title: The efficacy of contrast protocol in hepatic dynamic computed tomography: multicenter prospective study in community hospitals.
abstract: OBJECTIVE
  To investigate four different contrast protocols to detect hypervascular hepatocellular carcinoma (HCC) most adaptable for patients at any body weight (BW) in clinical practice.
  
  
  METHODS
  A post-marketing surveillance of liver dynamic CT was prospectively performed by four different protocols in 415 patients: Protocol-A, BW-tailored dose of contrast media (CM: iohexol 300 mgI/mL), fixed injection duration (30s), fixed scan timing at arterial phase (AP); Protocol-B, BW-tailored dose of CM, fixed injection duration (30s), by bolus tracking; Protocol-C, BW-tailored dose of CM, fixed injection flow rate, by bolus tracking; Protocol-D, 100 mL constant of CM at any BW, fixed scan timing. Scan timing and tumor conspicuity at AP was scored qualitatively. The quantitative CT values of aorta and tumor liver contrast (TLC) were obtained.
  
  
  RESULTS
  The qualitative rate assessed "good" as scan timing of AP in Protocol-C was significantly lower than those in Protocols A and D (difference:16.6%, 17.4%, P = 0.0069, P = 0.0140, respectively). Scatter plot of Protocol-D (R(2) = 0.1283) at AP showed significant inverse relationship between TLC and BW (P =0.0053), although not significant in Protocols A, B, C.
  
  
  CONCLUSIONS
  In patients with higher BW, protocols of BW-tailored dose of CM and/or fixed injection duration have no dependence on BW to diagnose hypervascular HCCs.
authors: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-0811 Japan.
authors: Masahiro
authors: M
authors: Okada
authors: Hiroshi
authors: H
authors: Kondo
authors: Hironobu
authors: H
authors: Sou
authors: Takamichi
authors: T
authors: Murakami
authors: Masayuki
authors: M
authors: Kanematsu
authors: Tomoaki
authors: T
authors: Ichikawa
authors: Shushi
authors: S
authors: Yoshikawa
authors: Kazuhito
authors: K
authors: Shiosakai
authors: Akiko
authors: A
authors: Hayakawa
authors: Kazuo
authors: K
authors: Awai
authors: Kengo
authors: K
authors: Yoshimitsu
authors: Yasuyuki
authors: Y
authors: Yamashita
keywords: CT; Contrast media; Hepatocellular carcinoma; Injection method; Liver
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