1. Lab Positioning for GU SYSTEM IVP & Cysto & ERCP 2014 revised

2. IVU /IVP 2014 FOR SERIES NOTES SCOUT (14 X 17) Kidney cone down (11x14) – 1 min or 5 min (upper abd) (KUB with contrast-all 14 X 17) 10 - 15 MIN (AP with contrast) RPO/LPO (30º rotation) Special IMAGES: DELAY FILMS (PA /AP/PA) UPRIGHT (1” below IC) – Kidneys & bladder drop POST VOID 2

3. 3 SCOUT 14 X 17 KUB

4. 4 Kidneys “cone down:

5. 5 3 – 5 min film CONE DOWN 1min & 5 min (KIDNEYS) (some may want 1min, 3min, 6min, 9min)

6. 6 1 min blush nephrogram

7. 7 5 minute cone down

8. 8 10 MINUTES – BLADDER NOT YET FULL

9. 9 RPO/LPO taken between 10 – 15 minutes (time marker ?)

10. 10

11. 11 RPO

12. 12

13. 13

14. 14 15 min full done AP or PA

15. 15 Additional imaging: Upright – can show mobility of kidneys and bladder (see cysto for more info)

16. 16

17. 17 RESIDUAL CONTRAST CHECK WITH RADIOLOGIST MAY WANT ANOTHER POST VOID

18. 18 CYSTOGRAMS & VCUG Indications? CHILDREN ADULT MALE : – AP, OBL’s (30º to 40º rotation) – & LAT FEMALE – AP, OBL’s (40º to 60º rotation) FLUORO OR OVERHEADS

19. CYSTOGRAMS (only) : (CONE DOWN ON THE BLADDER) FOR FEMALES - 10 X 12 CW – CR 2" above PS (2" below ASIS) Crosswise Perpendicular CR only (no angles) - AP, BOTH OBLIQUES (40-60 degrees) - so just use 40degrees (LATERAL ?) FOR MALES -10 X 12 LW – AP, BOTH OBLIQUES (30 -40 degrees) CR centered AT PS For LATERAL only - CR 2" above PS (2" below ASIS) (The book was somewhat confusing - the lateral (pg 222) showing a male patient - is shown as the same centering as for the Female pg 221 - but the male information starts on page 223)

20. VCUG ONLY : VOIDING CYSTO URETHROGRAMS Need to cone down on bladder to include urethra and distal ureters (for reflux) FOR FEMALES & MALES - 11x14 LW – (BUT - cone down as needed for the SIZE of the patient) see page 223 & 224 Perpendicular CR only (no angles) - ONE OBLIQUE (RPO OR LPO) – (40 degrees) TAKE IMAGE WHILE VOIDING - CR CENTERING JUST ABOVE THE PS (PUBIC SYMPHYSIS) FOR BOTH MALE AND FEMALE (you would never use a 14 x 17 for cystograms, unless the refulux went all the way to the kidneys are you were instructed to do so by the Radiologist)

21. 21

22. 22 MALE CYSTO AP, RPO, LPO, LAT C/R @PS

23. 23

24. 24

25. Lateral Cysto 25

26. 26

27. 27 FEMALE CYSTO AP, RPO, LPO, ? LAT

28. 28

29. 29

30. 30

31. 31 Foley balloon seen

32. 32 VCUG

33. 33

34. 34

35. 35

36. 36 HEPATOBILIARY & the Gall Bladder (GB) RT 124 rev Sp 2010

37. 37 PA SCOUT 14 X 17 or 11 x 14 RUQ - PA OR AP

38. 38 This position will be tested in lab Taken as a scout and post – contrast filling For ERCP

39. 39

40. 40

41. LAO or RPO for RUQ

42. 42 Drainage film

43. RUQ- RPO