Shintaro Ichikawa MD, Presenter: Nothing to Disclose

Katsuhiro Sano MD, Abstract Co-Author: Nothing to Disclose

Hironobu Sou MD, Abstract Co-Author: Nothing to Disclose

Utaroh Motosugi MD, Abstract Co-Author: Nothing to Disclose

Tomoaki Ichikawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Tsutomu Araki MD, Abstract Co-Author: Nothing to Disclose

Ali Mutsher Muhi MBChB, Abstract Co-Author: Nothing to Disclose

Kazufumi Kimura, Abstract Co-Author: Nothing to Disclose

Tatsuaki Tsukamoto MD, Abstract Co-Author: Nothing to Disclose

Hiroto Nakajima, Abstract Co-Author: Nothing to Disclose

To determine an optimal combination of dose and concentration of iodine CM to assess HCC on HAP of CE-MDCT.

539 hypervascular HCC (mean size, 14.6 mm) in 391 patients were included. All patients underwent CE-MDCT with nine groups with different injection protocols based on combinations of three total dose of CM (600mgI/kg, 550mgI/kg, and 500mgI/kg) and three concentration of CM (300mgI/mL, 350mgI/mL, and 370mgI/mL). Injection duration time of CM was constantly 30 sec, and HAP scanning was started 40 sec after start of injection. Lesion-liver contrast (HU; CT value of the lesion minus CT value of the liver) was calculated in all lesions. Based on the results of three blind readers, Az value and the mean lesion sensitivity and the specificity of HAP were calculated for all groups based on receiver operating characteristic (ROC) analysis.

For the lesion-liver contrast, there were no significant differences with medium concentration of CM (300mgI/mL) among all dose of CM. 600mgI/kg (50, 48HU, respectively) and 550mgI/kg (45, 38HU, respectively) with 350mgI/mL and 370mgI/mL were higher than that of 500mgI/kg (30, 32HU, respectively) (p<.01). 600mgI/kg with 370mgI/mL was also higher than that of 550mgI/kg (p<.01). 500mgI/kg with 300mgI/mL (44HU) was higher than those with 350 and 370mgI/mL (p<.01). For high concentration of CM of both 350mgI/mL and 370mgI/mL, Az values of 600mgI/kg (.97, .97, respectively) were higher than those of 500mgI/kg (.94 (p<.05), .93 (p<.01), respectively). For all concentration of CM, the mean lesion sensitivities of 600mgI/kg (89%, 86%, 88%) were higher than those of 550mgI/kg (80%, 77%, 79%) and 500mgI/kg (79%, 78%, 81%) (p<.05). There were no significant differences in the mean specificity with 300mgI/mL (93%, 90%), 89%) among all dose of CM. For the high concentration of CM, the mean lesion specificities of 600mgI/kg with 350mgI/mL (92%, p<.05) and of 600mgI/mg (94%) and 550mgI/kg (90%) with 370mgI/mL (p<.01) were higher than those of 500mgI/kg (84%, 79%, respectively). The mean specificity of 500mgI/kg with 300mgI/mL (89%) was higher than that with 370mgI/mL (p<.01).

600mgI/kg with any concentration of CM was considered as optimal dose of CM for evaluating hypervascular HCC on HAP of CE-MDCT.

600mgI/kg with any concentration of CM was considered as optimal dose of CM for evaluating hypervascular HCC on HAP of CE-MDCT.

Ichikawa, S, Sano, K, Sou, H, Motosugi, U, Ichikawa, T, Araki, T, Muhi, A, Kimura, K, Tsukamoto, T, Nakajima, H, An Optimal Combination of Dose and Concentration of Iodine Contrast Material (CM) to Assess Hypervascular Hepatocellular Carcinoma (HCC) on Hepatic Arterial-dominant Phase Images (HAP) of Contrast-enhanced Multi-Detector Row CT (CE-MDCT).  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9007728.html