Split-bolus single-phase versus single-bolus split-phase CT acquisition protocols for staging in patients with testicular cancer: A retrospective study.

Autor: O'Regan PW; Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: patrickoregan@ucc.ie., Dewhurst C; Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: cdewhurst@muh.ie., O'Mahony AT; Department of Radiology, Cork University Hospital/Mercy University Hospital, Cork, Ireland. Electronic address: alexlocum@gmail.com., O'Regan C; Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: croregan@muh.ie., O'Leary V; Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: voleary@muh.ie., O'Connor G; Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: goconnor@muh.ie., Ryan D; Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: david.ryan2@hse.ie., Maher MM; Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: m.maher@ucc.ie., Young R; Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College, Cork, Ireland. Electronic address: rena.young@ucc.ie.
Jazyk: angličtina
Zdroj: Radiography (London, England : 1995) [Radiography (Lond)] 2024 Mar; Vol. 30 (2), pp. 628-633. Date of Electronic Publication: 2024 Feb 07.
DOI: 10.1016/j.radi.2024.01.020
Abstrakt: Introduction: Computed tomography (CT) imaging has become indispensable in the management of medical oncology patients. Risks associated with high cumulative effective dose (CED) are relevant in testicular cancer patients. Split-bolus protocols, whereby the contrast medium injection is divided into two, followed by combining the required phase images in a single scan acquisition has been shown to provide images of comparable image quality and less radiation dose compared to single-bolus split-phase CT for various indications. We retrospectively evaluated the performance of split-bolus and single-bolus protocols in patients having follow-up CT imaging for testicular cancer surveillance.
Methods: 45 patients with testicular cancer undergoing surveillance CT imaging of the thorax, abdomen, and pelvis who underwent split-bolus and single-bolus protocols were included. Quantitative image quality analysis was conducted by placing region of interests in pre-defined anatomical sub-structures within the abdominal cavity. The signal-to-noise ratio (SNR) and radiation dose in the form of dose length product (DLP) and effective dose (ED) were recorded.
Results: The DLP and ED for the single-bolus, split-phase acquisition was 506 ± 89 mGy cm and 7.59 ± 1.3 mSv, respectively. For the split-bolus, single-phase acquisition, 397 ± 94 mGy∗cm and 5.95 ± 1.4 mSv, respectively (p < 0.000). This represented a 21.5 % reduction in radiation dose exposure. The SNR for liver, muscle and fat for the single-bolus were 7.4, 4.7 and 8, respectively, compared to 5.5, 3.8 and 7.4 in the split-bolus protocol (p < 0.001).
Conclusion: In a testicular cancer patient cohort undergoing surveillance CT imaging, utilization of a split-bolus single-phase acquisition CT protocol enabled a significant reduction in radiation dose whilst maintaining subjective diagnostic acceptability.
Implications for Practice: Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
(Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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