Implementation of a split-bolus single-pass CT protocol at a UK major trauma centre to reduce excess radiation dose in trauma pan-CT.


Journal Article

To quantify the dose reduction and ensure that the use of a split-bolus protocol provided sufficient vascular enhancement.Between 1 January 2014 and 31 May 2014, both split bolus and traditional two-phase scans were performed on a single CT scanner (SOMATOM Definition AS+, Siemens Healthcare) using a two-pump injector (Medrad Stellant). Both protocols used Siemens' proprietary tube current and tube voltage modulation techniques (CARE dose and CARE kV). The protocols were compared retrospectively to assess the dose-length product (DLP), aortic radiodensity at the level of the coeliac axis and radiodensity of the portal vein.There were 151 trauma CT examinations during this period. Seventy-eight used the split-bolus protocol. Seventy-one had traditional two-phase imaging. One patient was excluded as they were under the age of 18 years. The radiodensity measurements for the portal vein were significantly higher (p<0.001) in the split-bolus protocol. The mean aortic enhancement in both protocols exceeded 250 HU, although the traditional two-phase protocol gave greater arterial enhancement (p<0.001) than the split-bolus protocol. The split-bolus protocol had a significantly lower (p<0.001) DLP with 43.5% reduction in the mean DLP compared to the traditional protocol.Split-bolus CT imaging offers significant dose reduction for this relatively young population while retaining both arterial and venous enhancement.

Full Text

Cited Authors

  • Leung, V; Sastry, A; Woo, TD; Jones, HR

Published Date

  • October 2015

Published In

Volume / Issue

  • 70 / 10

Start / End Page

  • 1110 - 1115

PubMed ID

  • 26152880

Pubmed Central ID

  • 26152880

Electronic International Standard Serial Number (EISSN)

  • 1365-229X

International Standard Serial Number (ISSN)

  • 0009-9260

Digital Object Identifier (DOI)

  • 10.1016/j.crad.2015.05.014


  • eng