Minimally required iodine dose for the detection of hypervascular hepatocellular carcinoma on 80-kVp CT

Abstract

OBJECTIVE. The objective of our study was to determine the iodine dose per unit of body weight (BW) or body surface area (BSA) that is minimally required to detect hypervascular hepatocellular carcinoma (HCC) on 80-kVp CT. SUBJECTS AND METHODS. One hundred eleven patients (78 men and 33 women; mean age, 68 years; age range, 43-85 years) with chronic hepatitis were randomized into three groups with different iodine loads (0.5, 0.4, and 0.3 g I/kg BW) and underwent contrastenhanced CT at 80 kVp. Enhancement of the liver and of hypervascular HCCs was quantitatively and qualitatively assessed on hepatic arterial, portal venous, and equilibrium phase images and compared between the groups. Values for iodine dose per unit of BSA (g I/m2) were also computed and analyzed. RESULTS. No significant differences in the contrast-To-noise ratio (CNR) of hypervascular HCCs in any phase were found between the groups (p = 0.34-0.99). In the portal venous phase, the mean increase in hepatic contrast enhancement (δHU) of the 0.5 g I/kg group (80.3 HU) was higher than those of the 0.4 g I/kg (63.4 HU) and 0.3 g I/kg (53.3 HU) groups (p > 0.001). Linear correlation equations for the increase in hepatic contrast enhancement were as follows: (δHU = 5.9 + 150.0 × ILBW (r = 0.69, p > 0.001), where ILBW is the iodine load per unit of BW (g I/kg), and δHU = 13.0 + 3.68 × ILBSA (r = 0.66, p > 0.001), where ILBSA is the iodine load pre unit of BSA (g I/m2). CONCLUSION. The minimal iodine dose required to achieve a tumor-To-liver CNR that is acceptable for the detection of hypervascular HCCs on 80-kVp CT was 0.3 g I/kg BW or 11.0 g I/m2 BSA.