Dose Report

1. Patient: HILDA CARAMUTI VALERA (female, *1944-01-12, #6115)
Referring Physician: CARBONEL ARACELLY
Study: Abdomen^TX_ABD_PEL_CONTRASTE (Adult) (#1)
Series: Dose Report (#502)
Manufacturer: SIEMENS (SOMATOM Scope, #99222)
Completion Flag: COMPLETE
Verification Flag: UNVERIFIED
Content Date/Time: 2021-06-19 16:31:39
X-Ray Radiation Dose Report
Concept Modifier: Procedure reported = Computed Tomography X-ray (P5-08000, SRT)
Concept Modifier: Has Intent = Diagnostic Intent (R-408C3, SRT)
Observation Context: Observer Type = Device (121007, DCM)
Observation Context: Device Observer UID = 99222
Observation Context: Device Observer Name = "CT99222"
Observation Context: Device Observer Manufacturer = "SIEMENS"
Observation Context: Device Observer Model Name = "SOMATOM Scope"
Observation Context: Device Observer Serial Number = "99222"
Observation Context: Device Observer Physical Location during observation = "DPI DR ROSAS"
Observation Context: Start of X-Ray Irradiation = 2021-06-19 16:28:39
Observation Context: End of X-Ray Irradiation = 2021-06-19 16:31:31
Observation Context: Scope of Accumulation [Annex 1]
CT Accumulated Dose Data
Total Number of Irradiation Events:
3 {events}
CT Dose Length Product Total:
1031.93 mGy.cm
CT Acquisition
Acquisition Protocol:
Topograma
Target Region:
Abdomen (T-D4000, SRT)
CT Acquisition Type:
Constant Angle Acquisition (113805, DCM)
Procedure Context:
CT without contrast (P5-0808E, SRT)
Irradiation Event UID:
2.30000021061912212792900000080
CT Acquisition Parameters
Exposure Time:
6.95 s

2. Scanning Length:
612.5 mm
Nominal Single Collimation Width:
0.6 mm
Nominal Total Collimation Width:
2.4 mm
Number of X-Ray Sources:
1 {X-Ray sources}
CT X-Ray Source Parameters
Identification of the X-Ray Source:
A
KVP:
130 kV
Maximum X-Ray Tube Current:
25 mA
Mean X-Ray Tube Current:
25 mA
CT Dose
Mean CTDIvol:
0.07 mGy
CTDIw Phantom Type:
IEC Body Dosimetry Phantom (113691, DCM)
DLP:
4.58 mGy.cm
Dose Check Alert Details
DLP Alert Value Configured:
No (R-00339, SRT)
CTDIvol Alert Value Configured:
Yes (R-0038D, SRT)
CTDIvol Alert Value:
1000 mGy
Dose Check Notification Details
DLP Notification Value Configured:
No (R-00339, SRT)
CTDIvol Notification Value Configured:
No (R-00339, SRT)
X-Ray Modulation Type:
OFF
Comment:
Internal technical scan parameters: Organ Characteristic = "Abdomen", Body Size = "Adult", Body
Region = "Body", X-ray Modulation Type = "OFF"
Device Role in Procedure:
Irradiating Device (113859, DCM)

3. Properties: Device Name = "SOMATOM Scope"
Properties: Device Manufacturer = "SIEMENS"
Properties: Device Serial Number = "99222"
CT Acquisition
Acquisition Protocol:
TX ABD
Target Region:
Abdomen (T-D4000, SRT)
CT Acquisition Type:
Spiral Acquisition (P5-08001, SRT)
Procedure Context:
CT without contrast (P5-0808E, SRT)
Irradiation Event UID:
2.30000021061912212792900000081
CT Acquisition Parameters
Exposure Time:
16.9 s
Scanning Length:
608 mm
Exposed Range:
629.8 mm
Nominal Single Collimation Width:
1.2 mm
Nominal Total Collimation Width:
19.2 mm
Pitch Factor:
1.5 {ratio}
Number of X-Ray Sources:
1 {X-Ray sources}
CT X-Ray Source Parameters
Identification of the X-Ray Source:
A
KVP:
130 kV
Maximum X-Ray Tube Current:
180 mA
Mean X-Ray Tube Current:
167 mA
Exposure Time per Rotation:
0.8 s
CT Dose
Mean CTDIvol:
8.76 mGy
CTDIw Phantom Type:

4. IEC Body Dosimetry Phantom (113691, DCM)
DLP:
532.86 mGy.cm
Dose Check Alert Details
DLP Alert Value Configured:
No (R-00339, SRT)
CTDIvol Alert Value Configured:
Yes (R-0038D, SRT)
CTDIvol Alert Value:
1000 mGy
Dose Check Notification Details
DLP Notification Value Configured:
No (R-00339, SRT)
CTDIvol Notification Value Configured:
No (R-00339, SRT)
X-Ray Modulation Type:
XYZ_EC
Comment:
Internal technical scan parameters: Organ Characteristic = "Abdomen", Body Size = "Adult", Body
Region = "Body", X-ray Modulation Type = "XYZ_EC"
Device Role in Procedure:
Irradiating Device (113859, DCM)
Properties: Device Name = "SOMATOM Scope"
Properties: Device Manufacturer = "SIEMENS"
Properties: Device Serial Number = "99222"
CT Acquisition
Acquisition Protocol:
TX ABD CC
Target Region:
Abdomen (T-D4000, SRT)
CT Acquisition Type:
Spiral Acquisition (P5-08001, SRT)
Procedure Context:
CT without contrast (P5-0808E, SRT)
Irradiation Event UID:
2.30000021061912212792900000085
CT Acquisition Parameters
Exposure Time:
17.34 s
Scanning Length:
624 mm
Exposed Range:
645.8 mm

5. Nominal Single Collimation Width:
1.2 mm
Nominal Total Collimation Width:
19.2 mm
Pitch Factor:
1.5 {ratio}
Number of X-Ray Sources:
1 {X-Ray sources}
CT X-Ray Source Parameters
Identification of the X-Ray Source:
A
KVP:
130 kV
Maximum X-Ray Tube Current:
180 mA
Mean X-Ray Tube Current:
151 mA
Exposure Time per Rotation:
0.8 s
CT Dose
Mean CTDIvol:
7.92 mGy
CTDIw Phantom Type:
IEC Body Dosimetry Phantom (113691, DCM)
DLP:
494.49 mGy.cm
Dose Check Alert Details
DLP Alert Value Configured:
No (R-00339, SRT)
CTDIvol Alert Value Configured:
Yes (R-0038D, SRT)
CTDIvol Alert Value:
1000 mGy
Dose Check Notification Details
DLP Notification Value Configured:
No (R-00339, SRT)
CTDIvol Notification Value Configured:
No (R-00339, SRT)
X-Ray Modulation Type:
XYZ_EC
Comment:
Internal technical scan parameters: Organ Characteristic = "Abdomen", Body Size = "Adult", Body
Region = "Body", X-ray Modulation Type = "XYZ_EC"
Device Role in Procedure:

6. Irradiating Device (113859, DCM)
Properties: Device Name = "SOMATOM Scope"
Properties: Device Manufacturer = "SIEMENS"
Properties: Device Serial Number = "99222"
Source of Dose Information:
Automated Data Collection (113856, DCM)
Annex
Annex 1
Scope of Accumulation:
Study (113014, DCM)
Properties: Study Instance UID = 1.3.12.2.1107.5.1.4.99222.30000021061912211930900000067
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