title: 80-kV pulmonary CT angiography with 40 mL of iodinated contrast material in lean patients: comparison of vascular enhancement with iodixanol (320 mg I/mL)and iomeprol (400 mg I/mL).
abstract: OBJECTIVE
  The purpose of this article is to compare the vascular enhancement obtained with a low-kilovoltage pulmonary CT angiography (CTA) protocol in lean patients, using 40 mL of a moderate-concentration isoosmolar (iodixanol, 320 mg I/mL) and a high-concentration low-osmolar (iomeprol, 400 mg I/mL) iodinated contrast medium injected at the same iodine delivery rate.
  
  
  METHODS
  Forty-two lean patients (31 men and 11 women; body mass index, ≤ 23 kg/m(2)) with suspected pulmonary embolism and non-small cell lung carcinoma underwent pulmonary CTA with a 64-MDCT scanner using a tube voltage of 80 kV. Twenty-three patients (54.8%) received 40 mL of iodixanol (320 mg I/mL) injected at a rate of 5 mL/s, and the remaining 19 patients (45.2%) were administered an equal volume of iomeprol (400 mg I/mL) at a flow rate of 4 mL/s. Intraarterial density was measured in the common pulmonary artery trunk, the main right and left pulmonary arteries, lobar arteries, and at the segmental level, for a total of 15 regions of interest per patient. Intravascular enhancement homogeneity from central to subsegmental level was also assessed visually using a semiquantitative score (1 = poor, 2 = good, and 3 = excellent).
  
  
  RESULTS
  The overall vascular density of pulmonary arteries down to the segmental level was significantly higher with iodixanol (320 mg I/mL) than with iomeprol (400 mg I/mL) (p = 0.036). Enhancement homogeneity was good with both contrast agents, with no statistically significant difference between them (p = 0.8966).
  
  
  CONCLUSIONS
  In 80-kV pulmonary CTA of lean patients, higher intravascular enhancement can be achieved with 40 mL of iodixanol (320 mg I/mL) than with the same volume of iomeprol (400 mg I/mL), with good vessel conspicuity down to the subsegmental level.
authors.affiliation: Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa 2, Pisa 56100, Italy. lfaggioni@sirm.org
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Faggioni
authors.forename: Emanuele
authors.initials: E
authors.lastname: Neri
authors.forename: Paola
authors.initials: P
authors.lastname: Sbragia
authors.forename: Rachele
authors.initials: R
authors.lastname: Pascale
authors.forename: Luigia
authors.initials: L
authors.lastname: D'Errico
authors.forename: Davide
authors.initials: D
authors.lastname: Caramella
authors.forename: Carlo
authors.initials: C
authors.lastname: Bartolozzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D015992:Body Mass Index; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003287:Contrast Media; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007479:Iopamidol / Q000031:analogs & derivatives*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric; D013851:Thinness; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C057937:iomeprol; C044834:iodixanol; D007479:Iopamidol