Evaluation of the preoperative staging of clear cell renal cell carcinoma with split-bolus dual-phase contrast-enhanced CT
10.13491/j.issn.1004-714X.2025.04.016
- VernacularTitle:CT分次团注双期增强对肾透明细胞癌术前分期的评估
- Author:
Pan YIN
1
;
Zhenyi ZHANG
1
;
Can CHEN
1
;
Xingyou ZHENG
1
Author Information
1. Changsha Fourth Hospital (Changsha Hospital of Integrated Traditional Chinese and Western Medicine), Changsha 410200, China.
- Publication Type:OriginalArticles
- Keywords:
Clear cell renal cell carcinoma;
Split-bolus;
Preoperative staging;
Effective dose
- From:
Chinese Journal of Radiological Health
2025;34(4):566-570
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of split-bolus dual-phase contrast-enhanced computed tomography (CT) in preoperative staging of clear cell renal cell carcinoma (ccRCC), and to analyze its effect on radiation dose. Methods From June 2021 to July 2024, 118 patients with suspected renal space occupying lesions admitted to Changsha Fourth Hospital were initially selected. Using a random number table, these patients were assigned to a single-bolus group (single-bolus three-phase enhancement program) and a split-bolus group (split-bolus dual-phase enhancement program), with 59 patients in each group. According to the postoperative pathological results, 100 patients with ccRCC were selected as the study subjects, including 48 patients in the single-bolus group and 52 patients in the split-bolus group. The CT values of ccRCC tissues in various phases were compared between the two groups. The accuracy of preoperative ccRCC staging was analyzed using postoperative pathological staging as the gold standard, and the effective dose (ED) was compared between the two groups. Results There was no significant difference in ccRCC staging between the two groups (P > 0.05). The CT value in the parenchyma-excretion phase of the split-bolus group was (88.24 ± 18.34) HU, which was lower than that of the single-bolus group in the parenchyma phase [(102.43 ± 20.66) HU, P < 0.05]. The accuracy of preoperative staging of ccRCC was 86.54% in the split-bolus group, which was not significantly different from 87.50% in the single-bolus group (P > 0.05). The mean ED was (14.54 ± 1.42) mSv in the split-bolus group, which was lower than (20.43 ± 1.18) mSv in the single-bolus group (P < 0.05). Compared with the single-bolus group, the ED of the split-bolus group decreased by 28.83%. Conclusion Split-bolus dual-phase contrast-enhanced CT provides similar accuracy compared to single-bolus CT in evaluating the preoperative staging of ccRCC, and can reduce the radiation dose.
