Prospective multicenter study on personalized and optimized MDCT contrast protocols: results on liver enhancement.
Eur Radiol
; 31(11): 8236-8245, 2021 Nov.
Article
in En
| MEDLINE
| ID: mdl-33914115
ABSTRACT
OBJECTIVE:
To determine a personalized and optimized contrast injection protocol for a uniform and optimal diagnostic level of liver parenchymal enhancement, in a large patient population enrolled in a multicenter study.METHODS:
Six hundred ninety-two patients who underwent a standardized multi-phase liver CT examination were prospectively assigned to one contrast media (CM) protocol group G1 (100 mL fixed volume, 37 gI); G2 (600 mgI/kg of total body weight (TBW)); G3 (750 mgI/kg of fat-free mass (FFM)), and G4 (600 mgI/kg of FFM). Change in liver parenchyma CT number between unenhanced and contrast-enhanced images was measured by two radiologists, on 3-mm pre-contrast and portal phase axial reconstructions. The enhancement histograms were compared across CM protocols, specifically according to a target diagnostic value of 50 HU. The total amount of iodine dose was also compared among protocols by median and interquartile range (IQR). The Kruskal-Wallis and Mann-Whitney U tests were used to assess significant differences (p < 0.005), as appropriate.RESULTS:
A significant difference (p < 0.001) was found across the groups with liver enhancement decreasing from median over-enhanced values of 77.0 (G1), 71.3 (G2), and 65.1 (G3) to a target enhancement of 53.2 HU for G4. Enhancement IQR was progressively reduced from 26.5 HU (G1), 26.0 HU (G2), and 17.8 HU (G3) to 14.5 HU (G4). G4 showed a median iodine dose of 26.0 gI, significantly lower (p < 0.001) than G3 (33.9 gI), G2 (38.8 gI), and G1 (37 gI).CONCLUSIONS:
The 600 mgI/kg FFM-based protocol enabled a diagnostically optimized liver enhancement and improved patient-to-patient enhancement uniformity, while significantly reducing iodine load. KEY POINTS ⢠Consistent and clinically adequate liver enhancement is observed with personalized and optimized contrast injection protocol. ⢠Fat-free mass is an appropriate body size parameter for correlation with liver parenchymal enhancement. ⢠Diagnostic oncology follow-up liver CT examinations may be obtained using 600 mgI/kg of FFM.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Contrast Media
/
Iodine
Type of study:
Clinical_trials
/
Guideline
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Eur Radiol
Journal subject:
RADIOLOGIA
Year:
2021
Document type:
Article
Affiliation country:
Belgium