Excess of radiation burden for young testicular cancer patients using automatic exposure control and contrast agent on whole-body computed tomography -imaging
Background: To assess patient dose from whole-body computed tomography (CT) in association with patient size, automatic exposure control (AEC) and intravenous (IV) contrast agent.
Patients and methods: Sixty-five testicular cancer patients (mean age 28 y) underwent altogether 279 whole-body CT scans from April 2000 to April 2011. The mean number of repeated examinations was 4.3. The GE LightSpeed 16 equipped with AEC and the Siemens Plus 4 CT scanners were used for imaging. Whole‑body scans were performed with (216) and without (63) IV contrast. The ImPACT software was used to determine the effective and organ doses.
Results: Patient doses were independent (p<0.41) of patient size when the Plus 4 device (mean 7.4 mSv, SD 1.7 mSv) was used, but with the LightSpeed 16 AEC device, the dose (mean 14 mSv, SD 4.6 mSv) increased significantly (p<0.001). Imaging with the IV contrast agent caused significantly higher (13 % Plus 4, 35 % LightSpeed 16) exposure than non-contrast imaging (p<0.001).
Conclusions: Great caution on the use of IV contrast agent and careful set-up of the AEC modulation parameters is recommended to avoid excessive radiation exposure on the whole-body CT imaging of young patients.