Determination of optimal intravenous contrast agent iodine dose for the detection of liver metastasis at 80-kVp CT

Eur Radiol. 2014 Aug;24(8):1853-9. doi: 10.1007/s00330-014-3227-5. Epub 2014 May 28.

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).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Surface Area
  • Body Weight
  • Contrast Media / administration & dosage
  • Diagnosis, Differential
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Injections, Intravenous
  • Iodine* / administration & dosage
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary
  • Male
  • Middle Aged
  • Multidetector Computed Tomography / methods*
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Contrast Media
  • Iodine