Vol. 3, 2018

Original research papers



Andrea Bonfanti, Elena Ciortan, Luciano Abate, Ruggero Luigi Baroni, Serena Padelli, Roberto Moltrasi

Pages: 159–162

DOI: 10.21175/RadProc.2018.34

The objective was to compare the contrast enhanced computed tomography (CT) “LOW DOSE” protocol for thoraco-abdominal scans, with the standard CT protocol for oncologic follow up. We analyzed these two different imaging techniques and the overall radiation dose in order to determine benefits in terms of diagnosis. We included 50 patients where oncologic follow up included a triphasic thoraco-abdominal CT for staging of liver disease. Eligibility criteria were the medical indication for a contrast-enhanced thoraco-abdominal CT as part of an oncologic follow up (breast cancer, hepatocarcinoma, neuroendocrine tumors, kidney cancer and prostatic cancer) and the availability of previous enhanced CT scans performed over the past year of follow up. The LOW DOSE protocol for triphasic CT in oncologic follow up permits saving of effective dose up to 50% (27% on average) for each scan and an overall saving of up to 40% (15% on average) for complete procedure in the normal BMI group. The LOW DOSE protocol was also effective in the diagnosis of thromboembolic disease. All the scans from the LOW DOSE CT protocol were analyzed by radiologists, all with at least 10 years of experience, unaware of the introduction of the protocol – there were no reported differences or difficulties in diagnosis compared to the standard CT protocol.
  1. Recommendations of the International Commission on Radiological Protection, ICRP Publication 103, Ottawa, Canada, 2007.
    Retrieved from: http://www.icrp.org/docs/ICRP_Publication_103-Annals_of_the_ICRP_37(2-4)-Free_extract.pdf;
    Retrieved on: Jun. 19, 2018
  2. European Commission. (Feb. 18, 2000). European guidelines of quality criteria for computed tomography.
    Retrieved from: https://publications.europa.eu/en/publication-detail/-/publication/d229c9e1-a967-49de-b169-59ee68605f1a;
    Retrieved on: Jun. 19, 2018
  3. Basic anatomical and physiological data for use in radiological protection, ICRP Publication 89, ICRP, Ottawa, Canada, 2002.
    PMid: 14506981
  4. Relative biological effectiveness (RBE), quality factor (Q), and radiation weighting factor (wR), ICRP Publication 92, ICRP, Ottawa, Canada, 2002.
    PMid: 14614921
  5. Low dose extrapolation of radiation-related cancer risk, ICRP Publication 99, ICRP, Ottawa, Canada, 2005.
    DOI: 10.1016/j.icrp.2005.11.002
    PMid: 16782497
  6. Assessing dose of the representative person for the purpose of radiation protection of the public and the optimisation of radiological protection: Broadening the process,ICRP Publication 101, ICRP, Ottawa, Canada, 2006.
    DOI: 10.1016/j.icrp.2006.09.003
    PMid: 17174713
  7. G. Starck, L. Lonn, et al., “A method to obtain the same levels of CT image noise for patients of various size, to minimize radiation dose,” Br. J. Radiol., vol. 75, no. 890, pp. 140 – 150, Feb. 2002.
    DOI: 10.1259/bjr.75.890.750140
    PMid: 11893638
  8. C. S. Alvin, J. L. Holly et al., “Innovation in CT Dose Reduction Strategy: Application of the Adaptive Statistical Iterative Reconstruction Algorithm,” Am. J. Roentgenol., vol. 194, no. 1, pp. 191 – 199, Jan. 2010.
    DOI: 10.2214/AJR.09.2953
    PMid: 20028923