Multiphase multi-detector row computed tomography in the setting of chronic liver disease and orthotopic liver transplantation: can a series be eliminated in order to reduce radiation dose?

OBJECTIVE: The objectives of this study were to explore utilization of multi-detector row computed tomography (MDCT) in screening for hepatocellular carcinoma (HCC) and to modify a liver CT protocol with a goal of dose reduction. METHODS: An electronic mail survey querying HCC surveillance practices was sent. One hundred forty consecutive patients referred for HCC indications underwent 4-phase MDCT of the liver. The unenhanced and delayed phases were evaluated by 3 readers for identification of HCC and reader confidence. The estimated effective dose (ED) was calculated. RESULTS: Computed tomography is primarily used to screen for HCC. Average estimated ED was 35.5 mSv. Unenhanced phase did not add to reader confidence; delayed phase increased confidence in 47% of cases. Thirty-two percent of the screening population had cumulative ED of greater than 200 mSv. CONCLUSIONS: Multi-detector row CT of the liver is used frequently in screening for HCC. Unenhanced phase imaging does not add to HCC detection and may be eliminated to reduce radiation dose.

Duke Scholars

Author Brian C Allen Radiology, Abdominal Imaging

Author Lisa Mei-ling Ho Radiology, Abdominal Imaging

Author Sandra Sue Stinnett Biostatistics & Bioinformatics, Division of Biostatistics

Author Andrew Joseph Muir Medicine, Gastroenterology

Author Tracy Anne Jaffe Radiology, Abdominal Imaging