CLINICAL RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2017; 23: 1834-1841 DOI: 10.12659/MSM.904129
Preoperative Assessment of Hepatocellular Carcinoma with Split-Bolus Combined Phase Contrast-Enhanced Computed Tomography
Received: 2017.03.03 Accepted: 2017.03.29 Published: 2017.04.16
Authors’ BCDE Contribution: Jian Jiang Study Design A ABCDEF Ke Wang Data Collection B BCD Yufeng Xu Statistical Analysis C Data Interpretation BCDEF D Jianxin Liu Manuscript Preparation E BD Jingjing Luo Literature Search F BCD Xin Tao Funds Collection G
Department of Radiology, Peking University First Hospital, Beijing, P.R. China
ABCEF Xiaoying Wang
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Xiaoying Wang, e-mail:
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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. 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. All mean CT values were significantly higher in the split-bolus protocol than in the multiphasic protocol (all 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