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.
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.
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).
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.
Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
Radiography (London, England : 1995). 2024 Feb 07 [Epub ahead of print]
P W O'Regan, C Dewhurst, A T O'Mahony, C O'Regan, V O'Leary, G O'Connor, D Ryan, M M Maher, R Young
Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: ., Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: ., Department of Radiology, Cork University Hospital/Mercy University Hospital, Cork, Ireland. Electronic address: ., Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: ., Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: ., Department of Radiology, Mercy University Hospital, Cork, Ireland. Electronic address: ., Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: ., Department of Radiology, School of Medicine, University College Cork, Ireland. Electronic address: ., Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College, Cork, Ireland. Electronic address: .