PMID- 35238963
OWN - NLM
STAT- MEDLINE
DCOM- 20220517
LR  - 20221008
IS  - 2366-0058 (Electronic)
VI  - 47
IP  - 6
DP  - 2022 Jun
TI  - Split-bolus CT urography after microwave ablation of renal cell carcinoma 
      improves image quality and reduces radiation exposure.
PG  - 2230-2237
LID - 10.1007/s00261-022-03448-x [doi]
AB  - 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.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Tannenbaum, Alex P
AU  - Tannenbaum AP
AD  - University of Wisconsin School of Medicine and Public Heath, Madison, WI, USA.
FAU - Lubner, Meghan G
AU  - Lubner MG
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA.
FAU - Mithqal, Ayman
AU  - Mithqal A
AD  - Department of Radiology, University of Virginia, Charlottesville, VA, USA.
FAU - Ziemlewicz, Timothy J
AU  - Ziemlewicz TJ
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA.
FAU - Allen, Glenn O
AU  - Allen GO
AD  - Department of Urology, University of Wisconsin, Madison, WI, USA.
FAU - Brace, Christopher L
AU  - Brace CL
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA.
AD  - Department of Biomedical Engineering, University of Wisconsin, Madison, WI, USA.
FAU - Jason Abel, E
AU  - Jason Abel E
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA.
AD  - Department of Urology, University of Wisconsin, Madison, WI, USA.
FAU - Mankowski-Gettle, Lori
AU  - Mankowski-Gettle L
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA.
FAU - Schenkman, Noah S
AU  - Schenkman NS
AD  - Department of Urology, University of Virginia, Charlottesville, VA, USA.
FAU - Wells, Shane A
AU  - Wells SA
AUID- ORCID: 0000-0002-1067-6624
AD  - Department of Radiology, University of Wisconsin School of Medicine and Public 
      Health, E3/366 600 Highland Avenue, Madison, WI, 53792, USA. sawells@wisc.edu.
AD  - Department of Urology, University of Wisconsin, Madison, WI, USA. 
      sawells@wisc.edu.
LA  - eng
PT  - Journal Article
DEP - 20220303
PL  - United States
TA  - Abdom Radiol (NY)
JT  - Abdominal radiology (New York)
JID - 101674571
RN  - 0 (Contrast Media)
SB  - IM
MH  - Aged
MH  - *Carcinoma, Renal Cell/diagnostic imaging/surgery
MH  - Contrast Media
MH  - Female
MH  - Humans
MH  - *Kidney Neoplasms/diagnostic imaging/surgery
MH  - Male
MH  - Microwaves/therapeutic use
MH  - Middle Aged
MH  - *Radiation Exposure
MH  - Tomography, X-Ray Computed/methods
MH  - Urography/methods
OTO - NOTNLM
OT  - Ablation
OT  - CT
OT  - Iodinated contrast
OT  - Microwave
OT  - Renal cell carcinoma
EDAT- 2022/03/04 06:00
MHDA- 2022/05/18 06:00
CRDT- 2022/03/03 12:18
PHST- 2022/01/01 00:00 [received]
PHST- 2022/02/07 00:00 [accepted]
PHST- 2022/02/04 00:00 [revised]
PHST- 2022/03/04 06:00 [pubmed]
PHST- 2022/05/18 06:00 [medline]
PHST- 2022/03/03 12:18 [entrez]
AID - 10.1007/s00261-022-03448-x [pii]
AID - 10.1007/s00261-022-03448-x [doi]
PST - ppublish
SO  - Abdom Radiol (NY). 2022 Jun;47(6):2230-2237. doi: 10.1007/s00261-022-03448-x. 
      Epub 2022 Mar 3.