Radiation dose from volumetric helical perfusion CT of the thorax, abdomen or pelvis

Goh, Vicky; Dattani, Minaxi; Farwell, J. A.; Shekhdar, Jane; Tam, Emily; Patel, Shilpan M.; Juttla, Jaspal; Simcock, Ian C; Stirling, James; Mandeville, Henry; Aird, Edwin; Hoskin, Peter

doi:10.1007/s00330-010-1997-y

Cited by 43 publications

(19 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The radiation dose of our protocol is within the range of usual body CTP protocols in oncology. 44,45 Within the direct x-ray beam in prostatic CTP, the organ that is most vulnerable to radiation is the prostate itself, and no other sensitive organs are contained within the x-ray volume besides the bone marrow. The prostate is usually sought to undergo definitive therapy, either by surgery or by radiation therapy, and unlike in other oncological CTP applications, such as colorectal cancer or lung cancer, no functioning prostate parenchyma is left after therapy.…”

Section: Clinical Implementation and Radiation Burdenmentioning

confidence: 99%

Assessment of Prostate Cancer With Dynamic Contrast-Enhanced Computed Tomography Using an En Bloc Approach

Huellner¹,

Pauli²,

Mattei³

et al. 2014

Investigative Radiology

View full text Add to dashboard Cite

OBJECTIVES The aim of this study was to assess the performance of dynamic contrastenhanced computed tomography of the prostate in patients with biopsy-proven prostate cancer. MA-TERIAL AND METHODS A total of 46 male patients (median age, 65 years; range, 49-73 years) with biopsy-proven prostate cancer underwent an en bloc computed tomography perfusion (CTP) scan of the prostate before surgery. The perfusion parameters mean transit time (MTT), blood flow (BF), and blood volume (BV), as well as the microvessel density (MVD) of surgical specimens were determined. Differences in CTP parameters and MVD among postsurgical Gleason score (sGS) and postsurgical combined Gleason grade (sGG) groups were analyzed. Spearman correlation coefficients were determined between CTP parameters and presurgical biopsy-derived Gleason score (bGS), presurgical biopsy-derived combined Gleason grade (bGG), sGS, sGG, MVD, and pathological tumor stage. A linear regression analysis was carried out for exogenous variables BF, BV, MTT, bGS, and presurgical biopsy-derived combined Gleason grade and endogenous variables sGS, sGG, MVD, and T stage. A receiver operating characteristics analysis was performed to analyze the discriminating performance of CTP parameters and bGS between intermediate-and high-grade tumors. RESULTS The mean perfusion parameters within the prostate tissue were as follows: BF, 39.1 ± 13.4 mL/100 mL min; BV, 4.9 ± 2.4 mL/100 mL; and MTT, 8.9 ± 3.7 seconds. The mean MVD of the tumor tissue was 144.3 ± 55.6/mm. Computed tomography perfusion parameters and MVD were significantly higher in patients with high-grade tumors compared with those with intermediate-grade tumors (P < 0.01 for BF, BV, and MVD). Only BV and MVD were significantly different among sGS and sGG groups. Moderate correlations were found between BF and sGS (0.38) and between BV and sGS (0.43). Linear relations of BV to sGS and to sGG were found.

show abstract

Section: Clinical Implementation and Radiation Burdenmentioning

confidence: 99%

Assessment of Prostate Cancer With Dynamic Contrast-Enhanced Computed Tomography Using an En Bloc Approach

Huellner¹,

Pauli²,

Mattei³

et al. 2014

Investigative Radiology

View full text Add to dashboard Cite

show abstract

“…Kinetics, which can be recorded quantitatively, can provide useful data to monitor changes in tumor angiogenesis following therapy [42][43][44][45][46][47]. However, the technique is still limited by a higher ionizing radion dose than a standard CT study [48]. This has prevented more widespread uptake and perhaps the expectation that dosage will reduce with technological refinement partly explains the lack of multicenter studies, to date, to evaluate its use [49].…”

Section: Review Afaq and Akinmentioning

confidence: 98%

Imaging Assessment of Tumor Response: Past, Present and Future

Afaq

Akın

2011

Future Oncol.

View full text Add to dashboard Cite

Anatomical response assessment criteria have been in use for decades, with the WHO guidelines being replaced by Response Evaluation Criteria in Solid Tumors (RECIST), updated in 2009 to RECIST 1.1. These methods rely on a change in size of a tumor as the main response criteria, but newer cytostatic agents tend to target tumor function at a molecular level before changing the size of a lesion. Recent modifications, such as the Choi criteria, have improved assessment by taking into account density of tumor, but all of these criteria fail to utilize functional imaging parameters, which are becoming increasingly available, including perfusion CT, perfusion MRI, diffusion-weighted imaging, magnetic resonance spectroscopy, dynamic contrast-enhanced ultrasound and combined PET/computed tomography. Developments in these modalities and standardization of imaging acquisition will help to optimize the next set of response criteria, with inclusion of multiparametric, functional modalities, evaluating tumors at the same molecular level at which they are being targeted by therapeutic agents.

show abstract

“…In our study, the mean effective radiation dose to each individual was 25.6 mSv, which is within the range of current oncological perfusion studies. [16] Main methodological limitations of CTP of the prostate are related to poor anatomical intraprostatic detail, its inability both to detect small tumors, and also to assess extracapsular extension of the disease. A recent en-bloc approach has shown that patients with high-grade and intermediate-grade PCa can be more precisely differentiated with CTP rather than with biopsy.…”

Section: Discussionmentioning

confidence: 99%

Assessment of prostate cancer with integrated CT-perfusion using a sector-wise approach

Ferrari¹,

Huellner²,

Pauli³

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: The role of computed tomography perfusion (CTP) in characterizing primary prostate cancer (PCa) is not definitely known. The aim of the present study was to investigate the relationship between CTP parameters and histopathological features of PCa tissue, using a sector-wise approach. Material and methods:Fifty-one patients with biopsy-proven PCa underwent prospectively a CTP scan prior to radical prostatectomy. Blood flow (BF), mean blood volume (BV) and mean transit time (MTT) were calculated, with the prostate being divided into eight sectors. Corresponding sector-wise histopathological analysis of whole-mount prostatectomy specimens was performed to determine tumoral area (mm Conclusion: BF correlates weakly with size and vascularity of PCa. There is a need for further studies to elucidate the association between CTP parameters and other histopathological parameters.

show abstract

Radiation dose from volumetric helical perfusion CT of the thorax, abdomen or pelvis

Abstract: The radiation dose imposed by perfusion CT was on average 1.5 times that of a CT thorax, abdomen and pelvis. The dose is not insubstantial, and must be balanced by the potential clinical utility of additional physiologic data. Further efforts towards dose reduction should be encouraged.

Cited by 43 publications

References 21 publications

Assessment of Prostate Cancer With Dynamic Contrast-Enhanced Computed Tomography Using an En Bloc Approach

Assessment of Prostate Cancer With Dynamic Contrast-Enhanced Computed Tomography Using an En Bloc Approach

Imaging Assessment of Tumor Response: Past, Present and Future

Assessment of prostate cancer with integrated CT-perfusion using a sector-wise approach

Contact Info

Product

Resources

About