Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center

BackgroundThe whole-body low-dose CT (WBLDCT) is the first-choice imaging technique in patients with suspected plasma cell disorder to assess the presence of osteolytic lesions. We investigated the performances of an optimized protocol, evaluating diagnostic accuracy and effective patient dose reduc...

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Autores principales:	Davide Tore, Osvaldo Rampado, Carla Guarnaccia, Roberto Mina, Maria Oronzio, Ambra Santonocito, Alessandro Serafini, Giulio Antonino Strazzarino, Laura Gianusso, Sara Bringhen, Paolo Fonio, Alessandro Depaoli
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	ultra-low-dose whole-body CT multiple myeloma plasma cell disorders effective dose dose reduction Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/9f2c4499f83e4920b6c9dc405115f550
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spelling	oai:doaj.org-article:9f2c4499f83e4920b6c9dc405115f5502021-11-17T05:17:55ZUltra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center2234-943X10.3389/fonc.2021.769295https://doaj.org/article/9f2c4499f83e4920b6c9dc405115f5502021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.769295/fullhttps://doaj.org/toc/2234-943XBackgroundThe whole-body low-dose CT (WBLDCT) is the first-choice imaging technique in patients with suspected plasma cell disorder to assess the presence of osteolytic lesions. We investigated the performances of an optimized protocol, evaluating diagnostic accuracy and effective patient dose reduction using a latest generation scanner.Methods and MaterialsRetrospective study on 212 patients with plasma cell disorders performed on a 256-row CT scanner. First, WBLDCT examinations were performed using a reference protocol with acquisition parameters obtained from literature. A phantom study was performed for protocol optimization for subsequent exams to minimize dose while maintaining optimal diagnostic accuracy. Images were analyzed by three readers to evaluate image quality and to detect lesions. Effective doses (E) were evaluated for each patient considering the patient dimensions and the tube current modulation.ResultsA similar, very good image quality was observed for both protocols by all readers with a good agreement at repeated measures ANOVA test (p>0.05). An excellent inter-rater agreement for lesion detection was achieved obtaining high values of Fleiss’ kappa for all the districts considered (p<0.001). The optimized protocol resulted in a 56% reduction of median DLP (151) mGycm, interquartile range (IQR) 128–188 mGycm vs. 345 mGycm, IQR 302–408 mGycm), of 60% of CTDIvol (2.2 mGy, IQR 1.9–2.7 mGy vs. 0.9 mGy, IQR 0.8–1.2 mGy). The median E value was about 2.6 mSv (IQR 1.7–3.5 mSv) for standard protocol and about 1.5 mSv (IQR 1.4–1.7 mSv) for the optimized one. Dose reduction was statistically significant with p<0.001.ConclusionsProtocol optimization makes ultra-low-dose WBLDCT feasible on latest generation CT scanners for patients with plasma cell disorders with effective doses inferior to conventional skeletal survey while maintaining excellent image quality and diagnostic accuracy. Dose reduction is crucial in such patients, as they are likely to undergo multiple whole-body CT scans during follow-up.Davide ToreOsvaldo RampadoCarla GuarnacciaRoberto MinaMaria OronzioAmbra SantonocitoAlessandro SerafiniGiulio Antonino StrazzarinoLaura GianussoSara BringhenPaolo FonioAlessandro DepaoliFrontiers Media S.A.articleultra-low-dose whole-body CTmultiple myelomaplasma cell disorderseffective dosedose reductionNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ultra-low-dose whole-body CT multiple myeloma plasma cell disorders effective dose dose reduction Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	ultra-low-dose whole-body CT multiple myeloma plasma cell disorders effective dose dose reduction Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Davide Tore Osvaldo Rampado Carla Guarnaccia Roberto Mina Maria Oronzio Ambra Santonocito Alessandro Serafini Giulio Antonino Strazzarino Laura Gianusso Sara Bringhen Paolo Fonio Alessandro Depaoli Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
description	BackgroundThe whole-body low-dose CT (WBLDCT) is the first-choice imaging technique in patients with suspected plasma cell disorder to assess the presence of osteolytic lesions. We investigated the performances of an optimized protocol, evaluating diagnostic accuracy and effective patient dose reduction using a latest generation scanner.Methods and MaterialsRetrospective study on 212 patients with plasma cell disorders performed on a 256-row CT scanner. First, WBLDCT examinations were performed using a reference protocol with acquisition parameters obtained from literature. A phantom study was performed for protocol optimization for subsequent exams to minimize dose while maintaining optimal diagnostic accuracy. Images were analyzed by three readers to evaluate image quality and to detect lesions. Effective doses (E) were evaluated for each patient considering the patient dimensions and the tube current modulation.ResultsA similar, very good image quality was observed for both protocols by all readers with a good agreement at repeated measures ANOVA test (p>0.05). An excellent inter-rater agreement for lesion detection was achieved obtaining high values of Fleiss’ kappa for all the districts considered (p<0.001). The optimized protocol resulted in a 56% reduction of median DLP (151) mGycm, interquartile range (IQR) 128–188 mGycm vs. 345 mGycm, IQR 302–408 mGycm), of 60% of CTDIvol (2.2 mGy, IQR 1.9–2.7 mGy vs. 0.9 mGy, IQR 0.8–1.2 mGy). The median E value was about 2.6 mSv (IQR 1.7–3.5 mSv) for standard protocol and about 1.5 mSv (IQR 1.4–1.7 mSv) for the optimized one. Dose reduction was statistically significant with p<0.001.ConclusionsProtocol optimization makes ultra-low-dose WBLDCT feasible on latest generation CT scanners for patients with plasma cell disorders with effective doses inferior to conventional skeletal survey while maintaining excellent image quality and diagnostic accuracy. Dose reduction is crucial in such patients, as they are likely to undergo multiple whole-body CT scans during follow-up.
format	article
author	Davide Tore Osvaldo Rampado Carla Guarnaccia Roberto Mina Maria Oronzio Ambra Santonocito Alessandro Serafini Giulio Antonino Strazzarino Laura Gianusso Sara Bringhen Paolo Fonio Alessandro Depaoli
author_facet	Davide Tore Osvaldo Rampado Carla Guarnaccia Roberto Mina Maria Oronzio Ambra Santonocito Alessandro Serafini Giulio Antonino Strazzarino Laura Gianusso Sara Bringhen Paolo Fonio Alessandro Depaoli
author_sort	Davide Tore
title	Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
title_short	Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
title_full	Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
title_fullStr	Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
title_full_unstemmed	Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center
title_sort	ultra-low-dose whole-body computed tomography protocol optimization for patients with plasma cell disorders: diagnostic accuracy and effective dose analysis from a reference center
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9f2c4499f83e4920b6c9dc405115f550
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Ultra-Low-Dose Whole-Body Computed Tomography Protocol Optimization for Patients With Plasma Cell Disorders: Diagnostic Accuracy and Effective Dose Analysis From a Reference Center

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