Prospective multicenter study on personalized and optimized MDCT contrast protocols: results on liver enhancement.

Details

Serval ID
serval:BIB_3FA96D951441
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prospective multicenter study on personalized and optimized MDCT contrast protocols: results on liver enhancement.
Journal
European radiology
Author(s)
Zanca F., Brat H.G., Pujadas P., Racine D., Dufour B., Fournier D., Rizk B.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
11/2021
Peer-reviewed
Oui
Volume
31
Number
11
Pages
8236-8245
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
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.
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.
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).
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.
• 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.
Keywords
Contrast Media, Humans, Iodine, Liver/diagnostic imaging, Multicenter Studies as Topic, Prospective Studies, Tomography, X-Ray Computed, Abdomen, Contrast media, Liver, body composition, Multidetector computed tomography
Pubmed
Web of science
Create date
19/05/2021 13:59
Last modification date
18/03/2022 7:34
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