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- Title
Split-bolus CT urography after microwave ablation of renal cell carcinoma improves image quality and reduces radiation exposure.
- Authors
Tannenbaum, Alex P.; Lubner, Meghan G.; Mithqal, Ayman; Ziemlewicz, Timothy J.; Allen, Glenn O.; Brace, Christopher L.; Jason Abel, E.; Mankowski-Gettle, Lori; Schenkman, Noah S.; Wells, Shane A.
- Abstract
Objective: To compare image quality and radiation dose between single-bolus 2-phase and split-bolus 1-phase CT Urography (CTU) performed immediately after microwave ablation (MWA) of clinically localized T1 (cT1) RCC. Methods: Forty-two consecutive patients (30 M, mean age 67.5 ± 9.0) with cT1 RCC were treated with MWA from 7/2013 to 12/2013 at two academic quaternary-care institutions. Renal parenchymal enhancement, collecting system opacification and distention and size-specific dose estimate (SSDE) were quantified and image quality subjectively assessed on single-bolus 2-phase versus split-bolus 1-phase CTU. Kruskal–Wallis and Pearson's Chi-squared tests were performed to assess differences in continuous and categorical variables, respectively. Two-sample T test with equal variances was used to determine differences in quantitative and qualitative image data. Results: Median tumor diameter was larger [2.9 cm (IQR 1.7–5.3) vs 3.6 cm (IQR 1.7–5.7), p = 0.01] in the split-bolus cohort. Mean abdominal girth (p = 0.20) was similar. Number of antennas used and unenhanced CTs obtained before and during MWA were similar (p = 0.11–0.32). Renal pelvis opacification (2.5 vs 3.5, p < 0.001) and distention (4 mm vs 8 mm, p < 0.001) were improved and renal enhancement (Right: 127 HU vs 177 HU, p = 0.001; Left: 124 HU vs 185 HU, p < 0.001) was higher for the split-bolus CTU. Image quality was superior for split-bolus CTU (3.2 vs 4.0, p = 0.004). Mean SSDE for the split-bolus CTU was significantly lower [163.9 mGy (SD ± 73.9) vs 36.3 mGy (SD ± 7.7), p < 0.001]. Conclusion: Split-bolus CTU immediately after MWA of cT1 RCC offers higher image quality, improved opacification/distention of the collecting system and renal parenchymal enhancement at a lower radiation dose.
- Subjects
RENAL cell carcinoma; RADIATION exposure; GENITOURINARY organ cancer; CANCER diagnosis; PATIENT management
- Publication
Abdominal Radiology, 2022, Vol 47, Issue 6, p2230
- ISSN
2366-004X
- Publication type
Article
- DOI
10.1007/s00261-022-03448-x