Determination of Optimal Intravenous Contrast Agent Iodine Dose for the Detection of Liver Metastasis at 80-kVp CT

Overview

Journal Eur Radiol

Specialty Radiology

Date 2014 May 29

PMID 24865696

Citations 5

Authors

Satoshi Goshima

Masayuki Kanematsu

Yoshifumi Noda

Hiroshi Kondo

Haruo Watanabe

Hiroshi Kawada

Nobuyuki Kawai

Yukichi Tanahashi

Kyongtae T Bae

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine the optimal iodine mass (IM) to achieve a 50-HU increase in hepatic attenuation for the detection of liver metastasis based on total body weight (TBW) or body surface area (BSA) at 80-kVp computed tomography (CT) imaging of the liver.

Methods: One-hundred and fifty patients who underwent contrast-enhanced CT at 80-kVp were randomised into three groups: 0.5 gI/kg, 0.4 gI/kg and 0.3 gI/kg. Portal venous phase images were evaluated for hepatic parenchymal enhancement (∆HU) and visualisation of liver metastasis. Iodine mass per BSA (gI/m(2)) calculated in individual patients were evaluated.

Results: Mean ∆HU for the 0.5 gI/kg group (84.2 HU) was higher than in the 0.4 gI/kg (66.1 HU) and 0.3 gI/kg (53.7 HU) groups (P < 0.001). Linear correlation equations between ∆HU and IM per TBW or BSA are ∆HU = 7.0 + 153.0 × IM/TBW (r = 0.73, P < 0.001) and ∆HU = 11.4 + 4.0 × IM/BSA (r = 0.75, P < 0.001), respectively. The three groups were comparable for the visualisation of hepatic metastases.

Conclusions: The iodine mass to achieve a 50-HU increase in hepatic attenuation at 80-kVp CT was estimated to be 0.28 gI/kg of body weight or 9.6 gI/m(2) of body surface area.

Key Points: • Hepatic enhancement is expressed as ∆HU = 7.0 + 153.0 × IM [g]/TBW [kg]. • Hepatic enhancement is expressed as ∆HU = 11.4 + 4.0 × IM [g]/BSA [m(2)]. • Essential iodine dose at 80-kVp CT was 0.28 gI/kg or 9.6 gI/m(2).

Citing Articles

Quantifying iodine concentration in the normal bowel wall using dual-energy CT: influence of patient and contrast characteristics.

Nehnahi M, Simon G, Moinet R, Piton G, Camelin C, Ronot M Sci Rep. 2023; 13(1):22714.

PMID: 38123632 PMC: 10733335. DOI: 10.1038/s41598-023-50238-6.

Evaluation of Iodinated Contrast Media Use in Abdominal CT Scans in Cancer Assessments: A Cross-Sectional Study in Lomé (Togo).

Gbande P, NTimon B, Tchakpedeou D, Tchaou M, Adambounou K, Sonhaye L Radiol Res Pract. 2023; 2023:8296467.

PMID: 36644494 PMC: 9836791. DOI: 10.1155/2023/8296467.

Individualized Contrast Media Application Based on Body Weight and Contrast Enhancement in Computed Tomography of Livers without Steatosis.

de Jong D, van Cooten V, Veldhuis W, de Jong P, Kok M Diagnostics (Basel). 2022; 12(7).

PMID: 35885457 PMC: 9322492. DOI: 10.3390/diagnostics12071551.

Finding the optimal tube current and iterative reconstruction strength in liver imaging; two needles in one haystack.

Martens B, Bosschee J, van Kuijk S, Jeukens C, Brauer M, Wildberger J PLoS One. 2022; 17(4):e0266194.

PMID: 35390018 PMC: 8989341. DOI: 10.1371/journal.pone.0266194.

Low kV Computed Tomography of Parenchymal Abdominal Organs-A Systematic Animal Study of Different Contrast Media Injection Protocols.

Overhoff D, Jost G, McDermott M, Weber O, Pietsch H, Schoenberg S Tomography. 2021; 7(4):815-828.

PMID: 34941641 PMC: 8705800. DOI: 10.3390/tomography7040069.

References

Nakaura T, Awai K, Maruyama N, Takata N, Yoshinaka I, Harada K . Abdominal dynamic CT in patients with renal dysfunction: contrast agent dose reduction with low tube voltage and high tube current-time product settings at 256-detector row CT. Radiology. 2011; 261(2):467-76. DOI: 10.1148/radiol.11110021. View

Kondo H, Kanematsu M, Goshima S, Watanabe H, Kawada H, Moriyama N . Body size indices to determine iodine mass with contrast-enhanced multi-detector computed tomography of the upper abdomen: does body surface area outperform total body weight or lean body weight?. Eur Radiol. 2013; 23(7):1855-61. DOI: 10.1007/s00330-013-2808-z. View

Tublin M, Tessler F, Cheng S, Peters T, McGovern P . Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology. 1999; 210(1):97-101. DOI: 10.1148/radiology.210.1.r99ja2197. View

Kalra M, Maher M, Toth T, Schmidt B, Westerman B, Morgan H . Techniques and applications of automatic tube current modulation for CT. Radiology. 2004; 233(3):649-57. DOI: 10.1148/radiol.2333031150. View

Awai K, Takada K, Onishi H, Hori S . Aortic and hepatic enhancement and tumor-to-liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology. 2002; 224(3):757-63. DOI: 10.1148/radiol.2243011188. View

Bae K, Heiken J, Brink J . Aortic and hepatic contrast medium enhancement at CT. Part II. Effect of reduced cardiac output in a porcine model. Radiology. 1998; 207(3):657-62. DOI: 10.1148/radiology.207.3.9609887. View

Huda W, Scalzetti E, Levin G . Technique factors and image quality as functions of patient weight at abdominal CT. Radiology. 2000; 217(2):430-5. DOI: 10.1148/radiology.217.2.r00nv35430. View

Nakayama Y, Awai K, Funama Y, Hatemura M, Imuta M, Nakaura T . Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology. 2005; 237(3):945-51. DOI: 10.1148/radiol.2373041655. View

Nakaura T, Nakamura S, Maruyama N, Funama Y, Awai K, Harada K . Low contrast agent and radiation dose protocol for hepatic dynamic CT of thin adults at 256-detector row CT: effect of low tube voltage and hybrid iterative reconstruction algorithm on image quality. Radiology. 2012; 264(2):445-54. DOI: 10.1148/radiol.12111082. View

10.

Yamashita Y, Komohara Y, Takahashi M, Uchida M, Hayabuchi N, Shimizu T . Abdominal helical CT: evaluation of optimal doses of intravenous contrast material--a prospective randomized study. Radiology. 2000; 216(3):718-23. DOI: 10.1148/radiology.216.3.r00se26718. View

11.

Heiken J, Brink J, McClennan B, Sagel S, Crowe T, Gaines M . Dynamic incremental CT: effect of volume and concentration of contrast material and patient weight on hepatic enhancement. Radiology. 1995; 195(2):353-7. DOI: 10.1148/radiology.195.2.7724752. View

12.

Brooks R . A quantitative theory of the Hounsfield unit and its application to dual energy scanning. J Comput Assist Tomogr. 1977; 1(4):487-93. DOI: 10.1097/00004728-197710000-00016. View

13.

Bae K . Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology. 2003; 227(3):809-16. DOI: 10.1148/radiol.2273020102. View

14.

Bae K, Seeck B, Hildebolt C, Tao C, Zhu F, Kanematsu M . Contrast enhancement in cardiovascular MDCT: effect of body weight, height, body surface area, body mass index, and obesity. AJR Am J Roentgenol. 2008; 190(3):777-84. DOI: 10.2214/AJR.07.2765. View

15.

Goshima S, Kanematsu M, Kondo H, Yokoyama R, Miyoshi T, Nishibori H . MDCT of the liver and hypervascular hepatocellular carcinomas: optimizing scan delays for bolus-tracking techniques of hepatic arterial and portal venous phases. AJR Am J Roentgenol. 2006; 187(1):W25-32. DOI: 10.2214/AJR.04.1878. View

16.

Marin D, Nelson R, Schindera S, Richard S, Youngblood R, Yoshizumi T . Low-tube-voltage, high-tube-current multidetector abdominal CT: improved image quality and decreased radiation dose with adaptive statistical iterative reconstruction algorithm--initial clinical experience. Radiology. 2009; 254(1):145-53. DOI: 10.1148/radiol.09090094. View

17.

Marin D, Nelson R, Samei E, Paulson E, Ho L, Boll D . Hypervascular liver tumors: low tube voltage, high tube current multidetector CT during late hepatic arterial phase for detection--initial clinical experience. Radiology. 2009; 251(3):771-9. DOI: 10.1148/radiol.2513081330. View

18.

Sigal-Cinqualbre A, Hennequin R, Abada H, Chen X, Paul J . Low-kilovoltage multi-detector row chest CT in adults: feasibility and effect on image quality and iodine dose. Radiology. 2004; 231(1):169-74. DOI: 10.1148/radiol.2311030191. View