Kidney and Urinary Tract Imaging: Triple-Bolus Multidetector CT Urography as a One-Stop Shop—Protocol Design, Opacification, and Image Quality Analysis

Kekelidze, Maka; Dwarkasing, Roy S.; Dijkshoorn, Marcel L.; Sikorska, Karolina; Verhagen, Paul C.M.S.; Krestin, Gabriël P.

doi:10.1148/radiol.09082074

Cited by 76 publications

(56 citation statements)

References 37 publications

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“…The 28.7% reduction in CTDIvol and 40.7% reduction in DLP followed a similar trend to previously reported data 8 . Clinical implications of these findings are significant.…”

Section: Summary Of Study Resultssupporting

confidence: 91%

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

Abedi

Okhunov

Lall

et al. 2014

Urology

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“…The 28.7% reduction in CTDIvol and 40.7% reduction in DLP followed a similar trend to previously reported data 8 . Clinical implications of these findings are significant.…”

Section: Summary Of Study Resultssupporting

confidence: 91%

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

Abedi

Okhunov

Lall

et al. 2014

Urology

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“…The use of CTU in haematuria is increasing as the availability of CT scanners improves and the radiation dose is minimised using techniques such as double or triple bolus contrast administration [4,5]. The impact of incidental findings is therefore increasing, and this study has identified the cost implication associated with this.…”

Section: Discussionmentioning

confidence: 93%

“…CTU has become more widely accessible, with an increased number of CT scanners globally. Additionally, the high radiation dose associated with CTU has been significantly reduced with the newer double and triple bolus techniques [4,5]. When CTU is performed as the primary imaging modality in haematuria, it reduces the number of patients who undergo CTU following an inadequate IVU.…”

mentioning

confidence: 99%

The economic implications of unsuspected findings from CT urography performed for haematuria

Bromage

Liew²,

Moore³

et al. 2012

BJR

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Objectives: We set out to determine the prevalence of unsuspected findings from CT urography (CTU) performed for haematuria and to evaluate the economic implications associated with the subsequent management of these findings. Methods: We analysed the results of 778 consecutive CTU scans performed in a haematuria clinic between 2008 and 2010. We excluded cases where diagnosis of an abnormality had been made prior to CTU. Costs incurred during the follow-up of unsuspected findings were calculated following guidance set out in the NHS Costing Manual 2009/10. Results: 778 CTU scans were performed for patients attending a haematuria clinic from 2008 to 2010. 455 men and 323 women underwent CTU scan; they had a median age of 62 years. 56% of scans were found to have unexpected extra-urinary findings (587 abnormalities in 439 scans). Common findings included diverticular disease (138, 17.7%), adrenal masses [85, 10.9%; 40 (5.1%) of which were indeterminate], lung abnormalities (67, 8.6%), gall bladders containing calculi (44, 5.7%), adnexal cysts (25, 7.7% of women) and aortic aneurysms (18, 2.3%). These findings led to a total of 136 outpatient appointments, 88 radiological investigations and 11 procedures (4 of which were major). The overall cost incurred was £47 366, or £60 per patient. Conclusion: CTU is associated with a high rate of unsuspected findings. There is an economic implication to performing CT scanning in this setting, in which further unanticipated investigation and treatment cost is approximately £60 per patient.

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“…split-bolus technique) [38,39] • Adjustment of image quality reference values of the automatic tube current modulation for oversized patients [40] • Reduction of the tube voltage and/or tube current for survey CT [41,42] • Positioning of the X-ray tube below the table for the survey CT (e.g. 180°, postero-anterior position) [41,42] • Prevention of the routine use of narrow collimations (e.g.…”

Section: Resultsmentioning

confidence: 99%

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

et al. 2011

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Objectives To establish an education and training programme for the reduction of CT radiation doses and to assess this programme's efficacy. Methods Ten radiological institutes were counselled. The optimisation programme included a small group workshop and a lecture on radiation dose reduction strategies. The radiation dose used for five CT protocols (paranasal sinuses, brain, chest, pulmonary angiography and abdomen) was assessed using the dose-length product (DLP) before and after the optimisation programme. The mean DLP values were compared with national diagnostic reference levels (DRLs). Results The average reduction of the DLP after optimisation was 37% for the sinuses (180 vs. 113 mGycm, P< 0.001), 9% for the brain (982 vs. 896 mGycm, P<0.05), 24% for the chest (425 vs. 322 mGycm, P<0.05) and 42% for the pulmonary arteries (352 vs. 203 mGycm, P<0.001). No significant change in DLP was found for abdominal CT. The post-optimisation DLP values of the sinuses, brain, chest, pulmonary arteries and abdomen were 68%, 10%, 20%, 55% and 15% below the DRL, respectively. Conclusions The education and training programme for radiological institutes is effective in achieving a substantial reduction in CT radiation dose.

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Kidney and Urinary Tract Imaging: Triple-Bolus Multidetector CT Urography as a One-Stop Shop—Protocol Design, Opacification, and Image Quality Analysis

Cited by 76 publications

References 37 publications

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

Comparison of Radiation Dose From Conventional and Triple-bolus Computed Tomography Urography Protocols in the Diagnosis and Management of Patients With Renal Cortical Neoplasms

The economic implications of unsuspected findings from CT urography performed for haematuria

An education and training programme for radiological institutes: impact on the reduction of the CT radiation dose

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