TY - JOUR
T1 - Individually Body Weight-Adapted Contrast Media Application in Computed Tomography Imaging of the Liver at 90 kVp
AU - Martens, Bibi
AU - Hendriks, Babs M. F.
AU - Eijsvoogel, Nienke G.
AU - Wildberger, Joachim E.
AU - Mihl, Casper
N1 - Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/3
Y1 - 2019/3
N2 - Objectives The aim of the present study was to evaluate the attenuation and image quality (IQ) of a body weight-adapted contrast media (CM) protocol compared with a fixed injection protocol in computed tomography (CT) of the liver at 90 kV. Materials and Methods One hundred ninety-nine consecutive patients referred for abdominal CT imaging in portal venous phase were included. Group 1 (n = 100) received a fixed CM dose with a total iodine load (TIL) of 33 g I at a flow rate of 3.5 mL/s, resulting in an iodine delivery rate (IDR) of 1.05 g I/s. Group 2 (n = 99) received a body weight-adapted CM protocol with a dosing factor of 0.4 g I/kg with a subsequent TIL adapted to the patients' weight. Injection time of 30 seconds was kept identical for all patients. Therefore, flow rate and IDR changed with different body weight. Patients were divided into 3 weight categories; 70 kg or less, 71 to 85 kg, and 86 kg or greater. Attenuation (HU) in 3 segments of the liver, signal-to-noise ratio, and contrast-to-noise ratio were used to evaluate objective IQ. Subjective IQ was assessed by a 5-point Likert scale. Differences between groups were statistically analyzed (P <0.05 was considered statistically significant). Results No significant differences in baseline characteristics were found between groups. The CM volume and TIL differed significantly between groups (P <0.01), with mean values in group 1 of 110 mL and 33 g I, and in group 2 of 104.1 +/- 21.2 mL and 31.2 +/- 6.3 g I, respectively. Flow rate and IDR were not significantly different between groups (P > 0.05). Body weight-adapted protocoling led to more homogeneous enhancement of the liver parenchyma compared with a fixed protocol with a mean enhancement per weight category in group 2 of 126.5 +/- 15.8, 128.2 +/- 15.3, and 122.7 +/- 21.2 HU compared with that in group 1 of 139.9 +/- 21.4, 124.6 +/- 24.8, and 116.2 +/- 17.8 HU, respectively. Conclusions Body weight-adapted CM injection protocols result in more homogeneous enhancement of the liver parenchyma at 90 kV in comparison to a fixed CM volume with comparable objective and subjective IQ, whereas overall CM volume can be safely reduced in more than half of patients.
AB - Objectives The aim of the present study was to evaluate the attenuation and image quality (IQ) of a body weight-adapted contrast media (CM) protocol compared with a fixed injection protocol in computed tomography (CT) of the liver at 90 kV. Materials and Methods One hundred ninety-nine consecutive patients referred for abdominal CT imaging in portal venous phase were included. Group 1 (n = 100) received a fixed CM dose with a total iodine load (TIL) of 33 g I at a flow rate of 3.5 mL/s, resulting in an iodine delivery rate (IDR) of 1.05 g I/s. Group 2 (n = 99) received a body weight-adapted CM protocol with a dosing factor of 0.4 g I/kg with a subsequent TIL adapted to the patients' weight. Injection time of 30 seconds was kept identical for all patients. Therefore, flow rate and IDR changed with different body weight. Patients were divided into 3 weight categories; 70 kg or less, 71 to 85 kg, and 86 kg or greater. Attenuation (HU) in 3 segments of the liver, signal-to-noise ratio, and contrast-to-noise ratio were used to evaluate objective IQ. Subjective IQ was assessed by a 5-point Likert scale. Differences between groups were statistically analyzed (P <0.05 was considered statistically significant). Results No significant differences in baseline characteristics were found between groups. The CM volume and TIL differed significantly between groups (P <0.01), with mean values in group 1 of 110 mL and 33 g I, and in group 2 of 104.1 +/- 21.2 mL and 31.2 +/- 6.3 g I, respectively. Flow rate and IDR were not significantly different between groups (P > 0.05). Body weight-adapted protocoling led to more homogeneous enhancement of the liver parenchyma compared with a fixed protocol with a mean enhancement per weight category in group 2 of 126.5 +/- 15.8, 128.2 +/- 15.3, and 122.7 +/- 21.2 HU compared with that in group 1 of 139.9 +/- 21.4, 124.6 +/- 24.8, and 116.2 +/- 17.8 HU, respectively. Conclusions Body weight-adapted CM injection protocols result in more homogeneous enhancement of the liver parenchyma at 90 kV in comparison to a fixed CM volume with comparable objective and subjective IQ, whereas overall CM volume can be safely reduced in more than half of patients.
KW - multidetector computed tomography
KW - diagnostic imaging
KW - liver
KW - radiation dosage
KW - contrast media
KW - ITERATIVE RECONSTRUCTION
KW - TUBE VOLTAGE
KW - HEPATOCELLULAR-CARCINOMA
KW - HEPATIC ENHANCEMENT
KW - CT
KW - IODINE
KW - QUALITY
KW - IMAGES
KW - REDUCTION
KW - INJECTION
U2 - 10.1097/RLI.0000000000000525
DO - 10.1097/RLI.0000000000000525
M3 - Article
C2 - 30721159
SN - 0020-9996
VL - 54
SP - 177
EP - 182
JO - Investigative Radiology
JF - Investigative Radiology
IS - 3
ER -