title: The optimal contrast media policy in CT of the liver. Part II: Clinical protocols.
abstract: The advent of multidetector computed tomography (MDCT) revolutionized abdominal imaging. In particular, the definitive assessment of CT injection protocols, for the evaluation of the liver parenchyma, is still a critical issue for radiologists. Over the last years, this feature encouraged several authors to address their efforts to find the most accurate delay between the contrast medium injection and the effective scan-start, for the identification and characterization of liver lesions. Technological developments of the present century such as number of slices, submillimetric collimation, and the use of multiple dynamic post-contrast phases per single examination, may all contribute to increase the radiation exposure of single patients. The aim of this review is to propose liver imaging protocols, taking into consideration different clinical needs such as patients with chronic liver disease, healthy patients with focal liver lesion, and oncological patients to minimize radiation exposure. Finally, two recent innovations in MDCT which illustrate the potential application of multi-energy computed tomography (MECT) and perfusion computed tomography (CTp) when evaluating liver parenchyma will be discussed in a short closing paragraph.
authors.affiliation: Department of Radiological, Oncological and Pathological Sciences, University of Rome Sapienza, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rengo
authors.forename: Davide
authors.initials: D
authors.lastname: Bellini
authors.forename: Carlo N
authors.initials: CN
authors.lastname: De Cecco
authors.forename: Marcello
authors.initials: M
authors.lastname: Osimani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Vecchietti
authors.forename: Damiano
authors.initials: D
authors.lastname: Caruso
authors.forename: Marco M
authors.initials: MM
authors.lastname: Maceroni
authors.forename: Paola
authors.initials: P
authors.lastname: Lucchesi
authors.forename: Franco
authors.initials: F
authors.lastname: Iafrate
authors.forename: Erica
authors.initials: E
authors.lastname: Palombo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Paolantonio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ferrari
authors.forename: Andrea
authors.initials: A
authors.lastname: Laghi
mesh_terms: D002985:Clinical Protocols; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011835:Radiation Protection; D011856:Radiographic Image Enhancement / Q000379:methods; D011860:Radiography, Abdominal / Q000379:methods* / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000639:trends
chemical_list: D003287:Contrast Media