Does iodine concentration affect the diagnostic efficacy of biphasic spiral CT in patients with hepatocellular carcinoma?

Abstract

Even though a small number of patients was examined, our study suggests that, in patients with cirrhosis, an increased concentration of iodine improves liver-to-lesion contrast and may improve the detection of hepatocellular carcinoma.

Effect of varying contrast material iodine concentration and injection technique on the conspicuity of hepatocellular carcinoma during 64-section MDCT of patients with cirrhosis

“…These findings, which corroborate the results of previous reports either in the same [6] or in different [5,16] patient groups, are probably caused by two concurrent factors. First, when the injection flow rate remains constant, an increase in the iodine concentration in the contrast medium yields proportionally higher amounts of iodine administered per unit of time.…”

“…First, when the injection flow rate remains constant, an increase in the iodine concentration in the contrast medium yields proportionally higher amounts of iodine administered per unit of time. There is compelling evidence that, during early arterial contrast medium dynamics, increasing the iodine delivery rate -using either faster injection flow rates or a higher iodine concentration contrast medium, or both -has a profound influence on the magnitude of enhancement of the arterial system [5,16,17] of wellperfused organs, such as the renal cortex, pancreas and spleen [17,18], and of hypervascular liver tumours [5][6][7][8]. The second factor for the differences we found in tumour conspicuity and arterial enhancement between MCCM and HCCM during the hepatic arterial phase is the discrepancy in the duration of the contrast material injection (on average, 30 s vs 24 s, respectively, for scheme B) using a fixed injection flow rate.…”

“…Recent investigations have emphasised the importance of using test bolus or bolus-tracking methods to synchronise CT data acquisition with the peak tumourto-liver contrast for hypervascular HCC lesions [2,3]; however, the most effective contrast medium injection technique for maximising tumour enhancement during the narrow temporal acquisition of modern MDCT systems remains largely unexplored. Previous studies with early generation MDCT scanners reported conflicting results with varying volumes and concentrations of iodine, injection flow rates and durations of injection of contrast material on the conspicuity of hypervascular HCC tumours [4][5][6][7][8]. Owing to large differences in study design, the demographic characteristics of patients, the type and dose of contrast medium and contrast material injection protocols, these data cannot be compared with each other.…”

Scan and contrast administration principles of MDCT

“…Recently, there has been a growing interest in using and studying contrast media with high iodine concentration (350 mgI/mL and above) with MDCT [21,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. This trend is related to the fact that for a fast scan of MDCT, a high rate of iodine delivery is desired to maximize arterial enhancement for CTA and to depict hypervascular tumors.…”

Analysis of the Effects of Different Iodine Concentrations on the Characterization of Small Renal Lesions Detected by Multidetector Computed Tomography Scan: A Pilot Study

“…With recent improvements in the temporal and spatial resolutions in MDCT, the need for a more efficient approach in the use of iodinated CM has increased (4). Several studies investigated the influence of CM with different iodine concentration on parenchymal and vascular enhancement in body imaging (1,(5)(6)(7).…”