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Submission: On November 14 via api (November 14th 2024, 7:34:03 pm UTC) from US — Scanned from CA

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CT PARAMETERS

The following CT scan radiographic parameters have been optimized in order to
provide appropriate input to generate a StratX® Lung Analysis Report.

In order to produce quality output parameters displayed in the StratX Report, it
is recommended to adhere as closely as possible to the ideal parameters. If a
scan can’t be obtained with the ideal parameters, we have specified acceptable
scan parameters on pages 3 and 4. Significant deviation from these parameters
may result in reduced accuracy or an inability to analyze the CT scan.

For more specific information related to scan parameters or if your CT scanner
manufacturer is not listed below, please contact us directly for support
at: stratxussupport@pulmonx.com

GENERAL INFORMATION

1. Ensure all files are in standard DICOM format.

2. Only SUPINE position chest CT scans with arms positioned above the head are
supported. Scans obtained in PRONE position can NOT be analyzed.

3. The CT scans must have a slice thickness of 1.5 mm or less (smaller slices
provide more information for fissure completeness) in the axial plane.
Reconstruction slice thickness must be greater than or equal to acquisition
slice thickness.

4. The input image should NOT be reconstructed with a slice spacing larger
than the slice thickness (slice spacing should be less than or equal to
slice thickness, no gaps in the 3D volume are allowed).

5. The complete lung must be present on the CT scan. If parts of the lung are
missing, the output parameters will be compromised.

6. Only non-contrast TLC (inspiration) scans are accepted for analysis.

7. Technologist should instruct the patient to take a full inspiration breath
and hold. The scan should start once the patient has reached breath hold
and relaxed their body.

8. Ensure the CT scan is not of poor quality (e.g., movement artifacts,
artifacts due to metal, high noise levels due to dose level, etc.)

9. Please ensure the CT scan does NOT suffer from image artifacts such as
streak artifacts from implants

10. Scans taken from CT scanners with less than 16 detector rows are not
recommended.

11. Any series containing less than 120 images will be automatically removed by
the system.

1. Ensure all files are in standard DICOM format.

2. Only SUPINE position chest CT scans with arms positioned above the head are
supported. Scans obtained in PRONE position can NOT be analyzed.

5. The complete lung must be present on the CT scan. If parts of the lung are
missing, the output parameters will be compromised.

6. Only non-contrast TLC (inspiration) scans are accepted for analysis.

7. Technologist should instruct the patient to take a full inspiration breath
and hold. The scan should start once the patient has reached breath hold
and relaxed their body.

8. Ensure the CT scan is not of poor quality (e.g., movement artifacts,
artifacts due to metal, high noise levels due to dose level, etc.).

9. Please ensure the CT scan does NOT suffer from image artifacts such as
streak artifacts from implants.

10. Scans taken from CT scanners with less than 16 detector rows are not
recommended.

11. Any series containing less than 120 images will be automatically removed by
the system.

IDEAL SCAN PARAMETERS

Following these parameters will achieve the highest quality report possible

Highest Quality Report Parameters PARAMETERSSIEMENSPHILIPSTOSHIBAGE Kernel
StandardB30BFC08Standard Tube CurrentRegular Patient (<30 BMI): 80 mAs
Large Patient (>30 BMI): 100 mAs
*No tube current modulation KV120 Slice Thickness0.625 mm Reconstruction
Interval
(Slice Spacing)≤0.625 mm PitchRange: 0.5–1.2Range: 0.5–1.2Range: 0.5–1.0Range:
0.5–1.375 Rotation or Gantry Speed (sec)≤0.5 Iterative ReconstructionNone
ContrastNone

ACCEPTABLE SCAN PARAMETERS

CT Scan Parameters WITHOUT Iterative Reconstruction

*No iterative reconstruction preferred

3–4mSv Dose PARAMETERSSIEMENSPHILIPSTOSHIBAGE Tube Current0 mA–900 mA
*No tube current
modulation preferred20 mA–450 mA
*No tube current
modulation preferred20 mA–600 mA
*No tube current
modulation preferred30 mA–770 mA
*No tube current
modulation preferred KV120 Dose ModulationCareDose ON
CarekV OFFZ-Dom ONSURE Exposure ONSmart mA ON PitchRange: 0.5–1.2Range:
0.5–1.2Range: 0.5–1.0Range: 0.5–1.375 Rotation or Gantry Speed (sec)≤0.5 Kernel
Standard≤B45fB, C≤FC45Bone, Standard Slice Thickness≤1.5 mm
*Thinnest slice possible preferred Slice Spacing≤slice thickness Average mSv<4.0
ContrastNone

ACCEPTABLE SCAN PARAMETERS

CT Scan Parameters WITH Iterative Reconstruction

*No iterative reconstruction preferred

1–2mSv Dose PARAMETERSSIEMENSPHILIPSTOSHIBAGE Tube Current0 mA–900 mA
*No tube current
modulation preferred20 mA–450 mA
*No tube current
modulation preferred20 mA–600 mA
*No tube current
modulation preferred30 mA–770 mA
*No tube current
modulation preferred KV120 Dose ModulationCareDose ON
CarekV OFFV-Dom ONSURE Exposure ONSmart mA ON PitchRange: 0.5–1.2Range:
0.5–1.2Range: 0.5–1.0Range: 0.5–1.375 Rotation or Gantry Speed (sec)≤0.5
Iterative ReconstructionUse SAFIRE, ADMIREUse IMRUse ADIR 3D standardUse VEO,
ASiR Iterative Strength3Routine 2Standard30–50 Kernel Standard≤B45fB,
C≤FC45Bone, Standard Slice Thickness≤1.5 mm
*Thinnest slice possible preferred Slice Spacing≤slice thickness Average mSv<2.0
ContrastNone

HOW STRATX® REPORT RESULTS ARE DETERMINED

The data presented in the StratX Report is based on Hounsfield units to measure
fissure completeness, destruction scores, and lobar volumes. The quality of the
uploaded CT images directly influences the Hounsfield unit of measurement. Below
are examples of reasons why images will be rejected:

MOTION ARTIFACT SCAN REJECTION

MOTION ARTIFACT IMAGE DISTORTION

Taking a CT scan while a patient is moving distorts the image quality, making it
appear blurry or fuzzy. The image distortion directly impacts the accuracy of
destruction, fissure, and volume scoring. A StratX Report will not be provided
if a motion artifact is detected.

INADEQUATE BREATH-HOLD SCAN REJECTION

EXPIRATORY SCANS

Expiratory scans are noted by the raised diaphragm and lobar compression.
Expiratory scans will lead to artificially low destruction scores and inaccurate
lobar volumes. A StratX Report will not be provided if an expiratory scan is
detected.

RAISED DIAPHRAGM

CONTRAST SCAN REJECTION

SCANS WITH CONTRAST

If an image is taken with contrast, the vasculature will appear bright and will
permeate into lung tissue resulting in
artificially low destruction scores. A StratX® Report will not be provided if a
scan with contrast is detected.

INCORRECT KERNEL

Images reconstructed with an incorrect kernel may result in inaccurate
destruction scores. In the example below, an incorrect kernel has added noise to
the image, resulting in an artificially low destruction score. If an incorrect
kernel is detected, a StratX Report will be provided with a warning that the
report may be inaccurate.

Download StratX Report CT Parameters PDF

US-EN-2237-V3

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