## Patient Information

Patient Name : KISLOV A

Patient ID : 830316300030

Patient Birth Date : 19830316

Patient Sex : M

## Study Information

Study Instance UID : 1.2.156.112605.189250943072451.220127072953.2.10500.18291

Study Date : 20220127

Study Time : 13:30:27

Referring Physician's Name :

Study ID : 5935

Accession Number :

## Series Information

Modality : SR

Series Instance UID : 1.2.156.112605.189250943072451.220127073151.3.7112.64458

Series Number : 10002

## Equipment Information

Manufacturer : UIH

Manufacturer's Model Name : uCT 528

Device Serial Number : 230316

Software Versions : R001

## SR Document Information

Instance Number : 1

Completion Flag : COMPLETE

Verification Flag : UNVERIFIED

Content Date : 20220127

Content Time : 13:31:52

# X-Ray Radiation Dose Report

Procedure reported : Computed Tomography XRay

Has Intent : Diagnostic Intent

Observer Type : Device

Device Observer UID : 230316

Start of X-Ray Irradiation : 20220127 13:31:13

End of X-Ray Irradiation : 20220127 13:31:49

Scope of Accumulation : Study

Study Instance UID : 1.2.156.112605.189250943072451.220127072953.2.10500.18291

Source of Dose Information : Automated Data Collection

## CT Accumulated Dose Data

Total Number of Irradiation Events : 2 events

CT Dose Length Product Total : 335.45 mGy.cm

## CT Acquisition

Acquisition Protocol : Scout

Target Region : Chest

CT Acquisition Type : Constant Angle Acquisition

Irradiation Event UID : 1.2.156.112605.189250943072451.220127073027.9.7112.36808

### CT Acquisition Parameters

Exposure Time : 2.658699 s

Scanning Length : 402.0897 mm

Nominal Single Collimation Width : 0.55 mm

Nominal Total Collimation Width : 2.2 mm

Number of X-Ray Sources : 1 X-Ray sources

#### CT X-Ray Source Parameters

Identification of the XRay Source : A

KVP : 120 kV

Maximum X-Ray Tube Current : 40.26048 mA

X-Ray Tube Current : 40 mA

### CT Dose

Mean CTDIvol : 0.04747757 mGy

CTDIw Phantom Type : IEC Body Dosimetry Phantom

DLP : 1.92 mGy.cm

## CT Acquisition

Acquisition Protocol : Chest Helical

Target Region : Chest

CT Acquisition Type : Spiral Acquisition

Irradiation Event UID : 1.2.156.112605.189250943072451.220127073027.9.7112.86808

### CT Acquisition Parameters

Exposure Time : 11.97684 s

Scanning Length : 387.5225 mm

Nominal Single Collimation Width : 0.55 mm

Nominal Total Collimation Width : 22 mm

Pitch Factor : 1.175 ratio

Number of X-Ray Sources : 1 X-Ray sources

#### CT X-Ray Source Parameters

Identification of the XRay Source : A

KVP : 120 kV

Maximum X-Ray Tube Current : 278.0952 mA

X-Ray Tube Current : 139.4333 mA

Exposure Time per Rotation : 0.75 s

### CT Dose

Mean CTDIvol : 8.078528 mGy

CTDIw Phantom Type : IEC Body Dosimetry Phantom

DLP : 333.53 mGy.cm