AEC are designed with the
assumption that the patient is centered in the gantry. Finally, if there is any question, radiologic
technologists should always consult their medical physicist and radiologist to ensure that proper
exposure techniques are used.

AEC Does Not Guarantee Reduction of Radiation Doses in All

Patients
The use of AEC does not always result in dose reduction, especially when compared to a fixed
mA/mAs protocol. For example, when providing the desired image noise/quality criterion setting
for a large patient, AEC might appropriately increase the scanner radiation output as compared to
that for an average-sized patient. For most examinations of average-sized or small patients, and
for the same image noise/quality criterion settings, AEC use will result in the same or lower
CTDIvol as that of a fixed mA/mAs protocol. (However, a larger patient would appropriately require
more fixed mA than for a smaller patient.)

NOTE Radiologic technologists must be fully aware that proper patient centering is critical for
accurate AEC function. Improper patient centering can result in an exposure that is either
too high or too low to achieve the desired image noise/quality criterion. Note that proper
patient centering can be more challenging for smaller pediatric patients, and so special
care should be taken.

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Effect of AEC Control Setting

For a given patient, changing the image noise/quality criterion setting in AEC will affect the patient
dose: asking for lower image noise/higher image quality criterion will result in more dose to the
patient as the noise index value is decreased (made smaller). In contrast, asking for higher image
noise/lower image quality criterion by increasing (make larger) the noise index value will result in
less dose to the patient.

AEC Considerations of Patient Size, Shape, Composition, and Age

For a given AEC image noise/quality criterion setting, larger patients and more attenuating body
regions may result in a higher scanner radiation output. Smaller patients and less attenuating body
regions may result in a lower scanner radiation output.

While AEC can be an effective dose-reduction tool for pediatric patients, special care should be
taken with this patient group. The GE online education module available on the Image Gently
website describes issues to consider when using our AEC features with pediatric patients.

Dynamic AEC Scanning

When a scanning protocol contains multiple X-ray tube rotations at the same table location, the
effect on patient dose of incorrect selection of protocol settings will be multiplied by the number of
rotations. For such protocols, operators must take extra care when setting manual mAs or AEC
parameters to achieve the desired level of image noise/quality criterion. For example, in perfusion
scanning, the image noise can often be much higher (yielding a lower dose) than for routine
diagnostic scanning of the same region because the primary application of perfusion-scan data is
for quantitative analysis and characterization of perfusion parameters rather than for diagnostic
visualization. The manufacturer’s reference protocol provides an indication as to whether use of
AEC is or is not recommended with these scan modes.

How to tell if the dose has changed

For every patient, and any time AEC settings are changed, in order to confirm a correct level of
scanner radiation output for that patient’s size and exam protocol, users should examine the
predicted CTDIvol and DLP displayed prior to performing the scan, as a step in operator
confirmation of system settings. When a large patient is scanned at a particular setting of image
noise/quality criterion, the CTDIvol and DLP will be higher than for a smaller patient at the same
AEC settings. Predicted CTDIvol and DLP values are displayed on the scanner’s dose display on
the user interface prior to confirmation of settings for scanning. After scanning, the values are
updated to reflect the average of the actual mAs values used in the scan and are displayed on the
user interface as well as recorded in the DICOM secondary screen capture and DICOM radiation
dose structured reports.

Summary
AEC is a versatile and powerful tool designed to tailor the scanner’s radiation output to each
patient based on the patient’s size, age, shape and attenuation and the user’s requested level of
image noise/quality criterion. AEC technology uses measured patient attenuation values to adjust
the mA dynamically in order to achieve the requested level of image noise/quality criterion.
However, AEC settings must be chosen with the same care used to choose all other parameters

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that affect radiation dose to the patient. Before the scan parameters are confirmed, careful
attention must be paid to CTDIvol and DLP displayed on the user interface; scanner radiation
output associated with the prescribed protocol must be checked and confirmed prior to scanning.
Used properly, AEC is a key technology to help ensure that the appropriate radiation dose is used
for every patient.

Scout Based Attenuation Characterization

A patient’s size, shape and density define the attenuation characteristics seen by the X-rays. An
understanding of the desired image quality (noise and contrast) and the attenuation characteristics
of the region being scanned can be used to determine the required scan technique factors (kVp
and mA).

Automatic characterization of the patient’s attenuation can enable a CT system to aid the user in
determining the scan technique factors required to achieve desired image quality. The scout image
is a measurement of the distribution of the attenuation for the patient. This distribution of
attenuation can be analyzed to give a metric of total attenuation (or patient size) and a metric of
patient shape.

One size metric that can be used is Water Equivalent Diameter, Dw. This is the diameter of a
uniform cylinder of water that gives the same total attenuation as the patient. Although Dw
assumes a circular water object, patients are rarely circular. Most anatomical regions, however,
can be approximated as ovals. Therefore, in addition to Dw, it is beneficial to have a shape metric
to indicate how non-circular the anatomy is. One shape metric is the Oval Ratio, OR. The OR is
the ratio of the major and minor diameters, with a value of 1 indicating a circle. Together, these two
metrics can be determined at every location over the selected scan range of the patient to create a
3D characterization of the attenuation. This information can then be used by different applications,
such as AutomA, Snapshot Assist, GSI Assist and kV Assist.

The following are some examples of phantom images and their representative Dw and OR
characterizations:

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Figure 11-8 35cm Polyethylene Phantom with Water Equivalent Diameter = 33.6cm
(OR=1)

Figure 11-9 20x32cm Polyethylene Phantom shown with overlay indicating: Left - Water
Equivalent Diameter = 33.6cm (OR=1) and Right - Ellipse based on Dw and OR
(OR=1.58)

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Figure 11-10 Thorax Phantom shown with overlay indicating: Left - Water Equivalent
Diameter = 22.1cm (OR=1) and Right - Ellipse based on Dw and OR (OR=1.08)

Figure 11-11 Large Thorax Phantom shown with overlay indicating: Left - Water
Equivalent Diameter = 33.8cm (OR=1) and Right - Ellipse based on Dw and OR
(OR=1.14)

Since these metrics are dependent on the attenuation distribution, Dw and OR measurements can
vary across the entire anatomical region. In an anatomical area like the abdomen, which contains
little air pockets, the Dw is similar to the average physical diameter of the patient. But for an area
like the chest, which contains the lungs, Dw may be significantly smaller than the average
diameter.

An example of this behavior can be seen in the figure below of a scout torso phantom with the
measured Dw and OR at different locations.

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Figure 11-12 Scout of Torso Phantom in Lateral View (middle) with measured Water
Equivalent Diameter (top) and (bottom) Oval Ratio

Torso images from the scout are shown with their representative Dw and OR characterizations.

Figure 11-13 Torso Phantom shown with overlay indicating: Left - Water Equivalent
Diameter = 26.3cm (OR=1) and Right - Ellipse based on Dw and OR (OR=1.80)

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Figure 11-14 Torso Phantom shown with overlay indicating: Left - Water Equivalent
Diameter = 25.6cm (OR=1) and Right - Ellipse based on Dw and OR (OR=1.24)

Unlike AutomA where there is mA modulation over the scan range in the z-direction based on
patient size, applications like SnapShot Assist, GSI Assist and kV Assist set parameters that do
not modulate during the scan acquisition. SnapShot Assist calculates a median Dw from the
specified scan range to translate it to a scout-attenuation BMI estimate based on conversion
detailed in Menke, Radiology 2005.

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AutomA
Background
A significant factor in the quality of a CT image is the amount of X-ray quantum noise contained in
the scan data used to reconstruct the image. Most technologists know how the choices of X-ray
scan technique factors affect image noise. That is, noise decreases with the inverse square root of
the mAs and slice thickness. Noise also decreases approximately inversely with kVp. For
example, increasing the mA from 50 to 200 (a factor of 4) will decrease quantum noise by a factor
of 2 (the square root of 4). Quantum noise also increases with increasing helical pitch; however,
the exact relationship is dependent on the details of the helical reconstruction process.

The most significant factor that influences the quantum noise in the scan data is the X-ray
attenuation of the patient section being scanned. The X-ray attenuation is related to the size and
tissue composition of the patient section. Figure 11-15 shows a distribution of patient attenuation
area values (PAA) for adult abdominal images that ranges from 19 to about 41 with a mean of 27.6
(for this patient sample set). The patient attenuation area (also called the Patient Attenuation
Indicator, PAI)1 is computed for the patient section as the square root of the product of the sum of
raw pixel attenuation values times the pixel area.

Figure 11-15 Adult abdominal patient distribution in terms of average patient attenuation

1T Toth, Z.Ge, and M. Daley,"The influence of bowtie filter selection, patient size and patient centering on CT dose and image
quality", Poster SU-FF-I42, 2006AAPM Conference (MedPhy, Vol 33, No.6, June 2006)

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Figure 11-16 Example small patient (PAI = 20) with factor of 5 noise increase (simulated)

For a given fixed scan technique, the quantum noise varies by about a factor of 5 from the smallest
to the largest patients attenuation (PAI range of 17 to 41). Figure 11-16 shows an example of a five
times noise increase simulated for a small patient (20 PAI). With a fixed mA scan protocol, the
technologist must select the mA using a qualitative estimate of the patient attenuation. This may
be accomplished using patients weight, diameter measurements, body mass index, or just as a
qualitative visual classification. Because these methods provide very rough X-ray attenuation
estimates and do not account for attenuation changes within the patient region being scanned, the
technologist must use a high enough technique margin to avoid the possibility of compromising the
diagnostic quality of the images with too much noise. Since dose is inversely related to the square
of the noise, many patients are likely to be receiving more dose than necessary for the required
diagnostic quality using such manual methods.

Automatic tube current modulation: AutomA is an automatic tube current modulation feature that
can make necessary mA adjustments much more accurately than those estimated for the patient
by the user and thereby can obtain a more consistent desired image noise in spite of the wide
range of patients. Since image noise variability is substantially reduced, a significant overall patient
dose reduction is possible with proper scan parameter selection.

AutomA (Z-axis modulation) adjusts the tube current to maintain a user selected quantum noise
level in the image data. It regulates the noise in the final image to a level desired by the user.
AutomA is the CT equivalent of the auto exposure control systems employed for many years in
conventional X-ray systems. The goal of AutomA is to make all images contain similar X-ray
quantum noise independent of patient size and anatomy.

The AutomA tube current modulation is determined from the attenuation and shape of scout scan
projections of the patient just prior to CT exam sequence.

SmartmA (angular or xy modulation) has a different objective than Z-modulation. It adjusts the
tube current to minimize X-rays over angles that have less importance in reducing the overall
image noise content. In anatomy that is highly asymmetric, such as the shoulders, X-rays are
significantly less attenuated in antero-posterior (AP) direction than in the lateral direction. Thus,
the overwhelming abundance of AP X-rays can be substantially reduced without a significant
effect on overall image noise.

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Angular modulation was first introduced on GE single slice scanners in 1994. 1, 2

AutomA Theory
AutomA is an automatic exposure control system that employs Z axis tube current modulation and
is available on all GE multislice scanners. A noise index parameter allows the user to select the
amount of X-ray noise that will be present in the reconstructed images. Using a single patient
scout exposure, the CT system computes the required mA to be used based on the selected noise
index setting. The noise index value will approximately equal the standard deviation in the central
region of the image when a uniform phantom (with the patient's attenuation characteristics) is
scanned and reconstructed using the standard reconstruction algorithm.

Figure 11-17 Example noise variation with fixed mA and mA variation with AutomA with a Noise
Index setting

The system determines the tube current using the patient's scout projection data and a set of
empirically determined noise prediction coefficients for a reference technique. The reference
technique is the selected kVp, and an arbitrary 2.5 mm slice at 100 mAs for an axial reconstruction
using the standard reconstruction algorithm. The scout projections contain density, size and shape
information about the patient. The total projection attenuation (projection area) contains the patient
density and size information and the amplitude and width of the projection contains the patient
shape information. These patient characteristics determine how much X-ray will reach the detector
for a specified technique and hence predict the image standard deviation due to X-ray noise for
the standard reconstruction algorithm.

1
L. Kopka and M. Funke, "AutomAticallyadapted CT tube current: Dose reduction and image quality in phantom and patient
studies," Radiology 197 (P), 292 (1995)

2D.R. Jacobson, W. D. Foley, S. Metz, and A. L. Peterswen, "Variablemilliampere CT: Effect on noise and low contrast
detectability,"Radiology 210(P), 326 (1996)

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To predict the image noise at a given z position for the reference technique, the projection area
and oval ratio are obtained from the patient's scout. The oval ratio is an estimate of the patient
asymmetry that is determined from the amplitude and width of the projection data. The expected
X-ray noise for the reference technique (reference noise) is then calculated as a function of the
projection area and oval ratio from the scout using polynomial coefficients that were determined by
a least squares fit of the noise measurements from a set of phantoms representing a clinical range
of patient sizes and shapes.

Knowing the reference noise and the difference between the reference technique and the selected
prescribed technique, the mA required to obtain the prescribed noise index is calculated using well
know X-ray physics equations. That is, the noise is inversely related to the square root of the
number of photons and the number of photons is proportional to the slice thickness, slice
acquisition time, and mA. In the GE AutomA design, an adjustment factor for helical pitches is also
incorporated in the calculation to account for noise differences that scale between helical
selections and the axial reference technique.

AutomA FAQs
1. What suggestions do you have for a new AutomA user?

 If you are not familiar with the concept of noise index (image noise) you can use the GE
reference protocols that have automa enabled as a starting point, use the standard
deviation from an acceptable image for approximation of a noise index, or consult the
literature until you find the highest noise index value that provides acceptable diagnostic
quality. Experiment by scanning some phantoms with different noise index values to gain
some confidence. A 30 cm diameter water phantom or a 35 cm diameter low density
polyethylene phantom have an attenuation similar to the average adult abdominal patient
(27.6 PA).
 It is important to review the image quality that is obtained with the noise index selected to
optimize your mA range and noise index values accordingly.
 You should also check the mA table on the scan set up screen to see what mA is actually
being used. If you see that it is frequently at the maximum mA range, consider increasing
the noise index if more noise can be tolerated in your reconstructed images without
compromising the diagnostic value, or increase the maximum mA limit if it is not at the
maximum limit of the x-ray generator and you have determined that you require lower
noise in your images than you are currently obtaining. Each dose step decrease will
increases the Noise Index by 5% and reduces the mA in the mA table about 10%.
 If you normally reconstruct images with thin sections for 3D reformatting and thicker slices
for axial viewing it is important to understand that the first prospective reconstructed slice
thickness is used for calculating AutomA. Generally you would want to set the noise index
for the thicker slice images. For example, you might want a noise index of 10.0 for 5 mm
thick images for viewing but you may also want 0.625 mm slices for 3D reformatting. If you
prescribe the 0.625 mm slice recon first followed by the 5 mm recon, AutomA will calculate
the mA needed to obtain an image noise of 10 for the 0.625 mm slices since it is
prescribed first. In this case, to avoid excessively high mA and high dose, you need to
readjust the noise index using the following approximation:

ViewingSliceThickness
RxNoiseIndexthin  RxNoiseIndexthick 
FirstRxSliceThickness

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Example:

5mm
28.3  10 
0.625

2. Why is the standard deviation I measure in the image some times different than the
noise index I selected for the scan?

 There are many factors that can account for this. But, first consider that the noise index
setting you make only causes the tube current to be adjusted so that the system projects a
similar X-ray intensity through the patient to the detector. Hence it regulates the X-ray
noise or quantum noise in the scan data. The noise in the image depends on other factors
as well. The selection of reconstruction algorithms, reconstructed slice thickness selection
(if different than your prospective selection), and the use of image space filters will also
change the noise in the image. In addition, it is very difficult to make standard deviation
measurements on patient data since the standard deviation is affected by small CT
number variations of the anatomy and by patient motion or beam hardening artifacts. Even
with uniform phantoms, standard deviation measurements will produce some variability in
measured results because of the inherent nature of quantum statistics.
 Another situation that can cause significant differences between the selected noise index
and the image standard deviation is when very large patients provide insufficient detector
signal. In these cases, electronic noise sources can become the dominant image noise
source instead of X-ray noise. In these cases at various threshold levels, special
projection data dependent filters begin to be applied to help preserve image quality. The
highest kVp is recommended when excessively large patients are to be scanned.
 Another factor is how well the patient is centered in the SFOV. Image noise can increase
significantly if the patient is mis-centered. This occurs because the bowie filter projects
maximum X-rays intensity at isocenter since this is the region of maximum attenuation if
the patient is centered. If the patient is mis-centered, there are fewer X-rays projected to
the thickest part of the patient, and hence image noise will increase. The optimum strategy
is to find the highest noise index sufficient for the clinical task and let AutomA select the
mA without using significant constraints.
3. Will I get a dose reduction when I use AutomA?

 AutomA will use a dose that depends on the noise index you select and the size of the
patient you are scanning. If, you do not obtain a dose reduction over a population of
patients, you may have selected a lower noise index than you really need and this results
in higher mA values on average than your fixed mA protocols. One strategy to avoid using
more dose is to set the max mA parameter to the same level as your fixed mA protocols.
This will cap the maximum dose to the same level as your fixed mA protocol. Hence,
AutomA will never be allowed to use more dose then you previously used. However,
image noise will increase in regions where the mA is limited by the max mA selection and
the IQ will degrade with increasing patient size. The optimum strategy is to find the highest
noise index sufficient for the clinical task and let AutomA select the mA without using
significant mA limits.
4. Why do my images seem noisier when I use AutomA?

 AutomA will produce an X-ray intensity to maintain the noise index you select. Thus, you
may need to use a lower noise index. This may be the case if you find that the average mA
for your population of patients is generally lower than your previous fixed mA protocols.
This situation indicates you are using lower dose and hence higher noise levels would be
expected.

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 Certain patient images may also be noisier than your experience suggests. For example,
your experience tells you to expect significantly lower noise in thin patients than obese
patients. Since AutomA makes the image noise approximately the same for all patients,
you may have to re-learn what to expect. What is most important, is to find the highest
noise index that allows you to make a confident diagnosis for the clinical problem since
this results in the lowest patient dose.
 If you desire somewhat lower noise in small patients, you may want to create Small,
Nominal, and Large patient protocols. You can use the slightly a slightly lower noise index
for the small patients and a slightly higher noise index for large patients.
 A conditional noise limiting strategy you can employ, is to increase the low mA range
parameter. If you find that images are generally not acceptable to you below some
minimum mA value, then you may set this value as the low mA range limit. This will
prevent AutomA from using lower mA values than you desire. Note, however, that this
defeats the purpose of AutomA and causes the image noise to decrease below the
selected noise index and thereby increases the dose.
 Yet another possibility for higher noise than you might expect is if you are looking at
multiple reconstructed images that have thinner slices than the prospective scan Rx slice
thickness. AutomA uses prospective slice thickness as a factor when the mA table is
generated. You need to be sure the noise index is set for the first prospective image based
on image thickness you will use for axial image viewing (see FAQ 1). This caveat applies
equally for fixed mA as well as AutomA scanning.
 Higher noise images can also occur when patients are not well centered in the scan field
of view. The bowtie filter attenuation increases with distance away from isocenter. Hence
the thickest part of the patient should be approximately centered in the scan field of view.
Otherwise image noise will increase since the patient thickness adds to the bowtie filter
thickness. This is especially important for highly asymmetric anatomy such as through the
shoulders. Again, this effect is no different with AutomA than with fixed mA.
 Recognize also that there are also some obese patients that exceed the capabilities of the
tube and generator to satisfy the selected noise index. This is also no different than fixed
mA scanning. For such obese patients, one strategy is to select a higher kVp setting when
possible.
5. Why is the mA that is annotated on the image sometimes slightly different than the mA
I see in the mA table?

 The mA displayed on the image is determined by measuring the generator mA during the
scan and averaging the measured result over the total number of views used to
reconstruct the image. The number of views used to produce the image may be more than
one gantry rotation for a helical scan. Hence the annotated value is a combination of the
mA table values that depends on how many views from each rotation were used for the
image. In addition, the generator is automatically adjusting the filament current to account
for changing conditions during the scan to keep the mA within the desired tolerance of the
commanded mA table. For example, this is why you may see an mA value of 41 in the
image where the mA table indicated 40.
6. I understand that noise in the image noise changes with reconstruction parameter
selections, but why is the noise sometimes different when I retro reconstruct the same
scan data at a different display field of view?

 When you select a reconstruction algorithm, the system may sometimes re-adjust the
actual filter Algorithm. This readjustment will change the image standard deviation. This
will happen if the display field of view selection exceeds a certain size and is especially
apparent with higher resolution algorithms such as Bone and Edge. The change in
Algorithm is required when the DFOV selection makes the pixel size too large to support
the intended spatial resolution. This characteristic is independent of AutomA.

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kV Assist
There is growing interest in optimizing the tube voltage, kV, to minimize the radiation dose of a CT
scan. Lowering the kV has a significantly higher impact on the dose than lowering the mA, but kV
also has a very complex interaction with other scan technique and image quality factors. The
optimization of kV and mA parameters and image quality factors are also clinical task dependent.

 Lowering kV with a constant mA level will lower the radiation dose and can increase the image
contrast in certain clinical tasks. It will always significantly increase the image noise.
 Lowering the kV with AutomA can increase the image contrast in certain clinical tasks and will
keep the image noise constant. It will have very little effect on the radiation dose.
Careful optimization of the kV, mA/AutomA and WW/WL settings can maintain or improve image
quality while reducing radiation dose in the context of specific clinical tasks.

When a tube voltage is selected, the desire is to pick the optimal tube voltage for the particular
patient and clinical task, based on some criterion. This optimization could be performed, for
example, in order to lower the amount of radiation dose associated with a CT scan, or to decrease
the amount of contrast agent delivered to the patient or to improve image quality in terms of image
contrast. For kV Assist, the goal is to optimize the tube voltage for radiation dose reduction. In
order to understand how the tube voltage can be optimally selected, it is beneficial to examine the
background of the impact of kV on CT imaging.

Background
Two significant factors that impact the quality of a CT image are the amount of X-ray quantum
noise and of X-ray contrast (either from contrast agent administered to the patient or from tissues
in the patient) in the scan data used to reconstruct the image. One key CT image quality factor is
the Contrast-to-Noise Ratio. Contrast-to-Noise Ratio gives an indication of how well structures can
be seen through the image noise. Contrast-to-Noise Ratio can be improved by increasing the
contrast between structures, lowering the noise level, or both. If one assumes that only a single
tube voltage will be used, these factors simplify to noise. For example, historically many CT scans
have been performed at 120 kV. In that case, the behavior of how image noise, and therefore
Contrast-to-Noise Ratio, is impacted by X-ray scan technique factors can be understood from the
description of AutomA. In this case where a particular tube voltage is used, the use of AutomA
allows the scanner to adjust the tube current for the patient size and tissue composition in order to
obtain a more consistent image noise.

In a more general look at X-ray scan technique factor setup, the behavior of image noise and
contrast becomes more complicated. In this case, the quality is impacted not only by the number
of X-rays that reach the detector, but also by their energy. This is impacted by what X-rays the
system generates (how many [tube current] and at what energies [tube voltage]), and how much
they are attenuated (patient size and composition). The selection of the tube voltage is related to
the desired image contrast because, for some materials, the amount of X-ray stopping power
varies greatly with the energy of the X-ray. The selection of the tube current is related to the
desired image noise, but it must be noted that it is also greatly impacted by the tube voltage
selection. For example, the number of X-rays produced at 100 mA at 80 kV is approximately three
times less than the number produced at 120 kV. AutomA, for example, compensates for this once
you select the tube voltage, but does not aid in tube voltage selection.

The selection of tube voltage in combination with tube current is important because the goal of
technique setup is to pick the parameters that give the desired image quality at the lowest
radiation dose. The behavior of both the image quality and the radiation output of the scanner is

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directly impacted by both the tube voltage and tube current selection. To help compensate for
patient size and tissue composition without impacting the clinical workflow, an assisted approach
for kV selection has been integrated into the Revolution Discovery CT scanner under the name kV
Assist.

kV Assist is a tube voltage selection feature that can suggest the optimal kV based on the
attenuation of the Scout image, and thereby provide a consistent desired image quality despite the
wide range of patients. This feature works in conjunction with both AutomA and Manual mA in
order to adjust the Noise Index/mA as needed once the kV is selected. In addition, because the
selection of kV and mA may result in differences in the image appearance relative to historical
techniques, kV Assist can also automatically modify WW and WL in order to optimize the image
display.

Theory
The selection of the tube voltage has a large impact on the number of X-rays that are used and
their energy. Higher energy X-rays have greater penetrating power, but provide less image
contrast. Lower energy X-rays have lower penetrating power, but provide more image contrast.
Some materials, such as iodine, have a large change in X-ray attenuation with energy (and
therefore have a large change in the resulting image contrast). For the example above (with
contrast at 80 kV approximately 1.6 times contrast at 120 kV), maintaining the CNR could be
achieved with a 60% and 20% increase in noise at 80 kV and 100 kV, respectively. This would
result in significant dose reduction. Other materials, such as water, have little change in X-ray
attenuation with energy (and therefore have little change in the resulting image contrast).

For the materials that do produce greater image contrast at different tube voltages, the resulting
image quality may be improved if the noise is kept constant when the tube voltage is lowered. This
is based on the impact that the Contrast-to-Noise Ratio has on image quality.1 2 Therefore, you
could maintain the image noise at a lower tube voltage with improved image contrast, in order to
improve the Contrast-to-Noise Ratio. Alternatively, you could maintain the image noise and reduce
the amount of contrast agent (if relevant) in order to maintain the Contrast-to-Noise Ratio. A third
option is to increase the image noise in order to maintain the Contrast-to-Noise Ratio while
reducing the radiation dose to the patient. kV Assist takes this third approach in order to maintain
the image quality and prevent excessive noise increase while reducing the radiation dose. For the
example above (with contrast at 80 kV ~ 1.6 times contrast at 120 kV), maintaining the Contrast-
to-Noise Ratio could be achieved with a 60% and 20% increase in noise, respectively. This would
result in significant dose reduction.

For many cases, maintaining the Contrast-to-Noise Ratio of a particular material may not be
clinically acceptable. Instead, both Contrast-to-Noise Ratio and overall image noise should be
taken into account. 3 kV Assist balances the consideration of Contrast-to-Noise Ratio and image
noise based on your selections on the kV Control screen (Figure 11-18).

1W Huda, EM Scalzetti and G Levin, “Technique Factors and Image Quality as Functions of Patient Weight at Abdominal CT.”
Radiology (2000), 217(2): 430-435.
2
JM Boone, EM Geraghty, JA Seibert and SL Wooten-Gorges, “Dose Reduction in Pediatric CT: A Rational Approach.” Radiology
(2003), 228(2): 352-360.
3
L Yu, H Li, JG Fletcher and CH McCollough, “Automatic Selection of Tube Potential for Radiation Dose Reduction in CT: A
General Strategy.” Medical Physics (2010), 37(1): 234-243.

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Figure 11-18 kV Control Screen in Scan

kV Assist will take the patient size information from the Scout, the initial/baseline kV, and the initial/
baseline Noise Index/mA as the starting point, along with the user preference parameters on the
kV Control screen into account for the selection of kV. The recommendation from kV Assist will be
a consistent set of parameters affecting the scanning and viewing of the images.

kV Assist will recommend:

 kV
 mA/NI – to meet Contrast-to-Noise Ratio for clinical task
 WW and WL settings adjusted based on the image contrast and noise changes
These parameters must be consistent; any direct adjustment of these parameters by the user will
disable kV Assist for the current scan.

With kV Assist, you can select between four clinical modes for each scan.

Table 11-10 kV Assist Clinical Modes

Clinical Modes Scan Situation Region of primary importance

CT Angiography (CTA) iodinated contrast agents are used enhanced tissue regions
Bone, non-contrast (BONE) contrast agents are not used bony regions
Soft Tissue, contrast-enhanced (C+) iodinated contrast agents are used both enhanced and non-enhanced tissue regions
Soft Tissue, non-contrast (C-) contrast agents are not used non-enhanced tissue regions

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Figure 11-19 kV Control Screen in Protocol Management

The system determines the patient size from the scout projection data in each mode. This is used
in conjunction with a reference protocol (i.e., the X-ray scan technique factors that would be used
without kV Assist) to determine the expected amount of image contrast for the relevant materials.
The system then determines the Noise Index/tube current needed to provide the proper balance
between Contrast-to-Noise Ratio and image noise at each of the tube voltages. The combination
of tube voltage and Noise Index/tube current that results in the lowest CTDIvol at the desired image
quality is then selected. Note that the tube voltage with the lowest CTDIvol may not be selected for
some patient sizes and applications in order to maintain the desired image quality (e.g., in order to
avoid situations where potential image artifacts could occur).

The Dose Savings control gives you the ability to fine-tune the balance between Contrast-to-Noise
Ratio and image noise in each mode. It has three levels defined in Table 11-11. The Dose Savings
adjustment can be made and saved per protocol or scan, which allows you to fine tune the Dose
Savings per application or per patient. The adjustment of this parameter will primarily affect the
mA/NI adjustment, but may also affect the kV selected. If even more or less Dose Savings is
desired than can be achieved using the Dose Savings control, the baseline protocol values for kV,
NI/mA may need to be adjusted for kV Assist to provide further changes for Contrast-to-Noise
Ratio and radiation dose.

Table 11-11 Dose Savings Levels

Dose Savings Level Description

+ Provides a stronger trade-off between noise and image quality (and radiation dose) if you
find the Normal level Contrast-to-Noise Ratio/noise balance not aggressive enough.
Normal Default Contrast-to-Noise Ratio/noise balance level.
- Provides a more conservative trade-off between noise and image quality (and radiation
dose) if you find the Normal level of Contrast-to-Noise Ratio/noise balance to be too
noisy. This may also result in a kV selection that is skewed more towards the reference
protocol.

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In addition to the impact of kV Assist Mode and Dose Savings level on kV selection, there may be
clinical situations in which you wish to lock out a kV or range of kV stations. This can be
accomplished using the kV Range settings on the kV Control screen (Figure 11-19) during protocol
setup. For example, if your site does not want kV Assist to select 80 kV for head scans, the head
protocol can be constructed with kV min = 100 kV and kV max = 140 kV. In this case, the kV Assist
feature would only select kV settings of 100, 120, or 140 kV.

Besides locking out a kV (or range of kV stations), you may wish to select a particular kV (e.g., in a
longitudinal study) while retaining the kV Assist update to the Noise Index/tube current. This is
possible with kV Assist through a control on the kV Control screen (Figure 11-18) at scan time.
Here, you can accept the recommended kV or select a different kV. When a different kV is
selected, kV Assist automatically updates the Noise Index/tube current based on the kV Assist
Mode and Dose Savings.

One final consideration is that you may wish to not deviate from your reference protocol unless
there are substantial dose savings to be made. Because there are difference preferences on what
is substantial, an additional control (Minimum CTDIvol Adjustment) is given in the kV Assist
Configuration to set a minimum CTDIvol savings that must be met in order for a kV other than the
baseline kV value to be suggested. For example, if the CTDIvol savings are less than 5%, the site
may not want to change the kV. This is handled appropriately by the kV Assist design.

Image Display
Images of the same anatomy scanned with different tube voltages appear different. This is
expected, because of the description above regarding Contrast-to-Noise Ratio changes. For
example, images obtained with X-ray scan technique factors set by kV Assist could be brighter in
areas (due to increased contrast) and noisier (due to increased noise). Even though similar
information is present in the image, the change to the image appearance could be distracting. In
order to minimize this change, kV Assist also provides the option for the system to modify the
protocol’s reference WW and WL (i.e., the WW and WL that would be used without kV Assist for
an average patient).

Figure 11-20 displays an example of three acquired images. The top image is from a conventional
liver scan. The middle image shows the impact of acquiring at a lower tube voltage with kV Assist
(higher iodine image contrast, and higher image noise). The bottom image (which appears more
similar to the original image) has the WW and WL adjusted based on the expected change in
image contrast and noise.

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Figure 11-20 Original image (top); Image with higher iodine contrast and noise (middle);
Same image as middle with WW and WL adjusted (bottom)

Adjustment of the WW and WL (if selected in the protocol or scan) is based on the kV Assist Mode
and Dose Savings, as well as the reference WW and WL. In the case where image contrast is
increased, the WL is adjusted to compensate for the brighter pixels. In the case where image

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noise is increased, the WW is adjusted to compensate for pixel variations. In addition, in order to
provide the capability to fine-tune the display changes that are made (per scanner), an additional
control is given in the kV Assist Configuration (Figure 11-21) to set how strong the WW and WL
changes are. Optimize WW/WL updates the window width and window level values entered in
Recon Option and Filming screens.

Figure 11-21 kV Assist Configuration

Table 11-12 kV Assist Configuration Parameters

Parameter Description
Minimum CTDIvol Adjstment 1%, 5%, 10%, 20% selections for kV Assist define the amount of dose savings to be
achieved before changing kV from current kV. Another way to look at it is -do not
change the kV unless there is at least a 1%, 5%, 10% or 20% dose savings.
WW/WL Adjustment Less, Normal, More sets the strength of adjustment in the WW/WL values when
Optimize WW/WL is enabled.

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Parameter Description
mA Limits (Auto mA) Allows the system to change the minimum/maximum mA values as needed for kV
specified in kV Assist, or, to operate within the minimum/maximum mA values specified
for the protocol in AutomA for selection of kV in kV Assist. If the mA (for a kV) is the max
mA value such that the mA is being limited by the range specified, kV Assist will not be
able to select that kV value. If the mA values (for all kV values) are at the max mA value,
kV Assist will not be able to select a kV value.

Whenever a scan is prescribed using AutomA, the scan setup uses limits for minimum
and maximum mA in order to allow you to limit the range over which the system can
modulate the mA. The maximum mA limit, for instance, allows you to restrict the
maximum amount of radiation emitted from the system during the scan. Because of the
interaction between tube voltage and tube current, however, the scanner output at a
fixed mA value is very different between kV stations. This is especially important for kV
Assist, since the scan kV may be different from the baseline kV in the protocol. This
could result in very different behavior if the same mA limit is used.

For example, if you select a maximum mA limit of 440 mA at 120 kV, and then perform a
scan at 80 kV (with the same 440 mA limit), the maximum mA output during the scan (at
the maximum mA limit) could be 2-3 times lower than expected. This is equivalent in
terms of maximum output to a scan at 120 kV with a mA limit of ~150-220 mA, which
may not be the desired behavior. In order to prevent you from having to perform this
type of calculation manually in order to update mA limits when a new kV is used, kV
Assist can be configured to automatically update the mA limits for the kV selected. In
this case, the mA limits are set in order to achieve the same minimum / maximum
scanner radiation output as at the baseline kV (up to the system limits). Alternatively, if
you prefer the same mA limits for all kV stations, kV Assist can be configured to not
modify the mA limits.

kV Assist FAQs
What suggestions do you have for a new kV Assist user?

 If you are not familiar with the concept of noise index (image noise), see AutomA. In order to
become familiar with kV Assist's impact on images, you can experiment by scanning different
phantoms (ones that include regions of contrast are most appropriate for evaluating the
modes based on contrast agent enhancement). Start with the Normal Dose Savings level and
increase or decrease as needed to meet clinical needs.
 Review the image quality that is obtained with the kV and Noise Index/mA selected to optimize
the settings.

Why is the kV the lowest CTDIvol not always the recommended kV?

Based on the mode and the size/composition of the patient, kV Assist may not recommend some
tube voltages that could result in degradation in image quality. You can manually select the tube
voltages and use the Noise Index/tube current calculated by kV Assist if you would like to move
beyond what kV Assist recommends.

What if a message states that no kV is possible?

The situation where no kV is possible can occur for several reasons, including:

 The NI in the reference protocol could be too low, which requires more tube current than is
achievable at any kV. Check the Noise Index and the mA table.

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 The kV range could be limited to kV stations that require more tube current than is achievable.
Check the Noise Index and the mA table.

Can kV Assist be used for all scan types?

 kV Assist is not compatible with cardiac scans. Snapshot Assist can be used to help set up
scans based on the attenuation of the patient being scanned.
 kV Assist is not compatible with GSI scans. GSI Assist can be used to help set up scans
based on the attenuation of the patient being scanned.
 kV Assist is not compatible with Biopsy, SmartStep and SmartView modes for interventional
where kV and mA have specific settings to meet the clinical goal.
 kV Assist is not compatible with modes used for perfusion imaging such as VolumeShuttle and
Volume Helical Shuttle where specific kV and mA requirements in these protocols need to be
met.

What if I do not want to view head images at 80 kV?

For some applications, such as brain scans, it may be desirable to avoid low tube voltages. In
cases such as this, the kV Assist setup in the protocol alllows you to define the kV range over
which kV Assist can provide a tube voltage recommendation.

What if the dose reduction results from kV Assist are not as large as I would like?

If the image quality away from the reference technique is better than required and the dose
reduction is lower than desired, you can increase the Dose Savings level for a given mode (e.g.
Dose Savings “-“ to Dose Savings “Normal” or Dose Savings “Normal” to Dose Savings “+”). If the
Dose Savings is already set to “+”, you can move to the next stronger mode (the modes are given
in order from strongest to weakest: CTA, BONE, C+, C-). For any scans, you can always manually
override the Noise Index/tube current to fine tune the technique.

What if the images produced by kV Assist appear too noisy?

If the image quality away from the reference technique is lower than required, you can decrease
the Dose Savings level for a given mode (e.g. Dose Savings “+“ to Dose Savings “Normal” or Dose
Savings “Normal” to Dose Savings “-”). If the Dose Savings is already set to “-”, you can move to
the next weaker mode (the modes are given in order from strongest to weakest: CTA, BONE, C+,
C-). For any scans, you can always manually override the Noise Index/tube current to fine tune the
technique.

How are mA limits for AutomA adjusted if kV Assist is configured to adjust the mA limits as
needed?

kV Assist will scale the mA limits at each kV in order to achieve the same minimum / maximum
scanner radiation output as at the baseline kV (up to the system limits). Because of the interaction
of tube voltage and tube current, this will result in higher mA limits at lower kV stations and lower
mA limits at higher kV stations.

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How will the behavior of kV Assist differ between mA limit configurations?

If kV Assist is configured to not adjust mA limits, the selection of lower kV stations may be
restricted. This can occur because of the interaction of tube voltage and tube current, which
dictates that higher mA values are needed when scanning at a lower kV. If the mA limit is not
adjusted by the system, it is more likely that the higher mA values needed at a lower kV would fall
above the mA limit. The actual system performance will depend on the mA limits set, as well as the
patient size and kV Assist mode.

How do mA limits effect kV Assist selection of kV?

If an AutomA scan prescription for a given patient would result in mA values falling below the
minimum mA limit, the mA values are adjusted to always fall above the minimum limit (i.e. clipped).
The kV may still be selected by kV Assist (with the dose calculation determined by the clipped mA
values). If a scan prescription for a given patient would result in mA values exceeding the
maximum mA limit, the mA values are adjusted to always fall below the maximum limit. In this
case, kV Assist would not recommend this kV since the resulting image quality could be
suboptimal. In this case, you can still override the selected kV on the kV Control screen and
perform the scan if deemed appropriate.

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ECG-Modulated MA Theory
Electrocardiograph Tube Current Modulation
Modulating tube current based on an electrocardiograph (ECG) signal is a technical innovation
that significantly reduces radiation dose to cardiac patients. The concept is based on the
fundamental principles of cardiac CT imaging.

ECG-modulated mA Theory
The motion of the heart has always been challenging for diagnostic imaging of the heart and
surrounding areas. Motion can cause blurring and mis-registration artifacts in images. Cardiac CT
acquires images when the heart motion is minimal. The motion is generally least near the end of
the diastolic phase of the cardiac cycle. The motion is generally greatest during the systolic phase
of the cardiac cycle, in which the heart is contracting. The ECG-modulation feature takes
advantage of this fact, and only provides full tube current to the patient during the diastolic period
of the cardiac cycle, which is most likely to produce the best image quality. The tube current is
modulated to a lower mA setting during systole to decrease the dose to the patient.

ECG-modulated mA applies to cardiac helical scans only. Cardiac helical acquisitions utilize
retrospectively gated reconstructions. Without ECG-modulation, radiation is on for the entire
length of the scan and images can be created at any phase of the cardiac cycle. ECG electrodes
are connected to the patient prior to the scan and an ECG monitor stores the ECG data during the
scan. The scanner measures one full heart period as the time from one QRS complex to the next.
The QRS complex is the portion of the ECG waveform corresponding to ventricular depolarization
signaling contractions. A particular time period in the cardiac cycle is prescribed in terms of a
percent phase of the heart period. With the ECG gating information and acquisition data from the
entire scan, the image reconstruction software can retrospectively create images centered on any
phase in the cardiac cycle. For most patients, 75% is considered to be the best phase for imaging
of the coronary arteries.

The ECG-modulated mA feature requires the user to input the maximum and minimum tube
current values and the start and end cardiac phase for the tube to be at maximum current for each
cycle. Minimum tube current can be no less than 20% of the maximum. Twenty-percent of the
peak mA may yield adequate image quality at systole to assess cardiac function from images
generated outside of the maximum mA phases. Start and end phases can be prescribed from 0 to
99% of the cardiac cycle. The scan will start off at the maximum tube current. The algorithm uses
a moving average of the heart periods to predict when the next QRS complex will occur. Once the
initial average is set, the system will start modulating the tube current. To guarantee the tube
current is at the minimum and maximum values when it should be, the system must take into
account the time required for the generator to ramp the tube up to maximum current and down to
minimum current.

In the event that the patient should experience a pre-ventricular contraction (PVC) or a missed
beat, there is the possibility that the images at full mA could become shifted from the prescribed
phases. The system has special checks in place for these abnormal heart beat situations and will
immediately ramp the tube up to full current in order to minimize the number of noisy images that
can occur during these abnormal cycles. Once the heart has settled into a normal rhythm again,
the system will resume modulation.

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Figure 11-22 ECG Waveform

ECG Waveform 1

265 ms

Reconstruction 2
Window

Cardiac Phase % 3

0% 25% 50% 75% 0% 25% 50% 75% 0% 25% 50% 75%

mA Magnitude 4
100%

50%

Minimum mA Threshold

Images at 70%, 75%, 80% 5

In this example, Start Phase = 70%, End Phase = 80% 6

Table 11-13 ECG Waveform

Number Description
1 ECG Waveform
2 Reconstruction Window
3 Cardiac Phase %
4 mA Magnitude
5 Images at 70%, 75%, 80%
6 In this example, Start Phase =70%, End Phase = 80%

Organ Dose Modulation (ODM)

The tube current is reduced where tube position is between -90 degree (°) and +90 degree (°).
Refer to Figure 11-23 and Figure 11-24.

ODM is only available when SmartmA is enabled within AutomA in the mA Control menu.

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Figure 11-23 mA modulation of Organ Dose Modulation

Table 11-14 Descriptions

Number Description
1 Anterior body surface
2 Posterior body surface
3 mA value
4 View Angle (deg. (°))

Figure 11-24 mA modulation angle of Organ Dose Modulation

Table 11-15 Descriptions

Number Description
1 Basic concept of sensitive organ dose modulation
2 Virtual bismuth on the scout image with localizer
3 Shielding angle (mA reduction)

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System Operational Modes

Overview
The system provides powerful data collection capability with following scan modes:

 Scout
 Axial
 Axial Scanning
 VolumeShuttle (Axial) mode
 Gemstone Spectral Imaging
 Helical
 Helical Scanning
 Volume Helical Shuttle Mode
 Gemstone Spectral Imaging
 Cardiac
 SnapShot Segment
 SnapShot Burst
 SnapShot Burst Plus
 SnapShot Pulse
 Gemstone Spectral Imaging SnapShot Pulse
 Cine
 Cine Scanning
 Gemstone Spectral Imaging

Scout (Reference YY0310)

Scout imaging is used for anatomical location in conjunction with scan and recon prescription, to
provide an anatomical cross-reference for axial images, and to provide quick feedback to the user
as to the anatomy scanned. Scout supports the following features:

 All kV and mA stations available, dependent on generator and tube limitations.

 100mm/sec table speed (75mm/sec).
 Data collected in 5mm Aperture acquisition mode.
 Data collected on large focal spot.

Scout Orientation
Presets: Anterior Posterior, Right Lateral, Posteriaor Anterior, Left Lateral

Manual: 0-359 degrees in increments of one degree.

Pediatric Imaging
Adult techniques and protocols should not be used on pediatric patients. Refer to the User Manual
on Imaging Pediatric and Small Patients.

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Axial and Cine Scans

Axial and Cine imaging features include:

 All kV and mA stations available, dependent on generator and tube limitations.

 Rotation speeds: 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, and 2.0 second for Axial.
 Rotation Speeds: 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, and 1.0 second for Cine.
 Variable Image Thickness selections: 0.625, 1.25, 2.5, and 5.0 mm.
 Sample rates: 492Hz-6240Hz
 The system can acquire up to 64 axial slices
 Segmented reconstruction option is available for Cine scans
 Scout data is collected on large focal spot.
 Scout Orientation
 Presets: Anterior Posterior (AP), Right Lateral (R Lat), Posterior Anterior (PA), Left Lateral
(L Lat).
 Manual: 0-359 degrees in increments of one degree.
Table 11-16 :Axial Mode Slice Thickness selections

Scan Mode 1i 2i 4i 8i 16i 32i 64i 128i

2 X 0.625 1.25 N/A N/A N/A N/A N/A N/A N/A
4 X 0.625 2.5 1.25 N/A N/A N/A N/A N/A N/A
8 X 0.625 5.0 2.5 1.25 N/A N/A N/A N/A N/A
16 X 0.625 N/A 5.0 2.5 1.25 0.625 N/A N/A N/A
32 X 0.625 N/A N/A 5.0 2.5 1.25 0.625 *0.625 N/A
64 X 0.625 (64 slice N/A N/A N/A 5.0 2.5 *1.25 *0.625 *0.625
only)

* Prescribed in Retro Recon only.

NOTE The 1i, 1.25 mm mode is intended for high resolution lung screening with an allowable
increment of no less than 5 mm. This is a special higher resolution mode and normal
imaging specifications like noise, CT number accuracy, and uniformity do not apply.

The 2i, 1.25 mm mode is intended for biopsy applications. Normal imaging specifications
like noise, CT number accuracy and uniformity do not apply.

128i images from 64x0.625 have ¼ detector offset.

64i images from 32x0.625 have ¼ detector offset.

VolumeShuttle (Axial)
VolumeShuttle Mode is a repetitive axial scan mode, where the table shuttles (moves back and
forth) between two adjacent axial locations with minimal interscan delay. No gaps are allowed with
VolumeShuttle Mode. Only 40 mm detector coverage is allowed.

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Figure 11-25 VolumeShuttle (Axial) Illustration

Helical Scans
The system supports helical mode imaging using two beam collimations, 32x0.625 and 64x0.625.
Additionally, the system supports the following selections during helical scanning:

 All kV and mA stations available, dependant on generator and tube limitations.

 60 second maximum helical scan time.
 Pitches: 0.5xx:1, 0.9xx:1, 1.375:1 and 1.531:1
 Scan Speeds: 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0 seconds.
 Variable image thickness (recon parameter): 0.625, 1.25, 2.5, 3.75, and 5.0 mm.
 Sample Rates: 984 Hz - 6240 Hz.
 Segmented reconstruction option is available.
 Helical Reconstruction Increment as small as 0.1mm available.

Image Interval
The system has the ability to generate images at very small spacing and thereby exceed the
number of native acquisition channels. When the scanner operates in a helical mode of data
acquisition with its 64x0.625 mm detector configuration and a 1.375:1 helical pitch, images can be
reconstructed spacings as small as 0.1 mm. The table below shows the average number of slices
(images) that can be generated per 360 deg of gantry rotation. The average number of slices
(images) per gantry rotation is calculated by dividing the total number of reconstructed slices
(images) by the number of rotations during the data acquisition.

Table 11-17

Number of Total number of reconstructed Average number of slices

Coverage in z (mm)
rotations slices (images) (images)/rotation
1.71 30 301 176
2.00 46 461 230
3.00 101 1011 337
4.00 156 1561 390
5.00 211 2111 422
6.00 266 2661 443

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Volume Helical Shuttle

NOTE Volume Helical Shuttle (VHS) is licensed for use with a GE X-ray tube. Use of a third party
X-ray tube will require an additional license for this feature.

Volume Helical Shuttle is a repetitive helical scan mode allowing the table to move continuously
back and forth across a prescribed area, where each pass has temporal time sampling
information. Adaptive scan-control architecture and dynamic pitch reconstruction improves
temporal sampling and extends Z-coverage, enabling dynamic studies. The resulting acquisition
can be used to create time resolved studies such as CT Angiography (CTA) of head, neck, and
body and perfusion studies. Z-coverage is extended for dynamic 4D CTA and perfusion studies up
to 312.5 mm (500 slices) and 140 mm, respectively. The Volume Helical Shuttle feature utilizes
dynamic helical pitch reconstruction for good helical image quality during the acceleration and
deceleration of the table, as shown in Figure 11-26. The Volume Helical Shuttle feature enhances
the Volume (Axial) Shuttle feature to provide a further increase in the achievable dynamic system
coverage.

Table 11-18

Application Coverage Scan Mode

Angiography Time per pass times number of 0.984:1 pitch
passes in 60 seconds or less
0.4 sec. Rotation time
Neuro Perfusion 120 mm 0.984:1 pitch

0.4 sec. Rotation time

Body Perfusion 120 mm 1.375 pitch

0.5 sec. Rotation time

Body Perfusion 140 mm 1.375 pitch

0.4 sec. Rotation time

Figure 11-26 Volume Helical Shuttle Illustration

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Cardiac Overview
Cardiac helical is a lower pitch helical scan available for cardiac applications in conjunction with
the CardIQ SnapShot option. In this scanning mode, heart rate monitoring is performed during the
helical acquisition and the associated EKG gating information is stored with the scan data such
that a cardiac gated SnapShot reconstruction algorithm can be applied for prospective and
retrospective images. SnapShot reconstruction is used to minimize the motion of the heart in the
resultant images. The pitch factor for the cardiac helical scan is determined by the system and is a
function of the patient heart rate.

Cardiac Helical imaging features include:

 All kV and mA stations available, dependent on generator and tube limitations.

 60 second maximum cardiac helical scan time.
 Rotation Speeds: 0.35, 0.375, 0.4, 0.425, 0.45, 0.475, and 0.5 second.
 Pitches: determined by system, ranging from .16 - .325, based on patient heart rate. A higher
heart rate will use a higher pitch factor.
 Image thickness of 0.625, 1.25 and 2.5 mm
 SnapShot Segment, Segment Plus, Burst, Burst Plus, and Segmented (non-gated)
reconstruction options.
 Cardiac phase location parameter of 0 to 99% of R-to-R cycle.
 0.1mm minimum incremental retrospective recon image spacing.
Once the cardiac helical data has been collected, it can be reconstructed at one or more arbitrary
heart cycle phase locations. Segmented reconstruction is also available retrospectively if non-
gated images are desired.

Cardiac Cine acquisition for cardiac imaging is available in conjunction with CardIQ SnapShot
Pulse and prospective cardiac gating. In this step and shoot cine scanning mode, the heart rate is
monitored during the scan and the R-Peak triggers the acquisition of data for that location. The
table moves to the next location and waits for the next R-Peak to trigger acquisition of data for the
phase specified. SnapShot Pulse is a lower dose mode compared to cardiac helical modes. A
padding value allows for flexibility of neighboring phase locations to accommodate small
fluctuations in heart rate (a few BPM or less). However, a stable heart rate of 65BPM or less is
recommended for SnapShot Pulse.

When the Gemstone Spectral Imaging option is installed, Cardiac (Cine) also supports GSI
SnapShot Pulse for cardiac imaging and prospective cardiac gating. In this step and shoot cine
scanning mode, the heart rate is monitored during the scan and the R-Peak triggers the acquisition
of data for that location. The table moves to the next location and waits for the next R-Peak to
trigger acquisition of data for the phase specified. A GSI Preset is selected which defines the kV,
mA, rotation time, SFOV and dose for the acquisition. A padding value allows for flexibility of
neighboring phase locations to accommodate small fluctuations in heart rate (a few BPM or less).
However, a stable heart rate of 65 BPM or less is recommended for GSI SnapShot Pulse.

Cardiac Cine imaging features include:

 Scan speed of 0.35 seconds.

 All kV and mA stations available, dependent on generator and tube limitations.
 Image thickness of 0.625 mm.
 Retrospective gated cardiac volumes are limited to common phases across all cine locations
in the acquisition.

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 Cine Scanning
Gemstone Spectral Imaging SnapShot Pulse (Cine) feature includes:

 Scan speed of 0.35 seconds.

 Specific GSI Presets to set kV and mA
 Image thickness of 0.625 mm.
 Retrospective gated cardiac volumes are limited to common phases across all cine locations
in the acquisition.
 SnapShot Pulse (Cine) Scanning with GSI mode
 Create Monochromatic images and Material Density pairs

Gemstone Spectral Imaging

NOTE Gemstone Spectral Imaging (GSI) is licensed for use with a GE X-ray tube. Use of a third
party X-ray tube will require an additional license for this feature.

Gemstone Spectral Imaging is a novel dual energy scan mode that uses two nearly simultaneous
scans at two different energy levels to generate material characterization information. The X-ray
tube kV determines the average energy level of the X-ray beam. By acquiring data of an object at
different energy levels, data with different attenuation values corresponding to the energy levels is
generated. This data can be utilized to identify material-specific differences in attenuation in terms
of Water, Iodine, Calcium, and Hydroxyapatite (HAP) basis-pair images, allowing monochromatic
and effective-Z image representations.

Dual Energy scanning has been researched for several years in conventional X-ray Imaging as
well as CT imaging. The earlier methods include sequential Axial / Cine scans and dual source
scans. Both earlier methods suffer from the inability to temporally register the high and low energy
data leading to artifacts in the images. The system cycles or switches the kV from high to low at a
very fast switching rate of up to 4.8kHz and utilizes the fast response of the GE Gemstone
Detector to capture the two data sets that are temporally registered to within micro-seconds. The
acquisition of the two kV samples that are temporally well registered, provides the ability to use the
feature for a broad range of applications.

Gemstone Spectral Imaging has the following image quality benefits and capabilities:

 Improved Beam Hardening performance - Streaking and shading artifacts in traditional CT

imaging, which is caused by the presence of bone or metal, is mitigated when using Gemstone
Spectral Imaging.
 Improved Contrast Visualization - The Gemstone Spectral Imaging feature allows for improved
contrast visualization by providing the capability to visualize the data at lower derived
monochromatic spectral energy settings.
 Virtual Contrast Subtraction - The Gemstone Spectral Imaging feature allows for virtual
"subtraction" of virtual non-contrast like images.
 Iodine/Calcium Separation - The Gemstone Spectral Imaging feature enhances CT
Angiographic capabilities to better discern the differences between contrast opacified vessels
and surrounding bone structures.
The Gemstone Spectral Imaging features provides better accuracy and sensitivity of identification
of materials and may lead to new uses or applications that require more accurate quantification
than achievable with current CT imaging.

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Figure 11-27 Gemstone Spectral Imaging Illustration

The feature has the ability to generate multiple image representations including:

 Material Basis Pair Images (in mg/cm3)

 Monochromatic
 Color Overlay
 Effective Z Images (based on atomic numbers)
 QC High kVp Images
With the rapid switching of the kV values, it is helpful to think of the data as "Mean Low Energy"
and "Mean High Energy". The concept of Mean Energy is illustrated in Figure below. As the CT
detector integrates the signal during one sample or one view, the kV value for each view will also
be an integral of the rise and fall curves as illustrated.

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Figure 11-28 Gemstone Spectral Imaging Illustration

Two important specifications that are impacted by the non-static beam energy are X-ray dose
reporting and kV accuracy. X-ray dose measurements using the standard CTDIw metric will be
performed using a scan with the rapid kV switching. A separate set of CTDI100 measurements
have been defined and reported in the Dosimetry section. Further, since the kV is rapidly switched
view by view, an accuracy specification has been defined for the GSI modes.

High Resolution Scanning Capability

NOTE High Resolution Scanning Capability (Hi Res) is licensed for use with a GE X-ray tube.
Use of a third party X-ray tube will require an additional license for this feature.

The data acquisition chain, the X-ray tube and generator, the Digital Acquisition System and the
detector capabilities have been designed, integrated and leveraged to provide high spatial
imaging.

These critical components form the sampling technology triangle (Figure 11-29), and a good
system must leverage all of these components in order to obtain higher resolution and better
image quality. The Volara HD DAS has the capability to sample every 136 microseconds, which is
used to collect up 2496 Views Per Rotation in high resolution imaging mode and allows for
sampling uniformity across rotation speeds. Rapid sampling and increased views allows for a
reduction in the uncertainty of the position of an object or in other words brings higher resolution.
Figure 11-30 illustrates this concept.

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Figure 11-29 CT sampling technology triangle

1 3

1. Performix HD Tube

2. Volara HD DAS

3. Gemstone Detector

Figure 11-30 Higher resolution due to increased views per rotation

As can be seen when comparing the two sides of Figure 11-30, taking less views per rotation
increases the spatial uncertainty, which results in a lower precision of the object location (or in
reality resulting in lower resolution). Essentially, by sampling more densely, one is able to
determine more precisely the location of an object or an edge that is imaged. It is important to note
resolution naturally degrades as you move away from iso-center (ISO). Taking more views per
rotation drastically reduces the uncertainty away from ISO, translating into a full field of view
improvement in resolution. A clear example of this benefit can be seen in Figure 11-31, where the
same phantom is imaged at approximately 20 cm from ISO with two different sampling schemes.

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Figure 11-31 Improvement in resolution due to increased sampling

Approximately 20 cm from iso-center

a) Standard sampling b) Increased sampling

The new Performix HD tube and HD Generator improve resolution by allowing additional view
sampling without increasing the required X-ray output. This is accomplished by dynamically
deflecting the in-plane position of the focal spot, enabling the ability to provide multiple looks at the
same object across multiple cells at different angles. This provides a primary goal for high
resolution imaging, better clarity to the images. Another way to look at this is that one gets
additional distinct samples at different view angles per detector cell, thereby increasing the amount
of information used in the reconstruction of the image. The theory behind improvement in spatial
resolution using focal spot deflection is the fulfilling the Nyquist sampling theorem. In order to
obtain the maximum resolution without aliasing, an interval needs to be sampled twice, as seen in
Figure 11-32.

Figure 11-32 Focal Spot Deflection Illustration

An important technological trade off of taking more views per rotation, is the decrease in flux. In
order to take more views, one needs to spend less time integrating at each view, which results in
less signal per view. The 100 kW tube, and noise reducing reconstruction algorithms such as ASiR
enable high resolution sampling.

In addition to focal spot deflection, the Performix HD tube and HD Generator provide the capability
to control the focal spot width, length and position that allows for tuning the appropriate focal spot
size and power.

The extremely fast speed of this Gemstone detector enables the Revolution Discovery CT system
to take full advantage of the faster sampling of the DAS, and the dynamic focal spot deflection
capability of the X-ray tube, thus significantly improving the spatial resolution. Key features of this

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new detector technology that allow it to be used for optimal sampling are the fast decay time
(primary speed), and its distinct lack of afterglow. Both of these effects have traditionally
challenged the optimization of proper sampling in CT systems, and with the advent of this new
technology, fast sampling complications are a thing of the past.

Afterglow refers to a secondary decay of light emitting from the scintillator for several milliseconds
after the X-ray source is turned off. It carries a part of the signal from one view to the next during a
scan, thereby smearing the information, and potentially causing artifacts extending from low
attenuation anatomy into areas of higher attenuation. This has the direct effect of decreasing in-
plane spatial resolution. The Gemstone detector has a primary decay time of only 0.03
microseconds.

New HD reconstruction algorithms are available when utilizing this high-resolution scan mode, in
addition to the standard set of reconstruction algorithms available on previous products.

Adaptive Statistical Iterative Reconstruction (ASiR)

NOTE ASiR is licensed for use with a GE X-ray tube. Use of a third party X-ray tube will require
an additional license for this feature.

Adaptive Statistical Iterative Reconstruction (ASiR) is a new reconstruction technique that enables
reduction in image noise and improvement in image quality. The ASiR reconstruction algorithm
can be used to reduce the image noise in diagnostic images and thereby may reduce the dose
required for routine imaging. ASiR reconstruction is available in three modes:

 Slice Mode ASiR

 Volume Mode ASiR
 GSI Mode ASiR
The three modes are user selectable for thin slice acquisitions, but the slice mode and GSI mode
are available for all slice thickness settings.

In addition to providing a selection of the mode of ASiR reconstruction, the scanner allows the user
to select levels of ASiR settings from none to 100% in 10% increments. These "levels" or "blend
levels" provide a varying degree of noise removal from the images. In order to enable the user to
select the right level of ASiR, an ASiR review tool is provided that allows the user to change the
settings and review the images for each protocol.

For GSI mode, an additional level of ASiR can be applied to GSI Monochromatic and Material
Density images at the time of reconstruction. Volume mode is applied to 0.625mm slice thickness
and slice mode is applied to 1.25, 2.5 and 5mm slice thicknesses prospectively in PMR or
retrospectively in Retro Recon.

Overlapped Recon (Axial)

Overlapped Recon (Axial) generates 128 images per rotation from a 40mm acquisition and 64
images per rotation from a 20mm acquisition. This reconstruction mode is only available for 40mm
and 20mm Axial scan type. Image thickness remains the same but the image interval is 50% of the
image thickness and the image location moves ¼ row outward. This reconstruction mode is only
available in Retro Recon. It is not compatible with Axial for Hi Res, GSI, or Cardiac modes.

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Figure 11-33 Overlapped Recon (Axial) for 40mm Detector Coverage

SmartView
 Rotation speed: 0.5, 0.8 and 1.0 sec.
 Slice thickness: 1i mode 2.5mm, 5mm, 10mm 3i mode 1.25mm, 2.5mm, 5.0mm
 Nominal image lag: 0.2sec
 Recon: 1i mode - image display of 12 frames per second, 3i mode -image display of 8 frames
per second per viewport or 24 frames per second.
 Reconstruction matrix: 340×340

Image Check
Image check function provides 340x340 matrix images for confirming Axial images with real time
and tracking to up to maximum scannable length with real time. Reconstruction time is as follows.

 FPS = Up to 55 fps
 TTFI (Time To First Image) = Up to 2 sec after X-ray on
 TTLI (Time To Last Image) - Scan duration = Up to 1sec at maximum helical scan range
 Reconstruction matrix = 340×340
NOTE Specifications of FPS, TTFI, and TTLI are not compatible and limited to the specific
conditions of operation such as rotation speed and helical pitch.

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System Image Quality Features

Calibration Scans
Revolution Discovery CT calibrations include:

 Tube Warmup
 Tube Warmup is used to ready the X-ray tube for patient scanning or calibration.
 Air calibration
 Air calibration is one of the most important calibrations in CT. A periodic air calibration for
the CT scanner is required and it has to be done daily. This calibration is called Fast
Calibration. Fast Calibration can be accessed from the Daily Prep menu.
 Detailed and Spectral calibration
 Detailed and spectral calibration is performed during periodic maintenance of the system.
It is not required to be run by the user as the scanner components are stable and the
calibration will not need frequent updates.
 Water Cal
 Water calibration or CT Number Adjustment is used to adjust the HU of water to 0. This
calibration is also not required to be performed periodically by the user.

Tube Capacity and ISD

The system provides prescription alternatives when:

 Current prescription requires excessive prep, interscan, or intergroup delay.

 Technique requirements exceed the prescribed delays.
Although the rotating anode increases the tube's heat tolerance, it still has a physical limit. The
anode transfers its heat to the oil filled tube housing. The housing, in turn, dissipates heat into the
surrounding air.

The system keeps a running total of estimated tube heat. When you request scans during Scan
Prescription, the system estimates the number of heat units these scans will produce, and
compares this value with the running total.

If the prescription estimate exceeds the current capacity, the system displays a series of
prescription Optimize screens that recommend increased delays, alternative Scan Technic
settings, or offer to split the current scan group into smaller groups.

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Focal Spot
The X-ray tube produces multiple focal spot sizes. The small size improves spatial resolution but
cannot tolerate high technique. The large sizes tolerate high technique but lose some spatial
resolution.

The system automatically selects the focal spot size based on:

 Power (kW)
 Scan mode
 kV
Example: Reduce mA setting from 495 mA to 490 mA (@ 140kV) to enable the selection of the
Small Focal Spot.

Focal Spot Selection

On CT systems, the focal spot selection affects the slice thickness for thin slice scanning, with the
larger focal spots producing slightly larger effective slice thicknesses.

Focal Spot Selection Table

The Revolution Discovery CT system follows the following table for power based focal spot
selection:

Table 11-19 mA ranges by kV, Focal Spot Size, and Scan Type

Scan Mode kV Small Focal Spot Large Focal Spot GSI Focal Spot**
Normal 80 10-620 625-700 305-715 mA commanded 765mA commanded at High
100 10-680 685-800 at High kV for GSI kV for GSI
120 10-570 575-835
140 10-490 495-715
Hi Res 80 10-620 625-700 N/A N/A
100 10-500 505-750
120 10-420 425-625
140 10-360 365-540
Hi Res SnapShot 80 10-620 625-700 N/A N/A
Pulse* 100 10-575 580-800
120 10-480 485-740
140 10-410 415-630

* For Hi Res SnapShot Pulse Mode - Based on maximum four (4) 0.5-second exposures with 1
second ISD.

** GSI Focal Spot is not enabled/used outside of the GSI mode. It is only enabled/used with GSI
scanning and for Service/Calibration Scanning. (total scan time of 5 seconds)

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Data Collection
The detector and DAS assembly mounts opposite the X-ray tube on the rotating base. The X-ray
beam leaves the X-ray tube, passes through the gantry opening, and enters the detector. Any
material (patient or phantom) positioned within the gantry opening absorbs or scatters the lower
energy X-ray photons. The numbers of photons that enter the detector depends upon the intensity
of the X-ray beam and the density of the material in the gantry opening. An increase in density
causes a decrease in the number of photons that enter the detector.

The Gemstone detector allows 64 rows of data to be collected at a time for both axial and helical
imaging. This allows 64 axial images to be generated in a single gantry rotation in the axial mode.

The DAS measures the detected X-ray at regular time intervals, called views, and transmits the
information to the image reconstruction computer for reconstruction into an image. The total
degrees of gantry rotation and the scan time determine the number of raw views per image.

Table 11-20 Scan Parameters

Scan Choice Determines:

kV X-ray energy intensity and calibration data used
mA X-ray dose
Scan Time and Interscan Delay Length of scan rotation in seconds; length of delay in seconds between
exposures
Scan Rotation (normal scan, partial Degrees of scan rotation during data collection (X-ray on)
scan)
Gantry Tilt Angle X-ray travels through patient
Spacing Z-Axis distance between scan centers
Thickness Width of image
Azimuth X-ray tube location during scout scan
SFOV — Scan Field of View Centimeters of data available, and any special processing applied or
available, for image reconstruction.

NOTE kVs and mA are preset for GSI patient scanning.

Reconstruction
The reconstruction engine pre-processing the data through scanner specific calibrations and
corrections and generates a three dimensional matrix of corrected attenuation data. Further, a
reconstruction algorithm is used to covert the raw attenuation data into a series of 2D pixel matrix.
These images, referred to, as "Axial images" will be displayed after reconstruction is completed.

Your choices control the image outcome. Choose parameters to enhance or tailor the acquisition
and processing to the anatomy of interest. Select scan technique and image parameters that
provide optimum resolution.

Overlapped reconstruction for Axial scan type generates 128 slices per rotation from 40mm
detector coverage or 64 slices per rotation from 20mm detector coverage providing better image
quality in clinical studies where post processing applications are used.

The system has disk space for over 6700 64-row scan rotations. The system stores the most
recent scan data in the oldest scan file with an unreserved status. The system continually
overwrites the scan files with data.

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Conjugate Cone-Beam Backprojection

The Revolution Discovery CT scanner is able to acquire two sets of distinct projections that are
180 degrees apart. The projection pair is typically called the conjugate projections. The conjugate
projections provide 128 distinct projection measurements at each angular position, which are not
available when each projection view is considered alone. During the backprojection process, the
conjugate projections are used to perform backprojection operation, using GE’s conjugate cone-
beam reconstruction algorithm to significantly improve the z-resolution.

This approach is used in helical scanning at pitch = 0.5 and in all axial modes.

Figure 11-34 The Slice Sensitivity Profile effect due to a conventional row-to-row interpolation
(dotted line) and with interpolation with additional conjugate projection samples (solid line).
Intensity

Normalized Distance, z/d

Figure 11-35 Reformatted Catphan image with 64 X 0.625 mm detector configuration at pitch
0.516:1 WW=600 with row-to-row interpolation (a) and conjugate backprojection approach (b).

0.56 mm 0.56 mm

0.50 mm 0.50 mm

0.45 mm 0.45 mm

0.42 mm 0.42 mm

0.38 mm 0.38 mm

0.36 mm 0.36 mm
0.33 mm 0.33 mm

(a) (b)

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Reference: Conjugate cone-beam reconstruction algorithm, Hsieh et al, Optical Engineering June
2007, Vol. 46 (6).

Helical Scan Data Usage

In general, every data channel will contribute to at least one image during helical image
reconstruction. Some data channels are not used at the very beginning and end of the helical scan
due to the physics of multi-slice scanning and helical view weighting algorithms.

During helical image reconstruction, some data channels in the middle of the helical scan are not
used if the image interval prescribed is greater than the image reconstruction slice thickness.

For example, all data channels will be used for 0.6mm images, 0.5:1 pitch, if the image interval is
less than or equal to 0.3mm.

Calibration Scans
The System Calibration process utilizes scans of air, and uniform objects called phantoms to
generate the calibration files. The calibration files provide the baseline information the system
needs to produce patient images. The system needs calibration data for every possible
combination of kV, detector collimation mode, focal spot size, and scan field of view.

Warmup Required
If tube warmup is skipped or cancelled, the mA will be limited to 250 mA for small focal spot and
500 mA for large spot for the first exam. kV Assist mode is not allowed if tube warmup is skipped
or cancelled. GSI mode is not allowed if tube warmup is skipped or cancelled.

A warmup of the tube is required:

 When the tube has cooled to the point that a warmup is required to ensure optimal image
quality.

Data Storage
The Console/Computer contains 1 terabyte of magnetic disk that records and retains image and
scan data. System supports approximately 1,450 rotations of 64-row 1 second Hi Res acquisitions
scan data, a Reconstruction Processor that processes scan data into image data, and a magnetic
disk that stores CT specific scan software.

The system image disk holds:

 uncompressed 512 x 512 image files: at least 460,000

 uncompressed 1024 x 1024 image files: at least 115,000
Despite storage space, the system eventually runs out of disk space. If your facility plans to
preserve image data, you must periodically transfer images and scan information to the
designated archive media.

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Image Display
Requested images pass through the IP (image processor) on their way to the LCD screen. The
Image Processor uses a bulk memory to store images selected for Auto View, MID, paging,
magnification, rotation, reformat or 3D (3D optional).

The images appear on the image monitor or LCD. The LCD screen contains a display matrix of
1024 x 1024 picture elements, or 1,048,576 pixels. The 1024 display can be further divided into
viewports. The number of viewports displayed determine the number of pixels within a viewport.
Each pixel displays one of the 256 available shades of gray.

The system reconstructs axial and continuous images of 5122 pixels. Images from other scanners
may display 64, 128, 320, or 1024 pixel image matrices.

The amount of anatomy represented by each pixel equals the Display Field of View diameter in
mm divided by the matrix width/height.

The system assigns a unique CT number value, originally called a Hounsfield Unit, to each pixel.
The two dimensional pixel represents a three dimensional portion of patient tissue. The pixel value
represents the proportional amount of X-ray beam that passed through anatomy and entered the
detector.

Gray Scale
The monitor translates the computed pixel value into a shade of gray. Your window Width and
Level choices control which range of CT values receive emphasis. The window Width assigns the
quantity of pixel values to the gray scale. The window Level determines the center pixel value in
the gray scale.

Figure 11-36 Gray Scale

 Window Width = selected range of pixel values

 Window Level = middle value
The system displays every pixel value that falls outside the gray scale as either black or white. It
assigns a gray value to every pixel that falls within the selected window. IF enabled, the filmed
image displays a gray scale icon along the left border of the image.

The system displays the currently selected window Width and window Level along the bottom of
the screen: W = xxxxx and L = xxxxx. To determine the pixel values currently represented by the
gray scale: Divide the window Width by 2; add and subtract this number to/from the window Level.

Example: W=320; L= -1500; 320 / 2 = 160

-1500 + 160 = -1340; -1500 - 160 = -1660

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The gray scale represents values from -1340 to -1660

To find the best gray scale for an image, decrease the window width to 2. Increase or decrease
levels until the tissue of interest turns gray. Now increase the window width until it includes the rest
of the image.

CT Number
Image reconstruction supports two ranges of pixel CT Numbers, the "normal range" and an
"extended range".

 Normal Range is -1024 to 3071

 Extended Range is -31743 to 31743
However, the system display supports pixels with a range of -32,767 to +32,767.

The system references CT number zero to water and CT number -1000 to Air. Lung and fat have
negative pixel values and normally appear black. A CT number over 200 represents dense
material like contrast agent, calcium, bone, and normally appears white

Inverse Video reverses video white to black, but pixel values remain the same.

CAUTION CT Numbers are NOT absolute; misdiagnosis is possible. System and patient
variables may effect CT Number accuracy. If you rely solely upon CT numbers
without taking imaging variables into consideration you could misdiagnosis an
image.

The following variables effect CT Number accuracy:

 Partial volume effects of anatomy

 Scans acquired with IV or oral contrast agents
 X-ray tube deterioration
 Improperly calibrated system (poorly centered phantom, used wrong phantom, replaced
current calibration files with extremely old Cal files)
 Beam hardening due to patient anatomy, especially bone.
To reduce CT Number variations:

 Warmup the X-ray tube whenever the system recommends it; make sure the tube design
matches the software configuration parameters
 Center the patient anatomy of interest in the gantry opening. Select an SFOV that
encompasses the patient.
 Acquire comparable images with similar scan and reconstruction choices.
 Maintain consistent table height throughout the exam.
 Test image quality on a regular basis to provide the numerical data to track system
performance over time.
To decrease the potential for misdiagnosis:

 Use ROI to compare pathology to surrounding tissue

 Scan structures with slice thicknesses about one-half the thickness of the lesion or less.

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Example: Prescribe scan thickness of 5mm or less to scan a Lesion with a 10mm thickness.
(Display an axial image and use the Measure Distance and ROI functions to determine the size of
the pathology.

Center ROI measurements over the midpoint of the pathology to minimize partial volume effects.

The Window Width and Window Level for GSI images will vary depending on the keV selected
compared to non-GSI images. Place an ROI on an anatomical area and note the mean value. Set
the Window Level to the mean value and adjust the Window Width to the desired viewing level.

Variables You Cannot Control

The mixture of tissue types, such as fat with tissue within the same voxel (a pixel with depth),
varying patient sizes, differences between CT machines and X-ray tubes, all lead to CT number
variance. In a well calibrated scanner, water has a CT number that ranges from -3 to +3. The CT
number remains uniform across all kV settings. However, as the X-ray tube ages, kV decreases
and pixel values become less dependable.

Pixels
The anatomic image consists of rows and columns of small, square, picture elements called pixels.
The monitor displays 1,048,576 pixels in a matrix of 1024 horizontal rows of 1024 pixels. Add
number of viewports selected for viewing to determine the number of pixels used for display in
each viewport. The monitor pixel size remains the same, but the amount of anatomy the pixels
represent varies with the scan and display field of view (SFOV & DFOV). A pixel also represents a
specific anatomic area. The system identifies each two dimensional pixel by its location, area and
value.

Pixel Coordinates
Describe pixel location two ways.

 Matrix Coordinates: Upper left pixel = (0,0);

Lower right pixel = (511,511);
Pixel in center of matrix = (255,255);
Pixel ten columns to the right = (10,0)

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Figure 11-37 RAS Coordinates Schematic

NOTE The illustration above represents a 512 x 512 matrix viewport.

 RAS: Anatomic distance from the center of the landmark slice

Target the image; decrease the DFOV diameter. Center the reconstruction on coordinates other
than the SFOV center.

Magnifying and targeting can displace the central SFOV pixel from the central monitor pixel. Look
at the DFOV coordinates and magnification annotation to find the SFOV center, or display the grid.
The grid always appears over the pixel in the center of the DFOV Matrix (coordinate 255,255).

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RAS Coordinates
These three distances in millimeters appear on the upper left of the viewport on which the mouse
cursor is on, when Continuous Report Cursor is selected.

 The pixel with the R/L and A/P coordinates closest to zero, represents the SFOV center. The
S/I coordinate always equals the table location at isocenter.
 Coordinates transition from R to L, A to P, and S to I, to show relationships between current
location, landmark location, and isocenter.
Figure 11-38 RAS Coordinates Schematic

Right: Coordinate location falls to the patient's right of the mid-sagittal plane (right of
isocenter)
Left: Coordinate location falls to the patient's left of the mid-sagittal plane (left of
isocenter)
Anterior Coordinate location falls above the mid-coronal plane (above isocenter)
Posterior: Coordinate location falls below the mid-coronal plane (below isocenter)
Inferior: Scan location falls between the selected landmark and patient's feet
Superior: Scan location falls between the selected landmark and patient's head

The DFOV and matrix determine pixel size.

A reconstructed pixel represents an area determined by dividing the Display FOV (in mm) by the
reconstruction matrix, squared. You may magnify pixels up to eight times the reconstructed size, or
minify them to one half size. The anatomic area represented by each monitor pixel decreases as
the magnification factor increases; anatomic area/monitor pixel increases as the magnification
factor decreases.

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Pixel Size in millimeters

DFOV in cm 512 x 512

5 0.10
10 0.20
15 0.29
20 0.39
22 0.43
25 0.49
30 0.59
35 0.68
40 0.78
45 0.88
50 0.98

The DFOV determines the anatomic area imaged by a single reconstruction.

 Area equals pr2 (Area =3.14 x radius x radius)

 The 50cm FOV has a 25cm radius, so its area equals 1963cm2.
 The ROI or magnification factor determines the anatomic area covered by a magnified image.
Example: A monitor pixel represents 0.5 by 0.5mm. Magnify pixel size by 2. Each monitor pixel
now represents 0.25 by 0.25mm of anatomy.

Figure 11-39 Pixel Size and DFOV Illustration

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Pixels and CT Numbers

Besides anatomic location and area, each CT pixel also represents a CT number, which in turn
indicates tissue density.

 An ROI averages the values of the enclosed pixels, and displays the resulting Mean value.
 Standard Deviation describes the difference between the minimum and maximum ROI value.
 A large ROI provides a larger, more accurate statistical sample than a small ROI.
An image pixel represents a three dimensional volume, or voxel. It represents anatomy with a
location, an area, and a pixel (density) value. The system flattens the 0.625, 1.25, 2.5, 3.75, and 5
mm scan thickness into a two dimensional screen image. If a pixel represents a variety of tissues,
the system averages the contents to produce an averaged, rather than accurate, pixel value.
Uniform tissues (within the voxel) produce fairly accurate pixel values.

CT pixel shading shows relative density. Denser materials weaken X-ray and produce whiter
pixels. (Assumes Inverse Video OFF)

Reformat displays non axial planes created from contiguous pixels extracted from multiple
images. 3D locates similar pixel values within contiguous images, and generates a mathematical
model to produce images that appear three dimensional. BMD samples pixel values to estimate
bone or tissue density.

Reconstruction assigns one value to every image pixel. CT uses pixel values of -32767 to
+32767. MR uses pixel values of +16,000. The screen pixel translates the assigned value into one
of the 256 shades of gray. Vary the gray scale window width and level to select anatomy for
display. Window Width determines the quantity of gray pixel values. Window Level selects the
center Window Width pixel value.

Example: Two windows may contain identical widths of 100 values, but display completely
different anatomy, because one has a level of -100 and the other has a level of 150

Window Width
The system uses 256 gray shades to display 63,486 CT pixel values. The Window Width selection
determines the number of CT values represented by each shade of gray. A narrow window
assigns fewer pixels to each gray level than a wide window.

Example: WW = 256 System assigns one pixel value to each gray shade WW = 2560 System
assigns ten pixel values to each gray shade.

Window Level
The Level equals the CT number value of pixel in the center of the Window Width range. The Level
value receives the middle shade of gray. The system displays pixel values that fall between the
center and upper window level as gray to off white. It displays pixel values that fall between the
center and lower window values as gray to charcoal. When you change the level, the window
width moves up and down the CT number line. The CT values change with Window Level, but the
Window Width and number of pixels per gray level don’t change.

Inverse Video reverses display conventions. Dense or high numbers are portrayed as black rather
than white.

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Chapter 12
Quality Assurance

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Introduction
In order to assure consistent image quality over the system’s lifetime, establish and
maintain a regular Quality Assurance (QA) program.

Constancy testing of the system should be performed in accordance with IEC 61223-2-6 or
per your facility’s specific QA program.

Scan a known material (usually a phantom) under a prescribed set of conditions.

 Compare the results to previous or optimum values.

 Repeat these tests on a regular basis to detect changes in image quality values before the
problem becomes visible.
 If you notice a degradation in image quality, or a change in QA values, you can schedule a
site visit and let the service person or imaging physicist run more detailed tests.
 Early intervention could prevent a major breakdown.
Quality Assurance begins with baseline performance data acquired during system installation, or
after the repair or replacement of an X-ray tube, collimator, detector, DAS, or PDU circuitry.

 Compare subsequent QA results against the baseline.

 You can save baseline images for a visual comparison with your daily QA checks, but the
measurement values provide a more objective way to monitor quality.
NOTE Copy the QA Data Form found at the end of this section. Use the form to record baseline
data and subsequent QA data.

QA Phantom (Reference 21CFR 1020.33(d)(1))

21CFR 1020.33 (d)(1) requires a phantom for Quality Assurance that is capable of providing an
indication of contrast scale, noise, nominal tomographic section thickness, the spatial resolution
capability of the system for low and high contrast objects, and measuring the mean CT number of
water or a reference material.

Use the Quality Assurance Phantom to assess system performance and establish an ongoing
Quality Assurance program.

The phantom design provides maximum performance information with minimum effort.

Before beginning the QA process, please record the serial number of the QA phantom on the QA
data form provided.

This phantom measures six aspects of image quality.

 Contrast Scale
 High Contrast Spatial Resolution
 Low Contrast Detectability
 Noise and Uniformity
 Slice Thickness
 Laser Light Accuracy

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The QA phantom contains two sections, each corresponding to a single scan plane.

 Section 1: Resolution block S0 mm scan location.

 Section 2: Water section is between S40 - S80 mm scan locations.
The following illustration contains a list of the sections and corresponding tests.

Table 12-1 QA Phantom

Section 1

 High Contrast Resolution

 Contrast Scale
 Slice Thickness
 Laser Accuracy
Location: S0 mm

Section 2

 Noise and Uniformity

 Low Contrast Detectability
Location: S80 mm

(Any location between S40 to S80 mm)

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QA Schedule (Reference 21CFR 1020.33 (d)(2))

Each facility determines QA and phantom calibration schedule.

GE recommends that you acquire scans of both Sections 1 and 2 of the QA Phantom each day.

Create a Scan Protocol file for these QA scans.

Figure 12-1 QA Phantom Alignment

Table 12-2 QA Phantom Alignment

Number Description
1 Circumferential Reference Line
2 Vertical Reference Line
3 Horizontal Reference Line
4 Horizontal Reference Line
5 Phantom Bracket
6 Phantom Holder
NOTE Reference Lines are etched into the plastic and are unpainted.

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System Performance (Reference 21CFR 1020.33

(d)(2))
This section outlines the instructions for use of the Quality Assurance Phantom, including a
schedule of testing appropriate for the system, allowable variations for the indicated parameters,
and a method to store as records, quality assurance data, in compliance with 21 CFR 1020.33
(d)(2).

Maintain Image Quality

Many factors affect Image Quality:

 Proper alignment of X-ray tube, DAS, detector, and table

 KV and mA adjustments within specifications
 Current Calibration files
 Tube Warmup every time the system recommends it
 Daily Fast Cals
 Appropriate pixel size, slice thickness, reconstruction algorithm, and special processing
selections during Scan Rx
 Patient remains motionless during scan acquisition
At least three people must cooperate to produce optimum images:

 Service representative aligns the system and adjusts kV and mA

 Operator follows facility guidelines to maintain daily image quality, prescribe the exams, and
update the calibration files
 Patient follows operator (and autovoice) instructions during exam
A QA program helps locate the source of image quality problems:

 Replaces patient with phantom

 Provides standard Scan Rx parameters
 Provides System Performance tests and comparisons

Handling the QA Phantom

Adhere to the following guidelines when handling or positioning the QA Phantom.

 Visually inspect the QA Phantom and Phantom Holder for damage before each use. If
damaged, do not use the broken piece. Have it replaced immediately.
 The Phantom Bracket on the QA Phantom, used to support it on the Phantom Holder, is not a
handle. It should not be used to hold or carry the phantom. While transporting the QA
Phantom, carry it securely with both hands to avoid dropping it. A damaged QA Phantom can
potentially cause injury.
 The Phantom Bracket is meant to have a snug fit on the Phantom Holder. This minimizes
motion during scanning, which could lead to false failures in the QA images. The snug fit
requires the user to take care when positioning or removing the QA Phantom from the
Phantom Holder.

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 When positioning or removing the QA Phantom from the Phantom Holder, the patient cradle
should be moved out of the gantry fully (home position) and lowered enough so the user can
lift it straight up and off the holder. If the table is not moved to this position, and the user
reaches into the bore to adjust the QA Phantom, stress can cause the bracket to break.
 If the QA Phantom is broken, cracked or leaking, it should be discarded immediately and
replaced with a new QA Phantom. Care should be taken to avoid any sharp edges which may
develop on the broken pieces, which can potentially cause injury. If the QA Phantom is leaking
water onto the floor, there is a potential slip and fall hazard. If the QA Phantom is leaking while
on or near the scanner, it is possible for water to get under the table or gantry covers and
cause damage.

Position the QA Phantom

Place the QA phantom on the phantom holder, and level it.

Turn the knob facing the cradle clockwise to tilt the top of the phantom AWAY from the gantry.

Use the laser alignment lights to position the phantom:

1. Align the axial light to the circumferential line marking Section 1.

2. Align the coronal light to the horizontal lines on either side of the phantom.

3. Align the sagittal light (where it strikes the top of the phantom) to the vertical line on the top of
the phantom.

4. Position the phantom and select .

Prescribe the QA Series for the Resolution, Low Contrast

Detectability, and Noise and Uniformity Tests
1. Click [New Patient] to display the Patient/Exam Parameters screen.
 Use the same ID for all related QA tests so you can store the exams together.
2. Enter any additional information in the corresponding data field(s). (Optional)
3. Exam Description: Enter up to 22 characters to describe the test. (Recommended)
4. Select a protocol from the anatomical selector to select a QA protocol. (If available)
If your facility hasn't created a QA protocol, use the following parameters to finish the QA series
prescription:

On the Helical ViewEdit screen select the following parameters:

Table 12-3 Parameters for QA

Interface Input
Entry Head First
Position Supine
Anatomical Reference QA
Scan Range I0-S80
Thickness 5 mm
Detector Coverage 40 mm Aperture
Recon Interval 5 mm

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Interface Input
Tilt 0 degrees
Scan FOV Small Body
kV 120
mA 335
Scan Type Hi Res Off Helical
Pitch 0.516:1
Rotation Speed 0.4 seconds
Prescribe 3 scan groups
Algorithm, DFOV Test
Recon 1 Standard, 25 cm DFOV High Contrast Resolution

Scan Range: S0-S40

Recon 2 Bone, 15.0 cm DFOV High Contrast Spatial Resolution

Scan Range: S0-S40

Recon 3 Standard, 22.7 cm DFOV Noise and Uniformity

Scan Range: S40-S80 Low Contrast Detectability

Matrix 512
Contrast None
Special Processing None

Analyze the QA Images

1. Display the first QA image, which is section #1 at scan location S0.

2. Copy the QA Data Form at the end of this section.

3. Record the data from the tests that follow in the corresponding area of the form.

4. Compare the current values to previously recorded values.

 If you notice a significant change in values, check the Small SFOV calibration status.
5. Calibrate the Small SFOV if the most recent calibration date falls outside the guidelines
established by your facility.

6. Report significant changes, or values that fall outside suggested windows, to your supervisor
or imaging physicist.

7. Follow facility procedures to notify service personnel.

8. Perform the following:

a. Contrast Scale test at scan location S0 of the helical scan.

b. High Contrast Spatial Resolution test at scan location S0-S15 of the helical scan.

c. Low Contrast Detectability test at scan location S40 - S80 of the helical scan.

d. Noise and Uniformity test at scan location S40 - S80 of the helical scan.

e. Slice Thickness test at scan location S0 of the axial slice thickness scans.

f. Alignment Light Accuracy test at scan location S0 of the Alignment Light test scan.

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Contrast Scale
Section 1 of the Phantom Tests the Contrast Scale

CT assigns CT numbers, also called (HU) Hounsfield Units, to the attenuation values of X-ray
passing through a variety of material densities.

Software makes the attenuation visible by assigning shades of gray to groups of numbers selected
with the Window Width/ Level functions during image Display.

For test purposes, the CT values of water and Plexiglas in the phantom represent the standard
against which you track the system contrast scale over time.

The test for contrast scale follows:

Figure 12-2 Contrast Scale Phantom Section

Table 12-4 Contrast Scale Phantom Section

Number Description
1 Place box #1 on the plexiglas portion of the phantom
2 Place box #2 in the center of the hole

1. Select a Box ROI with an area around 70 mm2 on the image, as shown in Figure 12-2.

2. For consistency, use the same size cursor and location each time you perform this test.

3. Select Grid to provide a reference.

4. Select Box ROI to position a cursor over the Plexiglas resolution block (refer to Box #1 in
Figure 12-2).

5. Record the mean CT number on the QA Data Form.

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6. Optional: Record the Standard deviation

7. Select Box ROI to position a cursor over water (refer to Box #2 in Figure 12-2).

8. Record the mean CT number for water on the QA Data form.

9. Optional: Record the Standard deviation

10. Subtract the CT number of water from the CT number of Plexiglas

a. Record the difference on the QA Data form.

b. The difference should equal 120 ± 12.

High Contrast Spatial Resolution

Section 1 (Figure 12-3) of the phantom contains six sets of bar patterns in a Plexiglas block used
to test high contrast spatial resolution.

Each pattern consists of sets of equally sized bars and spaces

Water fills the spaces and provides about 12% (120 HU) contrast.

The resolution block contains the following bar sizes: 1.6mm, 1.3mm, 1.0mm, 0.8mm, 0.6mm, and
0.5mm.

1. Examine the bar patterns in images from Recon 2 to determine the limiting resolution, defined
as the smallest bar pattern in which you see all five bars.

2. You should see all five 0.6mm bars in images reconstructed with the Bone algorithm (15cm
FOV).

3. Using images from Recon 1 with the standard algorithm, measure the standard deviation of
the pixel values in a single or multiple bar pattern to provide a quantitative method for
assessing changes in system resolution.

4. ROI standard deviation provides a good indicator of system resolution and a sensitive method
to detect changes in system resolution.

The recommended procedure follows:

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Figure 12-3 High Contrast Spatial Resolution Section

2
3

Table 12-5 High Contrast Spatial Resolution Section

Number Description
1 Plexiglas
2 Water
3 Place the reference box #1 over the 1.6 mm line pair pattern and ensure the box does not
exceed the line pair boundaries.
4 Optional: Repeat this procedure for the 1.3, 1.0, and 0.8mm bar patterns.

5. Select Erase to remove previous ROI data.

6. Position a Box cursor over the largest (1.6mm) bar pattern, and size it to fit within the bar
pattern as shown in Figure 12-3.

7. Record the standard deviation on the QA data form.

a. Standard deviation should equal 37 ± 4, if you used standard algorithm.

Optional: Repeat this procedure for the 1.3, 1.0, and 0.8mm bar patterns.

8. Record the standard deviation on the QA data form.

MTF (optional)
The Modulation Transfer Function (MTF) mathematically quantifies high contrast resolution.

MTF measures the contrast preserved for a sine wave pattern as a function of frequency.

An MTF curve begins at 1 for zero frequency, and decreases as frequency increases.

Example: An MTF of 1 equals total preservation of contrast

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Example: An MTF of 0.5 equals 50% loss of contrast

The limiting resolution equals the frequency at which MTF falls to 0.

An MTF curve is shown in Figure 12-32.

Measure Frequency in line pairs per centimeter.

One line pair per centimeter equals one 5mm Plexiglas bar next to one water filled 5mm space.

Optional: Consult the publication listed as Reference 1 in section for MTF measurement
instructions (Droege RT, Morin RL. “A Practical Method to Measure the MTF of CT Scanners,”
Medical Physics, Volume 9, No. 5, pp 758-760, 1982).

Low Contrast Detectability

Low Contrast Detectability (LCD) refers to the visibility of small objects at low contrast levels. In
practical terms, it can be defined as the contrast required to resolve an object of a given diameter
at a given dose. Traditionally, one would image a tissue-equivalent phantom containing small, low-
contrast objects, and visually inspect the images. GE recommends a statistical method of
quantifying LCD based upon the noise properties of a standard image. Since this method yields a
quantitative measurement, as opposed to a visual verification, it is suitable for daily tracking of
system image quality.

Procedure:

Scan the Quality Assurance Phantom using the Daily Image Quality protocol. Analyze the images
from Recon 3, the water section (Locations S40 to S80), using the Image Analysis tool, which can
be found on the Image Quality tab of the Service Desktop. Refer to Figure 12-4.

Figure 12-4 Image Quality Tab on the Service Desktop

Using the image list-select browser, highlight all the images to be analyzed. Select the Image
Analysis tool, click the Manual radio button (not Auto 1x), and select LCD under the Manual tools
menu. Click [Accept] to begin the analysis.

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Figure 12-5 Image Analysis Tool

A dialog box will now open, allowing the selection of object size, in millimeters, for the analysis.

Figure 12-6 Dialog Box

Enter the value 3.0 and click [OK]. After a few seconds of calculation, a report window will open,
displaying the results:

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Figure 12-7 Report

A 1% contrast means that the mean CT number of the object differs from its background by 10 HU.
Therefore, divide contrast in HU by 10 to convert to % contrast.

Record the “Contrast @ 95% CL" value from Figure 12-7 on the QA Data Form.

Noise and Uniformity (Reference 21CFR 1020.33(j))

Section 2 (Figure 12-8) of the phantom tests noise and uniformity. Use any scan location from S40
- S80 (Recon 3).

Noise limits low contrast resolution, and masks anatomy with similar structure to surrounding
tissue.

QA phantom Section 2 (Recon 1) provides a uniform image by which to assess image CT number
noise and uniformity.

Use the Standard algorithm to reconstruct the image.

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Figure 12-8 Noise and Uniformity Section

2

Table 12-6 Noise and Uniformity Section

Number Description
1 Position a 2 cm Box ROI over the center of the image.
2 Optional: Select Box ROI and move the cursor to the 12 o'clock position 75 mm from center
box.
3 Optional: Select Box ROI and move the cursor to the 3 o'clock position 75 mm from center box.

Image noise equals the standard deviation of CT numbers within a region of interest (ROI).

Noise results from electronic, mechanical, and mathematical differences in detected X-Ray
energy, electronic outputs, and reconstruction algorithms.

Tube warmups, up to date calibration files, and daily Fast Cals minimize noise and help provide
uniform images.

Refer to Figure 12-8.

1. Select Erase to remove previous ROI data.

2. Select Box ROI to position a 2 cm Box ROI over the center of the image.

3. Record the mean CT number and standard deviation on the QA Data Form.

a. QA data form (Table 12-14) is at end of this section.

4. Optional: Select Box ROI and move the cursor to the 12 o'clock position.

5. Record the mean CT number and standard deviation on the QA Data Form.

6. Optional: Select Box ROI to move the cursor to the 3 o'clock position.

7. Record the mean CT number and standard deviation on the QA Data Form.

a. If the Image is reconstructed with Standard algorithm and Small SFOV, the Mean of
Center ROI should equal 0 ± 3.

b. Standard deviation of the center ROI should equal 4.5 ± 0.5 @ 18.2 mGy CTDIvol.

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NOTE The expected tolerance (± 0.5 HU) for standard deviation (4.5 HU) is derived based on
systems staged through manufacturing staging and initial acceptance tests during
installation by averaging the measurements of four scans. The standard deviation value in
this QA measurement may vary as the tube ages or when taking a single image
measurement. The maximum deviation expected for the upper specification limit (5 HU:
4.5 + 0.5 HU) is ± 15% (≤ 5.7 HU). This is in accordance with the information provided in
the Maximum Deviation section of the Quality Assurance chapter.

NOTE The scan technique suggested for this test, 260mAs, @120kV, and 40 mm aperture
nominally provides 18.2 mGy.

c. The uniformity difference between the center ROI and the average of the edge ROIs
should be 0 ± 3.

Prescribe the QA Series for the Slice Thickness Test - Phantom Section #1
1. Select a protocol from the anatomical selector to select a QA protocol (if available).

2. If your facility hasn't created a QA protocol, use the following parameters to finish the QA
series prescription:

3. On the Axial View Edit screen select the following parameters:

4. Analyze the slice thickness in all the images.

Table 12-7 QA Protocol for Slice Thickness

Interface Input
Entry Head First
Position Supine
Anatomical Reference QA
Landmark Location 0 on resolution phantom at circumferential line/cross hatch.
Scan Type Axial
Scan Range Prescribe 3 scan groups
Group 1 Thickness Scan Range Interval
Recon 1 5mm/8i I17.5 - S17.5 0
Recon 2 2.5mm/16i I18.75 - S18.75 0
Group 2 Thickness Scan Range Interval
Recon 1 1.25/16i I9.375 - S9.375 0
Tilt 0 degrees
Scan FOV Small Body
kV 120
mA 260
Rotation Speed 1 second
DFOV 25 cm (phantom diameter: approximately 21.5cm)
Algorithm Standard
Matrix 512
Contrast None
Special Processing None

5. To determine slice thickness, display the image at the recommended window level and width,
and count the visible holes.

a. Black lines in the image represent a full millimeter of slice thickness.

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b. Gray lines count as fractions of a millimeter; two equally gray holes count as a single 1mm
slice thickness.

c. Refer to Figure 12-9.

Recommended window width: 250

Recommended window level:

 -100 for 1.25mm

 -25 for 2.5mm
 + 50 for 5.0mm
Figure 12-9 Slice Thickness Lines

3 1

Table 12-8 Slice Thickness Descriptions

Number Description
1 Adjust the window width and level, then count the number of visible “lines” that represent the air
filled holes.
2 Each black line represents 1 mm of slice thickness. Gray color lines represents 0.5 mm.
3 NOTE The slice thickness bars are less distinctive in helical scans.

You should see one line for each millimeter of scan thickness.

Figure 12-9 represents a 5mm image.

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Slice Thickness
Section 1 of the phantom also tests slice thickness.

Both sides of the resolution block contain a pattern of air filled holes designed to demonstrate slice
thickness (refer to Figure 12-10).

Figure 12-10 Slice Thickness Section

Table 12-9

Number Description
1 Air Filled Holes

The resolution block contains holes drilled 1mm apart and positioned to form a line at 45 degrees
to the scan plane.

Each visible hole in the image represents 1mm of beam thickness.

The software assigns less negative CT numbers to partial hole images or holes located on the
edge of the slice profile.

Prescribe the QA Series for Alignment Light Accuracy - Phantom

Section #1
If available, select a QA protocol from the anatomical selector. If your facility hasn't created a QA
protocol, use the following parameters to finish the QA series prescription:

On the Axial View Edit screen select the following parameters:

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Table 12-10 Parameters for Alignment Lights Check

Interface Input
Entry Head First
Position Supine
Anatomical Reference Type EX for the external alignment light test

Type IN for the internal alignment light test.

Landmark Location 0 on resolution phantom at circumferential line/cross hatch.
Scan Type Axial
Scan Range I8.75 - S8.75
Thickness 2.5 mm/8i
Tilt 0 degrees
Scan FOV Small Body
kVp 120
mA 260
Rotation Speed 1 second
DFOV 25cm (phantom diameter: approximately 21.5cm)
Algorithm Standard
Matrix 512
Contrast None
Special Processing None

Figure 12-11 Alignment Light Section

Table 12-11 Alignment Light Section

Number Description
1 Center Hole position corresponds to the etched line around the phantom circumference.
2 Align the etched line or the phantom to the alignment light.

1. Align the phantom to the Internal light and scan it.

 The actual scan plane should equal 0 ± 2.0mm.

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2. Align the phantom to the External light and scan it.

 The actual scan plane should equal 0 ± 2.0mm.
3. Align the vertical, horizontal and circumferential lines on the phantom to the corresponding
laser lines.
 Azimuth 0 laser: Center phantom left and right within the FOV
 Azimuth 90 and 270 lasers: Center phantom up and down within the FOV.
4. Scan the phantom.
5. Display the resulting phantom image.
 Refer to Figure 12-11.
6. Select Grid to check sagittal and coronal light accuracy.
 Refer to Figure 12-12.
7. Center the phantom to isocenter, ± 4.0mm, along the sagittal and coronal planes.
 Refer to Figure 12-11.
Figure 12-12 Grid Check
1

Table 12-12 Grid Check

Number Description
1 A centered 5 mm scan
2 QA phantom “Prone” or “Supine”

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Alignment Light Accuracy (Reference 21CFR 1020.33(g)(2))

This section provides the means to visually determine the location of the scanner's reference
plane.

The manufacturers drilled deeper center holes on the reference to help identify them in the image.

The center hole position corresponds precisely to the etched marker placed on the circumference
of the phantom.

When you use an accurate light, and align the phantom's circumferential etched marker to the
axial light, the resulting image should contain a symmetrical hole pattern around the center
(longer) hole in the slice thickness pattern.

Refer to Figure 12-11.

Typical Results and Allowable Variations

Because the human eye determines clinical image quality, it remains subjective and difficult to
define.

GE expects the standards of allowable variation in image quality parameters to vary with the
installation and image evaluator(s).

GE encourages you to establish and follow a Quality Assurance (QA) program so you can
discover any degradation of image quality before it affects clinical images.

Over time, institutions use the QA procedure to establish a correlation between acceptable clinical
image quality and acceptable variations in the image performance indices included in the program.

Compare your images to the set of performance images that accompanied your system.

This section contains typical variations; don't mistake them for absolutes.

Compare any parameter variation to the maximum deviation specified in the next section called,
Dose and Performance.

Make sure you used the prescribed technique, then follow your facility guidelines to inform service
when the variations reach the specified maximum deviation.

Contrast Scale
The difference in CT numbers between the Plexiglas resolution block and water should equal 120,
with a suggested allowable variation of 10%.

High Contrast Spatial Resolution

The standard deviation for an ROI in the 1.6mm bar pattern should equal 37 ± 4 for the standard
algorithm.

Axial Scan Slice Thickness

Slice thickness should not vary by more than ± 0.5 mm from the expected value, when evaluated
according to instructions.

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This method is only intended to identify gross changes in slice thickness, possibly due to hardware
failure. More precise slice thickness measurements can be obtained by following the methodology
described along with Table 12-44.

Noise & CT Number of Water

When you correctly image and analyze the water section of the phantom, you should see:

 CT number for water of 0 ± 3 HU for the center ROI.

 The uniformity difference between the Center ROI and the average of the edge ROIs should
be 0 ± 3 for the Small Body Scan FOV (0 ± 8 maximum deviation if Large Body Scan FOV is
used).
 Expect the noise in the center of the image to approximately equal 4.5 ± 0.5, when using the
Small Body Scan FOV.
NOTE The expected tolerance (± 0.5 HU) for standard deviation (4.5 HU) is derived based on
systems staged through manufacturing staging and initial acceptance tests during
installation by averaging the measurements of four scans. The standard deviation value in
this QA measurement may vary as the tube ages or when taking a single image
measurement. The maximum deviation expected for the upper specification limit (5 HU:
4.5 + 0.5 HU) is ± 15% (≤ 5.7 HU). This is in accordance with the information provided in
the Maximum Deviation section of the Quality Assurance chapter.

References
Droege RT, Morin RL. “A Practical Method to Measure the MTF of CT Scanners,” Medical Physics,
Volume 9, No. 5, pp 758-760, 1982.

Jacobson DR. “Quality Assurance for Computed Tomography — Correlation with System
Performance,” Application of Optical Instrumentation in Medicine XI, D. Fullerton, Editor, Proc.
SPIE 419, pp 157-165,1983.

AAPM, “Phantoms for Performance Evaluation and Quality Assurance of CT Scanners,” Report
No. 1, American Association of Physicists in Medicine, 1977

Low Contrast Detectability

The expected contrast value for a 3 mm object, when measured as described in Table 12-3, is less
than 5.3 HU. Typical variation is 0.5 HU.

The tolerance applies to the average of all the acquired images and not to each of the individual
images.

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QA Master Data Form

Table 12-13 QA Master Data Form - CTDI Dose Reference Phantom Descriptions

QA Data Form QA Phantom Serial #: ______________

CONTRAST SCALE HIGH CONTRAST RESOLUTION
Mean CT # Mean CT # Mean CT # Measured Bar Size Specification Measured
Water Plastic
Plastic Std. Dev. Std. Dev.
Minus
Mean CT #
Water

Specification 1.6 37 ± 4
120 ± 12 1.3 --
1.0 --
0.8 --
SLICE THICKNESS ALIGNMENT LIGHT ACCURACY
Slice Width Specification # of Visible Light / Reference Centered
Lines Y/N
5.00 5 ± 0.5 INT Axial
2.50 2.5 ± 0.5 EXT Axial
1.25 1.25 ± 0.5 90 / 270 Laser
0 Laser
LOW CONTRAST DETECTABILITY NOISE AND UNIFORMITY
Object Specification Measured Specification Measurement:
Size Contrast
(mm)
3.0 < 5.3 HU Center Mean 0 ± 3 HU
CT #
Center Std. 4.5 ± 0.5 HU
Dev. CT #
max deviation:
5.7 HU
CT # 0 ± 3 HU
Uniformity
(Center Means - Outer Means)

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QA Phantom - Representative Images (Reference 21CFR 1020.33

(d)(3)(i)
This section contains representative images obtained with the phantom(s) using the same
processing mode and CT conditions of operation as described in previous section for a properly
functioning system.

Table 12-14 Representative Images

High Contrast Spatial Resolution Section Noise/CT Number/LCD Section

Digital Representative Images (Reference 1020.33 (d)(3)(ii))

To access digital form of the representative images stored on the system, use the following steps
to install the images in the system browser so they can be reviewed:

1. Click the [Service] icon in the display area. The Service desktop will display the Common
Service Desktop user interface.

2. Click on Image Quality. In the Image Quality menu, click on Install 21 CFR Images.

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Figure 12-13

A pop-up window will display showing that the images are being installed in the database.

Figure 12-14

3. Go to Image Works desktop. Select Exam 537 21 CFR1020.33, then click [Viewer].

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Figure 12-15 CTDI Dose Reference Phantoms (Reference 21CFR 1020.33(c)(1))

 Series 1 – Helical Head

 Series 2 – Helical Body
 Series 3 – Axial Head
 Series 4 – Axial Body
Digital Images are provided with the system in exam 537.

Table 12-15 Representative Images

Axial Head Axial Body

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Figure 12-16 Helical Head

Figure 12-17 Helical Body

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Gemstone Spectral Imaging (GSI) Quality Assurance - Optional

GSI Quality Assurance are optional system performance tests to maintain GSI image quality.

QA Phantom
GSI Quality Assurance system performance tests use the same QA Phantom as the regular
system performance tests. Refer to Table 12-1.

Position the QA Phantom

GSI Quality Assurance system performance tests use the same QA Phantom alignment and
positioning as the regular system performance tests. Refer to Figure 12-2, Table 12-2 and Position
the QA Phantom on page 12-6.

Prescribe the GSI QA Series for the CT Number Accuracy and Noise and
Uniformity Tests
1. Click [New Patient] to display the Patient/Exam Parameters screen.

 Use the same ID for all related QA tests so you can store the exams together.
2. Enter any additional information in the corresponding data field(s). (Optional)

3. Exam Description: Enter up to 22 characters to describe the test. (Recommended)

4. Select a protocol from the anatomical selector to select a QA protocol. (30.2: GSI Quality
Assurance in GE Misc).

Use the following parameters for the GSI QA series prescription.

On the Helical ViewEdit screen select the following parameters:

Table 12-16 Parameters for GSI QA

Interface Input
Entry Head First
Position Supine
Anatomical Reference QA
Scan Range S78-S78
Scan Type GSI Mode: On Helical
GSI Preset GSI-14
Thickness 5 mm
Recon Interval 5 mm
Tilt 0 degrees
Pitch 0.531:1 Helical
Rotation Speed 0.8 seconds
Algorithm Standard
DFOV 22.7 cm
Matrix 512
Recon Options GSI Mono, 70 keV, GSI Data File: Off
Recon Mode Full Helical
Contrast None

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Interface Input
Special Processing None
Window Width / Window Level 60/0

Analyze the GSI QA Images

Display the first QA image, which is section #2 at scan location S78.

Figure 12-18 Noise and Uniformity and CT Number Accuracy Section

2

Table 12-17 Noise and Uniformity and CT Number Accuracy Section

Number Description
1 Position a 2 cm Box ROI over the center of the image.
2 Optional: Select Box ROI and move the cursor to the 12 o'clock position 75 mm from center
box.
3 Optional: Select Box ROI and move the cursor to the 3 o'clock position 75 mm from center box.

Image noise equals the standard deviation of CT numbers within a region of interest (ROI).

Noise results from electronic, mechanical, and mathematical differences in detected X-Ray
energy, electronic outputs, and reconstruction algorithms.

Tube warmups, current calibration files, and daily Fast Cals minimize noise and improve image
uniformity.

Refer to Figure 12-18.

1. Select Erase to remove previous ROI data.

2. Select Box ROI to position a 2 cm Box ROI over the center of the image.

3. Record the mean CT number and standard deviation on the GSI QA Data Form.

a. GSI QA Data Form (Table 12-18) is at end of this section.

4. Optional: Select Box ROI and move the cursor to the 12 o'clock position.

5. Record the mean CT number and standard deviation on the GSI QA Data Form.

6. Optional: Select Box ROI to move the cursor to the 3 o'clock position.

7. Record the mean CT number and standard deviation on the GSI QA Data Form.

a. The mean CT number of the center ROI should equal 0 ± 3.

b. Standard deviation of the center ROI should equal 2.9 ± 0.5.

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c. The uniformity difference between the mean CT number of the center ROI and the
average of the edge ROIs should be 0 ± 3.

GSI QA Data Form

Table 12-18

QA Phantom Serial #: ______________ Specification Measurement:

Center Mean CT Number 0 ± 3 HU
Center Standard Deviation CT Number 2.9 ± 0.5 HU
CT Number Uniformity 0 ± 3 HU

QA Phantom - Representative Image for GSI QA

Table 12-19 Representative Images for GSI QA

Noise/CT Number Accuracy/Uniformity

Dosimetry
Reference: IEC60601-2-44:2009 Clause 203.5.5.4.1 and Clause 203.109.1

Dosimetry information is provided in terms of the CTDI and CTDIw dose indices. Optionally
CTDIvol and its associated DLP (dose length product) is automatically computed and displayed on
the patient Rx menu to assist in managing patient dose. This section provides a brief description to
help you better understand these dose reporting standards.

General Information
Dose is the amount of energy imparted by the X-ray beam at a given point in an exposed material
(patient tissue, phantom, air, etc.) and is measured in units of mGy (milliGray). The old unit was
the rad, which equals 10 mGy. Dose is dependent on the energy absorption factors of the material
and on the X-ray exposure. The X-ray exposure is measured in C/kg (coulombs per kilogram) and

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is dependent on the technique factors used for the scan. An absorbed dose of 1 mGy means that
1 Joule per gram of energy has been imparted. The dose is generally proportional to the exposure,
which increases with increasing mA, kV and scan time and decreases with increasing patient size.
The X-ray exposure to a point occurs from both direct X-ray from the tube and from scattered X-
ray due to adjacent material exposure.

Patient biological risk is related to dose but is also highly dependent on the specific organs
exposed and the age and gender of the patient. The effective dose is a way to characterize the
stochastic risk to the patient population. The effective dose is the sum of the doses weighted in
accordance with the specific radio-sensitivity of the particular organs or tissues exposed.
Weighting values are published in ICRP 60 (International Committee on Radiation Protection,
Publication 60). The effective dose is a whole body dose equivalent value that has been scaled to
represent the dose of the exposed organs. Although we can accurately describe the X-ray
exposure potential to a patient for a CT scan, we cannot easily determine the patient dose or risk
in terms of effective dose. This is because each patient is anatomically unique and the specific
details of his or her anatomy along with the source exposure must be processed using time-
consuming monte-carlo computer programs (or other more approximate methods) to predict how
radiation will be scattered and accumulated within various patient organs.

Since it is not possible to characterize the specific dose given to individual patients, the CT dose
indices are provided to help make relative comparisons. These dose index values can be used to
compare CT systems and to help select appropriate operating conditions for scanning. However, it
is important to recognize that the dose reported by these indices is inversely proportional to
phantoms size (see Figure 12-19). This means that for the same scan technique (protocol),
smaller phantoms (patients) will produce a higher absorbed dose than larger phantoms (patients) -
see “Influence of phantom diameter, kVp and scan mode upon computed tomography dose index”,
Edward L. Nickoloff, Ajoy K. Dutta, and Zheng F. Lu, Medical Physics 30, 395 (2003). Therefore, it
is critical to remember that the body scan FOV’s uses the 32cm CTDI phantom and all
pediatric and head filter uses the 16cm CTDI phantom for dose reporting purposes (CTDIvol
display on Scan Rx Menu). Table 12-21 indicates the phantom size used for each SFOV.

At the time of release of this manual, dosimetry information was measured with the following
instruments: 
(Calibration Tolerance: ± 5%)

 Radiation Meter: RadCal 9015

 Radiation Meter Converter: RadCal 9060
 CT Probe: RadCal 10×5 - 3CT

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Figure 12-19 Relationship between dose and phantom size for head and body filters at 120kVp.
Similar curves are obtained for the 80, 100, and 140 kVps.

1 2

Table 12-20

Number Description
1 Head Filter
2 Body Filter
3 Relative Dose
4 Phantom Diameter (cm)

Table 12-21 SFOV selection vs. CTDI phantom used for dose reporting

SFOV type CTDI phantom

Ped Head 16 cm Phantom
Ped Body
Small Head
Head
Small Body 32 cm Phantom
Medium Body
Large Body
Cardiac Small
Cardiac Medium
Cardiac Large

CTDIw (Reference IEC 60601-2-44 and 21 CFR 1020.33 (c))

CTDIw or weighted CTDI100 is a dose index which consists of 2/3 of the CTDI100 peripheral dose
plus 1/3 of the CTDI100 central dose. The CTDI100 dose is defined as the integral of the dose
profile, Da(z), produced in a single axial scan along a line perpendicular to the imaging plane from

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-50 mm to +50 mm, divided by the product of the number of slices, n, and the nominal tomographic
section thickness (row detection width), T.

CTDIw is measured using either a 16 cm (for head scanning) or a 32 cm (for body scanning)
PMMA phantom of at least 14 cm in length. The measurements are taken at the center and
peripheral (see Figure 12-20). The doses measured at these locations within the PMMA phantom,
are quoted as the dose absorbed in air rather than PMMA (absorption in air is about 11% higher
than absorption in PMMA).

The CTDI phantom should be on the patient table.

Figure 12-20 CTDI Dose Reference Phantom Description (Reference 21CFR 1020.33(c)(1))

1
2
3
4
5
6
7

Table 12-22 CTDI Dose Reference Phantom Description

Number Part Description

1 Head Phantom 16 cm diameter
2 Body Phantom 32 cm diameter
3 Material PMMA (polymethylmethacrylate)
4 Thickness > 14 cm
5 A through E Pencil chamber openings
6 A Center
7 B through E Peripheral 1 cm from the surface 0, 90, 180, or 270
degrees (°) direction

CTDI100 dose tables and index factors are provided in the following section. To determine the
CTDI100 dose, select the appropriate standard technique dose (small or large filters at Typical
Techniques (Reference 21CFR 1020.33(c)(1))) and multiply by the factors for describing the
technique used (refer to Table 12-23 to Table 12-28).

The CTDI100 values at the four peripheral locations are very similar due to the geometry of the
system and phantom. The “B” position is the maximum. The four locations “B, C, D, and E” are
averaged to give one value representative of all peripheral positions. All measurements made on
the 16cm and 32cm CTDI phantoms are with the phantom placed on the patient cradle without
additional attenuating materials present.

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Table 12-23 Helical Travel and Scan Mode Adjustment Factors

Acquisition Mode Parameters for CTDI100 and CTDIw

Helical mm/Rotation per Pitch and

Axial and Cine Slice Thickness
Acquisition Mode

(mm) (mm)
Acq. ~0.5:1 ~0.9:1 1.375:1 1.531:1 64i 32i 16i 8i 4i 2i 1i
64 X 0.625 20.63 39.38 55.00 61.25 0.625* 1.25* 2.50 5.00 N/A N/A N/A
32 X 0.625 10.63 19.38 27.50 30.62 N/A 0.625 1.25 2.50 5.00 N/A N/A
16 X 0.625 N/A N/A N/A N/A N/A N/A 0.625 1.25 2.50 5.00 N/A
8 X 0.625 N/A N/A N/A N/A N/A N/A N/A N/A 1.25 2.50 5.00
4 X 0.625 N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.25 2.50
2 X 0.625 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A 1.25

* Available in retro recon only.

Table 12-24 Typical Techniques (Reference 21CFR 1020.33 (c)(1))

Typical Techniques for CTDI100 and CTDIw

Small-axial-cine Medium- axial-cine Large-axial-cine
25 cm SFOV 32 cm SFOV 50 cm SFOV
120kV 120kV 120kV
260 mA 260 mA 260 mA
1 sec scan 1 sec scan 1 sec scan
40 mm Aperture, 64x0.625 40 mm Aperture, 64x0.625 40 mm Aperture,64x0.625

Table 12-25 CTDI100 Dose Values (Reference 21CFR 1020.33 (c)(2)(i) and 21CFR
1020.33 (c)(2)(ii))

CTDI100 DOSE VALUES (mGy)

AT TYPICAL TECHNIQUE

SFOV Filter Phantom Size Center Peripheral

Ped Head Small 16 cm 41.57 42.36
Ped Body Small 16 cm 41.57 42.36
Small Head Small 16 cm 41.57 42.36
Head Medium 16 cm 43.90 48.91
Small Body Small 32 cm 11.24 21.74
Medium Body Medium 32 cm 12.31 26.25
Large Body Large 32 cm 11.71 25.45
Cardiac Small Small 32 cm 11.24 21.74
Cardiac Medium Medium 32 cm 12.31 26.25
Cardiac Large Large 32 cm 11.71 25.45

Table 12-26 kV and mAs Adjustment Factors (Reference 21CFR 1020.33 (c)(2)(iii))

KV Adjustment Factor
Ped Head
Small Body Medium Body Large Body
Ped Body Head
KV Cardiac Small Cardiac Medium Cardiac Large
Small Head
Center Peripheral Center Peripheral Center Peripheral Center Peripheral Center Peripheral
80 0.34 0.37 0.34 0.37 0.28 0.35 0.28 0.35 0.28 0.35
100 0.64 0.66 0.64 0.66 0.59 0.64 0.59 0.64 0.59 0.64

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KV Adjustment Factor
Ped Head
Small Body Medium Body Large Body
Ped Body Head
KV Cardiac Small Cardiac Medium Cardiac Large
Small Head
Center Peripheral Center Peripheral Center Peripheral Center Peripheral Center Peripheral
120 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00
140 1.41 1.39 1.41 1.39 1.49 1.41 1.49 1.41 1.49 1.41
mAs ADJUSTMENT FACTOR = Rx mA * Rx single rotation time in seconds/ 260

Table 12-27 Aperture Adjustment Factors for Large Spot

CTDI Aperture Adjustment Factors for Large Spot

Ped Head
Small Body Medium Body Large Body
SFOV Ped Body, Head
Cardiac Small Cardiac Medium Cardiac Large
Acquisition Small Head
Mode Small Small Med. Med. Small Small Med. Med. Large Large
Center Peripheral Center Peripheral Center Peripheral Center Peripheral Center Peripheral
64 X 0.625 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00
32 X 0.625 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10
16 X 0.625 1.30 1.30 1.30 1.30 1.30 1.30 1.30 1.30 1.30 1.30
8 X 0.625 1.60 1.60 1.60 1.60 1.60 1.70 1.60 1.70 1.60 1.70
4 X 0.625 1.70 1.70 1.70 1.70 1.60 1.70 1.70 1.70 1.60 1.70
2 X 0.625 2.40 2.50 2.40 2.50 2.40 2.50 2.40 2.50 2.30 2.50

Table 12-28 Aperture Adjustment Factors for Small Spot

CTDI Aperture Adjustment Factors for Small Spot

Ped Head
Small Body Medium Body Large Body
SFOV Ped Body, Head
Cardiac Small Cardiac Medium Cardiac Large
Acquisition Small Head
Mode Small Small Med. Med. Small Small Med. Med. Large Large
Center Peripheral Center Peripheral Center Peripheral Center Peripheral Center Peripheral
64 X 0.625 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00
32 X 0.625 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10 1.10
16 X 0.625 1.20 1.20 1.20 1.20 1.20 1.20 1.20 1.30 1.20 1.20
8 X 0.625 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50
4 X 0.625 1.70 1.70 1.70 1.70 1.60 1.70 1.60 1.70 1.70 1.70
2 X 0.625 2.40 2.40 2.40 2.40 2.40 2.60 2.30 2.50 2.40 2.50

Example 1 - The CTDI100 large body peripheral dose for a 55 mm/sec helical scan (64X0.625) in
1.375:1 mode, scan at 250 mA, 1.0 Sec per rotation and 120 kV is determined as follows:

25.5 mGy Body peripheral dose at typical technique from CTDI Table 12-25
x 1.00 120 kV factor from CTDI kV Table 12-26
x 1.00 Aperture adjustment factor from CTDI100 aperture factor for 64 X 0.625 and small spot
Table 12-28 (i.e. at 120 kV, 250 mA < 570mA)
x 250/260 mA adjustment factor (250mA x 1 sec/rot/260) Table 12-26
=24.5 mGy CTDI100 Body Peripheral dose

Example 2 - The CTDI100 large body center dose for example 1 is determined as follows:

11.7 mGy Body Center Dose value from Table 12-25

x 1.00 120 kV factor from CTDI kV Table 12-26

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x 1.00 Aperture adjustment factor from CTDI100 aperture factor for 64 X 0.625 and small spot
Table 12-28 (i.e. at 120 kV, 250 mA < 570mA: Small Focal Spot)
x 250/260 mA adjustment factor (250mA x 1 sec/rot/260) Table 12-26
=11.3 mGy CTDI100 Body center dose

Example 3 - The CTDIw large body dose for example 1 and 2 is computed as:

24.5 x 2/3 + 11.3 x 1/3 = 20.1 mGy

Measuring Method for CTDI100

1. Remove the soft pad from the patient cradle as shown in Figure 12-21.

Figure 12-21 Patient Cradle with Soft Pad Removed

2. Place the CTDI phantom on the cradle as shown in Figure 12-22. To help with consistency of
the results, ensure that the phantom is at least 20cm from the end of the patient cradle. The
location and labeling of the dosimeter probe holes are illustrated in the figure. Dosimeter holes
are located in the center, on top, to the right, on the bottom and to the left, A, B, C, D and E,
respectively (refer to Figure 12-23).

Figure 12-22 32cm CTDI Phantom on Patient Cradle

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Figure 12-23 CTDI Dose Reference Phantom

1
2
3
4
5
6
7

Table 12-29 CTDI Dose Reference Phantom Description

Number Part Description

1 Head Phantom 16 cm diameter
2 Body Phantom 32 cm diameter
3 Material PMMA (polymethylmethacrylate)
4 Thickness > 14 cm
5 A through E Pencil chamber openings
6 A Center
7 B through E Peripheral 1 cm from the surface 0, 90, 180, or 270
degrees (°) direction

3. To correctly align the phantom in the x and y directions, acquire an axial scan of the CTDI
phantom using acquisition parameters suggested in Table 12-30; subsequently overlay a grid
on the reconstructed axial image of the phantom using the grid tool located in the ImageWorks
desktop. When correctly aligned, within ±10mm, the x and y axes will overlay all holes A, B, C,
D and E. If the grid axes do not overlay the hole locations, use the cradle positioning Up/Down
buttons on the CT gantry to modify the y position of the cradle and manually maneuver the
phantom to center the phantom in the x direction. Repeat the process and acquire as many
images of the CTDI phantom as are needed to ensure that the phantom is properly aligned in
the x and y directions. In addition, this alignment should be performed for all images of axial
scan considering lean in Z direction. An example of (left) a misaligned, and (right) a correctly
aligned phantom are shown in Figure 12-24.

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Figure 12-24 Example of a misaligned (left) and a correctly aligned (right) phantom. Note
the overlaid grid lines passing through all five hole locations in the correctly aligned
phantom.

Table 12-30 Suggested Technique to Acquire Alignment Images (Figure 12-24)

Parameter Value
Scan Mode Axial
Rotation Time 1.0 s/rot
kV 120kV
mA 200mA
Slice Collimation 64 x 0.625
SFOV Head (for 16cm phantom)
Large Body (for 32cm phantom)
Image Thickness 2.5mm
Recon Filter Stnd
DFOV 20cm (for 16cm phantom)
35cm (for 32cm phantom)
ww / wl 400 / 100

4. Place the dosimeter in the top probe position hole (B) as shown in Figure 12-25 and ensure
that all remaining empty holes are filled using solid acrylic rods.

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Figure 12-25 Dosimeter probe in the top probe position (B) with (left) the center
alignment mark indicated, and (right) the laser light as it appears when properly aligned.

To ensure that the dosimeter probe is aligned in the z direction, enable the laser alignment
lights and use the cradle positioning In/Out buttons until the laser light lies along the center
alignment mark on the dosimeter surface.

5. When satisfied that the CTDI phantom is properly aligned in the x, y, and z axes, securely
position the CTDI phantom on the cradle by covering the phantom with adhesive tape,
fastening the tape on both sides to the cradle. This is shown in Figure 12-26 with the probe in
the center position.

Figure 12-26 CTDI phantom secured to table with adhesive tape, probe in center position

6. Remove the dosimeter probe from the top probe position (B) and replace it in the center probe
position (A), filling all empty probe holes with acrylic rods as needed (Figure 12-26). Acquire
an axial scan and record the dose measured by the dosimeter from the scan using the
technique described in Table 12-31:

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Table 12-31 Sample Technique of 120kV, Large Body SFOV, 260mA and 64×0.625mm

Parameter Value
Scan Mode Axial
Rotation Time 1.0 s/rot
kV 120kV
mA 260mA
Slice Collimation / Aperture 64 x 0.625 / 40mm
SFOV Large Body SFOV

NOTE If a set of “Radiation Meter RadCal 9015” and “CT Probe RadCal 10×5 - 3CT” is used, the
displayed dose of RadCal 9015 is:

a) To be multiplied with calibration factor.

b) Already adjusted value of 1cm though the probe length is 10cm.

As a result of a) and b), measured CTDI100 is calculated by the following equation.

[Measured dose (mGy)] = [Displayed Dose (mGy)] ×[Calibration Factor] ×10.0 / [Aperture
in mm]

7. Repeat the same axial scan technique and measurement process ten times and record the
average measured dose of the ten scans to get the dose measurement of position B and is the
CTDIperipheral at position B.

8. Repeat the scan and measurement process (steps 1-7 above) for all other probe positions (A,
C, D, and E) making sure to fill the empty probe holes with acrylic rods each time. These will
give CTDIperipheral values for positions C,D, and E, as well as the CTDIcenter value (position
A).

9. The CTDIw value is obtained from the CTDIcenter and CTDIperipheral values above by the
equation:

CTDIw = ⅓CTDIcenter + ⅔CTDIperipheral

Where the CTDIperipheral is the average of the 4 values obtained in step 8.

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Table 12-32 Non-GSI Dose Calculations for 306 kg / 675 lb patient table / VT2000x -
Dose Scaling Factors

Pediatric Head Pediatric Body Cardiac Small Cardiac Medium Car0diac Large
Table Type
Center / Peripheral Center / Peripheral Center / Peripheral Center / Peripheral Center / Peripheral
VT1700 / VT2000 1/1 1/1 1/1 1/1 1/1
VT2000x 0.975 / 0.979 0.975 / 0.979 0.987 / 0.988 0.987 / 0.987 0.987 / 0.987

Small Body Medium Body Large Body Small Head Head

Table Type
Center / Peripheral Center / Peripheral Center / Peripheral Center / Peripheral Center / Peripheral
VT1700 / VT2000 1/1 1/1 1/1 1/1 1/1
VT2000x 0.987 / 0.988 0.987 / 0.987 0.987 / 0.987 0.975 / 0.979 0.976 / 0.978

Example 4 - For Small Body Center, the heavy cradle has a dose drop 1.32%, so the scaling factor
is 1-1.32%=0.987.

CTDI100 for Pediatric Head for 675 lb table

CTDI100_center = 41.57*0.975 = 40.706 mGy

CTDI100_peripheral = 42.36*0.979 = 41.470 mGy

Table 12-33 Dose Values for GSI with VT1700/VT2000 Tables (Axial, 1 rotation @ scan
technique for the preset)

Rotation Time
GSI Preset CTDIw Average mA SFOV Collimation Average kV
in seconds
GSI 1 17.49 630 Large Body 0.5 40 96
GSI 2 32.32 600 Medium Body 0.9 20 96
GSI 3 18.33 630 Medium Body 0.5 40 96
GSI 4 28.47 600 Large Body 0.9 40 96
GSI 5 32.01 600 Large Body 1 40 96
GSI 6 33.43 600 Medium Body 1 40 96
GSI 7 34.87 600 Large Body 1 20 96
GSI 8 36.34 600 Medium Body 1 20 96
GSI 9 70.38 600 Head 0.9 20 96
GSI 10 25.13 600 Large Body 0.8 40 96
GSI 11 26.27 600 Medium Body 0.8 40 96
GSI 12 27.33 600 Large Body 0.8 20 96
GSI 13 28.58 600 Medium Body 0.8 20 96
GSI 14 62.22 600 Head 0.8 20 96
GSI 15 21.50 640 Large Body 0.6 40 96
GSI 16 22.46 640 Medium Body 0.6 40 96
GSI 17 23.41 640 Large Body 0.6 20 96
GSI 18 24.42 640 Medium Body 0.6 20 96
GSI 19 53.00 640 Head 0.6 20 96
GSI 20 43.22 630 Head 0.5 20 96
GSI 21 38.42 630 Small Head 0.5 20 96
*GSI 22 14.79 375 Large Body 0.7 40 98
*GSI 23 15.56 375 Medium Body 0.7 40 98
*GSI 24 15.87 375 Large Body 0.7 20 98
*GSI 25 16.76 375 Medium Body 0.7 20 98
*GSI 26 35.58 375 Head 0.7 20 98
GSI 27 23.19 550 Large Body 0.8 40 96

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Rotation Time
GSI Preset CTDIw Average mA SFOV Collimation Average kV
in seconds
GSI 28 24.60 550 Medium Body 0.8 40 96
GSI 29 26.74 550 Medium Body 0.8 20 96
GSI 30 56.07 550 Head 0.8 20 96
*GSI 31 12.72 375 Large Body 0.6 40 98
*GSI 32 13.61 375 Medium Body 0.6 40 98
*GSI 33 13.69 375 Large Body 0.6 20 98
*GSI 34 14.16 375 Medium Body 0.6 20 98
*GSI 35 19.85 630 Medium Body 0.5 20 96
*GSI 36 10.14 260 Large Body 0.8 40 96
*GSI 37 10.81 260 Medium Body 0.8 40 96
*GSI 38 11.69 260 Medium Body 0.8 20 96
*GSI 39 25.40 260 Head 0.8 20 96
*GSI 40 12.09 360 Large Body 0.6 40 98
*GSI 41 12.86 360 Medium Body 0.6 40 98
*GSI 42 14.07 360 Medium Body 0.6 20 98
*GSI 43 29.76 360 Head 0.6 20 98
*GSI 44 10.51 275 Large Body 0.7 40 98
*GSI 45 11.10 275 Medium Body 0.7 40 98
*GSI 46 11.99 275 Medium Body 0.7 20 98
*GSI 47 26.02 275 Head 0.7 20 98
*GSI 48 8.91 260 Large Body 0.7 40 96
*GSI 49 9.54 260 Medium Body 0.7 40 96
*GSI 50 10.24 260 Medium Body 0.7 20 96
*GSI 51 10.18 360 Large Body 0.5 40 98
*GSI 52 10.59 360 Medium Body 0.5 40 98
*GSI 53 11.51 360 Medium Body 0.5 20 98
*GSI 54 8.96 275 Large Body 0.6 40 98
*GSI 55 9.51 275 Medium Body 0.6 40 98
*GSI 56 10.34 275 Medium Body 0.6 20 98
**GSI 57 8.61 375 Large Cardiac 0.35 40 105
**GSI 58 8.84 375 Medium Cardiac 0.35 40 105
**GSI 59 7.51 375 Small Cardiac 0.35 40 105
**GSI 60 14.53 600 Large Cardiac 0.35 40 108
**GSI 61 15.10 600 Medium Cardiac 0.35 40 108
**GSI 62 12.84 600 Small Cardiac 0.35 40 108
**GSI 63 17.61 640 Large Cardiac 0.35 40 112
**GSI 64 18.13 640 Medium Cardiac 0.35 40 112
**GSI 65 15.51 640 Small Cardiac 0.35 40 112
*GSI 66 22.40 260 Small Head 0.8 20 96

*Available with Enhanced GSI Option

**Available with GSI SnapShot Pulse Option

NOTE mA not selectable

Table 12-34 Dose Values for GSI with 306 kg / 675 lb patient table / VT2000x - (Axial, 1
rotation @ scan technique for the preset)

Rotation Time
GSI Preset CTDIw Average mA SFOV Collimation Average kV
in seconds
GSI 1 17.30 630 Large Body 0.5 40 96
GSI 2 31.81 600 Medium Body 0.9 20 96

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Rotation Time
GSI Preset CTDIw Average mA SFOV Collimation Average kV
in seconds
GSI 3 18.08 630 Medium Body 0.5 40 96
GSI 4 28.04 600 Large Body 0.9 40 96
GSI 5 31.55 600 Large Body 1 40 96
GSI 6 32.93 600 Medium Body 1 40 96
GSI 7 34.46 600 Large Body 1 20 96
GSI 8 35.82 600 Medium Body 1 20 96
GSI 9 69.23 600 Head 0.9 20 96
GSI 10 24.77 600 Large Body 0.8 40 96
GSI 11 25.87 600 Medium Body 0.8 40 96
GSI 12 26.99 600 Large Body 0.8 20 96
GSI 13 28.16 600 Medium Body 0.8 20 96
GSI 14 61.22 600 Head 0.8 20 96
GSI 15 21.20 640 Large Body 0.6 40 96
GSI 16 22.08 640 Medium Body 0.6 40 96
GSI 17 23.08 640 Large Body 0.6 20 96
GSI 18 24.09 640 Medium Body 0.6 20 96
GSI 19 52.16 640 Head 0.6 20 96
GSI 20 42.50 630 Head 0.5 20 96
GSI 21 37.81 630 Small Head 0.5 20 96
*GSI 22 14.61 375 Large Body 0.7 40 98
*GSI 23 15.37 375 Medium Body 0.7 40 98
*GSI 24 15.63 375 Large Body 0.7 20 98
*GSI 25 16.49 375 Medium Body 0.7 20 98
*GSI 26 34.97 375 Head 0.7 20 98
GSI 27 22.87 550 Large Body 0.8 40 96
GSI 28 24.23 550 Medium Body 0.8 40 96
GSI 29 26.31 550 Medium Body 0.8 20 96
GSI 30 55.10 550 Head 0.8 20 96
*GSI 31 12.52 375 Large Body 0.6 40 98
*GSI 32 13.42 375 Medium Body 0.6 40 98
*GSI 33 13.49 375 Large Body 0.6 20 98
*GSI 34 13.95 375 Medium Body 0.6 20 98
GSI 35 19.60 630 Medium Body 0.5 20 96
*GSI 36 9.93 260 Large Body 0.8 40 96
*GSI 37 10.61 260 Medium Body 0.8 40 96
*GSI 38 11.47 260 Medium Body 0.8 20 96
*GSI 39 24.93 260 Head 0.8 20 96
*GSI 40 11.82 360 Large Body 0.6 40 98
*GSI 41 12.56 360 Medium Body 0.6 40 98
*GSI 42 13.76 360 Medium Body 0.6 20 98
*GSI 43 29.17 360 Head 0.6 20 98
*GSI 44 10.37 275 Large Body 0.7 40 98
*GSI 45 10.94 275 Medium Body 0.7 40 98
*GSI 46 11.81 275 Medium Body 0.7 20 98
*GSI 47 25.58 275 Head 0.7 20 98
*GSI 48 8.74 260 Large Body 0.7 40 96
*GSI 49 9.37 260 Medium Body 0.7 40 96
*GSI 50 10.03 260 Medium Body 0.7 20 96
*GSI 51 9.96 360 Large Body 0.5 40 98
*GSI 52 10.34 360 Medium Body 0.5 40 98
*GSI 53 11.29 360 Medium Body 0.5 20 98

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Rotation Time
GSI Preset CTDIw Average mA SFOV Collimation Average kV
in seconds
*GSI 54 8.82 275 Large Body 0.6 40 98
*GSI 55 9.38 275 Medium Body 0.6 40 98
*GSI 56 10.18 275 Medium Body 0.6 20 98
**GSI 57 8.48 375 Large Cardiac 0.35 40 105
**GSI 58 8.71 375 Medium Cardiac 0.35 40 105
**GSI 59 7.40 375 Small Cardiac 0.35 40 105
**GSI 60 14.35 600 Large Cardiac 0.35 40 108
**GSI 61 14.93 600 Medium Cardiac 0.35 40 108
**GSI 62 12.68 600 Small Cardiac 0.35 40 108
**GSI 63 17.36 640 Large Cardiac 0.35 40 112
**GSI 64 17.86 640 Medium Cardiac 0.35 40 112
**GSI 65 15.27 640 Small Cardiac 0.35 40 112
*GSI 66 21.99 260 Small Head 0.8 20 96

*Available with Enhanced GSI Option

**Available with GSI SnapShot Pulse Option

NOTE mA not selectable

CTDIvol (Reference IEC 60601-2-44)

The volume CTDIw (CTDIvol) describes the average dose over the total volume scanned for the
selected CT conditions of operation. The system computes CTDIvol automatically.

NOTE System computations may vary slightly from manual calculations due to differences in
round-off or truncation operations.

The CTDIvol is defined as follows:

 For axial scanning

where N is the number of slices produced in a single axial scan, T is the slice thickness (or row
detection width), and ∆d is the table travel in z-direction between consecutive scans.
 For scanning without pre-programmed movement of the table (Cine, test bolus, axial shuttle
and fluoro modes), where n is equal to the maximum number of pre-programmed rotations
and can be calculated as the total X-ray on time divided by the gantry rotation speed.

 For helical scanning

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Figure 12-27 Dynamic Z-Axis Tracking Adjustment Factor

1

CTDIDynamicZͲAxisTrackingAdjustmentFactor
0.95

0.9

0.85

2 20mmaperture,0.531&0.969pitch
0.8
3 20mmaperture,1.375pitch

4 20mmaperture,1.531pitch

0.75 5 40mmaperture,0.516pitch

6 40mmaperture,0.984pitch

40mmaperture,1.375pitch
1 0.7 7
8 40mmaperture,1.531pitch

0.65
0 50 100 150 200 250 300 350 400 450 500
9 ZCoverage,mm

Table 12-35 Descriptions for Figure 12-27

Number Description
1 CTDI Dynamic Z-Axis Tracking Adjustment Factor
2 20 mm aperture, 0.531 & 0.969 pitch
3 20 mm aperture, 1.375 pitch
4 20 mm aperture, 1.531 pitch
5 40 mm aperture, 0.516 pitch
6 40 mm aperture, 0.984 pitch
7 40 mm aperture, 1.375 pitch
8 40 mm aperture, 1.531 pitch
9 Z coverage (mm)

The tracking adjustment factor is to account for the dose reduction provided by Dynamic Z-Axis
Tracking (see Collimator Theory section of the General Information Chapter for more details). The
tracking adjustment factor should be used for all helical scans except GSI, Cardiac and Volume
Helical Shuttle scans. These scan techniques do not employ Dynamic Z-Axis Tracking. A tracking
adjustment factor of 1 should be used for GSI and Cardiac Helical scans.

Table 12-36 Dynamic Z-Axis Tracking Adjustment Factor

Helical Pitch Adjustment Factor

20mm 20mm 20mm 40mm 40mm 40mm 40mm

Recon
aperture, 0.531 aperture, 1.375 aperture1.531 aperture, 0.516 aperture, 0.984 aperture, 1.375 aperture1.531
coverage (mm)
& 0.969 pitch pitch pitch pitch pitch pitch pitch

0 0.78 0.74 0.75 0.83 0.70 0.74 0.76

50 0.94 0.90 0.9 0.92 0.86 0.85 0.86

100 0.96 0.94 0.93 0.95 0.91 0.90 0.90

150 0.97 0.96 0.95 0.96 0.93 0.92 0.92

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Helical Pitch Adjustment Factor

20mm 20mm 20mm 40mm 40mm 40mm 40mm

Recon
aperture, 0.531 aperture, 1.375 aperture1.531 aperture, 0.516 aperture, 0.984 aperture, 1.375 aperture1.531
coverage (mm)
& 0.969 pitch pitch pitch pitch pitch pitch pitch

200 0.98 0.97 0.96 0.97 0.95 0.94 0.94

250 0.98 0.97 0.97 0.98 0.95 0.95 0.95

300 0.99 0.98 0.97 0.98 0.96 0.95 0.95

350 0.99 0.98 0.98 0.98 0.97 0.96 0.96

400 0.99 0.98 0.98 0.98 0.97 0.96 0.96

450 0.99 0.98 0.98 0.99 0.97 0.97 0.97

500 0.99 0.99 0.98 0.99 0.98 0.97 0.97

Table 12-37 Pitch Adjustment Factor

CT Pitch Adjustment Factor

40 mm Aperture 20 mm Aperture

Pitch Factor 0.516 0.984 1.375 1.531 0.531 0.969 1.375 1.531

Cardiac Pitch Adjustment Factor

Pitch Factor 0.160 0.180 0.200 0.220 0.240 0.260 0.280 0.300 0.320

Example 1 - The CTDIvol small head dose for a 10 mm 1i × 5 mm (5mm aperture acquisition
mode) axial scan, at 150 mA, 1.0 sec per rotation, 120 kV and a 30 mm table increment is
determined as follows:

41.57 mGy and 42.36 mGy Small Head Center and Peripheral Dose value from Table 12-25
x 1.00,1.00 120 kV factor from CTDI kV Table 12-26
x 1.50, 1.50 Aperture Adjustment factor from CTDI100 aperture factor for 8x0.625 small focal spot - Table 12-
28 (i.e: 120kV, 150mA < 570mA: Small Focal Spot)
x 150/260 = 0.58 mA Adjustment factor (150 mA x 1 sec/rot/260 mA) Table 12-26
35.98 mGy and 36.66 mGy CTDI100 (center, peripheral dose)
36.43 mGy CTDIw = 1/3 x 35.98 + 2/3 x 36.66
6.10 mGy CTDIvol = CTDIW x (1 x 5.0) /30

Example 2 - The CTDIvol for a large body peripheral dose for a 55 mm/sec helical scan
(64X0.625) in 1.375:1 mode, 200mm scan length, at 250 mA, 1.0 Sec per rotation and 120 kV is
determined as follows:

11.71 mGy 25.45 mGy Large body center and peripheral dose at typical technique from CTDI Table 12-25
x 1.00 120 kV factor from CTDI kV Table 12-26
x 1.00 Aperture adjustment factor from CTDI100 aperture factor for 64X 0.625 and small spot Table 12-
28 (i.e. at 120 kV, 250 mA <570mA)
x 250/260 = 0.96 mA adjustment factor (250mA x 1 sec/rot/260) Table 12-26
11.26 mGy 24.47 mGy CTDI100 (Center, Peripheral Dose)
20.07 mGy CTDIW = 1/3 x 11.26 + 2/3 x 24.47
x 0.94 tracking adjustment factor Figure 12-27
/ 1.375 CT pitch factor
13.72 mGy CTDIvol = CTDIw * 0.94/1.375 = 20.07 x 0.94/1.375

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Example 3 - The CTDIvol dose for a cardiac helical scan using the large SFOV, 40mm aperture
with helical pitch of 0.22:1, scan at 250 mA, 0.35 seconds per rotation, and 140 kV is determined
as follows:

11.7 mGy and 25.5 mGy Cardiac Large Center and Peripheral Dose value from Table 12-25
x 1.49,1.41 140 kV factor from CTDI kV Table 12-26
x 1.00, 1.00 Aperture Adjustment factor from CTDI100 aperture factor for 64x0.625 small focal spot - Table
12-28 (i.e: 140kV, 250mA < 495mA: Small Focal Spot)
x (250 x 0.35) / 260 = 0.34 mA Adjustment factor (250mA x 0.35s / rot / 260mA) Table 12-26
5.9 mGy and 12.1 mGy CTDI100 (center, peripheral dose)
10.0 mGy CTDIW=2/3 x 12.1 + 1/3 x 5.9
45.5 mGy CTDIvol = CTDIW / Pitch Factor (.22)

GSI Example 1: The CTDIvol dose for an axial scan for GSI Preset 14 for 60mm 4i x 5mm and a
20 mm table increment is determined as follows:

62.22 mGy CTDIw from Dose Values for GSI Table 12-33 for GSI Preset 14
x4 Number of slices, N
x 5.0 slice thickness, T
/ 20.0 table travel distance in z-direction between consecutive scans, ∆d
62.22 mGy CTDIvol = CTDIw x (4 x 5)/20

GSI Example 2: The CTDIvol dose for a helical scan using GSI Preset 4 with helical pitch of
0.984:1:

28.47 mGy CTDIw from Dose Values for GSI Table 12-33 for GSI Preset 4
/0.984 CT pitch factor
28.93 mGy CTDIvol = CTDIw / 0.984

GSI Example 3: Adjusted GSI SnapShot Pulse dose values in GSI 57 to GSI 65 are determined
as following example of GSI 65 case with 100 ms padding time:

15.27 mGy GSI 65 CTDIw dose value from CTDI Table 12-33 and Table 12-34
x 1.257 Adjustment of cardiac half scan time and padding time at the both ends of the scan from
one rotation CTDI value (240 ms + 2 x 100 ms) / 350 ms = 1.257
x 1.143 Adjustment of SnapShot Pulse scanning range and imaging range (Collimation/Imaging
range) 40 mm / 35 mm = 1.143
=21.94 mGy Adjusted GSI SnapShot Pulse dose value in GSI 65 with 100 ms padding

CTDI Dose Calculations (Reference 21CFR 1020.33 (c)(2))

CT Dose Index (CTDI) was established by the FDA and has been in use for many years. It is the
basis for the CTDI100 methodology because it defined a way to determine the dose at specific
points (center and peripheral) in a head or body size reference phantom (refer to Figure 12-19).

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The CTDI dose is defined as the dose absorbed in the phantom material (PMMA) at a point when
a volume of 7 contiguous slices is scanned adjacent to each side of the point.

The contiguous adjacent slices contribute to much of the total dose for large aperture cases, but it
greatly underestimates the dose for narrow slices because the index is defined for 14 slices and
typical modern procedures will include scattered dose from more than 7 adjacent slices.

Scanning Mode Specific Dosimetry Information

Volume Helical Shuttle
Volume Helical Shuttle, as described in the previous chapter uses dynamic helical reconstruction
to extend the coverage and usability of the radiated data by design. Since the feature is designed
for use with applications that may require multiple passes over the same anatomical area and the
fact that the table speed is lower than the steady state prescribed table speed during ramp-up and
ramp-down, the dose calculation for Volume Helical Shuttle is different than normal scanning
modes.

In general, CTDIvol for multiple helical scans over the same exposed area can be described as
follows:

The helical pitch factor can be further described as coverage in one rotation (d) in millimeters
divided by the total detection width (Number of Rows x Slice Thickness)

For Volume Helical Shuttle the d is defined as the ratio of the mean coverage per pass and total
number of rotations.

The number of rotations is defined as:

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Peak Skin Dose

This section provides information on the relationship between peak CT Skin Dose and CTDI as
standardized in IEC 60601-2-44, the most commonly used dose metric used to estimate dose to
the patient. The peak skin dose is actually a point dose and is of particular interest to assess
possible deterministic skin effects, especially in applications such as CT Perfusion and
interventional procedures where the same anatomical area is irradiated for relatively long
durations of time.

As CTDI100 is measured using a 10cm long pencil ionization chamber, at fixed locations within a
perfectly symmetrical and centered cylindrical phantom, the metric is not a direct measure of
patient dose given the non-uniform patient composition and natural differences in patient sizes
relative to the fixed sizes of the CTDI phantoms. In general terms, the dose to the skin can be
calculated only by estimating the amount of dose absorbed at surface of the object. The peripheral
CTDI100 measurement is measured at the surface (1cm inside the surface of the phantom).
However, for scans performed without table movement (such as CT Perfusion and Fluoroscopy),
the integrated-CTDI100 (peripheral) can be a significant overestimation of the peak skin dose as
much as a factor of two1.

As an informative description, a basic CT Skin Dose Index (CTSD) is provided below. While this is
not the peak skin dose (a point dose) for a patient, it is a metric that can be readily calculated
based on the CTDI100 (peripheral) value and associated kV, mA, and aperture adjustment factors
found in Chapter 12 of the Technical Reference Manual. This metric helps to address the
overestimation of peak skin dose by use of CTDIvol values especially for scanning without table
movement such as found in CT perfusion and interventional procedures.

Actual peak skin dose will vary due to a variety of factors that include actual patient size and
centering in the bore.

Computed Tomography Skin Dose Index (CTSD) is an indicator of the peak absorbed dose in skin
tissue located within the area of coverage of the radiation field.

For Axial scanning:

N The number of tomographic sections produced in a single axial scan of the X-ray
source.
T The nominal tomographic section thickness.
d The patient support travel in z-direction between consecutive scans.
CTDI100 (peripheral) The average of the four values of CTDI100 measured around the dosimetry
phantom periphery.

NOTE For axial scanning with a total table travel of less than N × T, this definition may
overestimate the dose.

1
The following article provides an explanation of the relationship between CTDIvol and peak skin dose for helical and cine-
mode exams: J. A. Bauhs, T. J. Vrieze, A. N. Primak, M. R. Bruesewitz, and C. H. McCollough, 2008, "CT dosimetry:
comparison of measurement techniques and devices," Radiographies Vol. 28, pp. 245-253. Available at: http://
radiographics.rsna.org/content/28/ I/245.full.pdf+html.

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NOTE For the selected CT condition of operation, but irrespective of any scanning length that
may be used clinically, the axial-scanning CTSD is an index of dose based on a
convention of 100 mm range of integration along the z-axis. For axial scanning, CTSD
corresponds to the dose averaged over the phantom central section peripheral holes.

For Helical scanning:

NOTE CT pitch factor will be a function of time when  d or N × T are variable during the
exposure.

NOTE For helical scanning with a small number of rotations and a table travel per rotation of less
than N × T, this definition may overestimate the dose.

NOTE For the selected CT condition of operation, but irrespective of any scanning length that
may be used clinically, the helical-scanning CTSD is an index of dose based on a
convention of 100 mm range of integration along the z-axis. For helical scanning, CTSD
corresponds to the dose averaged over the phantom central section peripheral holes.

For scanning without movement of the patient support:

n Equal to the number of rotations.

max {Dperipheral(z)} The maximum value of the four dose profiles measured in the phantom periphery
produced in a single axial rotation along lines z perpendicular to the tomographic
plane, where dose is reported as absorbed dose in air and is evaluated within a
polymethyl methacrylate (PMMA) dosimetry phantom.

NOTE Includes situations where the patient support may be moved manually, for example, during
an interventional procedure.

For Axial and Helical scanning involving table travel in two directions (“shuttle” mode):

n Equal to the number of rotations.

N The nominal tomographic section thickness.
R The range of table travel during the entire loading.
max {Dperipheral(z)} The maximum value of the four dose profiles measured in the phantom periphery
produced in a single axial rotation, with time weighted average CT conditions of
operation, along lines z perpendicular to the tomographic plane, where dose is
reported as absorbed dose in air and is evaluated within a polymethyl methacrylate
(PMMA) dosimetry phantom.

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Other Dosimetry Information

Dose Length Product (DLP)
The dose length product (DLP) is a simple calculation and is given in milliGray-Centimeters (mGy-
cm). The DLP is computed and displayed on Scan Rx Menu for each group prior to the scan as
well as an accumulated DLP for all scans taken up to the current time during the exam. Note that
system computations may vary slightly from manual calculations due to differences in round-off or
truncation. The final exam accumulated DLP provides a convenient measure for maintaining
patient or procedure dose management statistics. The DLP is computed given the CTDIvol
described above as follows:

DLP = CTDIvol x (total scan coverage in cm).

The total scan coverage can be determined from the Scan Rx Menu as the product of the table
speed in cm/sec and the total exposure time in seconds. For helical scanning, the total scan
coverage (length) will be longer than the image length due to the having to obtain additional scan
views at both the beginning and end of a scan in order to have sufficient data for reconstruction of
the end images. - this is known as helical over beaming. Differences between the displayed and
manually calculated DLP value may occur if the total coverage as a function of X-ray on-off time is
not used.

For the Volume Helical Shuttle feature however, the opposite holds true. The system produces
images beyond the actual start and end locations of the scan. Hence, to obtain the total coverage
for this feature, multiply the mean detector coverage in one rotation times the total number of
rotations.

Max Z Location CTDIvol

Max Z location CTDIvol represents the peak of the CTDIvol summation profile by table location. The
CTDIvol values for each scan group are summed into the total profile for the range of z locations
covered. Max Z location CTDIvol describes the maximum total exposure of any point along z of the
patient. For example, the first group has a CTDIvol of 10mGy and 10mGy will be the max since it is
the only exposure. A second group will contribute a CTDIvol of 15mGy to a different region. 15mGy
will become the new max. A fourth group contributes 7 mGy, but only overlaps with one previous
region. The max remains 20mGy. Max Z loc CTDIvol is displayed when Alert Value (AV) checking
is enabled in Dose Check.

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Figure 12-28 Max Z location CTDIvol and scan groups

Dose Efficiency (Reference IEC 60601-2-44)

The dose efficiency, which is a function of focal spot size and beam collimation, is also
automatically computed and displayed on the Scan Rx Menu. The dose efficiency is a measure of
how much of the Z-axis X-ray beam is used by the system.

Dose Profile (Reference IEC 60601-2-44, IEC 60601-2-44: 2002 clause

29.1.103.1/2 and 2009 clause 203.110/111 and 21CFR 1020.33 (c)(2)(iv) and
(c)(3)(iv))
The dose profile is the dose measured as a function of a line in the Z-Axis of the system. The dose
profile, like the dose efficiency calculation is a function of focal spot size and beam collimation. The
Full Width at Half Maximum (FWHM) measurements of the dose profiles in air represent the beam
width at iso-center. The dose profile plots, along with the Detection Sensitivity Profiles (defined as
the active detector length measured at iso-center) are represented in Figure 12-29 through Figure
12-31.

GE recommends use of Thermo luminescent dosimeters or solid-state dosimeters for the

measurements of dose profiles. The measurements provided were taken with a solid state probe.

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Figure 12-29 40 mm Aperture: CTDI free air, Dose Phantom and Sensitivity Profile

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Figure 12-30 20 mm Aperture: CTDI free air, Dose Phantom and Sensitivity Profile

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Figure 12-31 1.25 mm Aperture: CTDI free air, Dose Phantom and Sensitivity Profile

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Table 12-38 Dose Profile in Air Full Width at Half Maximum (FWHM)

Dose Profile Full Width at Half Maximum (FWHM in mm)

Focal Spot Size

Aperture
Small Large GSI
1.25 2.8 2.9 N/A
2.5 4.2 4.4 N/A
5 7.4 8.3 N/A
10 12.4 13.2 N/A
20 21.9 22.5 23.0
40 42.2 42.4 42.5

Table 12-39 Geometric Efficiency Table

Geometric Efficiency (%)

Focal Spot Size

Aperture
Small Large GSI
1.25 41.5 38.6 N/A
2.5 56.4 53.1 N/A
5 63.9 57.9 N/A
10 77.0 72.7 N/A
20 87.4 85.4 83.6
40 92.6 91.9 91.6

Dose Deterministic Effects (IEC 60601-2-44:2009 Clause 203.5.2.4.5)

There is the possibility that in normal use, the patient could be exposed to radiation dose levels of
1Gy CTDI100 (peripheral) or above, at which deterministic effects may occur. Management of the
high radiation dose is critical to maintain radiation safety. The available settings concerning the
radiation dose level include: mA, kV, scan time, Aperture, SFOV, etc.

The table below provides the scan duration (seconds) required to meet 1Gy CTDI100 (peripheral)
at 200 mA exposure at same scan location.

Table 12-40 Dose Deterministic Effects (IEC 60601-2-44:2009 Clause 203.5.2.4.5)

Cine scan duration (s) at 200 mA required to meet 1Gy CTDI100 Peripheral

Pediatric
Head Small Body Medium Body Large Body
SFOV Small Head Head
Pediatric Cardiac Small Cardiac Medium Cardiac Large
Body

CTDI Phantom 16cm 16cm 16cm 32cm 32cm 32cm

Large Small Large Small Large Small Large Small Large Small
Aperture Small Focal
kV Focal Focal Focal Focal Focal Focal Focal Focal Focal Focal
(mm) Spot
Spot Spot Spot Spot Spot Spot Spot Spot Spot Spot
80 40 83 83 83 72 72 171 171 141 141 146 146
20 75 75 75 65 65 155 155 129 129 133 133
10 69 64 69 55 60 131 142 109 118 112 122
5 55 52 55 45 48 101 114 83 94 86 97
2.5 49 49 49 42 42 101 101 83 83 86 86
1.25 35 33 35 29 30 68 66 57 54 58 58

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Cine scan duration (s) at 200 mA required to meet 1Gy CTDI100 Peripheral

Pediatric
Head Small Body Medium Body Large Body
SFOV Small Head Head
Pediatric Cardiac Small Cardiac Medium Cardiac Large
Body

CTDI Phantom 16cm 16cm 16cm 32cm 32cm 32cm

Large Small Large Small Large Small Large Small Large Small
Aperture Small Focal
kV Focal Focal Focal Focal Focal Focal Focal Focal Focal Focal
(mm) Spot
Spot Spot Spot Spot Spot Spot Spot Spot Spot Spot
100 40 46 46 46 40 40 93 93 77 77 80 80
20 42 42 42 37 37 85 85 70 70 73 73
10 39 36 39 31 34 72 78 60 64 61 67
5 31 29 31 25 27 55 62 46 52 47 53
2.5 27 27 27 24 24 55 55 46 46 47 47
1.25 19 19 19 16 17 37 36 31 30 32 32
120 40 31 31 31 27 27 60 60 50 50 51 51
20 28 28 28 24 24 54 54 45 45 46 46
10 26 24 26 20 22 46 50 38 41 39 43
5 20 19 20 17 18 35 40 29 33 30 34
2.5 18 18 18 16 16 35 35 29 29 30 30
1.25 13 12 13 11 11 24 23 20 20 20 20
140 40 22 22 22 19 19 42 42 35 35 36 36
20 20 20 20 17 17 39 39 32 32 33 33
10 18 17 18 15 16 33 35 27 29 28 30
5 15 14 15 12 13 25 28 21 23 21 24
2.5 13 13 13 11 11 25 25 21 21 21 21
1.25 9 9 9 8 8 17 16 14 14 14 14

Scout Dose
Generally, because of short scan times and low mA, the scout dose will be a small part of the total
patient exam dose, additionally a standardized scout dose calculation method has yet to be
developed for CT, therefore scout dose is not currently reported by the system.

Phantoms for Performance Testing (Reference 21CFR 1020.33(c)(3)(v))

The results of this section conform to federal regulation 21CFR 1020.33 (c). GE used the
phantoms and procedures recommended in the CDRH final draft of “Routine Compliance Testing
for Computed Tomography X-ray Systems” (dated April 26, 1984) to measure dose and dose
profile, and calculate CTDI.

The specifications and measurements in this section are based on scanning a 21.5cm-water filled
acrylic phantom. The GE Quality Assurance Phantom is used to measure noise performance
tests.

Testers placed a 30cm wide acrylic ring around the water phantom to measure Body performance.

Noise (Reference 21CFR 1020.33 (c)(3)(i))

Noise is the statistical measure of the CT numbers represented by an array of pixels contained in
a 2x2cm central region of interest (ROI). Noise equals the standard deviation expressed in

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Hounsfield units, divided by 1000 to represent the contrast scale between air and water, and then
multiplied by 100 to give a value in percent.

The image Standard Deviation in the center is acquired with Typical Technique and Standard 512
Reconstruction at 5mm, 8i acquisition mode.

Table 12-41 Image Noise

Standard Deviation
Scan FOV kV mA
(%)
Head: Small Body SFOV, 25cm 120 260 0.5
DFOV
Body: Large Body SFOV, 35cm 120 260 1.3
DFOV

The tables below represent the expected approximate noise when comparing Monochromatic
images for the GSI Presets for Head and Body acquired in Axial for 1 rotation in the water section
of QA phantom attached to the phantom holder inserted in cradle at 70 keV, 5 mm slice thickness,
25 cm DFOV, Standard Algorithm, and a center ROI of 12.5 x 12.5 mm.

Table 12-42 Body Presets

GSI Preset Noise

1 4.79
2 3.66
3 4.65
4 3.85
5 3.60
6 3.34
7 3.60
8 3.37
10 4.09
11 3.79
12 4.10
13 3.91
15 4.30
16 4.12
17 4.33
18 4.20
22 5.52
23 5.52
24 5.44
25 5.33
27 4.23
28 3.99
29 4.05
31 5.52
32 5.52
33 5.89
34 5.33
35 4.81
36 7.18
37 6.85
38 6.97
40 5.91

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GSI Preset Noise

41 5.69
42 5.86
44 6.73
45 6.36
46 6.41
48 7.67
49 7.34
50 7.52
51 6.61
52 6.36
53 6.40
54 7.21
55 6.76
56 6.97

Table 12-43 Head Presets

GSI Preset Noise

9 3.66
14 3.91
19 4.20
20 4.81
21 4.38
26 5.33
30 4.05
39 7.14
43 5.95
47 6.45
66 6.41

Nominal Slice Thickness and Sensitivity Profile (Reference 21CFR

1020.33 (c)(3)(iii) and (c)(3)(iv))
The sensitivity profile is a graph of the axial thickness of an image. To create the original
measurements for Axial or Cine scans, scan a GE Slope 4 Wire Phantom centered at ISO, which
consists of two rows of 0.05mm tungsten wires in air that make 14.04 degree angles with the scan
plane (slope 4:1). FWHM values reported are averaged ones of all the wires across all the images
in the acquisition. For Helical scans, the slice sensitivity profile is measured by taking scans of a
Gold Foil Phantom made by QRM, a German phantom company, with the smallest image
reconstruction intervals available. The gold foil (1 mm diameter x 0.025 mm thickness) embedded
in tissue equivalent plastic is used to provide simulated point spread function in the axial direction.

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Table 12-44 Nominal Slice Thickness - Axial Scan Modes (FWHM in mm) (Reference
YY310)

Selected Slice Thickness

Aperture 64 Slice System

(mm)

0.625 1.25 2.50 5.00

40.00 0.77 0.95 2.27 5.22
20.00 0.69 0.98 2.20 5.02
10.00 0.52 1.12 2.35 4.75
5.00 N/A 1.12 2.33 4.79
2.50 N/A 1.07 2.25 N/A
1.25 N/A 1.00 N/A N/A

Table 12-45 Nominal Slice Thickness - Helical Scan Modes (FWHM in mm) (Reference
YY310)

Aper. Pitch 0.5:1 “Full Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 0.68 1.09 2.25 3.59 5.01
20 0.66 1.08 2.22 3.52 5.01

Aper. Pitch 0.9:1 “Full Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 N/A 1.12 2.33 3.87 5.07
20 N/A 1.10 2.39 3.84 5.13

Aper. Pitch 1.375:1 “Full Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 N/A 1.26 2.34 3.87 5.01
20 N/A 1.24 2.33 3.97 5.13

Aper. Pitch 1.531:1 “Full Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 N/A 1.26 2.51 3.84 5.28
20 N/A 1.24 2.50 3.83 5.32

Aper. Pitch 0.5:1 “Plus Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 0.99 1.40 2.78 4.20 5.90
20 0.98 1.40 2.72 4.11 6.01

Aper. Pitch 0.9:1 “Plus Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 0.98 1.39 3.00 4.53 5.86
20 0.98 1.38 2.88 4.64 6.00

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Aper. Pitch 1.375:1 “Plus Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 0.98 1.39 2.77 4.71 5.98
20 0.98 1.38 2.75 4.68 6.07

Aper. Pitch 1.531:1 “Plus Mode”

(MM) 0.625 1.25 2.5 3.75 5

40 1.00 1.50 3.06 4.73 6.31
20 0.98 1.50 3.01 4.72 6.30

Table 12-46 Nominal Slice-Thickness - Cardiac Scan Modes (FWHM in mm)

Aperture Selected Slice Thickness: Heart Rate 60 BPM

(mm) 0.625 1.25 2.5

40 0.88 1.10 2.38

Table 12-47 Nominal Slice Thickness - GSI Axial Scan Modes (FWHM in mm)

Selected Slice Thickness (mm)

Aperture (mm) Full Mode Plus Mode*

0.625 1.25 2.50 5.00 0.625 1.25 2.50 5.00

40.00 0.75 0.95 2.23 5.09 --- --- --- ---
20.00 0.71 0.90 2.17 4.93 --- --- 2.65 5.68

*Axial Plus mode reconstruction is only available for GSI exams in which the Head or Small Head
SFOV is selected.

Table 12-48 Nominal Slice Thickness - GSI Helical Scan Modes (FWHM in mm)

Selected Slice Thickness (mm)

Pitch Aperture 0.625 1.25 2.5 3.75 5.0 0.625 1.25 2.5 3.75 5.0

Full Mode Plus Mode

0.516:1 40 0.9 1.15 2.24 3.56 5.11 1.06 1.42 2.73 4.2 6.0
0.531:1 20 0.88 1.13 2.22 3.49 4.94 1.03 1.41 2.71 4.11 5.81
0.984:1 40 N/A 1.17 2.35 3.79 5.02 1.04 1.42 2.91 4.45 5.97
0.969:1 20 N/A 1.16 2.33 3.74 4.98 1.03 1.41 2.89 4.43 5.91
1.375:1 40 N/A 1.18 2.35 3.81 5.08 1.03 1.45 2.78 4.53 6.0
1.375:1 20 N/A 1.18 2.32 3.76 5.10 1.03 1.46 2.74 4.47 6.03
1.531:1 40 N/A 1.28 2.46 3.70 5.15 1.03 1.50 2.96 4.52 6.07
1.531:1 20 N/A 1.26 2.48 3.73 5.16 1.00 1.50 2.94 4.59 6.16

Table 12-49 Nominal Slice Thickness - GSI Snapshot Pulse Scan Modes (FWHM in mm)

Selected Slice Thickness: Heart Rate 60 BPM

Aperture
0.625
40 0.75

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Modulation Transfer Function (MTF) (Reference 21CFR 1020.33

(c)(3)(ii))
Same conditions as Noise (see Table 12-41).

The MTF data is acquired with Typical Technique and Standard 512 Reconstruction at 5mm, 8i
acquisition mode using Standard reconstruction algorithm.

An MTF of 100% or 1.0 indicates no signal loss. An MTF of 0.0 indicates total signal loss. In
practice, small, high contrast objects become impossible to resolve when MTF reaches the 0.05 -
0.02 range.

Figure 12-32 Typical MTF Curve – Standard

Maximum Deviation (Reference IEC 60601-2-44 and 21CFR 1020.33

(c))
In order to come up with “the maximum deviation,” manufacturers must imagine every possible
situation, however unlikely, that might occur within the entire user community.

Our statements of deviation include a maximum deviation to assure compliance with the
regulation, as well as a statement of expected deviations (2s) in the large majority of our systems.

GE bases the expected deviations on the results of extensive multiple system testing.

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Typical Dose (Reference IEC 60601-2-44 and 21CFR 1020.33 (c)(2)(v))

Deviations may be greater than the expected deviation range for low mA or narrow aperture scans
where variation may be greater (up to a factor of two) due to the inherent deviation in small values.

Expected deviation equals ±15% with a maximum deviation anticipated for tube output equal to
±40%.

Dose Profile (Reference 21CFR 1020.33 (c)(2)(v))

The maximum deviation relating to dose profiles (FWHM or Full Width at Half Maximum) should
equal ± 30% or 1.5mm, whichever is larger. This value includes variability inherent in the
measurement of dose profile with TLD (thermoluminescence dosimeter) chips, and/or ion
chambers and solid state dosimeters. The expected deviation equals ± 10% or 0.5mm, whichever
is larger.

Performance (Reference 21CFR 1020.33 (c)(3)(v))

Noise
The noise squared (σ2) in a CT image is inversely proportional to the X-ray dose. The maximum
deviation equals ± 15%. Expected deviation equals ± 10%.

MTF
With the protocol used to generate the data reported here, expected deviations for values on the
MTF curve: ± 10%.

Maximum deviations may reach ± 20%.

Sensitivity Profile/Slice Thickness

With the protocol used to generate the data reported here, the slice sensitivity profiles (FWHM)
may vary ± 10% or 0.5mm whichever is larger.

In the case of cardiac exams, a larger variation could be observed due to the inherent nature of the
cardiac reconstruction (half - scan).

With other methods, the maximum deviation may reach 1.5mm for all thicknesses; thin slices are
most affected by these measurement errors.

Frequency of Constancy Tests (Refer to Section 4.7 of IEC

61223-2-6)
The constancy tests shall be repeated as indicated for the individual test methods. However, the
frequency of each constancy test may be reduced if the system under test proves to be within
tolerance for a period of 6 months. In this case the dose measurement may be repeated annually;
all other tests may be done quarterly.

In addition, the constancy tests should be repeated:

 Whenever malfunction is suspected; or

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 Immediately after the CT scanner has undergone maintenance that could affect the
performance parameter under test.
 Whenever the constancy test leads to results outside the established criteria to confirm the
test result.

Stray Radiation
NOTE One 32 cm acrylic CTDI phantom centered at isocenter was used as scatter material to
comply with IEC specifications.

Table 12-50 Stray Radiation Measurements — Horizontal Plane

Stray Radiation Measurements — Horizontal Plane (μGy / 100 mAs)

X-axis (meters versus Y-Z isoplane)

Y=0
-1.5 -1.0 -0.5 0 0.5 1.0 1.5
-3.5 1.3 1.4 1.4 1.4 1.3 1.4 1.4
-3.0 1.8 2.0 1.9 1.9 1.9 1.9 1.8
-2.5 2.5 2.7 2.8 2.9 2.8 2.8 2.6
-2.0 4.5 4.2 4.4 4.7 4.5 3.5 3.6
-1.5 5.3 7.2 8.4 8.9 8.2 5.4 5.5
Z-axis -1.0 3.4 12.0 16.1 22.0 18.8 7.9 3.9
(meters versus -0.5 0.2 7.2 48.0 91.3 51.9 2.2 0.3
0 0.0 0.0
X-Y isoplane) 0.5 0.1 0.0
1.0 0.1 0.8 19.0 23.3 18.8 1.3 0.1
1.5 0.6 6.9 9.3 10.0 8.9 6.8 0.9
2.0 2.3 4.4 5.1 5.3 4.9 4.2 3.0
2.5 2.4 2.9 3.3 3.3 3.2 2.9 2.5
3.0 1.8 2.1 2.2 2.2 2.2 2.1 1.8
3.5 1.5 1.7 1.7 1.7 1.7 1.6 1.5

NOTE Pink areas indicate data could not be collected at these locations.

Table 12-51 Stray Radiation Measurements — Vertical Plane

Stray Radiation Measurements — Vertical Plane (μGy / 100 mAs)

Z-axis (meters versus X-Y isoplane)

X=0
3.5 3.0 2.5 2.0 1.5 1.0 0.5 0 -0.5 -1.0 -1.5 -2.0 -2.5 -3.0 -3.5
Y-axis -0.5 1.5 2.1 3.0 4.6 7.8 14.7
(meters 0 1.7 2.2 3.3 5.3 10.0 23.3 91.3 22.0 8.9 4.7 2.9 1.9 1.4
versus 0.5 1.7 2.3 3.4 5.3 9.5 19.3 59.3 23.3 10.0 5.7 3.6 2.4 1.6
X-Z 1.0 1.7 2.2 3.1 4.6 7.3 5.8 0.1 1.4 17.8 13.4 7.8 5.3 3.5 2.4 1.8
isoplane) 1.5 1.6 2.0 2.7 3.6 2.1 0.2 0.1 0.4 1.0 4.9 5.5 4.1 3.0 2.2 1.7

NOTE Pink areas indicate data could not be collected at these locations.

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Radiation Field
Figure 12-33 Maximum Symmetrical Radiation Field for Revolution Discovery CT

1
2

5
4

Focal Spot Position and Tolerance -- “x” axis 0 ± 0.25 mm

Focal Spot Position and Tolerance -- “z” axis 0 ± 0.80 mm

Table 12-52 Maximum Symmetrical Radiation Field for Revolution Discovery CT

Number Description
1 X-Ray Tube
2 Focal Spot
3 539.1 mm (ISO center)
4 610 mm (X-Axis)
5 42.7 mm (Z-Axis)

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Chapter 13
Performix™ HD X-ray Tube
Specifications

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Performix™ HD X-ray Tube Specifications

X-ray Tube Model Numbers

The X-ray Tube on the Revolution Discovery CT System has the part number 5195800-x.
Throughout this chapter, model numbers may contain “-x” (i.e. 5195800-x). In these instances “-x”
can be any numeric character. For example, in 5195800-x, “-x” refers to 5195800, 5195800-2,
5195800-3, etc.

NOTE In addition to the tube model numbers, unique serial numbers are assigned to each tube
unit and insert manufactured. These marking can be found on the end of the tube housing.

Table 13-1 Tube Model And Catalog Numbers

Component Model Number Catalog No.

Performix HD Tube Assembly 5195800-x D3701T

D3703T

D3704T
Performix HD Insert 5195900-x N/A
Performix HD Heat Exchanger 5262891-x N/A
Performix Pro VCT 100 Pump 5105346-x N/A

Beam Limiting Devices

Table 13-2 Beam Limiting Devices

Beam Limiting Devices Model Number

Tube Collimator 5222001-x

Environmental Specifications
Non-Operating Environment (Reference IEC 60601-1 and IEC
60601-2-28)
Maintain a temperature range between -40°C and 70°C (relative humidity up to 95% non-
condensing) during storage and shipment of the tube unit.

Use GE Medical Systems transport packaging during shipment.

Shipment may be done via commercial airlines.

Operating Environment
Maintain an ambient temperature of less than 18°C - 26° C and 30% - 60% (non-condensing)
relative humidity (50% nominal) during operation.

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X-ray Characteristics
Leakage Technique Factors
(Reference IEC 60601-1-3, IEC 60601-2-28, IEC 60601-2-44 and 21CFR 1020.30(h)(2)(i) and
21CFR 1020.30(h)(4)(ii))

The loading factors used for leakage radiation measurement for the Performix HD X-ray Tube Unit
with Collimator, Model No. 5222001-x.

 140 kV
 32.1 mA

Quality Equivalent Filtration

(Reference IEC 60601-1-3 and 21CFR 1020.30(h)(2)(i) and 21CFR
1020.30(h)(4)(i))
The aluminum equivalent filtration of the system consists of the tube filtration plus fixed filtration in
the collimator. All filtration is permanent and cannot be removed by the user without the use of a
tool.

The “Quality Equivalent Filtration” of the Performix HD X-ray Tube Assembly is nominal 4.3 mm,
minimum 3.91 mm of aluminum calculated using the NIST photon cross sections database with an
X-ray spectrum generated by a 7-degree tungsten anode at a potential of 70 kVp. The X-ray Tube
has a rating plate that includes this information.

The nominal material lengths and the aluminum quality equivalent filtration for added filters along
the system Iso-center ray is provided in Table 13-3 below.

Table 13-3 Quality Equivalent Filtration

Ped Head

Ped Body Head

Large Body
User SFOV Selection Small Head Medium Body
Cardiac Large
Small Body Cardiac Medium

Cardiac Small
Minimum QEF Values
Tube QEF 3.91 mm 3.91 mm 3.91 mm
Collimator (Filter) Filter name Filter 1 - small Filter 2 - medium Filter 3 - large
C (graphite) 1.938 mm 1.938 mm 1.938 mm
Al (aluminum) 0.19 mm 0.19 mm 0.19 mm
Cu (copper) - - 0.068 mm
Collimator Filter QEF 0.3 mm 0.3 mm 2.7 mm
Total QEF 4.21 mm 4.21 mm 6.61 mm
Nominal QEF Values
Tube QEF 4.3 4.3 4.3

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Performix™ HD X-ray Tube Specifications

Ped Head

Ped Body Head

Large Body
User SFOV Selection Small Head Medium Body
Cardiac Large
Small Body Cardiac Medium

Cardiac Small
Collimator (Filter) Filter name Filter 1 - small Filter 2 - medium Filter 3 - large
C (graphite) 1.998 mm 1.998 mm 1.998 mm
Al (aluminum) 0.25 mm 0.25 mm 0.25 mm
Cu (copper) - - 0.075 mm
Collimator Filter QEF 0.4 mm 0.4 mm 3.1 mm
Total QEF 4.7 mm 4.7 mm 7.4 mm

Half Value Layer

(Reference IEC 60601-1-3, IEC 60601-2-44: 2002/2009 and 21CFR 1020.30(m)(1))

The "Half Value Layer" of the CT system at 120kV with the X-ray Tube (Part Number 5195800-x)
tube and collimator is provided in Table 13-4 below:

Table 13-4 Half Value Layer Measurements

Ped Head

User SFOV Ped Body Head

21 CFR 1020.30(m) , IEC
Selection IEC Large Body
IEC 60601-1-3: 2008, 60601-2-44:
60601-1-3: 1994 Small Head Medium Body
IEC 60601-2-44: 2009 2002
Half Value Requirement Cardiac Large
Requirement Requirement Small Body Cardiac Medium
Layer by kVp

Cardiac Small
80 kV ≥ 2.9 mm Al ≥ 2.3 mm Al ≥ 2.4 mm Al 5.1 mm Al 5.3 mm Al 6.1 mm Al
100 kV ≥ 3.6 mm Al ≥ 2.7 mm Al ≥ 3.0 mm Al 5.8 mm Al 6.0 mm Al 7.0 mm Al
120 kV ≥ 4.3 mm Al ≥ 3.2 mm Al ≥ 3.8 mm Al 6.4 mm Al 6.7 mm Al 7.7 mm Al
140 kV ≥ 5.0 mm Al ≥ 3.8 mm Al ≥ 4.6 mm Al 7.1 mm Al 7.3 mm Al 8.4 mm Al

CT Scan Ratings
These ratings apply to a system with computer controlled technique selection, scan mode, and
scan duration.

The system uses a mathematical model to track tube temperature.

This tube cooling algorithm delays the start of a scan, if necessary, to avoid exceeding
temperatures that may damage the tube anode or unit.

Table 13-5 Permissible kV and mA ranges

Scan Mode kV Small Focal Spot Large Focal Spot GSI Focal Spot
Normal 80 10-620 10-700 10-765*
100 10-680 10-800 10-825**
120 10-570 10-835 10-890**
140 10-490 10-715 10-765*

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Performix™ HD X-ray Tube Specifications

Scan Mode kV Small Focal Spot Large Focal Spot GSI Focal Spot
Hi Res 80 10-620 10-700 N/A
100 10-500 10-750
120 10-420 10-625
140 10-360 10-540
Hi Res SnapShot 80 10-620 10-700
Pulse*** 100 10-575 10-800
120 10-480 10-740
140 10-410 10-630

*GSI scanning and system calibration only

** System calibration only

*** For Hi Res SnapShot Pulse Mode - Based on maximum four (4) 0.5-second exposures with 1
second ISD.

Performix HD X-ray Tube Assembly

Classification and Compliance

(Reference IEC 60601 2-28)

The Performix HD X-Ray Tube Assembly meets the requirements of IEC60601-2-28 and has the
following classifications:

 Type of protection against electric shock: CLASS 1

 Degree of protection against electric shock: TYPE B

Labeling
The X-ray tube carries identification labels according to IEC Standard 60601-2-28, which identify
Manufacturer, Model and Serial Number of the component. This marking is designed to remain
legible when the X-ray tube is dismantled from the X-ray tube housing after a period of normal use.

Marking
The X-ray Tube Assembly carries markings required by IEC 60601-2-28 in the form of a combined
description.

When applicable, the X-ray Tube Assembly also carries labels to certify compliance with regulation
of addressee states (US Federal Regulation CFR Sub-Chapter J, Nationally Recognized Testing
Laboratory, CSA and CE Marking).

A second set of labels is supplied in a separate bag with each shipment of an X-ray Tube
Assembly. This second set is for use when the tube assembly is either partially or totally covered
by the configuring system.

To comply with current marking visibility requirements, instructions for affixing the two sets of
labels are supplied in the assembler manual of the configured system.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-5

Performix™ HD X-ray Tube Specifications

Reference Axis for Target Angle and Focal Track

(Reference IEC 60601-2-28)

The reference axis for the target angle is normal to the longitudinal axis of the X-ray tube as shown
in Figure 13-1 below.

Figure 13-1 Reference Axis for target angle and focal track

Focal Spot Location

(Reference IEC 60601-2-28:2010)

The position of the focal spots within the X-ray Tube Assembly is shown in Figure 13-2. This
position is referenced to three mutually orthogonal reference planes visually indicated in the figure.
When the X-ray Tube Assembly is mounted at the 12:00 position in the Revolution Discovery CT
system, the z-reference plane is parallel to the scan plane, the y-reference plane is parallel to the
table top, and the x-reference plane is perpendicular to both the scan plane and the table top.

13-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Figure 13-2 Focal Spot Location and Tolerance (applies for all focal spots)

High Voltage (HV) Connection

(Reference IEC 60601-2-28)

This Performix HD Tube is a monopolar, anode grounded X-ray tube. The cathode high voltage
cable is connected to the X-ray Tube Assembly via a ceramic insulator while the “free” end is fitted
with a 6-conductor cable and plug. This tube is designed to be used with the HD generator (part
numbers 5173970-x and 5332530-x).

The accessible metal parts of the X-ray Tube Assembly body and flexible conductive housing of
high-voltage cables must be connected to the conductive enclosure of the high-voltage generator.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-7

Performix™ HD X-ray Tube Specifications

Figure 13-3 High Voltage Connection Diagram

Nominal Tube Voltage

(Reference IEC 60613)

140 kVp

Maximum High Voltage

(Reference IEC 60613)

140 kVp

13-8 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Envelope Voltage
(Reference IEC 60613:2010)

0 kV with respect to earth (ground)

Principal Dimensions (with mounting bracket)

(Reference IEC 60601-2-28)

 Width 44.4 cm
 Height 32.6 cm
 Depth 52.6 cm
NOTE The focal spot position is indicated on the X-ray Tube housing by the use of three labels
(solid circle with “Focal Spot” wording). Two labels are present on the sides of the housing
and one is present near the high voltage connection.

Construction
(Reference IEC 60601-2-28)

The X-ray Tube Housing is made of a lead-lined lightweight alloy. It is filled under vacuum with
specially processed insulating oil. An expansion volume in the separate heat exchanger
compensates for oil dilation at permissible temperatures. The weight of the X-ray Tube Assembly
is approximately 106.8 kg. The mounting mechanism is integral to the tube assembly.

Performix HD X-ray Tube Assembly Heating and Cooling Curves

(Reference IEC 60613 and 21 CFR 1020.30 (h)(2)(ii)

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-9

Performix™ HD X-ray Tube Specifications

Figure 13-4 Performix HD X-ray Tube Assembly Heating and Cooling Curves

Thermal characteristics
(Reference IEC 60613)

Heat Storage Capacity and Continuous Dissipation (Reference

YY310 and IEC 60613)
 Maximum X-ray Tube Assembly heat content: 8MJ (11.2MHU)

Maximum Continuous Dissipation

(Reference IEC 60613:1989)

13-10 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Nominal Continuous Input Power

(Reference IEC 60613:2010)

Maximum continuous heat dissipation and Nominal Continuous Input Power of the X-Ray Tube
Assembly: 5.1 kW (4.5 kW from maximum continuous anode power/continuous anode input
power, 109 W from pump, 492 W from stator, 40 W from filament).

The X-ray Tube Assembly is rated for a maximum continuous anode power of 4.5kW over any 1
hour period. This value is utilized in calculating the following loading factors for leakage radiation
measurement for the Performix HD X-ray Tube Assembly:

 140 kV
 32.1 mA

Pressure and Thermal Management

The Performix HD X-Ray Tube is designed to be used with the pump GE part number 5105346-x
and heat exchangers GE part number 5262891-x. The X-ray Tube Assembly and heat exchanger
contain the following pressure and thermal management features: bellows assembly, overpressure
switch, pressure relief valve and overtemperature switch.

Beam Limiting Devices

The Performix HD X-ray Tube Assembly must always be equipped with a beam-limiting device in
order to meet requirements for the maximum X-ray beam extent required for its specified
applications.

The beam-limiting device compatible with the Performix HD is show in Table 13-2.

Any Performix HD X-ray Tube Assembly having beam limiting devices other than those listed
above is obliged to be checked for compliance examination for beam quality and leakage radiation
according to the requirements of IEC Standard 60601-1-3.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-11

Performix™ HD X-ray Tube Specifications

Performix HD X-ray Tube Insert

Target Material
(Reference IEC 60601-2-28)

The target material is a Tungsten-Rhenium focal track on a molybdenum alloy substrate backed by
graphite.

Nominal Anode Input Power

(Reference IEC 60613)

The nominal anode input power is 100 kW (0.1 sec) for an anode heat content of 404 kJ (at an
Equivalent Anode Input Power of 170 W for 2 hours).

Nominal CT Anode Input Power

(Reference IEC 60613:2010)

The nominal CT anode input power is 90 kW.

Nominal CT Scan Power Index

(Reference IEC 60613:2010)

The nominal CT scan power index is 76 kW when employing the large focal spot.

The nominal CT scan power index is 55 kW when employing the small focal spot.

Maximum Anode Heat Capacity

(Reference IEC 60613)

The maximum anode heat capacity is 5.7 MJ (8MHU).

Focal Spots
(Reference IEC 60336 and YY310)

Small Focal Spot:

1.0 x 0.7 per IEC 60336: 2005

Loading Factors: 120kV, 284mA

13-12 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Large Focal Spot:

1.6 x 1.2 per IEC 60336: 2005

Loading Factors: 120 kV, 417 mA

GSI Focal Spot:

2.0 x 1.2 per IEC 60336: 2005

Loading Factors: 120 kV, 446 mA

Zero Bias Focal Spot:

The zero bias focal spot is not intended for normal use according to the IEC definition and does
not conform to IEC 60336 regarding nominal focal spot values.

Reference Axis:
The reference axis is defined to be normal to the mounting surface of the X-ray Tube housing and
passing through the center of the focal spot.

Target Angle with Respect to Reference Axis

(Reference IEC 60601-2-28)

The target angle is 7º with respect to reference axis, which is normal to longitudinal axis of the X-
ray tube.

Anode Rotation
(Reference IEC 60601-2-28)

Anode rotation speed is 8400 RPM. Low speed operation also available under certain conditions.

Minimum Inherent Filtration

(Reference IEC 60601-1-3)

The minimum inherent filtration of the X-ray tube is 0.04 mm Al equivalent at 70 kV. This value is
determined according to theoretical method of calculating by Birch and Marshall.

Anode Heating and Cooling Curve

(Reference IEC 60613 and 21CFR 1020.30 (h)(2)(ii)

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-13

Performix™ HD X-ray Tube Specifications

Figure 13-5 Performix HD Anode Heating and Cooling Curve

Data required for driving rotating anode, or the type designations of suitable driving and
control equipment:

(Reference IEC 60601-2-28)

 3-phase, 4-pole, star-connected configuration with DC resistance of 2.21 ohms ± 5% at 25C

and an inductance of 6.6mH ± 10% at 1 kHz
 3 pin male Phoenix connection to stator shielded with pig tail and terminal for M4 screw
 Acceleration: 12s, 0 - 140Hz and 6s, 0 - 50Hz
 Max Current During Boost: 24A, 3-phase motor, 280Hz (to produce 140Hz drive)
 Steady state: 7A at 480V, 3-phase motor, 280 Hz
 Brake Time: 30s, 12A, 3-phase motor, 140Hz to less than 20Hz
Data for auxiliary supplies required.

(Reference IEC 60601-2-28)

 Tube thermal switch (93.3±1.6°C): 15V DC with 3 pin female Phoenix connector
 Overpressure switch on heat exchanger (5±1psi): 15V DC with 2 pin female Molex connector

Single Load Rating

(Reference IEC 60613 and 21CFR 1020.30(h)(2)(iii))

The single load ratings shown in Table 13-6 and Table 13-7 below are controlled by system
software and are applicable for a “cold” tube (equivalent anode input power of 170 W for two
hours).

13-14 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Table 13-6 Permissible mA values for single 5-second exposure from cold

Scan Mode kV Small Focal Spot mA Large Focal Spot mA

Normal 80 620 700
100 680 800
120 570 835
140 490 715
Hi Res 80 620 700
100 500 750
120 420 625
140 360 540
Hi Res 80 620 700
SnapShot 100 575 800
Pulse*
120 480 740
140 410 630

*mA capabilities for Hi Res SnapShot Pulse operation based on four 0.5 second exposures with 1
second ISD's

Table 13-7 Permissible mA values for single 10-second exposure from cold Tube Current
(mA) Single Exposure Ratings - Normal Mode

Scan Mode kV Small Focal Spot mA Large Focal Spot mA

Normal 80 620 700
100 650 800
120 540 755
140 460 650
Hi Res 80 610 700
100 490 710
120 405 590
140 350 505

Table 13-8 Tube Current (mA) Single Exposure Ratings - Normal Mode

Scan Time 140kV 120kV 100kV 80kV

5 seconds 715 835 800 700
10 seconds 650 755 800 700
20 seconds 565 665 790 700
30 seconds 500 590 700 700
40 seconds 450 535 635 700
50 seconds 360 430 510 640
60 seconds 355 420 495 625

Table 13-9 Tube Current (mA) Single Exposure Ratings - HiRes mode

Scan Time 140kV 120kV 100kV 80kV

5 seconds 530 625 750 700
10 seconds 495 585 695 700
20 seconds 445 530 630 700
30 seconds 420 500 595 700
40 seconds 405 480 570 700
50 seconds 390 465 550 690
60 seconds 380 450 535 670

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-15

Performix™ HD X-ray Tube Specifications

Serial Load Rating

(Reference IEC 60613 and 21 CFR 1020.30(h)(2)(iii))

The serial load ratings shown in Table 13-10 and Table 13-11 below are controlled by system
software and are applicable for repeats every 10 minutes

Table 13-10 Permissible mA values for serial 5-second exposures (10 min. IPD)

Small Focal Spot Large Focal Spot

Scan Mode kV
mA mA
Normal 80 620 700
100 610 800
120 505 705
140 435 605
Hi Res 80 575 700
100 460 670
120 380 555
140 325 475
Hi Res SnapShot Pulse* 80 620 700
100 545 800
120 455 690
140 390 590

* mA capabilities for Hi Res SnapShot Pulse operation based on four 0.5 second exposures with 1
second ISD's (total "scan" time of 5 seconds)

Table 13-11 Permissible mA values for serial 10-second exposures (10 min. IPD)

Small Focal Spot Large Focal Spot

Scan Mode kV
mA mA
Normal 80 620 700
100 550 760
120 455 630
140 390 540
Hi Res 80 535 700
100 430 600
120 355 500
140 305 425

Highest Constant Load at 4s (Reference IEC 60601-2-44)

The system can acquire 100 kW at 120kVp for 4 second scan duration. The single exposures are
controlled by system software.

Maximum Filament Current

(Reference IEC 60601-2-28)

The maximum filament current is 7.1A.

13-16 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Performix™ HD X-ray Tube Specifications

Cathode Emission Characteristics

(Reference IEC 60613)

The following are the Electron Emission Curves as per IEC 60613 Section 4.5. During operation,
the HD generator (part number 5173970-2 and 5332530-x) controls the bias voltages applied to
the tube for each focal spot size in order to maintain consistent MTF across the emission range.
The V-I curve listed is representative of the cathode with no bias voltages applied.

Figure 13-6 Cathode Emission Curves (GSI Focal Spot)

Figure 13-7 Electron Emission Curves (Large Focal Spot)

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 13-17

Performix™ HD X-ray Tube Specifications

Figure 13-8 Electron Emission Curves (Small Focal Spot)

Figure 13-9 Filament V-I Characteristics)

13-18 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 14
Regulatory Information

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 14-1

Regulatory Information

Applicable Regulations and Standards

The system is classified as a Class I, IPX0 equipment, not suitable for use in the presence of a
flammable anaesthetic mixture with oxygen or nitrous oxide. It is rated for continuous operation
with intermittent loading. No sterilization is applied. The patient table cradle and patient support
accessories are considered Type B applied parts.

This product complies with the requirements of the following regulations and standards:

Council Directive 93/42/EEC concerning medical devices when it bears the following CE marking
of conformity:

0459

Authorized representative for Europe/European registered place of business:

GE Medical Systems SCS
Quality Assurance Manager
283 rue de la Minière
78530 BUC France
Tel +33 130704040

Code of Federal Regulations, Title 21, Part 820 -Quality System Regulation

Code of Federal Regulations, Title 21, Sub chapter J -Radiological Health

 Federal U.S. law restricts this device for sale by or on the order of a physician.
GE Medical Systems is ISO 9001 and ISO 13485 certified.

Applicable standards of Underwriters' Laboratories, Inc. (UL), an independent testing laboratory

Applicable standards of the Canadian Standards Association (CSA)

Applicable standards of the International Electrotechnical Commission (IEC):

 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC60601-
1:1988, UL60601-1 and EN60601-1:1990.
 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC 60601-
1:2005*, ES60601-1* and EN60601-1:2006*.
 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC 60601-1-
1:2000.
 All portions of the Revolution Discovery CT and Discovery CT750 HD system are suitable
for use in the patient environment.
The system should be used only with GE approved equipment.

 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC 60601-1-
2:2004.
 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC 60601-1-
2:2007*.
 Detailed information concerning Electromagnetic Compatibility can be found in the
Electromagnetic Compatibility chapter of the Technical Reference Manual.
 The Revolution Discovery CT and Discovery CT750 HD systems comply with radiation
protection in accordance with IEC 60601-1-3:1994.

14-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Regulatory Information

 The Revolution Discovery CT and Discovery CT750 HD systems comply with radiation
protection in accordance with IEC 60601-1-3:2008*.
 The Revolution Discovery CT and Discovery CT750 HD systems comply with applicable
portions of IEC 60601-2-28.

X-ray Source Assembly Performix HD Tube Unit Assembly IEC 60601-2-28 (1993)

X-RAY TUBE ASSEMBLY Performix HD Tube Unit Assembly IEC 60601-2-28:2010*

 The Revolution Discovery CT and Discovery CT750 HD systems comply with the applicable
portions of IEC 60601-2-32.

Associated Equipment Patient Table IEC 60601-2-32:1994

 The Revolution Discovery CT and Discovery CT750 HD systems comply with IEC 60601-2-44.

CT SCANNER... Revolution Discovery CT and Discovery IEC 60601-2-44:2001

CT750 HD System

CT SCANNER... Revolution Discovery CT and Discovery IEC 60601-2-44:2009*

CT750 HD System

* NOTE: The following components are compliant to the additional standards noted above when
the part number is:

Component Model Number

Power Distribution Unit 2326492-6x. Where x is any numeric value of 1 to 9.
Gantry 5232083-x. Where x is any numeric value of 1 or higher.
Patient Table 5121647-x. Where x is any numeric value of 4 or higher.

5122080-x. Where x is any numeric value of 4 to 9.

5380966-x. Where x is any numeric value.

Console 5212920-1xx. Where xx is any numeric value of 15 or higher.

Intended Use of the System

The system is intended for head, whole body, cardiac and vascular X-ray Computed Tomography
applications.

Indications for Use of the System

The Computed Tomography X-ray system is intended to produce cross-sectional images of the
body by computer reconstruction of X-ray transmission data taken at different angles and planes,
including Axial, Cine, Helical (Volumetric), Cardiac, Spectral, and Gated acquisitions for all ages.
These images may be obtained either with or without contrast. This device may include signal
analysis and display equipment, patient and equipment supports, components and accessories.

This device may include data and image processing to produce images in a variety of trans-axial
and reformatted planes. Further the images can be post processed to produce additional imaging
planes or analysis results.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 14-3

Regulatory Information

The system is indicated for head, whole body, cardiac and vascular X-ray Computed Tomography
applications for both single kV acquisitions and with fast kV switching spectral imaging option
(GSI).

The device output is a valuable medical tool for the diagnosis of disease, trauma, or abnormality
and for planning, guiding, and monitoring therapy.

If the spectral imaging option is included on the system, the system can acquire CT images using
different kV levels of the same anatomical region of a patient in a single rotation from a single
source. The differences in the energy dependence of the attenuation coefficient of the different
materials provide information about the chemical composition of body materials. This approach
enables images to be generated at energies selected from the available spectrum to visualize and
analyze information about anatomical and pathological structures.

GSI provides information of the chemical composition of renal calculi by calculation and graphical
display of the spectrum of effective atomic number. GSI kidney stone characterization provides
additional information to aid in the characterization of uric acid versus non-uric acid stones. It is
intended to be used as an adjunct to current standard methods for evaluating stone etiology and
composition.

14-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 15
Electromagnetic Compatibility

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 15-1

Electromagnetic Compatibility

Introduction
This equipment complies with IEC 60601-1-2:2004 and IEC 60601-1-2:2007 EMC standard for
medical electrical equipment. This equipment generates, uses, and can radiate radio frequency
energy. The equipment may cause radio frequency interference to other medical and non-medical
devices and radio communications.

To provide reasonable protection against such interference, this product complies the radiated
emission as per CISPR11 Group1 Class A standard limits.

Detailed requirements and recommendations about the power supply distribution and installation
are listed in the Site Preparation Manual.

However, there is no guarantee that interference will not occur in a particular installation. If this
equipment is found to cause interference (which may be determined by turning the equipment on
and off), the user (or qualified service personnel) should attempt to correct the problem by one or
more of the following measure(s):

 Reorient or relocate the affected device(s)

 Increase the separation between the equipment and the affected device
 Power the equipment from a source different from that of the affected device
 Consult the point of purchase or service representative for further suggestions
The manufacturer is not responsible for any interference caused by using other than
recommended interconnect cables or by unauthorized changes or modifications to this equipment.
Unauthorized changes or modifications could void the users' authority to operate the equipment.

All interconnect cables to peripheral devices must be shielded and properly grounded, except
when technologically prohibited. Use of cables not properly shielded and grounded may result in
the equipment causing radio frequency interference.

Do not use devices which intentionally transmit RF Signals (Cellular Phones, Transceivers, or
Radio Controlled Products) in the vicinity of this equipment as it may cause performance outside
the published specifications.

Recommended separation distances are detailed in the PIM document (Pre-installation Manual).

The medical staff in charge of this equipment is required to instruct technicians, patients, and other
people who may be around this equipment to comply fully with the above equipment. In order to
achieve the Electromagnetic Compatibility for a typical installation, further detailed data &
requirements are described in the Site Preparation Manual.

15-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Electromagnetic Compatibility

General Scope
This equipment complies with IEC 60601-1-2:2004 and IEC 60601-1-2:2007 EMC standard for
medical electrical equipment.

The Revolution Discovery CT system is suitable to be used in the electromagnetic environment, as

per the limits & recommendations described in the tables hereafter:

 Emission Compliance level & limits (Table 15-1)

 Immunity Compliance level & recommendations to maintain equipment clinical utility (Table
15-2).
NOTE This system complies with above mentioned EMC standard when used with supplied
cables up to maximum lengths referenced in the MIS MAPS or system cable interconnect
diagrams.

Electromagnetic Emission
Table 15-1 EMC Emissions Guidance & Declaration for Revolution Discovery CT System

EMC Emissions Guidance & Declaration for Revolution Discovery CT System

The Revolution Discovery CT System is intended for use in the electromagnetic environment specified below. The
customer or the user of the Revolution Discovery CT System should assure that it is used in such an environment.

Electromagnetic Environment
Emissions Test Compliance
Guidance
RF emissions Group 1 The Revolution Discovery CT System
uses RF energy only for its internal
CISPR 11 function. Therefore, its RF emissions are
RF emIssions Class A very low and are not likely to cause any
interference in nearby electronic
CISPR 11 equipment
HarmonIc emissions Not applicable The Revolution Discovery CT System is
suitable for use in all establishments other
IEC 61000-3-2 than domestic and those directly
Voltage fluctuations/flicker emissions Not applicable connected to the public low-voltage power
supply network that supplies buildings
IEC 61000-3-3 used for domestic purposes.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 15-3

Electromagnetic Compatibility

Electromagnetic Immunity
Table 15-2 EMC immunity Guidance & Declaration for Revolution Discovery CT System

EMC Immunity Guidance & Declaration for Revolution Discovery CT System

The Revolution Discovery CT System is Intended for use in the electromagnetic environment specified below. The customer or
the user of the Revolution Discovery CT System should assure that it is used in such an environment.

Immunity Test IEC 60601-1-2 Test Level Compliance Level Electromagnetic Environment Guidance
Electrostatic discharge ± 6 kV contact ± 6 kV contact Floors should be wood, concrete, or ceramic tile If
(ESD) floors are covered with synthetic material, the
± 8 kV air ± 8 kV air relative humidity should be at least 30%.
IEC 61000-4-2
Electrical fast transient/ ±2 kV for power supply lines ±2 kV for power supply lines Mains power quality should be that of a typical
burst commercial or hospital environment.
± 1 kV for input/output lines ± 1 kV for input/output lines
IEC 61000-4-4
Surge ± 1 kV line-line ± 1 kV line-line Mains power quality should be that of a typical
commercial or hospital environment.
IEC 61000-4-5 ± 2 kV line-earth ± 2 kV line-earth
Voltage dips, short < 5% UT < 5% UT Mains power quality should be that of a typical
interruptions and commercial or hospital environment If the user of
voltage variations on (>95% dip in UT) for 5 (>95% dip in UT) for 5 the Revolution Discovery CT System requires
power supply input lines seconds seconds continued operation during power mains
interruptions, it is recommended that the
IEC 61000-4-11 Revolution Discovery CT System be powered from
an uninterruptible power supply or a battery.
Power frequency (50/60 3 A/m 3 A/m Power frequency magnetic fields should be at
Hz) magnetic field levels characteristic of a typical location in a typical
commercial or hospital environment.
IEC 61000-4-8
NOTE UT is the a.c. mains voltage prior to application of the test level.

15-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Electromagnetic Compatibility

EMC Immunity Guidance & Declaration for Revolution Discovery CT System

The Revolution Discovery CT System is Intended for use in the electromagnetic environment specified below. The customer or
the user of the Revolution Discovery CT System should assure that it is used in such an environment.

Immunity Test IEC 60601-1-2 Test Level Compliance Level Electromagnetic Environment Guidance
Conducted RF 3 VRMS 3 VRMS Portable and mobile RF communications
equipment should be used no closer to any part of
IEC 61000-4-6 150 kHz to 80 MHz 150 kHz to 80 MHz the Revolution Discovery CT System, Including
cables, than the recommended separation distance
calculated from the equation appropriate for the
frequency of the transmitter Recommended
Radiated RF 3 V/m 3 V/m
Separation Distance (see Table 15-3)
IEC 61000-4-3 80 MHz to 2.5 GHz 80 MHz to 2.5 GHz 3,5
d = ------- P
3

(alternative method: (80 MHz to 800 MHz (see Table 15-3)

3,5
IEC 61000-4-21) d = ------- P
3

(8OO MHz to 2.5 GHz (see Table 15-3}

7
d = --- P
3

where P IS the maximum output power rating of the

transmitter in watts (W) according to the transmitter
manufacturer and d is the recommended
separation distance in metres (m).

Field strengths from fixed RF transmitters, as

determined by an electromagnetic site survey,a
should be less than the compliance level in each
frequency rangeb.

Interference may occur in the vicinity of equipment

marked with the following symbol:

 Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile radios,
amateur radio. AM and FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy. To assess the
electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the measured
field strength in the location in which the Revolution Discovery CT System is used exceeds the applicable RF compliance level
above, the Revolution Discovery CT System should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as re-orienting or relocating the Revolution Discovery CT System.
 Over the frequency range 150 kHz to 80 MHz. field strengths should be less than 3 V/m.
NOTE These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from
structures, objects, and people

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Electromagnetic Compatibility

Table 15-3 Recommended separation distances between portable and mobile RF

communications equipment and the Revolution Discovery CT System

Recommended separation distances between portable and mobile RF communications equipment and the
Revolution Discovery CT System

The Revolution Discovery CT System is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The customer or the user of the Revolution Discovery CT System can help prevent
electromagnetic Interference by maintaining a minimum distance between portable and mobile RF
communIcations equipment (transmitters) and the Revolution Discovery CT System as recommended below,
according to the maximum output power of the communications equipment
Rated Maximum Output Separation distance according to frequency of transmitter
Power (P) of Transmitter 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2,5 GHz
Watts (W)
3,5 3,5 3,5
d = ------- P d = ------- P d = ------- P
3 3 3

Separation Distance meters Separation Distance meters Separation Distance meters

0.01 0.12 0.12 0.23
0.1 0.37 0.37 0.74
1 1.17 1.17 2.33
10 3.69 3.69 7.38
100 11.7 11.7 23.3
For transmitters rated at a maximum output power not listed above, the separation distance can be estimated using the
equation in the corresponding column, where P is the maximum output power rating of the transmitter in watts (W)
according to the transmitter manufacturer.

NOTE At 80 MHz and 800 MHz, the separation dIstance for the higher frequency range applies.

NOTE These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects, and people.

15-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Electromagnetic Compatibility

Limitations Management
Adhering to the distance separation recommended in Table 15-3, between 150KHz & 2.5GHz, will
reduce disturbances recorded at the image level but may not eliminate all disturbances. However,
when installed and operated as specified herein, the system will maintain its essential
performance / basic safety by continuing to acquire, display, and store diagnostic quality images
safely.

*For example. a 1W mobile phone (800MHz to 2.5GHz carrier frequency) shall be put 2.3 meters
apart from the Revolution Discovery CT System (in order to avoid image interference risks).

Use Limitation
External Components
The use of accessories, transducers, and cables other than those specified may result in
degraded ELECTROMAGNETIC COMPATIBILITY of the EQUIPMENT and/or SYSTEM.

Installation Requirements & Environment Control

In order to minimize interference risks, the following requirements shall apply.

Cable Shielding & Grounding

All interconnect cables to peripheral devices must be shielded and properly grounded. Use of
cables not properly shielded and grounded may result in the equipment causing radio frequency
interference.

This Product Complies with the Radiated Emission as per CISPR11

Group1 Class A Standard Limits
The Revolution Discovery CT System is predominantly intended for use, in non-domestic
environments, and not directly connected to the Public Mains Network. The Revolution Discovery
CT System is predominantly intended for use (e.g. in hospitals) with a dedicated supply system,
and with a X-ray shielded room. In case of using in a domestic environment(e.g. doctors' offices),
in order to avoid interferences, it is recommended to use a separated AC power distribution panel
&line, with a X-ray shielded room.

Subsystem & Accessories Power Supply Distribution

All components, accessories subsystems, systems which are electrically connected to the
Revolution Discovery CT System, must have all AC power supplied by the same power distribution
panel & line.

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Electromagnetic Compatibility

Stacked Components & Equipment

The Revolution Discovery CT System should not be used adjacent to or stacked with other
equipment; if adjacent or stacked use is necessary, the Revolution Discovery CT System should
be observed in order to verify normal operation in the configuration in which it will be used.

Low Frequency Magnetic Field

In case of a digital Revolution Discovery CT System, the Gantry (digital detector) shall be apart 1
meter from the generator cabinet, and1 meter apart from any analog (CRT) monitors. These
distance specifications will minimize the low frequency magnetic field interference risk.

Static Magnetic Field Limits

In order to avoid interference on the Revolution Discovery CT System, static field limits from the
surrounding environment are specified.

Static field is specified less than <1 Gauss in Examination room, and in the Control Area.

Static field is specified less than <3Gauss in the Technical Room.

Electrostatic Discharge Environment & Recommendations

In order to reduce electrostatic discharge interference, install a charge dissipative floor material to
avoid electrostatic charge buildup.

The relative humidity shall be at least 30 percent.

The dissipative material shall be connected to the system ground reference, it applicable.

15-8 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 16
System Specifications

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-1

System Specifications

System Component Labeling

Table 16-1 Model Numbers (Reference 21CFR 1020.30(e))

Component Model Number Rating Plate Locations Certified Component?

Gantry 5232083-x Lower, left Gantry base in rear Y
CT Operator Computer Console 5212920-1zz Rear of console Y
VT 1700 Table 5122080-x Right side, low on front leg Y

VT 2000 Table 5121647-x

VT 2000x Table 5380966-x

Metal Free adapter 87999PM Bottom angled surface, front end N
Tube Unit 5195800-x On Housing center Y
Collimator 5222001-x Tube at 12 o’clock on collimator front Y
High Voltage Tank 5173970-x On Surface of the HV-Tank Y

5332530-x
Power Distribution Unit 2326492-4 Back horizontal surface of top cover N

2326492-6z

Throughout this manual, model numbers may contain a “-x” (i.e. 5173970-x). In these instances “x”
can be any numeric character of 1 or higher. For example, in 5173970-x, “-x” refers to 5173970,
5173970-2, 5173970-3, etc.

Throughout this manual the Operator Console model number contains a "-1zz". The z represents
any number from 0 to 9.

Throughout this manual the Power Distribution model number contains a "-6z". The z represents
any number from 0 to 9 or may not be present.

Table 16-2 System Dimensions

Size (inches) Size (cm) Weight Weight

Component
(wide, height, depth) (wide, height, depth) (lb) (kg)
Gantry 89.25 x 74.6 to 75.6 x 39.6 226.7 x 189.5 x 100.7 4600 2086
Operator’s console 49 x 26.75-34.75: 123.8 x 68-88.3 475 216

Keyboard table, Keyboard table,

26.75-31.75 Monitor table 68-80.7 Monitor table

40-48 102-122.8
Table VT 2000x (including foot 26(w), 41(h), 215(d) 66(w), 104(h), 545(d) 1122 509
switch assembly)
Table VT 2000 (including foot 26(w), 41(h), 215(d) 66(w), 104(h), 545(d) 1113 505
switch assembly)
Table VT 1700 (including foot 26(w), 41(h), 182(d) 66(w), 104(h), 460(d) 1047 475
switch assembly)
Power Distribution Unit 28 x 42 x 22 711 x 1067 x 559 800 363
Total Weight with Operator Console VT 2000x 6997 3174
Total Weight with Operator Console VT 2000 6988 3170
Total Weight with Operator Console VT 1700 6922 3140

16-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Component Rating Plates

(Reference 1010.3)

Figure 16-1 System Name Plate Example

Legal Manufacturer

Model

Figure 16-2 System Name Plate Example

Legal Manufacturer

Model

Figure 16-3 Gantry Plate Example

Component
Manufacturer

Model Number

Serial Number

Manufactured

Description (Plate on rear of Gantry)

This is a statement of compliance with US

radiation regulation, not safety warning or
caution information

Gantry Rating Plate

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-3

System Specifications

Figure 16-4 Table Plate Example

Component
Manufacturer

Model Number

Serial Number

Manufactured

This is a statement of compliance with US radiation

regulation, not safety warning or caution information

Table Rating Plate

Figure 16-5 Table Plate Example

Component
Manufacturer

Model Number

Serial Number

Manufactured

This is a statement of compliance with US radiation

regulation, not safety warning or caution information

Table Rating Plate

16-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Figure 16-6 PDU Plate Example

Component
Manufacturer

Description

Model Number

Serial Number

Manufactured

Voltage

Supply Frequency

Max Power Input

Momentary

Continuous

Weight

PDU Rating Plate

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-5

System Specifications

Figure 16-7 PDU Plate Location

Rating plate location

NOTE Electrical Ratings on the PDU Rating Plate are the ratings for the CT System.

Figure 16-8 Console Plate Example

Component
Manufacturer

Model
Number

Serial Number

Manufactured
This is a statement of compliance with US radiation
Description regulation, not safety warning or caution information

Console Rating Plate

Table 16-3 Month Translated Text

English Text Translated Text

January
February
March
April
May
June
July
August
September
October
November
December

16-6 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Purchasable Options
The following table lists options that can be purchased with your system

Table 16-4 Purchased Options

Catalog Item Description

Operator Instruction Name Software Option Name Data Sheet Name
Name
SmartScore Pro SmartScore Pro SmartScore Acquisition SmartScore Pro
Software
ECG Viewer EKG Viewer ECG Trace Software ECG Viewer/R-Peak Editor

ECG Editor
CardIQ SnapShot CardIQ SnapShot CardIQ SnapShot Acquisition SnapShot Imaging
Software
SnapShot Pulse CardIQ SnapShot-Cine SnapShot Pulse option SnapShot Pulse
Cardiac Filters NoiseReductionFilter Cardiac Enhancement Filter Cardiac Image Filter
VolumeShuttle (Axial) AxialShuttle VolumeShuttle VolumeShuttle
Volume Helical Shuttle HelicalShuttle Volume Helical Shuttle Volume Helical Shuttle
SmartStep SmartStep SmartStep SmartStep
Xtream Injector Xtream Injector Xtream Integrated Injector Xtream Injector Interface
Interface Kit - Class I
Enhanced Xtream Injector Enhanced Xtream Injector Enhanced Xtream Integrated Enhanced Xtream Injector
Injector Interface Kit - Class IV Interface
Volume Viewer 5.0 VolumeViewer Volume Viewer 5.0 Volume Viewer 5.0
AutoBone Xpress AutoBone_Xpress AutoBone Xpress AutoBone Xpress
AVA Xpress AVA_Xpress Advanced Vessel Analysis AVA Xpress
Xpress
CardIQ Xpress 2.0 Reveal CardIQ Xpress Reveal CardIQ Xpress 2.0 Reveal CardIQ Xpress 2.0 Reveal
CardEP CardEP CardEP on the OP Console CardEP
Advantage CTC Pro CTColonoPro CTC Pro Advantage CTC Pro
CT Perfusion 4D CT Perfusion 4D Neuro Perfusion 4D Neuro CT Perfusion 4D Neuro
CT Perfusion 4D CT Perfusion 4D Perfusion 4D Multi-Organ CT Perfusion 4D Multi Organ
Advantage Dentascan DentaScan DentaScan DentaScan
Gemstone Spectral Imaging Gemstone Spectral Imaging Gemstone Spectral Imaging Gemstone Spectral Imaging
Tube License Enhanced Rotor Additional license required for Performix HD
Management-DS Non-GE X-ray tubes
Tube License
SmartView Real Time CT Fluoro SmartView Fluoro Upgrade SmartView
GSI SnapShot Pulse GSI SnapShot Pulse GSI SnapShot Pulse GSI Cardiac
SnapShot Assist SnapShot Assist SnapShot Assist SnapShot Assist
Veo Veo Iterative Recon Veo Veo
Temporal Enhance SnapShotAssist Temporal SnapShot Freeze SnapShot Freeze
Enhance
Hi Res High Resolution High Resolution High Resolution/Hi Res
Overlapped Reconstruction Overlapped Recon-Axial 128i Axial Reconstruction Overlapped Reconstruction

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-7

System Specifications

Purchasable Option Descriptions

The following table describes the function of the purchasable system options.

Table 16-5 Purchasable Options Descriptions

Operator Instruction Name Function Description

CardIQ SnapShot – CardIQ SnapShot Low pitch ECG-gated helical acquisition mode where the pitch value is set
based on the patient’s heart rate.

Three acquisition and reconstruction modes - SnapShot Segment, Burst

and Burst Plus and one additional reconstruction mode – SnapShot
Segment Plus.

Patient’s heart rate must be within 30-120 BPM range.

SnapShot Pulse – CardIQ SnapShot Cine Axial step and shoot mode used to acquire images during a specified phase
of the heart cycle with padding.

Padding provides additional phase information to account for heart rate

variation in the heart rate by adding time before and after the center phase
of the acquisition.

When used for coronary artery imaging the patient’s heart rate should be
within 30-65 BPM.
Prospective Gating – SmartScore Pro Acquires prospective ECG gating measurements, which provide
information that is valuable to for scan timing.

Using the measurements, the system synchronizes the collection of data

with the cardiac cycle.
ECG Viewer/ECG Editor – EKG Viewer Provides capability to display and view the ECG waveform on the operator
console.

Provides retrospective review of the gating information and capability to edit

the triggering information on the ECG waveform.
Cardiac Filters – Noise Reduction Filters Cardiac noise reduction filters C1, C2, C3 can be selected to reduce noise
in the images for SnapShot Segment, SnapShot Burst, SnapShot Burst
Plus or SnapShot Pulse acquisitions.
CardIQ Xpress 2.0 Reveal – CardIQ Xpress Reveal: Provides the user with multiple tools to post process images from cardiac
data sets.
AutoBone Xpress – Auto Bone: Facilitates removal of bone and CT table from CT Angiography (CTA)
studies of the abdomen and lower extremities.
AVA Xpress – AVA Xpress: Provides enhanced analysis of vascular features, which include stenosis
analysis, pre/post stent planning procedures and directional vessel
tortuosity visualization.
Advantage CTC Pro 3D EC – CT Colono Pro3D: Provides comprehensive software package for evaluation of quick,
accurate, noninvasive colon exams.
CardEP – CardEP: Post processing image analysis software for the application of
cardiovascular and electrophysiology imaging.
Volume Viewer 5.0 – VolumeViewer: VolumeViewer provides protocols for reformat, 3D rendering and volume
rendering.
CT Perfusion 4D Multi-Organ – Perfusion 4D: Multi-organ package includes protocols for neuro stroke and tumor
perfusion imaging and body tumor including liver perfusion imaging.
CT Perfusion 4D Neuro – Perfuion 4D Neuro: Package includes protocols for neuro stroke and brain tumor perfusion.
Advantage DentaScan – DentaScan: Allow specific analysis to aid in the pre-surgical evaluation of dental
implants.
SmartStep – SmartStep: A mode of scanning designed to be used by the Radiologist or Physician
during interventional procedures.

Accomplished by using the integrated Hand Held Controller (HHC) and foot
switch.

16-8 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Operator Instruction Name Function Description

VolumeShuttle (Axial) – Axial Shuttle: Repetitive axial scan mode where the table shuttles back and forth between
two adjacent locations with 40mm detector coverage.

Used for perfusion studies of the brain.

Volume Helical Shuttle – Helical Shuttle: Repetitive helical scan mode where table moves continuously back and
forth across prescribed area where each pass has temporal time sampling
information.

Can be used to create time resolved CT Angiography (CTA) of head, neck,

and body and perfusion studies.
Gemstone Spectral Imaging (GSI) and GSI Viewer –  An optional acquisition and reconstruction mode that acquires
GSI: interleaved data at two different energy levels using fast kV switching.
 This enables processing to separate data into different energies to
create monochromatic images or material density images.
GSI Cardiac – GSI SnapShot Pulse:  An optional cardiac imaging acquisition and reconstruction mode that
uses the GSI mode.
 This enables processing to separate data into different energies to
create gated monochromatic images and material density images.
Xtream Injector – Xtream Injector:  Enables Class1 in CiA425 of CiA425 complaint injector allowing only
ON/OFF control.
 The Xtream Injector is a start synchronization of CT Scanner and
injector.
Enhanced Xtream Injector – Enhanced Xtream  Enables Class4 in CiA425 of a CiA425 compliant injector allowing ON/
Injector: OFF and injector parameters to be set from the CT scanner.
 The Xtream Injector is a start synchronization of CT scanner and
injector.
SnapShot Assist Enables a mode that guides the user in selecting the appropriate cardiac
imaging mode based on patient profile.
Tube License – Enhanced Rotor Management – DS Enables ASiR, Volume Helical Shuttle, Hi Resolution Mode, and GSI when
using a Non-GE tube.
SmartView – Real Time Fluoro Enables a real-time fluoro mode of scanning designed for interventional
procedures.
Temporal Enhance – SnapShot Assist Temporal Reconstruction mode to create images to support SnapShot Freeze cardiac
Enhance: image post processing.
Veo An advanced Model-Based Iterative Reconstruction technology that may
provide higher resolution detail and improved low contrast detectability with
less pixel noise standard deviation than traditional filtered back projection
(FBP) image reconstruction approaches.
High Resolution Hi Res mode applies deflection of the x-ray beam in the x-y direction
providing an increase in the number of views per rotation from 984 to 2,496
for non-cardiac and from 655 to 1,662 for half scan in cardiac modes. This
increased number of views can improve resolution for off-center field of
view imaging. Improved resolution can be created when HD algorithm and
DFOV of 25cm are selected.
Overlapped Reconstruction Overlapped reconstruction for axial scan type generates 128 images per
rotation for a 40mm acquisition and 64 images from a 20mm acquisition.

Table 16-6 Hardware Options

Hardware Options
Advantage 4D CT
ECG Monitor
Uninterruptible Power Supply
Bar Code Reader
Flat Table Top
Advantage Workstation
Veo - Further information available in Direction Number: 550715-1EN

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-9

System Specifications

Helical High-Contrast Spatial Resolution

3D MTF
Measurement basis: In-plane (XY) limiting resolution is determined by the reconstruction filter
cutoff. The 50% and 10% MTF are demonstrated on the GE Performance Phantom. MTF is
calculated from a two-dimensional Fourier transform of the point spread function using pixel data
around a 0.05mm tungsten wire. A tolerance of ± 10% applies to all measurements.

NOTE The upper tolerance limit can be exceeded in the case of the expected results in table:
Standard and HD Edge Algorithm Results (XY Plane).

Table 16-7 Scan Parameters (XY Plane)

Scan Parameter
Scan Type Helical
kV 120
mA 260
Scan Modes Normal and Hi Res
Scan Time 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0 second gantry
rotation
Table Travel 10.62 mm/rot – 61.25 mm/rot
Image Thickness 0.625 mm
Pitch 0.531:1 – 1.531:1
SFOV Small, Medium or Large
DFOV 10 cm
Algorithm Standard and HD Edge

Measurement basis: Z-plane limiting resolution is determined by active Z-axis length of the
detector. The 50% and 10% MTF are demonstrated by scanning a Gold Foil Phantom (a gold foil,
1 x 0.025mm, embedded in tissue equivalent plastic) with the smallest image reconstruction
interval. The MTF is calculated from the Fourier transform of the slice sensitivity profile obtained
from the reconstructed images. A tolerance of ± 10% applies to all measurements.

Table 16-8 Scan Parameters (Z-Plane)

Scan Parameter
Scan Type Helical
kV 120
mA 260
Scan Time 0.4, 0.5, 0.6, 0.7, 0.8, 0.9 and 1.0 second gantry
rotation
Table Travel 20 mm/rot – 61.25 mm/rot
Image Interval 0.06 mm
Image Thickness 0.625 mm
Pitch 0.516:1 – 1.531:1
SFOV Small, Medium or Large
DFOV 10 cm
Algorithm Detail

16-10 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Table 16-9 Standard and HD Edge Algorithm Results (XY Plane)

Normal + Hi Res Mode

Scan Mode Hi Res Mode
(Typical Mode)

Algorithm Standard HD Edge

50% MTF 4.2 13.0
10% MTF 6.8 18.0
0% MTF 8.5 21.4

Table 16-10 Z-Axis Resolution

Z-Axis MTF (lp/cm)

Scan Mode Normal and Hi Res Mode
50% MTF 7.3
10% MTF 12.2
0% MTF 19.8

Axial High Contrast Spatial Resolution

Measurement basis: In-plane (XY) limiting resolution is determined by the reconstruction filter
cutoff. the 50% and 10% MTF are demonstrated on the GE Performance Phantom. MTF is
calculated from a two-dimensional Fourier transform of the point spread function using pixel data
around a 0.05mm tungsten wire. A tolerance of ± 10% applies to all measurements.

NOTE The upper tolerance limit can be exceeded in the case of the expected results in table:
Standard and HD Edge Algorithm Results (XY Plane).

Table 16-11 Scan Parameters

Scan Parameter
Scan Type Axial
kV 120
mA 260
Scan Time 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0 and 2.0 second
gantry rotation
Scan Mode 40 mm aperture
Image Thickness 0.625, 1.25, 2.5 and 5mm
SFOV Small, Medium or Large
DFOV 10 cm
Algorithm Standard and HD Edge

Table 16-12 Standard & HD Edge Algorithm Results

Typical In-Plane (X/Y Axis) Resolution - lp/cm

Normal + Hi Res Mode

Hi Res Mode HD Edge
MTF Value (Typical Mode)
Algorithm
Standard Algorithm
50% 4.2 13.0
10% 6.8 18.0
0% 8.5 21.4

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-11

System Specifications

Figure 16-9 Typical In-plane Resolution

Helical Low-Contrast Detectability - Statistical (Reference YY310)

On 20 cm (8") Catphan® 600 phantom, the specifications listed in Table 16-13 apply, with a ± 10%
tolerance.

16-12 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Table 16-13 Standard & ASiR Algorithm Statistical LCD Results

Reconstruction Mode Object Size % Contrast Dose Suggested Technique

Standard Algorithm, 5mm Nominal 5 mm 0.3% 14.27 mGy Helical, 0.516:1 Pitch, 1 Second
Image Thickness, 22.7 cm Display Gantry Rotation Speed, 40mm
Field of View Aperture, 120 kV, 105 mA, 5mm
Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode
3 mm 0.3% 39.41 mGy Helical, 0.516:1 Pitch, 1 Second
Gantry Rotation Speed, 40mm
Aperture, 120 kV, 290 mA, 5mm
Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode
2 mm 0.3% 86.28 mGy Helical, 0.516:1 Pitch, 1 Second
Gantry Rotation Speed, 40mm
Aperture, 120 kV, 635 mA, 5mm
Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode
Standard Algorithm with ASiR 5 mm 0.3% 8.83 mGy Helical, 0.516:1 Pitch, 1 Second
Reconstruction, 5mm Nominal Image Gantry Rotation Speed, 40mm
Thickness, 22.7 cm Display Field of Aperture, 120 kV, 65 mA, 5mm
View Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
(Typical Mode) DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode, ASiR
3 mm 0.3% 23.78 mGy Helical, 0.516:1 Pitch, 1 Second
Gantry Rotation Speed, 40mm
Aperture, 120 kV, 175 mA, 5mm
Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode, ASiR
2 mm 0.3% 52.31 mGy Helical, 0.516:1 Pitch, 1 Second
Gantry Rotation Speed, 40mm
Aperture, 120 kV, 385 mA, 5mm
Slice Thickness, 5mm Interval,
Tilt 0, Small Body SFOV, 22.7
DFOV, R/L Center 0, A/P Center
0, Standard Algorithm, Full
Mode, ASiR

Test method is as follows:

1. Measure mean CT # values of an array of pixel groups with an area equal to the size of the
detectable object size.

2. Calculate the standard deviation for the means of the pixel groups.

3. Statistically calculate the % contrasted change needed to ensure with 95% confidence that an
object with this contrast could be detected with the above background noise, and 95%
confidence that it’s not detected when not present.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 16-13

System Specifications

NOTE Due to the scan length dependent nature of Dynamic Z-axis Tracking (CTDIvol (Reference
IEC 60601-2-44) on page 12-43), the system Noise and Low Contrast Detectability
specifications are reported without the scan length dependent dose reduction impact of
Dynamic Z-axis Tracking. This ensures that the system can achieve or exceed the
provided system specifications regardless of the chosen scan length. For short scan
length, such as those used for phantom scans, the dose reduction impact of Dynamic Z-
axis Tracking may result in dose values lower than provided system specifications, which
is to be expected and may be accounted for by adjusting the specified dose by the tracking
adjustment factor provided in Chapter 12. Recommended scan length for phantom
evaluation is at least the width of the beam aperture.

Axial Low-Contrast Detectability - Statistical (Reference YY310)

On 20 cm (8") Catphan® 600 phantom, the specifications listed in Table 16-14 apply, with a ± 10%
tolerance.

Table 16-14 Standard & ASiR Algorithm Statistical LCD Results

Reconstruction Mode Object Size % Contrast Dose Suggested Technique

Standard Algorithm, 5mm Nominal 5 mm 0.3% 14.01 mGy Axial, 40mm Aperture, 120 kV,
Image Thickness, 22.7 cm Display 200 mAs, 5 mm Slice
Field of View Thickness, 5 mm Interval, Tilt 0,
Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
Standard Algorithm, Full Mode
3 mm 0.3% 39.24 mGy Axial, 40mm Aperture, 120 kV,
560 mAs, 5 mm Slice
Thickness, 5 mm Interval, Tilt 0,
Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
Standard Algorithm, Full Mode
2 mm 0.3% 86.18 mGy Axial, 40mm Aperture, 120 kV,
1230 mAs, 5 mm Slice
Thickness, 5 mm Interval, Tilt 0,
Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
Standard Algorithm, Full Mode
Standard Algorithm with ASiR 5 mm 0.3% 8.41 mGy Axial, 40mm Aperture, 120 kV,
Reconstruction, 5mm Nominal Image 120 mAs, 5 mm Slice
Thickness, 22.7 cm Display Field of Thickness, 5 mm Interval, Tilt 0,
View Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
(Typical Mode) Standard Algorithm, Full Mode,
ASiR 100%
3 mm 0.3% 23.47 mGy Axial, 40mm Aperture, 120 kV,
335 mAs, 5 mm Slice
Thickness, 5 mm Interval, Tilt 0,
Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
Standard Algorithm, Full Mode,
ASiR 100%
2 mm 0.3% 51.85 mGy Axial, 40mm Aperture, 120 kV,
740 mAs, 5 mm Slice
Thickness, 5 mm Interval, Tilt 0,
Small Body SFOV, 22.7 DFOV,
R/L Center 0, A/P Center 0,
Standard Algorithm, Full Mode,
ASiR 100%

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System Specifications

Test method is as follows:

1. Measure mean CT # values of an array of pixel groups with an area equal to the size of the
detectable object size.

2. Calculate the standard deviation for the means of the pixel groups.

3. Statistically calculate the % contrasted change needed to ensure with 95% confidence that an
object with this contrast could be detected with the above background noise, and 95%
confidence that it’s not detected when not present.

Helical Image Noise

0.45% ± 0.05% at 18.4 mGy CTDlvol (1.8 Rad)

Suggested Scan Technique:

120 kVp, 135 mAs, 0.4 to 1.0 second gantry rotation, 0.516:1 helical pitch with a 40mm beam
aperture acquisition. Reconstruct the data at 5 mm thickness. Use the Small Body scan FOV, 22.7
cm display FOV, and standard algorithm.

0.45% ± 0.05% at 9.5 mGy CTDlvol (1 Rad)

Suggested Scan Technique:

120 kVp, 70 mAs, 0.4 to 1.0 second gantry rotation, 0.516:1 helical pitch with a 40mm beam
aperture acquisition. Reconstruct the data at 5 mm thickness. Use the Small Body scan FOV, 22.7
cm display FOV, and standard algorithm with ASiR reconstruction.

Measurement Basis: Noise is demonstrated on 8.5 in AAPM water phantom or GE Quality

Assurance phantom using 25 mm x 25 mm box ROI. Scan the suggested technique four times,
and apply the specification to the average of the noise measurements taken in the water section of
the phantom.

NOTE For daily QA measurements, please refer to the Quality Assurance chapter.

NOTE Due to the scan length dependent nature of Dynamic Z-axis Tracking (CTDIvol (Reference
IEC 60601-2-44) on page 12-43), the system Noise and Low Contrast Detectability
specifications are reported without the scan length dependent dose reduction impact of
Dynamic Z-axis Tracking. This ensures that the system can achieve or exceed the
provided system specifications regardless of the chosen scan length. For short scan
length, such as those used for phantom scans, the dose reduction impact of Dynamic Z-
axis Tracking may result in dose values lower than provided system specifications, which
is to be expected and may be accounted for by adjusting the specified dose by the tracking
adjustment factor provided in Chapter 12. Recommended scan length for phantom
evaluation is at least the width of the beam aperture.

Axial Image Noise

0.45% ± 0.05% at 18.2 mGy CTDlvol (1.8 Rad)

Suggested Scan Technique:

120kVp, 260mAs, 0.4 to 1.0 second gantry rotation, with a 40mm beam aperture acquisition.
Reconstruct the data at 5 mm thickness. Use the Small Body scan FOV, 22.7 cm display FOV, and
standard algorithm.

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System Specifications

0.45% ± 0.05% at 9.1 mGy CTDlvol (0.9 Rad)

Suggested Scan Technique:

120kVp, 130mAs, 0.4 to 1.0 second gantry rotation, with a 40mm beam aperture acquisition.
Reconstruct the data at 5 mm thickness. Use the Small Body scan FOV, 22.7 cm display FOV, and
standard algorithm with ASiR Reconstruction.

Measurement Basis: Noise is demonstrated on 8.5 in AAPM water phantom or GE Quality

Assurance phantom using a 25 mm x 25 mm box ROI. Scan the suggested technique four times,
and apply the specification to the average of the noise measurements taken in the water section of
the phantom.

NOTE For daily QA measurements, please refer to the Quality Assurance chapter.

CT Number Linearity
 CT number of water 0 HU ± 3 HU
 CT number of air -1000 HU ± 10 HU

CT Number Uniformity
 CT number uniformity ± 3 HU (25 cm DFOV)

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System Specifications

Dose Performance
Table 16-15 Helical Dose and Axial Dose Performance

CTDI100 Expressed in mGy**

Ped Head Head Small Body Medium Body Large Body

Ped Body Cardiac Small Cardiac Medium Cardiac Large

Small Head
Center 41.6 43.9 11.2 12.3 11.7
Peripheral 42.4 48.9 21.7 26.3 25.5
CTDIw Expressed in mGy*
Ped Head Head Small Body Medium Body Large Body

Ped Body Cardiac Small Cardiac Medium Cardiac Large

Small Head
42.1 47.2 18.2 21.6 20.9
CTDI100 Expressed in mGy/100mAs
Ped Head Head Small Body Medium Body Large Body

Ped Body Cardiac Small Cardiac Medium Cardiac Large

Small Head
Center 16.0 16.9 4.3 4.7 4.5
Peripheral 16.3 18.8 8.3 10.1 9.8
CTDIw Expressed in mGy/100mAs
Ped Head Head Small Body Medium Body Large Body

Ped Body Cardiac Small Cardiac Medium Cardiac Large

Small Head
16.2 18.2 7.0 8.3 8.0

NOTE *CTDIw = CTDI100 peripheral x 2/3 + CTDI100 center x 1/3

**Helical Scan Technique: 120kVp, 255 mA, 1.0 second gantry rotation, 64 x 0.625, pitch 0.984:1.

**Axial Scan Technique: 120kVp, 260 mA, 1.0 second gantry rotation, 64 x 0.625

Measurement Basis: Helical CTDI100 and CTDIw are identical to the measured axial CTDI100
and CTDIw data for the case for 1.0:1 helical pitch. Otherwise, the appropriate helical scan mode
correction factor should be applied. Both Axial and Helical measurements are adjusted for 260
mAs technique. Aperture adjustment Factors for Small and Large spot apply for all gantry speeds
from 0.35 to 2.0 second.

Expected deviation equals +/- 15%. Deviations may be greater than the expected deviation range
for low mA or narrow aperture scans where variation may be greater (up to a factor of two) due to
the inherent deviation in small values. Maximum deviation anticipated for tube output equals +/-
40%.

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System Specifications

Subsystem Specifications
Operator Console
Console
 Size: 48.9 in (1240mm) wide x 42.3-50.5 in (1075-1283mm) deep x 26.7-34.7 in (680-883mm)
high

Host Computer
PC Based System
 HP Z800 Technical/Graphics Workstation
 Dual Intel Xeon X5650 dual 2.66GHz SixC
 48GB DDR3-1333 Register ECC DIMM (12x 4GB)
 2x 300 GB 15000 rpm 6.0 Gb/s SAS Hard Disk Drive for system and image
 10 x 300 GB 15000 rpm 6.0 Gb/s SAS Hard Disk Drive RAID5 with LSI 9260-16i for raw data

Image Processor
 Dual Monitor Capability
 AMD Ati FirePro V5800 PCI-E x16 Graphics Card

Image Reconstruction Engine

 Up to 35 frames per second (s)
 GEHC DAS Interface Processor Card 10 Gb/s SERDES Processor
 AMD Ati FirePro V7800 PCI-E x16 GPU Compute PCA
 Adaptive Statistical Iterative Reconstruction (ASiR) Architecture

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System Specifications

The Revolution Discovery CT Operator Console User Interface

 Two 19in. 1280x1024 Monitors
 Active Pixel Format 1280 H x 1024 V (SXGA)
 Horizontal and Vertical viewing angle more than 176 degrees (°)
 Horizontal frequency 31.5kHz - 81.1kHz
 Vertical frequency 50Hz - 85Hz
 104-Key USB 2.0 Keyboard and 3-Button USB 2.0 Mouse
 3-Button USB 2.0 Trackball
 Slim-Line Tray-Load 16X DVD-ROM Optical Drive SATA 1st Drive
 5.25 in Bare Media
 9.4 GB Capacity
 480 Mb/s
 DVD-RW
 5.25 in DVD Form Factor
 Capacity
 480 Mb/s
 Global Scan Control Box (GSCB)
 Table Control
 Gantry Tilt Control
 Intercommunications
 Emergency Stop
 USB 2.0 Port for External Hard Disk Drive Connectivity

Data Acquisition
64-Row Detector
 64 rows x 888 active patient elements; 24 reference elements (total 912 channels)
 70% geometric efficiency
 98% absorption efficiency

Table
Load Capacity (Reference YY310)
 227 kg (500 lb) with ± 0.25 mm positional accuracy guaranteed (VT1700, VT2000)
 306 kg (675 lb) with ± 0.5 mm positional accuracy guaranteed (VT2000x)

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System Specifications

Maximum Cradle Travel (Reference YY310)

 1700 mm (VT 1700)
 2000 mm (VT 2000, VT 2000x)
 Table Height, Gantry Tilt and scanning software determine the scannable range

Cradle Speeds
 100mm/sec (scout imaging) (VT1700, VT 2000, VT 2000x)
 5.0 - 153.2 mm/sec (VT1700, VT 2000, VT 2000x)

Scan Location Accuracy (Reference YY310 and 21CFR 1020.33 (i))

± 0.25mm (VT1700, VT 2000)

Patient Weight:

 ≤ 227kg / 500 lb: ± 0.25mm (VT1700, VT 2000)

 ≤ 306kg / 675 lb: ± 0.5mm (VT 2000x)

Elevation Travel Time

 FAST < =22 seconds (VT1700, VT 2000)
 FAST < =20 seconds (VT 2000x)

Full Range
 SLOW < 45 seconds (VT1700, VT 2000)
 SLOW < 38 seconds (VT 2000x)

Elevation Accuracy
± 1.5 mm

Elevation Range (Reference YY310)

 430 mm to 991 mm (VT1700, VT 2000)
 525 mm to 991 mm (VT 2000x)

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System Specifications

Gantry
Tilt Limits (Reference YY310)
+30° to -30° in 0.5° increments

Tilt Speed
60 degrees/minute nominal

Gantry Opening Diameter (Reference YY310)

700 mm

Isocenter to Tube Distance

539 mm

Tube Focus to Detector Distance

947 mm

Running Noise (Reference YY310)

≤70db (A) from a distance of 1 meter from the gantry surface.

Rotational Speeds (Reference YY310)

360 degrees in 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1 and 2 second.

Optional rotation speeds: 0.35, 0.375, 0.425, 0.45, and 0.475 second.

Optional rotation speeds: 0.35, 0.375, 0.425, 0.45, and 0.475 second with CardIQ SnapShot and
the Sub 0.4 second option.

Scout Orientation (Reference YY310)

Presets: AP, RLAT, PA, LLAT

Manual: 0 to 359 degrees, increments of 1 degree

Rotational Freedom
1 continuous rotate

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System Specifications

Laser Alignment Lights (Reference 21CFR 1040.10 (h))

Maximum Output Power
<1.0 mW/laser beam

Maintenance
 Laser alignment lights do not require user maintenance.
 Qualified service personnel must inspect the lights periodically to assure proper alignment.

Laser Alignment Light Accuracy (Reference YY310 and 21CFR 1020.33 (g)(3))
The sagittal, coronal, and transverse alignment lights are within ± 1 mm of the scanner imaging
coordinates.

Gantry LCD Display

 LCD size: 12.1 inches with Touch Panel

X-ray Tube: Performix™ HD

Heat Storage (Reference YY310)
 Anode: 8 MHU
 Housing: 3.2 MHU

Focal Spots (Reference YY310)

Small Focal Spot
 1.0mm (W) x 0.7 mm (L) per IEC 60336: 2005

Large Focal Spot

 1.6mm (W) x 1.2mm (L) per IEC 60336: 2005

GSI Focal Spot

 2.0mm (W) x 1.2mm (L) per IEC 60336: 2005

Anode
 Target angle: 7 degrees
 Up to 107.1 kW maximum radiographic load

16-22 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

System Specifications

Main Power Supply (Reference IEC 60601-2-44)

Line Voltage (Reference 21CFR 1020.30 (h)(3)(i))
 Nominal: Taps selections of 380 to 480 V in 20 V Steps
 Daily Variation: Nominal ± 10%

3-Phase 50/60 Hz ± 3Hz (Reference 21CFR 1020.30 (h)(3)(i))

 Phase-to-phase balance within 2% of lowest phase-to-phase voltage.
 Line regulation 6% or less at 150 kVA, 85% P.F.

Maximum 3-Phase Power Demand at Full Rated Output

150 kVA

Continuous 3-Phase Power Demand

30 kVA Average effective (RMS) power and 11 kVA average power or less.

Maximum Line Current Demand (Reference 21CFR 1020.30 (h)(3)(ii) and

(h)(3)(iii))
180A @ 480 V

Maximum line current demand defined at 140 kV and 765 mA (GSI).

Generator Subsystem Specifications

Maximum Output Power (Reference IEC 60601-2-44)
107.1 kW power

kV Choices
80, 100 120, 140 kV

Maximum mA
 890 mA at 120 kV for Revolution Discovery CT for Hi Power and GSI options

Regulation
Recovery within 2 kV in 50msec for 10% line variation

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System Specifications

Rise Time
< 1msec, to attain 75% of selected value

Fall Time
< 10 msec to fall below 75% of selected value

Generator Duty Cycle (Reference 21CFR 1020.30 (h)(3)(v))

The generator duty cycle is determined by the tube protection algorithm based on tube type used.

kV, mA, Linearity, and Time Accuracy

Kilovolts
kV Selections
80, 100, 120, and 140 kV

Basic kV Accuracy
(Reference 21CFR 1020.30 (h)(3)(vi))
Average kV to nominal kV: ± (3% + 2 kV)

Peak kV to Average kV: + 3% / -0%

Excludes first 10 msec of exposure

(Reference YY0310)
kV Tolerance is less than ± 9.5%

kV Accuracy for GSI

(21CFR 1020.30 (h)(3)(vi) and YY310)
Avg kV is 103kV

Tolerance is less than ± 10% (Including instrumentation)

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System Specifications

kV Accuracy for GSI SnapShot Pulse / GSI Cardiac presets

(21CFR 1020.30 (h)(3)(vi) and YY310)
Within +/- 10% of Average kV (per Table 12-33 and Table 12-34)

Milliamperes
Selections
10 to 835 mA, by 5 mA increments

mA Accuracy
(Reference 21CFR 1020.30 (h)(3)(vi))
Patient scanning selections of 10 to 835 mA ± (10% + 0.5 mA)

(Reference YY0310)
mA Tolerance is less than ± 20%

mA Accuracy for GSI Mode

Avg mA is 600mA

Tolerance is less than ± 20% (Including instrumentation)

mA Accuracy for Enhanced GSI Modes*

Avg mA is the Average mA (Table 12-33 and Table 12-34 Dose Values for GSI)

Tolerance is less than ± 20% (Including instrumentation)

mA Accuracy for GSI SnapShot Pulse / GSI Cardiac Presets**

Avg mA is the Average mA (Table 12-33 and Table 12-34)

Tolerance is less than ± 20% (Including instrumentation)

** GSI SnapShot Pulse / GSI Cardiac presets are available with GSI SnapShot Pulse option.

Linearity of X-ray Output (Reference IEC 60601-2-44)

Linearity of X-ray output for the small focal spot and large focal spot is as shown in Figure 16-10
below. The expected accuracy is ± 10%.

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System Specifications

Figure 16-10 Linearity of X-ray Output

Table 16-16

Number Description
1 Small Focal Spot
2 Large Focal Spot
3 Linear (Small Focal Spot)
4 Linear (Large Focal Spot)

Exposure Time
X-ray Exposure Time Accuracy (Reference 21CFR 1020.30 (h)(3)(vi) and YY310)
± 10% not to exceed 50 msec (includes 3% instrumentation accuracy)

Normal Axial
0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1, or 2 sec

Cine
Up to 60 seconds for a continuous exposure.

Helical (Continuous scans)

Up to 60 seconds for a single continuous exposure.

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System Specifications

Cardiac
 Cardiac Helical (SnapShot Segment, SnapShot Segment Plus, SnapShot Burst, SnapShot
Burst Plus) – Up to 60 seconds for a single continuous exposure (Gantry rotation speed is
0.35, 0.375, 0.4, 0.425, 0.45, 0.475 or 0.5 sec)
 Cardiac Cine (SnapShot Pulse) – 0.35 sec
 GSI Cardiac (GSI SnapShot Pulse) – 0.35 sec

Volume Shuttle (Axial)

Up to 5 minutes of Elapsed Time or 99 passes.

SmartView/SmartStep
Up to 90 seconds per confirm.

Volume Helical Shuttle

Up to 60 seconds of Elapsed Time.

Scout
 Scan range of 50 to 1900mm at 100mm/sec for VT2000x Table
 Scan range of 50 to 1900mm at 100mm/sec for VT2000 Table
 Scan range of 50 to 1600mm at 100mm/sec for VT1700 Table
 Exposure time: 0.50 to 20.0 sec (exposure time increases proportionally with scan distance
selection)

Measuring Tool Variance

Reference 21CFR 1020.30(h)(3)

kV
The above stated accuracies are subject to additional variation due to calibration and
measurement instruments.

kV: ± 4%

NOTE The above stated accuracies are subject to additional variation due to calibration and
measurement instruments.

mA
mA: ± 5%

NOTE The above stated accuracies are subject to additional variation due to calibration and
measurement instruments.

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System Specifications

Exposure Time
Time: ± 3%

Accuracy Subject to Following Conditions

Line Voltages
 Line voltage in specified range for nominal system voltages of 380 to 480.
 Line to line voltages balanced within 2%.

Line Regulation
6% or less.

Transient Voltage Variations Caused by External Loads Must Not:

 Exceed 5%
 Exceed 5 cycles duration
 Occur more than 10 times per hour
To comply with the requirements of 21 CFR 1020.30, accuracies are stated in terms of maximum
theoretical deviation from selectable operating parameters for all technique factor combinations.

For radiation output, the coefficient of variation is less than 0.05 for successive exposures with
constant technique factors.

Measurement Basis
(Reference 21CFR 1020.30 (h)(3)(viii))

Kilovolts
Precision 20,000:1 voltage divider is built into the system.

Resulting low voltage signal provides continuous closed-loop control of the average kV.

Signal is noise filtered and periodically monitored by the computer system.

Operator console displays monitored value during calibration.

Precision 10000:1 voltage divider, model HSM-160-FS provides external feedback during
calibration.

 Use a calibrated dual channel oscilloscope with a divider for reference.

 Check calibration of the low voltage kV measuring circuits.

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System Specifications

 Average kV values measured by the system are slightly lower than the peak kV during
exposure, due to high frequency ripple in the HV power supplies.
 The difference amplitude, a function of kV and exposure current, always falls within the stated
kVp accuracy.

Milliamperes
Precision shunt resistors, built into the system, measure the tube current component returned from
the secondary of the high-voltage transformer.

 The resulting signal provides continuous closed-loop control of the average mA.
 Signal is noise filtered and periodically monitored by the computer system
 Operator console displays the monitored value during calibration.
 Check calibration of the shunt resistors and the low voltage mA measuring circuit with a
calibrated digital milliammeter.

Exposure Time
Traditional Exposure time interval: Duration of time High voltage remains at or above 75% of
selected value.

Exposure time interval: Duration of the Expose Command signal within the Stationary Controller,
minus the HV rise time, plus its fall time with respect to the Expose Command signal.

HV components reside on the gantry rotating base.

During stationary scans, use an oscilloscope to measure the HV rise and fall times, with respect to
the Expose Command signal.

Use the oscilloscope to measure the Expose Command signal during stationary scans, to verify
internal time measurements.

Use the internal timer to monitor time during axial/helical scans.

Environmental Specifications
Ratings and duty cycles of all subsystems apply if the site environment complies with the following.

The specified environment must be constantly maintained, weekends, holidays, and throughout
the night.

Shutdown the CT system whenever the air conditioning fails.

Optional: Turn air conditioner OFF during CT shutdown for repair.

Prior to powering on the system, the room environmental operating conditions found in the System
Specification chapter must be maintained for at least 24 hours.

These conditions must be constantly maintained when the system is energized and/or in use.

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System Specifications

System Cooling Requirements

The cooling requirements do not include cooling for the room lighting, personnel, or non-CT
equipment present. Cooling requirements are listed by subsystem to allow planning for each room
of the CT suite.

 The recommended cooling requirements assume patient throughput limited by the tube
cooling algorithm.
Table 16-17 System Heat Dissipation

Minimum Allowance
Subsystem
(Watts / BTU/Hr)
Gantry / Table / PDU 10250/35000

Operator Console 1760/6000

Cooling values should not be used for calculating system input power
requirements.

Temperature and Humidity Specifications

Ambient Temperature

Scan Room (Recommended for Patient Comfort)

64° - 79° F (18° - 26° C) for patient comfort

Control Room (including Console/Computer)

64° - 79° F (18° - 26° C).

Table and Gantry In Exam Room (when room is unoccupied)

64° - 79° F (18° - 26° C)

Equipment Room (if separate room to hold PDU)

64° - 79° F (18° - 26° C)

Rate of Change
5°F/Hr Max (3°C)

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System Specifications

Room Temperature Uniformity

5°F Max Gradient (3°C)

Media (disks/tapes)
Keep long term storage media in the same temperature range as the computer, 64° - 79° F (18° -
26° C).

Relative Humidity (All Areas)

 30% - 60% (non-condensing) during operation, all areas.
 Rate of Change 5% RH/Hr Max
NOTE Use a temperature and humidity recorder to monitor the designated system area during
pre-installation and installation, to verify true temperature and humidity conditions.

Electromagnetic Interference
Consider the following when trying to reduce suspected Electromagnetic Interference (EMI):

 The external field strength from a source of magnetic field decreases rapidly with the distance
from the source.
 A bank of three single phase transformers generates a smaller magnetic field (less external
leakage) than a three-phase transformer with an equivalent power rating.
 Large electric motors generate substantial EMI.
 Steel reinforcing in the building structure can act as an effective conductor of EMI.
 High powered radio signals can affect computers.
 No substitute exists for proper screening of cables and cabinets.

Pollution
Individual components contain filters to optimize environmental conditions.

 Keep air pollution to a minimum.

 Keep the CT suite clean at all times.
 Do not have dust and fume generating work near the system.
 Keep component filters clean and free from obstructions

Carpeting
 Install anti-static carpeting - or- treat existing carpets with an anti-static solution.
 Static discharges affect operation and may cause system failures.
Do NOT use steel wool to clean tile floors in scan suite. Fine metal fibers can enter enclosures and
cause internal shorts.

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System Specifications

Lighting
Patient Comfort
Use a variable indirect light source between 20 – 100 foot candles in the scan room

Control Room
Select and position subdued light to reduce monitor reflections, and prevent operator eye strain

Equipment Room
Provide a bright light source for use during maintenance.

Altitude
 Minimum Altitude: -150 m (-492 feet) below sea level
 Maximum Altitude: 2400 m (7,875 feet) above sea level

16-32 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 17
Planned Maintenance

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Planned Maintenance

Planned Maintenance (Reference 21CFR 1020.30

(h)(1)(ii) and IEC 60601-1 6.8.2))
The following chart gives a description, and frequency of Planned Maintenance (P.M.) procedures.
Please refer to Direction 5307450-8EN for the details of each P.M. procedure and P.M. report
charts. Planned Maintenance schedule will be performed every three months for a total of four
Planned Maintenance activities per year.

Table 17-1 PM Schedule

Sub- System Task sections A B C D

System Initial Procedures X X X X
System Review Error Logs X X X X
System General Tasks X X X X
System System Scanning Test X X X X
Console General Cleaning and Inspection X X X X
High Voltage Tube Heat Exchanger and Pump X X X X
Gantry General Gantry Inspection / Grease main Bearing X X X X
Gantry Emergency Off/Stop (Table/Console) X X X X
Gantry Slip Ring and Brush Block Inspection and Maintenance X X X X
Gantry Gantry Filter Cleaning X X X X
Gantry General Tasks X X X X
Console RAID BBU Battery Functional Checks X
Gantry Laser Alignment Inspection X
System System Options X
Gantry Tilt Speed Adjustment X
Gantry Tilt Speed and 30 degree Functional Check X
Gantry Hydraulic Tilt Pump (Inspect for Leaks) X
Gantry CT Belt Tension and Adjustment X
High Voltage Collimator Inspection X
NGPDU Initial Checks X
NGPDU General tasks X
Gantry Encoder X
Table General Table Cleaning and Inspection X
High Voltage mA, kV, HHS Verifications X
Gantry Meter Verification X
Gantry High Voltage Tank Feedback Resistor Verification X
Gantry GSI Meter Verification (For systems with GSI option X
installed)

Schedule A, B, C, D - PM happens in order every three months.

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 
Chapter 18
Product Manufacturer

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Product Manufacturer

Product Manufacturer
This chapter lists the manufacturer of the Revolution Discovery CT product. The manufacturer
listed is authorized to CE mark the product listed.

Table 18-1 Revolution Discovery CT Product Manufacturer

Manufacturer (*)
Model Name Manufacturer Address
Manufacturing Site
Revolution GSI GE Medical Systems, LLC * 3000 N. Grandview Blvd. 
Revolution HD Waukesha, WI - 53188, USA
Discovery CT750 HD

18-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 19
CT Acceptance Testing

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CT Acceptance Testing

Introduction
This section describes the procedures for CT acceptance testing, based on IEC 61223-3-5, and
additional testing required by MHLW PAL EP6 (Japan) and JJG 1026-2007 (China).

 (Reference IEC 61223-3-5 Clause 5.1) on page 19-3

 (Reference IEC 61223-3-5 Clause 5.2) on page 19-3
 (Reference IEC 61223-3-5 Clause 5.3) on page 19-9
 (Reference IEC 61223-3-5 Clause 5.4 and IEC 60601-2-44: 2009 Clause 203.6.3.2) on page
19-15
 (Reference IEC 61223-3-5 Clause 5.5) on page 19-17
 (Reference IEC 61223-3-5 Clause 5.6) on page 19-18
 (Reference IEC 61223-3-5 Clause Optional) on page 19-21

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Positioning of The Patient Support

(Reference IEC 61223-3-5 Clause 5.1)
Positional accuracy of the patient support includes both longitudinal positioning and backlash
evaluation.

The accuracy of longitudinal patient support positioning is evaluated by moving the patient support
a defined distance in one direction and confirming the distance traveled.

The accuracy of moving the patient support in one direction and moving it back to the starting
position is referred to as backlash.

The test procedure and data evaluation process should be followed per IEC 61223-3-5.

Patient Positioning Accuracy

(Reference IEC 61223-3-5 Clause 5.2)

Test Equipment
A thin wire with a diameter of 1mm is preferred. In order to be aligned with the laser light, the wire
can be taped down on a flat surface and then placed on the cradle (see Figure 19-1).

Figure 19-1 A thin wire is taped on a flat box for patient positioning accuracy testing.

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Test Procedure for Internal/external Laser Light Accuracy

1. Remove cradle pad.

2. Put the wire with the box on the cradle and use the level to position the box as horizontal as
possible in both z and x directions.

3. Align the wire with the internal laser light field and make it parallel to the scan plane, and use
coronal Laser light to center the wire in the up/down direction.

4. Landmark the wire using internal landmark.

5. Scan the wire using the scan protocol as listed in Table 19-1.

6. For the external laser light accuracy, move the cradle out and align the wire with the external
laser light field, and use coronal laser light to center the wire in the up/down direction.

7. Landmark the wire using external landmark.

8. Scan the wire using the protocol as listed in Table 19-1.

Table 19-1 Scan protocols for axial internal/external light accuracy

Scan Scan Aperture/ Slice Scan Range and DFOV

kV mA SFOV Algorithm
mode speed(s) thickness (mm) Orientation (cm)
Internal Light Axial 120 260 1 Small Body 20 / 0.625 mm I9.688 to S9.688 Bone 10
Head First
External Light Axial 120 260 1 Small Body 20 / 0.625 mm I9.688 to S9.688 Bone 10
Head First

Test Procedure for Sagittal and Coronal Light Accuracy

1. Remove the cradle pad.

2. Put the wire with the box flat on the cradle and use the level to position the box as horizontal
as possible in both z and x direction.

3. Position the wire along the iso center using both sagittal (left/right) and coronal (up/down)
laser light, and for this test, the wire should be perpendicular to the scan plane.

4. Landmark the wire using internal landmark.

5. Scan the wire using the protocol as listed in Table 19-2.

Table 19-2 Scan protocol for sagittal/coronal light accuracy

Scan Scan Aperture/ Slice Scan Range and

kV mA SFOV Algorithm DFOV (cm)
mode speed(s) thickness (mm) Orientation
Axial 120 260 1 Small 20 / 0.625 mm I9.688 to S9.688 Bone 10
Body Head First

Data Evaluation
Select the image with the maximum wire CT number for evaluation. (See Figure 19-2). For internal
laser light, confirm that the wire is in the image with image location between I2 and S2. Record the
image location in Table 19-3.

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For external laser light, follow the similar procedure as in step 1 and record the image location in
Table 19-3.

1. For sagittal laser light, select the image in the middle row (image #16, for example), adjust the
window width and window level, so that the wire is round and clear in the image (for example,
ww =1500, wl =0). Then, place the cursor at the center of the wire. Record the Left/Right
coordinate value in Table 19-3. See Figure 19-3 for details.

2. For coronal laser light accuracy, record the A/P coordinate value in Table 19-3.

3. The specifications for both internal and external light accuracy are ± 2mm (I2 –S2). Sagittal
light accuracy is ± 2mm. (L2 –R2) Coronal light accuracy is ± 2mm (A2 - P2).

Table 19-3 Patient Positioning Accuracy Results and Specifications

Axial Internal Light Axial External Light Sagittal Light Coronal Light
Measured
Specifications ± 2mm or I2- S2 ± 2mm or I2-S2 ± 2mm or L2-R2 ± 2mm or A2-P2
Pass/fail

Figure 19-2 Internal and External Light Accuracy Image. Left image with maximum wire CT
number is used for evaluation and the image location with the brightest wire is I0.31.

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Figure 19-3 The sagittal and coronal light accuracy. Cursor coordinates are the values next to “R
or L” and “A or P”.

Preview Image Accuracy Test

(Reference IEC 61223-3-5 Clause 5.2.1.3.3)

Test Equipment
Mount the QA phantom on the phantom holder.

Test Procedure for Preview Image Accuracy Test

1. Center the QA phantom at high contrast spatial resolution section.

2. Scan a scout at 90 degree. If QA phantom is tilted to AP direction, then adjust the tilt and
center the QA phantom again.

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Figure 19-4

Table 19-4

Scan Range
Scan Scan Aperture / Slice DFOV
kV mA SFOV Algorithm
mode Speed(s) thickness (cm)
and Orientation
Axial 120 260 1 Small 20/0.625 mm Block edge Stnd 25
Body
Head First

3. Perform an axial scan according to Table 19-4, with the phantom positioned as shown in
Figure 19-4, displaying the scout with “Show Localizer”, then positioning the axial scan center
“X” on the edge of high contrast spatial resolution block as shown in Figure 19-4.

Data Evaluation
Review images to determine the image number which includes the edge of high contrast spatial
resolution block. Confirm the image number is between 14 and 19 (Specification is within ± 2mm).
See Figure 19-5.

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Figure 19-5

Table 19-5

Item Edge Image Number

Measured
Specification Between 14 and 19
Pass/Fail

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Tomographic Section Thickness

(Reference IEC 61223-3-5 Clause 5.3)

Tomographic Section Thickness for Axial Scan

Test Equipment
Per IEC 61223-3-5, any test device containing one or preferably two ramps with known angles to
the scan plane and with a linear attenuation coefficients of not less than that of aluminum and
suitable for measuring all available tomographic section thickness should be used.

GE Performance Phantom has a pair of tungsten wires with a slope of 1:2 (27o) vs. the scan plane
in both top and bottom of an acrylic block insert, but at opposite direction. (See Figure 19-6 for the
top wire.)

Figure 19-6 View from the top of a GE Performance phantom with tungsten wire at 27° vs. the
scan plane.

The thin tungsten wire has a diameter of 0.05mm, and linear attenuation much higher than that of
aluminum. With a slope of 1:2, the magnification at the scan plane is by 2x, therefore, a slice
thickness of 0.625mm (FWHM) in z will be projected to a length of 1.25 mm (FWHM) in the scan
plane.

Catphan® 600 is commercially available and has a module CTP404, which has two pairs of wire
ramps with angle of 23° vs. the scan plane (see Figure 19-7). For Catphan® 600, the magnification
factor in the imaging plane is 1/tan(23°)= 2.35, slightly greater than the wire in GE performance
phantom.

Testing can be done with either the GE Performance Phantom or the Catphan® 600.

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Figure 19-7 Catphan® 600 module CTP404 has two pairs of wire ramps, one pair parallel vs. x-
axis, the other parallel vs. y-axis. Ramp angle at 23°, equal to a slope of 1:2.35.

Test Procedure
1. Center GE Performance phantom at the mark. If Catphan® 600 is used, center it at module
CTP404.

2. Scan the phantom using the scan protocols as listed in Table 19-6. This table provides the
protocols for all the apertures available from the system. To evaluate specific aperture, please
select related protocol(s) from Table 19-6. Images with other slice thickness can be
retrospectively reconstructed.

3. Table 19-7 lists all the slice thickness combinations for each aperture. “N/A” means this slice
thickness is not available for the aperture.

4. Due to limited z-axis width of both phantom inserts, only center few rows are useful for the
slice thickness analysis when the phantom is centered in the middle of insert along z-axis,
especially when the aperture is wide (for example, 40mm). To study the slice thickness for
outer images, the phantom has to be offset in z-axis by 10mm.

5. To study the slice thickness for the outer images at the tableside (A-side), move the phantom
and center it at S10. To study the slice thickness of the outer images at the gantry side (B-
side), move the phantom to I10.

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Table 19-6 Scan protocols for measuring slice thickness

Aperture /slice
Scan scan Scan Range, DFOV
kV mA SFOV thickness Algorithm
mode speed (s) orientation (cm)
(mm)
Axial* 120 260 1 I18.75 to S18.75 Small Body 40 /2.5 Detail 15

Head First
Axial 120 260 1 I9.688 to S9.688 Small Body 20 /0.625 Detail 15

Head First
Axial 120 260 1 I4.688 to S4.688 Small Body 10 /0.625 Detail 15

Head First
Axial 120 260 1 I1.875 to S1.875 Small Body 5 /1.25 Detail 15

Head First
Axial 120 260 1 I0.625 to S0.625 Small Body 2.5 /1.25 Detail 15

Head First
Axial 120 260 1 S0 to S0 Small Body 1.25 /1.25 Detail 15

Head First

NOTE *64 x 0.625mm only available in retrospective recon mode.

Table 19-7 Combination of aperture and slice thickness

Aperture (mm) Slice thickness (mm)

0.625 1.25 2.5 5.0
40
20
10
5.0 N/A
2.5 N/A N/A
1.25 N/A N/A N/A

NOTE 10 mm slice thickness options are not available in this release.

Data Evaluation
The tomographic section thickness of an axial scan is evaluated by measuring the width of the
wire ramp along x-axis direction and then multiply the measured in-plane width by the tangent of
the ramp angle (vs. the scan plane.) For GE Performance phantom, the tangent of the ramp angle
is 0.5; for Catphan® 600, it is 0.42.

1. Use proper size ROI (ROI should be placed within the wire to get accurate CT number) to
measure the CT number of both wire and background.

2. Adjust the window width to 1, and the window level to average of the CT number of the wire
and the background.

3. In window width and level adjusted, measure the width of both top and bottom wire.

4. Take average of the two widths, and multiply the average by 0.5 for GE Performance phantom,
and 0.42 for Catphan® 600.

5. For a step-by-step example, see the next section.

6. The deviation of measured slice thickness is specified in Table 19-8.

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CAUTION The limiting measurement resolution of the cursor is 1mm, i.e., the distance less
than 1mm but greater than 0.5mm is rounded to 1mm, therefore, the accuracy of
this testing is limited by the cursor measurement capability. This is especially
important for thin slice measurement where the FWHM is close to 0.625mm. The
results for these thin slice images will be not as accurate as the thick slice ones.
This is the limitation by this testing method.

Table 19-8 Deviation for the slice thickness @ each aperture

Slice thickness (mm)

Aperture (mm)
0.625** 1.25 2.5 5.0
40 0.625±0.5 1.25± 0.625 2.5±1.0 5.0±1.0
20 0.625±0.5 1.25± 0.625 2.5±1.0 5.0±1.0
10 0.625±0.5 1.25±0.625 2.5±1.0 5.0±1.0
5.0 N/A 1.25±0.625 2.5±1.0 5.0±1.0
2.5 N/A 1.25±0.625 2.5±1.0 N/A
1.25 N/A 1.25±0.625 N/A N/A

** The limiting resolution of the cursor measurement is 1mm, i.e., the distance less than 1mm but
greater than 0.5mm is round to 1mm, therefore, the accuracy of this testing is limited by the cursor.
This is especially important for thin slice measurement where the FWHM is close to 0.625mm. The
results for these thin slice images will be not as accurate as the thick slice ones.

A Step-by-step Example for Slice Thickness Measurement Using GE Performance Phantom

1. Scan the GE Performance phantom using 2.5mm/0.625mm slice mode protocol as listed in
Table 19-6 and reconstruct the images at 2.5mm slice thickness.

2. In Figure 19-8, place a narrow rectangular ROI (make sure it is entirely within the wire) to
measure the CT number of the wire. Place a similar ROI in the background. In this example,
ROI 1 is placed at the background, and ROI 2 is inside the wire. The CT number for ROI 1 =-
0.63HU, ROI 2 = 227.17HU. Take the average ~114HU.

3. Set the window width to 1, and window level to 114HU. See the image in Figure 19-9 with new
window width and window level.

4. The width of both wires is measured in Figure 19-10. In this case, the length of top wire is
measured at 4mm, and the bottom is measured at 4mm. The average of two widths is 4mm.

5. Multiply the average by 0.5 for the GE Performance phantom, 4mm * 0.5 =2mm

6. Therefore, the measured slice thickness (FWHM) is 2mm. According to Table 19-8, the
expected slice thickness for this slice mode is 2.5mm±1mm.

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Figure 19-8 Place two ROIs to measure the CT number of wire and background.

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Figure 19-9 To measure FWHM from the image, set WW =1, and WL =114.

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Figure 19-10 Measured the width of both top and bottom wires: 4mm, 4mm.

Tomographic Section Thickness for Helical Scan

Per IEC 61223-3-5, the slice thickness for helical scan is optional. However, if the testing is
desired, refer to Annex G of IEC 61223-3-5 for detailed testing device and procedures.

Dose
(Reference IEC 61223-3-5 Clause 5.4 and IEC 60601-2-44: 2009 Clause
203.6.3.2)
For details in dosimetry, refer to Chapter 12 of the Technical Reference Manual, “Quality
Assurance”-> “Dosimetry”.

The dose measurement methodology in the Technical Reference Manual follows those described
in IEC 60601-2-44.

In this section, the protocols are proposed for CTDIw, CTDIfree air per IEC 61223-3-5, Clause 5.4
under head and body scan conditions. The specifications for CTDIw and CTDIfree air under these
proposed CT operating conditions are listed.

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Scan Protocols and Dose Specifications for CTDIw

Table 19-9 describes the scan protocols for CTDIw under head and body conditions.

Figure 19-10 is the expected CTDIw value and maximum deviation allowed, due to variations in
tube output, phantom setup, dosimeter centering and calibration errors.

Table 19-9 CTDIw scan protocols for Head and Body conditions

Aperture /
Scan CTDI Scan Scan speed Scan Range Slice DFOV
kV mA SFOV Algorithm
conditions phantom mode (s) Orientation thickness (cm)
(mm)
Head 16cm CTDI Axial 120 260 1 I7.5 to S7.5 Head 20mm/4x5 Stnd 25
phantom
Head First
Body 32cm CTDI Axial 120 260 1 I7.5 to S7.5 Large 40mm/8x5 Stnd 50
phantom Body
Head First

Table 19-10 Expected Head and Body CTDIw and Maximum Variation using scan
protocols defined in Table 19-9

Head Body
CTDIw 51.9mGy ± 40% 20.9 mGy ± 40%

Scan Protocols and Dose Specifications for CTDIfree air

Table 19-11 describes the scan protocols for CTDIfree air under head and body conditions.

Table 19-12 is the expected CTDIfree air value and maximum deviation allowed due to the
variations in tube output, dosimeter centering and calibration errors.

Table 19-11 Scan Protocols for CTDIfree air

Scanning Scan Scan speed

kV mA Scan Range SFOV Aperture (mm) Algorithm DFOV (cm)
Conditions mode (s)
Head Axial 120 260 1 I7.5 to S7.5 Head 20mm/4x5 Stnd 25
Head First
Head Axial 120 600 1 I7.5 To S7.5 Head 20mm / 4x5 Stnd 25
Head First
Body Axial 80 260 1 I17.5 to S17.5 Large Body 40mm/8x5 Stnd 50
Head First
Body Axial 100 260 1 I17.5 To S17.5 Large Body 40mm/8x5 Stnd 50
Head First
Body Axial 120 260 1 I17.5 To S17.5 Large Body 40mm/8x5 Stnd 50
Head First
Body Axial 140 260 1 I17.5 To S17.5 Large Body 40mm/8x5 Stnd 50
Head First
Body Axial 120 260 1 I 7.5 To S7.5 Large Body 20mm/4x5 Stnd 50
Head First
Body Axial 120 260 1 I2.5 To S2.5 Large Body 10mm/2x5 Stnd 50
Head First
Body Axial 120 260 1 S0 To S0 Head Large Body 5mm/1x5 Stnd 50
First

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Scanning Scan Scan speed

kV mA Scan Range SFOV Aperture (mm) Algorithm DFOV (cm)
Conditions mode (s)
Body Axial 120 260 1 S0 To S0 Head Large Body 2.5mm/ 1x2.5 Stnd 50
First
Body Axial 120 260 1 S0 To S0 Head Large Body 1.25mm / Stnd 50
First 1x1.25
Body Axial 120 600 1 I7.5 To S7.5 Large Body 40mm/ 8x5 Stnd 50
Head First
Body Axial 120 260 1 I7.5 To S7.5 Small Body 40mm/ 8x5 Stnd 32
Head First
Body Axial 120 600 1 I7.5 To S7.5 Small Body 40mm/ 8x5 Stnd 32
Head First
Body Axial 120 260 1 I7.5 To S7.5 Medium 40mm/ 8x5 Stnd 36
Head First Body
Body Axial 120 600 1 I7.5 To S7.5 Medium 40mm/ 8x5 Stnd 36
Head First Body

Table 19-12 Expected CTDIfree air for scan conditions under Table 19-11

Scanning Expected CTDIfree air and

Scan mode kV mA SFOV Aperture (mm)
Condition maximum deviations
Head Axial 120 260 Head 20mm/ 4 x 5 75.65 mGy ± 40%**
Head Axial 120 600 Head 20mm/ 4 x 5 178.31 mGy ± 40%**
Body Axial 80 260 Large Body 40mm/8x5 21.74 mGy ± 40%
Body Axial 100 260 Large Body 40mm/8x5 38.58 mGy ± 40%
Body Axial 120 260 Large Body 40mm/8x5 56.66 mGy ± 40%**
Body Axial 140 260 Large Body 40mm/8x5 82.71 mGy ± 40%
Body Axial 120 260 Large Body 20mm/4x5 62.92 mGy ± 40%
Body Axial 120 260 Large Body 10mm/2x5 71.18 mGy ± 40%
Body Axial 120 260 Large Body 5mm/1x5 86.04 mGy ± 40%
Body Axial 120 260 Large Body 2.5mm/ 1x2.5 88.92 mGy ± 40%
Body Axial 120 260 Large Body 1.25mm/1x1.25 120.48 mGy ± 40%
Body Axial 120 600 Large Body 40mm/8x5 133.44 mGy ± 40%**
Body Axial 120 260 Small Body 40mm/8x5 71.22 mGy ± 40%**
Body Axial 120 600 Small Body 40mm/8x5 168.15 mGy ± 40%**
Body Axial 120 260 Medium Body 40mm/8x5 71.34 mGy ± 40%**
Body Axial 120 600 Medium Body 40mm/8x5 168.27 mGy ± 40%**

NOTE ** Each data point from a set of 10 measurements is within ±10% of the mean of the set of
those 10 measurements.

Noise, Mean CT Number and Uniformity

(Reference IEC 61223-3-5 Clause 5.5)

Test Equipment
For head scanning, an outside diameter of 20cm cylindrical water phantom, such as GE Quality
Assurance (QA) phantom should be used for noise, CT number and uniformity measurement.

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For body scanning, an outside diameter of 30cm to 35cm cylindrical water phantom should be
used. A 35cm diameter Polyethylene phantom may be obtained through GE, which has total
attenuation at least equivalent to 30cm of water. Therefore, it is recommended to use 35cm
Polyethylene phantom in body scanning technique.

Test Procedure
The detailed test procedures and data evaluation for noise, mean CT number and uniformity
measurements are well described in IEC 61223-3-5 Sections 5.5.3 and 5.5.4.

Expected Results and Variations

This is for Noise, Mean CT number and Uniformity results and Variations.

Table 19-13 describes the scanning protocols for head condition using 20cm GE Quality
Assurance (QA) phantom and body condition using 35cm GE Polyethylene phantom.

Table 19-14 describes the expected results and variations based on scanning conditions in Table
19-13. The recommended measurement basis is to scan the technique in Table 19-13 four times,
and apply the specification to the average of the noise measurements taken in the water section of
the phantom.

NOTE For daily QA measurements, please refer to the Quality Assurance chapter.

Table 19-13 Scan Protocols for Head and Body Scanning Conditions

Aperture/
scanning Scan scan speed Scan slice
kV mA SFOV Algorithm DFOV (cm)
condition mode (s) range thickness
(mm)
Head Axial 120 260 1 I17.5 To Head 40/ 8x5 Stnd 25
S17.5

Head First
Body Axial 120 260 1 I17.5 To Large body 40/ 8x5 Stnd 35
S17.5

Head First

Table 19-14 Expected results for head and body scanning conditions in Table 19-13

Noise Mean CT number Uniformity

Head, QA phantom <= 0.5% or 0 ± 3HU 0 ± 3HU

<= 5 HU
Body, 35cm poly phantom <= 1.4% or -95 ± 6HU 0 ± 8HU

<= 14 HU

Spatial Resolution
(Reference IEC 61223-3-5 Clause 5.6)

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Test Equipment
GE Performance phantom has a 0.05mm diameter tungsten wire perpendicular to the imaging
plane. This phantom can be used to evaluate the system Modulation Transfer Function (MTF)
combined with an automated software tool implemented in the GE system.

Test Procedure and Data Evaluation

1. Center the GE performance phantom along the mark.

2. Scan the phantom using the scan protocols as listed in Table 19-15

3. Due to limited width of the tungsten wire for GE performance phantom in z-axis, select the
center two images (images #4 and #5) for MTF analysis.

4. GE provides an automated tool for the MTF analysis. Use automatic MTF evaluation tool
(ImageAnalysis2) from the system to find the MTF results.

a. From “Service” desktop -> “Image Quality” tab ->”Image Analysis” button ->
ImageAnalysis2->”Manual” button-> “MTF_50_10”

b. Select the center two images (image 4 and 5) from the ImageWorks browser

c. Click “Accept” button to calculate the mean MTF50 and MTF10 values. See Figure 19-11.

d. If ImageAnalysis2 doesn’t analyze the proper wire image (GE Performance phantom has
several wires), move the outer rectangular ROI to the area where the wire is located, and
click “Accept Modification” button. MTF values for the wire will be re-calculated. See
Figure 19-11.

5. The ImageAnalysis2 displays the MTF50 and MTF10 values for each individual image and
also the average of these values. See Figure 19-11.

Table 19-15 Scan protocols for spatial resolution evaluation for head and body
conditions. "Stnd" algorithm is used for normal resolution, and "Edge" algorithm is used
for high resolution.

Slice
Scan speed Scan range / DFOV
Scan mode kV mA SFOV thickness Algorithm
(s) Orientation (cm)
(mm)
Axial 120 260 1 I17.5 to S17.5 Medium 8x5 Stnd 25
Body*
Head First
Axial 120 260 1 I17.5 to S17.5 Medium 8x5 Edge 10
Body*
Head First
Axial 120 260 1 I17.5 to S17.5 Large Body 8x5 Stnd 25

Head First
Axial 120 260 1 I17.5 to S17.5 Large Body 8x5 Edge 10

Head First

NOTE * Head SFOV is using Medium Body bowtie filter

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Figure 19-11 ImageAnalysis2 for MTF analysis using wire images from GE Performance
phantom (top) and the MTF results for the images selected from ImageWorks browser.

Expected Results and Tolerance

Expected MTF50 and MTF10 values are listed in Table 19-16 for the scan conditions from Table
19-15. The accuracy specification is listed as “>=” (no less) than the expected values.

Table 19-16 Expected MTF50 and MTF10 with Tolerance.

SFOV Algorithm 50% MTF 10% MTF

Head (Medium Body) * Standard >=3.8 >=6.1
Edge >=8.5 >=13.0
Body (Large Body) Standard >=3.8 >=6.1
Edge >=8.5 >=13.0

*: Head SFOV is using medium body bowtie filter.

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Low Contrast Resolution (or low contrast detectability (LCD))

(Reference IEC 61223-3-5 Clause Optional)
Low contrast resolution is optional for IEC 61223-3-5, but required by other regulatory bodies,
such as MHLW and SFDA, as part of the acceptance test.

Test Equipment
Catphan® 600 is a commercially available CT phantom. Its solid image uniformity module CTP486
can be used to evaluate the low contrast resolution (LCD) in a statistical manner (see Figure 19-
12). Module CTP515 can be used to evaluate visual low contrast resolution. However, the visual
low contrast resolution is highly subjective and requires observer’s study based on a large
population to get accurate results, therefore, in this section, a statistical method is used.

The alternative to Catphan® 600 for the statistical low contrast resolution measurement is the GE
Quality Assurance (QA) phantom. The uniform water section of the phantom can be used to
measure the statistical Low Contrast Detectability (or LCD).

Figure 19-12 Module CTP486 is used for Low Contrast Detectability (statistical) evaluation.

Test Procedure and Data Evaluation Using Catphan® 600

1. Center Catphan® 600 at the module CTP486.

2. Scan the phantom using the protocols as listed in Table 19-17.

3. Due to limited width along z-axis for the module CTP486, use only center 4 images (#3, 4, 5,
6) for analysis.

4. GE scanner has an automated tool to calculate statistical LCD values.

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a. From “Service” desktop -> click “Image Quality” tab ->click ‘Image Analysis” button ->in
“ImageAnalysis2” ->”Manual” button-> “LCD”. (See Figure 19-13).

b. Select the center four image(s) from the ImageWorks browser

c. Click “Accept” button.

d. In the LCD popup window “Input hole diameter (mm)”. Click the “OK” button to use the
default value of 3.00 for the object size (=3mm).

 A result panel will show the calculated LCD values for each individual image and the
average from all four images as shown in Figure 19-13. The individual results are
listed under column “% Contrast @95% CL”. The average LCD result is listed under
the column “Avg % Cnst@ 95% CL” as shown in Figure 19-13.
Table 19-17 Scan Protocols for Catphan® 600

Aperture/ slice
Scan Scan DFOV Images for
Scan mode kV mA Pitch SFOV thickness Algorithm
speed (s) Range (cm) LCD analysis
(mm)
Axial 120 605 1 I17.5 To N/A Small 40 8x5 Stnd 22.7 center 4
S17.5, Body images
Head First
Helical 120 310 1 I17.5 To 0.516 Small 40 8x5 Stnd 22.7 center 4
S17.5, Body images
Head First

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Figure 19-13 The LCD tool (upper half) panel and the result panel which displays the LCD
results for each individual image and the average of four images.

Test Procedure and Data Evaluation Using GE QA Phantom

1. Center the GE QA phantom at the middle of the water section.

2. Scan the phantom using the protocols as listed in Table 19-18.

3. For axial mode, only 1 scan is required. To avoid beam collimation induced artifacts, use only
center 4 images (#3, 4, 5, 6) for analysis in the axial mode.

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 19-23

CT Acceptance Testing

4. For helical mode, repeat the same scan four times to generate 4 images. All 4 images should
be selected for analysis.

5. GE scanner has an automated tool to calculate statistical LCD values.

a. From “Service” desktop -> click “Image Quality” tab ->click ”Image Analysis” button ->in
“ImageAnalysis2” ->”Manual” button-> “LCD”. (See Figure 19-13).

b. For axial mode, select the center 4 images from the ImageWorks browser; for helical
mode, select all 4 images reconstructed.

c. Click “Accept” button.

d. In the LCD popup window “Input hole diameter (mm)”. Click the “OK” button to use the
default value of 3.00 for the object size (=3mm).

e. A result panel will show the calculated LCD values for each individual image and the
average from all four images as shown in Figure 19-13. The individual results are listed
under column “Contrast @95 % CL”. The average LCD result is listed under the column
“Avg% Cnst@ 95 % CL” as shown in Figure 19-13.

Table 19-18 Scan protocols for QA phantom

slice
Scan Scan No of DFOV Images for
Scan mode kV mA Pitch SFOV mode Algorithm
speed (s) Range scans (cm) LCD analysis
(mm)
Axial 120 260 1 I17.5 To N/A 1 Small 40/ 8x5 Stnd 22.7 center 4
S17.5, Body images
Head
First
Helical 120 135 1 S0 To S0 0.516 4 Small 40/ 5 Stnd 22.7 all 4 images
Head Body
First

Expected Results and Variations

 For Catphan® 600, the expected statistical Low Contrast Resolution value and tolerance are
listed in Table 19-19 for scan conditions in Table 19-17.
 Due to added attenuation from the acrylic shell of the QA phantom, and also lower dose (mAs)
used in both axial and helical scan modes, as in Table 19-18, the expected statistical Low
Contrast Detectability (Resolution) specifications are different from the ones for Catphan®
600. See Table 19-19.
Table 19-19 Statistical Low Contrast Detectability (Resolution) Specifications

Phantom Scan Mode LCD Specification

Catphan® 600 Axial <= 3.5 HU
Helical <= 3.5 HU
GE QA phantom Axial <= 6.0 HU
Helical <= 6.0 HU

19-24 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Chapter 20
Abbreviations

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 20-1

Abbreviations

Abbreviations
Table 20-1 Abbreviations

Abbreviations Acronym
ASiR Adaptive Statistical Iterative Reconstruction
AW Advantage Workstation
CFR Code of Federal Regulations
CISPR International special committee on Radio Interference
cm centimeter
CRT Cathode Ray Tube
CSA Canadian Standards Association
CT Computed Tomography
CTDI Computed Tomography Dose Index
DAS Data Acquisition System
degree º
DFOV Display Field of View
DICOM Digital Imaging and Communication in Medicine
DLP Dose Length Product
ECG Electro cardiogram
EFUP Environment-friendly Use Period
EHS Environmental Health and Safety
EMC Electro-magnetic Compatibility
EMI Electro-magnetic Immunity
FAQ Frequently Asked Questions
FBDIMM Fully Buffered Dual Inline Memory Module
FWHM Full Width Half Maximum
FWTM Full Width Tenth Maximum
GSI Gemstone Spectral Imaging
HD High Definition
HU Hounsfield Units
HV High Voltage
HVL Half Value Layer
IEC International Electro-technical Commission
IGD Inter-group Delay
IPD Inter-patient Delay
ISD Inter-scan Delay
ISO Iso-center
IV Intra-venous
kg kilogram
kV kilo-volts
kW kilo-watts
lb pound
LCD Liquid Crystal Display
LCD Low Contrast Detectability
mA milli-amps
MD Material Density
MDC Main Disconnect Control
mGy milligray
ml milliliter
mm millimeter
MTF Modulation Transfer Function

20-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Abbreviations

Abbreviations Acronym
NCRP National Council on Radiation Protection and Measurements
OC Operator’s Console
ODM Organ Dose Modulation
Pa Pascal
PDU Power Distribution Unit
PM Planned Maintenance
PMMA Poly-methyl methacrylate
QA Quality Assurance
QEF Quality Equivalent Filtration
QSR Quality System Regulation
RAID Redundant Array of Independent Disks
RAM Random Access Memory
RF Radio Frequency
ROI Region of Interest
ROM Read Only Memory
S or “Sec” Second
SATA Serial Advance Technology Attachment
SCIM Scan Control Intercom Module
SFOV Scan Field of View
SSP Slice Sensitivity Profile
UL Underwriters’ Laboratories
VHS Volume Helical Shuttle
VS VolumeShuttle
WL Window Level
WW Window Width

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT 20-3

Abbreviations

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20-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Appendix A
Dose Information Reference

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT A-1

Dose Information Reference

Dose Information References

Table A-1 User Manual

Chapter Title
2 CTDIvol

Pediatric and Small Patient Imaging

Scanning Large Patient

4 Imaging Pediatric and Small Patients
10 Dose Reports

Dose Features and Technology

6 Dose Check
10 Reference Noise Index and Noise Index
Values

Auto mA

Auto mA Theory

mA Control

SmartmA

Auto mA FAQ’s

ASiR

Dose Reduction Guidance

Perfusion

kV Assist Theory

kV Assist

kV Assist FAQ

Automatic Exposure Control

Organ Dose Modulation

10 Set Scan Parameters

A-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Dose Information Reference

Table A-2 Technical Reference Manual

Chapter Title
2 Radiation Protection
3 CTDIvol

Pediatric and Small Patient Imaging

Organ Dose Modulation

11 Z-Axis Tracking

Dynamic Z-Axis Tracking

Automatic Exposure Control

Auto mA

Auto mA Theory

Auto mA FAQ’s

kV Assist Theory

kV Assist

kV Assist FAQ

Scout Based Attenuation Characterization

ECG-Modulated mA Theory

Scan Parameters

ASiR

Organ Dose Modulation

12 Dosimetry

Dose Profile

Radiation Protection

Radiation Field
16 Dose Performance
19 Dose

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT A-3

Dose Information Reference

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A-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 
Appendix B
Reference Noise Index

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT B-1

Reference Noise Index

Reference Noise Index

Table B-1 Configured to deliver lower noise in the images at a higher mA value

# Anatomy Mode 5.0 mm 3.75 mm 2.5 mm 1.25 mm 0.625 mm

1 Head Normal 2.80 3.00 3.80 5.20 7.00
2 Orbit Normal 2.80 3.00 3.80 5.20 7.00
3 Neck Normal 6.63 7.02 9.10 12.22 12.60
4 Upper Extremity Normal 9.88 10.66 13.52 18.33 19.00
5 Chest Normal 9.88 10.66 13.52 18.33 19.00
6 Abdomen Normal 9.88 10.66 13.52 18.33 19.00
7 Spine Normal 9.88 10.66 13.52 18.33 19.00
8 Pelvis Normal 9.88 10.66 13.52 18.33 19.00
9 Lower Extremity Normal 9.88 10.66 13.52 18.33 19.00
10 Miscellaneous Normal 9.88 10.66 13.52 18.33 19.00

Table B-2 Configured to deliver average noise in the images at a average mA value

# Anatomy Mode 5.0 mm 3.75 mm 2.5 mm 1.25 mm 0.625 mm

1 Head Normal 2.80 3.00 3.80 5.20 7.00
2 Orbit Normal 2.80 3.00 3.80 5.20 7.00
3 Neck Normal 6.63 7.02 9.10 12.22 12.60
4 Upper Extremity Normal 11.57 12.35 15.86 21.45 22.10
5 Chest Normal 11.57 12.35 15.86 21.45 22.10
6 Abdomen Normal 11.57 12.35 15.86 21.45 22.10
7 Spine Normal 11.57 12.35 15.86 21.45 22.10
8 Pelvis Normal 11.57 12.35 15.86 21.45 22.10
9 Lower Extremity Normal 11.57 12.35 15.86 21.45 22.10
10 Miscellaneous Normal 11.57 12.35 15.86 21.45 22.10

Table B-3 Configured to deliver higher noise in the images at a lower mA value

# Anatomy Mode 5.0 mm 3.75 mm 2.5 mm 1.25 mm 0.625 mm

1 Head Normal 2.80 3.00 3.80 5.20 7.00
2 Orbit Normal 2.80 3.00 3.80 5.20 7.00
3 Neck Normal 6.63 7.02 9.10 12.22 12.60
4 Upper Extremity Normal 13.13 14.17 18.07 24.57 25.30
5 Chest Normal 13.13 14.17 18.07 24.57 25.30
6 Abdomen Normal 13.13 14.17 18.07 24.57 25.30
7 Spine Normal 13.13 14.17 18.07 24.57 25.30
8 Pelvis Normal 13.13 14.17 18.07 24.57 25.30
9 Lower Extremity Normal 13.13 14.17 18.07 24.57 25.30
10 Miscellaneous Normal 13.13 14.17 18.07 24.57 25.30

B-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

 Index
A Dose 3-30
Abbreviations 20-1 Accumulated Exam DLP 3-30
Address Dose Length Product 3-30
CT Service Engineering 1-6 Projected Series DLP 3-30
Alignment Light Dosimetry and Performance
Alignment Light Accuracy test 12-20 Maximum Deviation 12-61
Axial 11-48 MTF 12-62
Noise 12-62
B
Nominal Slice Thickness 12-58
Beam Quality Check 6-2, 11-5
Sensitivity Profile 12-62
C
E
Calibration
Electromagnetic Compatibility 15-1
General information 11-63
Electromagnetic Interference 16-31
Calibration Scans 11-63
Emergency Stop 11-2
CAM Collimator 11-17
Environmental Specifications 13-2, 16-29
Cardiac Helical Overview 11-51
Altitude 16-32
Cardiac Helical Slice Profiles 11-63
Ambient Temperature 16-30
Check Disk Space 8-1
EMI 16-31
Image space 8-2
Lighting 16-32
CT
Pollution 16-31
General information 11-2
Relative Humidity 16-31
Operation Theory 11-2
System Cooling Requirements 16-30
CT Acceptance Testing 19-1
CT Description 11-2 F
CT Number 11-65 Fast Cal 6-1
General information 11-65 Fast Calibration 6-4
Pixels and CT Numbers 11-70 Fastcal
System Performance 12-8 Daily procedure 6-2
Window Width 11-70 Filament Selection 11-60
CT Safety 3-13 Focal Spot 11-60
CTDIw 3-30
G
D Gantry
Daily Fastcal Procedure 6-1 Subsystem Specifications 16-21
Daily Prep 6-3 Gantry Coordinate System 11-15
DAS General Information 11-1
Data Collection 11-61 Calibration Scans 11-63
Data Collection 11-61 CT Description 11-2
General information 11-61 CT Number 11-65
Data Storage 11-63 CT Operation Theory 11-2
General information 11-63 Data Collection 11-61
DICOM Print 11-3 Data Storage 11-63
Disk Space 8-1 DFOV and Pixel Size 11-68
Disk space 8-2 Filament Selection and Scan Thickness 11-60
Display Filament Selection Table 11-60
General information 11-64 Focal Spot 11-60
Documentation 4-1 Gray Scale 11-64
Image Display 11-64
Pixel Coordinates 11-66
Pixels 11-66

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT Index-1

 Pixels and CT Numbers 11-70 Measurement Basis 16-29
RAS coordinates 11-68 Maintain Image Quality 12-5
Reconstruction 11-61 Matrix
Tube Warmup 11-5 Pixel Coordinates 11-66
Variables you cannot control 11-66 MDC 10-5
Window Width 11-70 Mean 11-70
X-Ray 11-3 Media
X-Ray Tube Capacity Media 16-31
X-Ray Tube 11-59 Model Numbers 16-2
General information Modulation Transfer Function (MTF)
X-Ray 11-3 MTF 12-61
Generator Specifications MTF 12-61
Exposure Time 16-26, 16-29 Maximum Deviation 12-62
Kilovolts 16-24, 16-28 MTF test 12-10
kV, mA and Time Accuracy 16-24 Mylar ring 7-2
Main Power Supply 16-23 Mylar Window Check 6-4
Measurement Basis 16-28
N
Measuring tool variance 16-27
Noise 12-56
Milliamperes 16-25, 16-29
Maximum Deviation 12-62
Gray Scale 11-64
General information 11-64 O
Operator Documentation 4-1
H
Helical Overview 11-49 P
Helical Scan Data Usage 11-63 Pediatric Imaging 11-47
Help Performix™ HD X-Ray Tube Specifications 13-1
CT Applications phone number 1-4 Phantom
GE CARES phone number 1-4 Alignment Light Accuracy test 12-20
Center Phantom in FOV 12-6
I
Contrast Scale test 12-8
Image Display 11-64
High Contrast Spatial Resolution test 12-9
Image Quality
MTF test 12-10
Calibration and Scan Image Quality 12-4
Noise and Uniformity test 12-13
Maintain image quality 6-2
Phantoms and Procedures 12-56
Phantom Image Test and Analysis
QA Phantom description 12-2
System Performance 12-8
Slice Thickness test 12-17
QA Schedule
Test and Analyze QA Phantom Images 12-8
QA Procedure 12-4
Phone numbers
System Performance
CT Applications assistance 1-4
System Performance 12-5
GE CARES 1-4
Image Space 8-2
Pixel Coordinates 11-66
Image space 8-2
Pixels 11-66
Interventional / Biopsy Scanning 3-57
DFOV and Pixel Size 11-68
K General information 11-66
kV Pixel Coordinates 11-66
Accuracy 16-24 Pixels and CT Numbers 11-70
Measurement Basis 16-28 RAS Coordinates 11-68
Window Width 11-70
L
Pixels and CT Numbers 11-70
Limited Access Room Configuration
Planned Maintenance
3-75
Console 17-2
M HV System 17-2
mA Prepare the System
Accuracy 16-25 Overview sheet 7-1

Index-2 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

Product Manufacturer 18-1 Start Up 7-1, 10-1
Subsystem Specifications
Q
Detector 16-19
QA 12-1
Gantry 16-21
Position the phantom 12-5
Table 16-19
QA Phantom 12-2
System components 11-2
QA Procedure 12-1
System Data and Control Flow 11-14
Center QA Phantom in FOV 12-6
System Dimensions 16-2, 16-6
Copy the QA Data form 12-2
System Operational Modes 11-47
Prescribe the QA Series 12-6, 12-15, 12-17
System Performance 12-5
QA Schedule 12-4
Alignment Light Accuracy 12-20
System Performance
Analyze the QA Images 12-7
System Performance 12-5
Contrast Scale 12-8
Typical Results & Variations 12-20
High Contrast Spatial Resolution 12-9
QA Schedule 12-4
Maintain Image Quality 12-5
Quality Assurance 12-1
Maximum Deviation 12-61
Image Quality 12-1
MTF 12-10, 12-62
QA Procedure 12-1
Noise 12-56, 12-62
System Performance
Noise and Uniformity 12-13
System Performance 12-5
Phantoms and Procedures 12-56
R Sensitivity Profile 12-62
RAS Slice Thickness 12-17
Coordinates 11-68 Typical Results & Variations 12-20
RAS Coordinates 11-68 System Shutdown 9-2
Reconstruction 11-61 System Specifications 16-1
General information 11-61 CT Scan Ratings 13-4
Regulatory Information 14-1 Diagnostic Source Assembly 13-3
Reset 9-1 Environment 13-2
Reset Procedures 9-2 Environment See Environmental Specifications 16-
Revision History i-1 29
kV, mA and Time Accuracy 16-24
S
Measurement Basis 16-28
Safety 3-1, 14-1
Measuring tool variance 16-27
Scan Duration
Model Numbers 16-2
Accuracy 16-26
Performix Ultra Tube Insert 13-12
Measurement Basis 16-29
Subsystem Specifications See Subsystem
Scan Parameters 11-61
Specifications 16-18
Scan Thickness
System Dimensions 16-2, 16-6
Filament Selection Determines Range 11-60
Target Load in Kilowatts table 13-4
Nominal Slice Thickness 12-58
System Warmup 5-1
Slice Thickness test 12-17
Scan Time T
Duration and accuracy 16-26 Table
Scout 11-47 Subsystem Specifications 16-19
Sensitivity Technical Reference Manual 1-3
Maximum Deviation 12-62 Temperature & Humidity Specifications 16-30
Shutdown System 10-2 Tube Warmup 5-1, 11-5
Space on Disks General information 11-5
Maintain Image Space 8-1 Two hours elapse between exams 5-1
Spatial Resolution 12-9
U
Standard Deviation 11-70
user 4-2

5507106-1EN Rev 1 May 2014 Revolution™ Discovery™ CT Index-3

 V X-ray Protection 2-1
Variables You Cannot Control 11-66 X-Ray Tube
Variables you cannot control 11-66 Filament Selection 11-60
Filament Selection Table 11-60
W
Focal Spot 11-60
Warmup 5-1, 6-4
X-Ray Tube Capacity 11-59
Window Level 11-70
X-Ray Tube Specifications
Window Width 11-70
CT Scan Ratings 13-4
General information 11-70
Diagnostic Source Assembly 13-3
Pixels and CT Numbers 11-70
Performix Ultra Tube Insert 13-12
X
Z
X-Ray
Z-Axis Cell Summation 11-17
General information 11-3
X-ray Generation and Detection Details 11-15

Index-4 Revolution™ Discovery™ CT 5507106-1EN Rev 1 May 2014

© 2014 General Electric Company. All rights reserved.
GE Medical Systems, LLC
3000 N. Grandview Avenue
Waukesha, Wisconsin 53188
USA

www.gehealthcare.com