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

Szczegóły
Abstrakt

Tytuł:: Prospective multicenter study on personalized and optimized MDCT contrast protocols: results on liver enhancement.
Autorzy:: Zanca F; Palindromo Consulting, Willem de Corylaan, 51 3001, Leuven, Belgium. .
Brat HG; Institut de Radiologie de Sion, Groupe 3R, Sion, Switzerland.
Pujadas P; GE Healthcare, Buc, France.
Racine D; Institute of Radiation Physics (IRA), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Dufour B; Institut de Radiologie de Sion, Groupe 3R, Sion, Switzerland.
Fournier D; Institut de Radiologie de Sion, Groupe 3R, Sion, Switzerland.
Rizk B; Centre d'Imagerie de Fribourg, Groupe 3R, Fribourg, Switzerland.
Źródło:: European radiology [Eur Radiol] 2021 Nov; Vol. 31 (11), pp. 8236-8245. Date of Electronic Publication: 2021 Apr 29.
Typ publikacji:: Journal Article; Multicenter Study
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer International, c1991-
MeSH Terms:: Contrast Media*
Iodine*
Humans ; Liver/diagnostic imaging ; Multicenter Studies as Topic ; Prospective Studies ; Tomography, X-Ray Computed
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Contributed Indexing:: Keywords: Abdomen; Contrast media; Liver, body composition; Multidetector computed tomography
Substance Nomenclature:: 0 (Contrast Media)
9679TC07X4 (Iodine)
Entry Date(s):: Date Created: 20210429 Date Completed: 20211020 Latest Revision: 20220531
Update Code:: 20240104
DOI:: 10.1007/s00330-021-07953-3
PMID:: 33914115
: Czasopismo naukowe

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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.
(© 2021. European Society of Radiology.)

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