Abstract：
BACKGROUND: 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).
CONCLUSIONS: 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.
CONCLUSIONS: Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
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).
CONCLUSIONS: 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.
CONCLUSIONS: Use of split-bolus, single-phase acquisition has the potential to reduce CED in surveillance of testicular cancer patients.
摘要：
背景：计算机断层扫描（CT）成像在内科肿瘤患者的管理中已变得不可或缺。与高累积有效剂量（CED）相关的风险与睾丸癌患者有关。Split-bolus协议,其中造影剂注射被分为两个，然后在单次扫描采集中组合所需的相位图像，与单次推注分相CT相比，对于各种适应症，可以提供具有可比图像质量和较少辐射剂量的图像。我们回顾性评估了在进行睾丸肿瘤监测的CT随访患者中，分裂推注和单推注方案的表现。
方法：45例睾丸癌患者接受胸部CT检查，腹部，和骨盆谁接受了分裂推注和单推注方案被包括在内。通过将感兴趣区域放置在腹腔内预定义的解剖子结构中来进行定量图像质量分析。以剂量长度乘积（DLP）和有效剂量（ED）的形式记录信噪比（SNR）和辐射剂量。
结果：单推注的DLP和ED，分相采集为506±89mGycm和7.59±1.3mSv，分别。对于分裂推注，单相采集，397±94mGy*cm和5.95±1.4mSv，分别为（p<0.000）。这表示辐射剂量暴露减少21.5%。肝脏的信噪比,单次推注的肌肉和脂肪分别为7.4、4.7和8，与拆分推注方案中的5.5、3.8和7.4相比（p<0.001）。
结论：在接受CT监测的睾丸癌患者队列中，利用分裂推注式单相采集CT方案可以显著降低辐射剂量,同时保持主观诊断的可接受性.
结论：使用分裂推注，在睾丸癌患者的监测中,单相采集有可能减少CED.
方法：45例睾丸癌患者接受胸部CT检查，腹部，和骨盆谁接受了分裂推注和单推注方案被包括在内。通过将感兴趣区域放置在腹腔内预定义的解剖子结构中来进行定量图像质量分析。以剂量长度乘积（DLP）和有效剂量（ED）的形式记录信噪比（SNR）和辐射剂量。
结果：单推注的DLP和ED，分相采集为506±89mGycm和7.59±1.3mSv，分别。对于分裂推注，单相采集，397±94mGy*cm和5.95±1.4mSv，分别为（p<0.000）。这表示辐射剂量暴露减少21.5%。肝脏的信噪比,单次推注的肌肉和脂肪分别为7.4、4.7和8，与拆分推注方案中的5.5、3.8和7.4相比（p<0.001）。
结论：在接受CT监测的睾丸癌患者队列中，利用分裂推注式单相采集CT方案可以显著降低辐射剂量,同时保持主观诊断的可接受性.
结论：使用分裂推注，在睾丸癌患者的监测中,单相采集有可能减少CED.
