16 April 2017 : Clinical Research
Preoperative Assessment of Hepatocellular Carcinoma with Split-Bolus Combined Phase Contrast-Enhanced Computed TomographyJian Jiang1BCDE, Ke Wang1ABCDEF, Yufeng Xu1BCD, Jianxin Liu1BCDEF, Jingjing Luo1BD, Xin Tao1BCD, Xiaoying Wang1ABCEF*
Med Sci Monit 2017; 23:1834-1841
BACKGROUND: The aim of this study was to investigate the feasibility of a split-bolus combined phase contrast-enhanced computed tomography protocol in evaluation of liver vasculature in hepatocellular carcinoma (HCC) patients for the purpose of surgery guidance.
MATERIAL AND METHODS: Two groups of patients were recruited for the study: 24 consecutive cases of HCC who underwent multiphasic CT examination, and 22 consecutive cases who afterwards underwent split-bolus combined phase CT examination. The multiphasic protocol included an unenhanced scan and 3 image acquisitions after contrast injection. The injection of contrast medium was 440 mgI/kg in a single bolus. The split-bolus combined phase protocol included unenhanced scan and combined phase. The injection of contrast medium was 440 mgI/kg for the first bolus and 220 mgI/kg for the second bolus. The vascular delineation was evaluated with Likert scales. The CT values were measured, and the contrast-to-noise ratio (CNR) was calculated. We also compared the effective radiation dose (ED) of the 2 protocols.
RESULTS: All mean CT values were significantly higher in the split-bolus protocol than in the multiphasic protocol (all P<.05), except for the hepatic vein (P>.05). The ED was significantly lower in the split-bolus protocol, corresponding to a dose reduction of 66% compared to the multiphasic protocol (P<.05). The scores of the branches of the hepatic vein in the split-bolus protocol were not lower than those in the multiphasic protocol.
CONCLUSIONS: For the preoperative HCC patients, the split-bolus combined phase CT examination meets the diagnostic requirement of surgical planning, with approximately 60% reduction in the radiation dose.
Keywords: Radiation Dosage
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