title: Comparison of radiation dose from conventional and triple-bolus computed tomography urography protocols in the diagnosis and management of patients with renal cortical neoplasms.
abstract: OBJECTIVE
  To retrospectively compare the radiation dose of triple-bolus computed tomography (TBCT) and conventional CT (CCT) urography protocols, analyze the effects of body mass index (BMI) on radiation dose in each group, and assess image quality.
  
  
  METHODS
  We retrospectively reviewed the images of patients who underwent CCT or TBCT imaging in the management of renal cortical neoplasms. We used standard volumetric CT dose index (CTDIvol) and dose length product (DLP) to estimate radiation exposure. In addition, 2 urologists rated the quality of 20 CT images from each group using a survey with a 5-point Likert scale. The survey consisted of 10 questions relating to the ability of the scan to identify relevant renal anatomy.
  
  
  RESULTS
  The study included 120 patients. CTDIvol and DLP were 28.7% and 40.4% lower in the TBCT protocol, respectively (both P < .001). Increased BMI was associated with a higher DLP for the CCT group compared with the TBCT group (P < .001). The effect of BMI on CTDIvol did not differ between the CCT and TBCT groups. There was no difference in the urologists' assessments of CT image quality.
  
  
  CONCLUSIONS
  In patients with renal cortical neoplasms, TBCT provides comparable image quality to CCT, with lower ionizing radiation exposure without compromising image quality. Obese patients may benefit more from TBCT scans.
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Garen
authors.initials: G
authors.lastname: Abedi
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Zhamshid
authors.initials: Z
authors.lastname: Okhunov
authors.affiliation: Department of Radiology, University of California, Irvine, Orange, CA.
authors.forename: Chandana
authors.initials: C
authors.lastname: Lall
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Kara
authors.initials: K
authors.lastname: Babaian
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: del Junco
authors.affiliation: Department of Radiology, University of California, Irvine, Orange, CA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Helmy
authors.affiliation: Department of Urology, University of California, Irvine, Orange, CA. Electronic address: landmanj@uci.edu.
authors.forename: Jaime
authors.initials: J
authors.lastname: Landman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014567:Urography / Q000379:methods
chemical_list: D003287:Contrast Media