Optimal contrast dose for depiction of hypervascular hepatocellular carcinoma at dynamic CT using 64-MDCT.
OBJECTIVE
The objective of our study was to investigate prospectively the optimal contrast dose for the depiction of hypervascular hepatocellular carcinoma (HCC) during the hepatic arterial phase (HAP) at dynamic CT using a 64-MDCT scanner.


METHODS
The study included 135 patients with known or suspected HCC who underwent dynamic CT on a 64-detector scanner and 47 were found to have 71 hypervascular HCCs. The patients were randomly assigned to one of three protocols: A contrast dose of 450, 525, or 600 mg I/kg of body weight was delivered over 30 seconds in protocols A, B, and C, respectively. We measured the tumor-liver contrast (TLC) during HAP in the three groups and compared the results. Two radiologists qualitatively evaluated tumor conspicuity during HAP using a 3-point scale; their results were compared.


RESULTS
The TLC in protocols A, B, and C was 26.5, 38.4, and 52.3 H, respectively; the difference was significant between protocols A and B (p = 0.05), A and C (p < 0.01), and B and C (p = 0.02). In our qualitative analysis of tumor conspicuity, the mean score for protocols A, B, and C was 1.6, 2.3, and 2.7, respectively; there was a significant difference between protocols A and B and A and C, but not between protocols B and C.


CONCLUSIONS
The administration of a total iodine dose of 525 mg or more per kilogram of body weight is desirable for the good or excellent depiction of hypervascular HCC, although the administration of 450 mg I/kg of body weight can depict hypervascular HCC.
Yanaga
Yumi
Y
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan.
Awai
Kazuo
K
Nakaura
Takeshi
T
Namimoto
Tomohiro
T
Oda
Seitaro
S
Funama
Yoshinori
Y
Yamashita
Yasuyuki
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007479:Iopamidol