MP63-16 PROSPECTIVE RANDOMIZED COMPARISON OF CONVENTIONAL AND TRIPLE BOLUS COMPUTED TOMOGRAPHY FOR HEMATURIA EVALUATION

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology IV1 Apr 2018MP63-16 PROSPECTIVE RANDOMIZED COMPARISON OF CONVENTIONAL AND TRIPLE BOLUS COMPUTED TOMOGRAPHY FOR HEMATURIA EVALUATION Daniel Lama, Egor Parkhomenko, Chandana Lall, Roshan Patel, Kamaljot Kaler, Ralph Clayman, and Jaime Landman Daniel LamaDaniel Lama More articles by this author , Egor ParkhomenkoEgor Parkhomenko More articles by this author , Chandana LallChandana Lall More articles by this author , Roshan PatelRoshan Patel More articles by this author , Kamaljot KalerKamaljot Kaler More articles by this author , Ralph ClaymanRalph Clayman More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2039AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Hematuria is a common urological complaint requiring computed tomography (CT) imaging. While conventional CT with and without the use of intravenous contrast (CCT) is the gold standard for complete imaging of the upper and lower urinary tract, it is also associated with inherent ionizing radiation exposure. Alternatively, the triple bolus computed tomography (TBCT) protocol has previously been shown to expose patients to 20-40% less ionizing radiation compared to CCT. Herein, we present our preliminary findings of a prospective comparison of TBCT and CCT for the evaluation of hematuria. METHODS We prospectively randomized 52 patients at our institution with a chief complaint of macroscopic or microscopic hematuria to either CCT (n=35) or TBCT (n=17). Patient demographics, pre- and post-imaging creatinine, and urological pathology detection rate were recorded. Radiation exposure was quantified using two metrics; the volumetric computed tomography dose index (CTDIvol) and dose length product (DLP). In addition, a single experienced abdominal CT radiologist, blinded to the CT protocol used, completed an imaging quality questionnaire (rating system ranging from 1 (poor) to 5 (excellent)) for each imaging study. RESULTS There were no differences in patient age, gender, body mass index, Charlson-comorbidity index, change in creatinine, or CTDIvol between those who underwent CCT or TBCT. Patients with CCT imaging received twice the radiation dose compared to patients with TBCT (DLP: 1606 vs. 883 mGy*cm, respectively, p<0.01) (Table 1). CCT scores for imaging quality of the renal vasculature, renal parenchyma, and the collecting system were significantly higher than TBCT (4.94 vs. 4.71, 4.97 vs. 4.59, 4.71 vs. 4.29, respectively, p <0.05). The urological pathology detection rates were similar between CCT and TBCT (68% vs. 59%, respectively, p=0.49). CONCLUSIONS The TBCT protocol for hematuria evaluation exposes patients to a decreased dose of ionizing radiation and demonstrates a comparable radiological pathology detection rate to gold standard CT imaging despite a degradation in overall imaging quality. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e847 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Daniel Lama More articles by this author Egor Parkhomenko More articles by this author Chandana Lall More articles by this author Roshan Patel More articles by this author Kamaljot Kaler More articles by this author Ralph Clayman More articles by this author Jaime Landman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...