Recommended iodine dose for multiphasic contrast-enhanced mutidetector-row computed tomography imaging of liver for assessing hypervascular hepatocellular carcinoma: multicenter prospective study in 77 general hospitals in Japan.

Abstract

RATIONALE AND OBJECTIVES:

To determine the recommended iodine dose of contrast material (CM) for hepatic arterial-dominant phase (HAP) and hepatic parenchymal phase (HPP) imaging to assess hypervascular hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

This was a prospective study including 348 patients with hypervascular HCC in 77 hospitals as a postmarketing surveillance to investigate the effects of body weight-tailored dose of CM (300 mgI/mL of iohexol) for hepatic multiphasic contrast-enhanced multidetector-row computed tomography imaging. Informed consent was obtained from all patients who were enrolled. The tumor-to-liver contrast (TLC) of HAP images was assessed qualitatively (QL-TLC) and quantitatively (QT-TLC [HU]; computed tomography [CT] value of tumor-CT value of hepatic parenchyma). Minimal and sufficient QT-TLC were defined as CT values corresponding to the median and 75% of QL-TLC assigned with "good," respectively. The recommended iodine dose was estimated by the relationship between iodine dose (mgI/kg) and QT-TLC.

RESULTS:

There was a good correlation between QL-TLC and QT-TLC. The recommended iodine dose of CM for HAP imaging was considered to be in the range of 567-647 mgI/kg based on minimal (33.7 HU) and sufficient QT-TLC (40.9 HU). Meanwhile, the recommended dose of CM for HPP imaging was 572 mgI/kg as a dose that gives hepatic enhancement more than 50 HU during HPP imaging.

CONCLUSIONS:

The recommended iodine dose of CM for HAP and HPP imaging may be different, being 567-647 mgI/kg and 572 mgI/kg, respectively, in assessing hypervascular HCC.

• Authors: Tomoaki Ichikawa, Masahiro Okada, Hiroshi Kondo, Hironobu Sou, Takamichi Murakami, Masayuki Kanematsu, Shushi Yoshikawa, Kazuhito Shiosakai, Akiko Hayakawa, Kazuo Awai, Kengo Yoshimitsu, Yasuyuki Yamashita
• Journal: Academic radiology (Acad Radiol) Vol. 20 Issue 9 Pg. 1130-6 (Sep 2013) ISSN: 1878-4046 [Electronic] United States
• PMID: 23931427 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Chemical References

• Contrast Media
• Iohexol

Topics

• Aged
• Carcinoma, Hepatocellular (diagnostic imaging, epidemiology)
• Contrast Media (administration & dosage)
• Dose-Response Relationship, Drug
• Female
• Hospitals, General (statistics & numerical data)
• Humans
• Iohexol (administration & dosage)
• Japan (epidemiology)
• Liver Neoplasms (diagnostic imaging, epidemiology)
• Male
• Neovascularization, Pathologic (diagnostic imaging, epidemiology)
• Prevalence
• Radiographic Image Enhancement (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods, statistics & numerical data)