Michele Scialpi1, Barbara Palumbo2, Luisa Pierotti3, Sabrina Gravante3, Alessio Piunno3, Alberto Rebonato3, Alfredo D'Andrea4, Alfonso Reginelli5, Irene Piscioli6, Luca Brunese7, Antonio Rotondo5. 1. Division of Radiology 2, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy michelescialpi@libero.it. 2. Division of Nuclear Medicine, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy. 3. Division of Radiology 2, Department of Surgical and Biomedical Sciences, S. Maria della Misericordia Hospital, Perugia University, Perugia, Italy. 4. Division of Radiology, San Giuseppe Moscati Hospital, Aversa, Caserta, Italy. 5. Department of Experimental and Clinical Internistic, F. Magrassi-A. Lanzara, Second University of Naples, Naples, Italy. 6. Division of Radiology, Budrio Hospital, Bologna, Budrio, Italy. 7. Department of Health Sciences, Molise University, Contrada Tappino, Campobasso, Italy.
Abstract
AIM: To assess the diagnostic accuracy and radiation dose of split-bolus multidetector-row computed tomography (MDCT) protocol in the detection and characterization of focal liver lesions in oncologic patients. PATIENTS AND METHODS: We retrospectively analyzed triphasic CT at initial diagnosis and follow-up split-bolus 64-detector row CT protocol in 48 oncologic patients with focal liver lesions. Split-bolus MDCT protocol by i.v. injection of two boli of contrast medium combines hepatic arterial phase (HAP) and hepatic enhancement during portal venous phase (PVP) in a single pass. First bolus: 75-90 mL at 2.0 mL/sec to obtain adequate hepatic enhancement during the PVP; second bolus: 60 mL/sec at 3.5 mL/sec to ensure HAP. Each bolus is followed by 20 mL of saline solution at the same flow rate. Sensitivity, specificity, positive predictive value and negative predictive value of split-bolus MDCT protocol were calculated for detection and characterization of liver lesions. The effective radiation dose (ED) was calculated using dose-length product (DLP) values in mSv determined using a conversion factor. RESULTS: compared to triphasic-MDCT, split-bolus MDCT protocol confirmed all the 210 lesions identified and characterized by triphasic-MDCT technique, unchanged during the follow-up. The mean ED was 27.8 ± 6 mSv for chest-abdomen-pelvis biphasic split-bolus MDCT and 45.7 ± 13.6 mSv for triphasic-MDCT. CONCLUSION: The diagnostic efficacy of split-bolus protocol is comparable to that of triphasic protocol at MDCT with a reduction in radiation dose of approximately 35-40%. Copyright
AIM: To assess the diagnostic accuracy and radiation dose of split-bolus multidetector-row computed tomography (MDCT) protocol in the detection and characterization of focal liver lesions in oncologic patients. PATIENTS AND METHODS: We retrospectively analyzed triphasic CT at initial diagnosis and follow-up split-bolus 64-detector row CT protocol in 48 oncologic patients with focal liver lesions. Split-bolus MDCT protocol by i.v. injection of two boli of contrast medium combines hepatic arterial phase (HAP) and hepatic enhancement during portal venous phase (PVP) in a single pass. First bolus: 75-90 mL at 2.0 mL/sec to obtain adequate hepatic enhancement during the PVP; second bolus: 60 mL/sec at 3.5 mL/sec to ensure HAP. Each bolus is followed by 20 mL of saline solution at the same flow rate. Sensitivity, specificity, positive predictive value and negative predictive value of split-bolus MDCT protocol were calculated for detection and characterization of liver lesions. The effective radiation dose (ED) was calculated using dose-length product (DLP) values in mSv determined using a conversion factor. RESULTS: compared to triphasic-MDCT, split-bolus MDCT protocol confirmed all the 210 lesions identified and characterized by triphasic-MDCT technique, unchanged during the follow-up. The mean ED was 27.8 ± 6 mSv for chest-abdomen-pelvis biphasic split-bolus MDCT and 45.7 ± 13.6 mSv for triphasic-MDCT. CONCLUSION: The diagnostic efficacy of split-bolus protocol is comparable to that of triphasic protocol at MDCT with a reduction in radiation dose of approximately 35-40%. Copyright
Authors: A Russo; R Capasso; C Varelli; A Laporta; M Carbone; G D'Agosto; S Giovine; M Zappia; A Reginelli Journal: Musculoskelet Surg Date: 2017-02-16
Authors: A Barile; F Bruno; S Mariani; F Arrigoni; A Reginelli; M De Filippo; M Zappia; A Splendiani; E Di Cesare; C Masciocchi Journal: Musculoskelet Surg Date: 2017-02-13
Authors: A Barile; F Bruno; S Mariani; F Arrigoni; L Brunese; M Zappia; A Splendiani; E Di Cesare; C Masciocchi Journal: Musculoskelet Surg Date: 2017-02-14
Authors: M De Filippo; A Pesce; A Barile; D Borgia; M Zappia; A Romano; F Pogliacomi; M Verdano; A Pellegrini; K Johnson Journal: Musculoskelet Surg Date: 2017-02-06