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Erschienen in: European Radiology 7/2013

01.07.2013 | Computed Tomography

Body size indices to determine iodine mass with contrast-enhanced multi-detector computed tomography of the upper abdomen: does body surface area outperform total body weight or lean body weight?

verfasst von: Hiroshi Kondo, Masayuki Kanematsu, Satoshi Goshima, Haruo Watanabe, Hiroshi Kawada, Noriyuki Moriyama, Kyongtae T. Bae

Erschienen in: European Radiology | Ausgabe 7/2013

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Abstract

Objective

To compare total body weight (TBW), lean body weight (LBW) and body surface area (BSA) for the adjustment of the iodine dose required for contrast-enhanced multi-detector computed tomography (MDCT) of the aorta and the liver.

Methods

One hundred and three patients undergoing MDCT of the abdomen were randomised into three groups: the TBW group receiving 0.6 g iodine/kg of TBW (n = 33), the LBW group receiving 0.75 g iodine/kg of LBW (n = 35) and the BSA group receiving 22 g iodine/m2 (n = 35). ∆HU (increases in CT value) per gram of iodine (∆HU/g) and adjusted maximum hepatic enhancement (adjusted MHE; ∆HU/[g iodine/kg]) correlated with three groups using linear regressions.

Results

Correlation coefficients of ∆HU/g were 0.67 (TBW), 0.86 (LBW) and 0.85 (BSA) for the aorta, and 0.74 (TBW), 0.77 (LBW) and 0.84 (BSA) for the liver. Adjusted MHE was constant at 70.2 with LBW and at 2.69 with BSA, but correlated positively with TBW (r = 0.58, P < 0.001).

Conclusion

Iodine load may need to be tailored by LBW or BSA in contrast enhanced MDCT of the abdomen. BSA is a simple and feasible index for the determination of iodine dose in individual patients.

Key Points

Optimisation of enhancement is very important for high quality MDCT.
Iodine dose is best adjusted according to LBW or BSA.
BSA may be adopted because calculation is simple.
Iodine dose of 0.712 g/kg LBW/18.6 g/m 2 BSA gives 50 HU hepatic enhancement.
Literatur
1.
Zurück zum Zitat Haider MA, Amitai MM, Rappaport DC et al (2002) Multi-detector row helical CT in preoperative assessment of small (< or = 1.5 cm) liver metastases: is thinner collimation better? Radiology 225:137–142PubMedCrossRef Haider MA, Amitai MM, Rappaport DC et al (2002) Multi-detector row helical CT in preoperative assessment of small (< or = 1.5 cm) liver metastases: is thinner collimation better? Radiology 225:137–142PubMedCrossRef
2.
Zurück zum Zitat Onishi H, Murakami T, Kim T et al (2006) Hepatic metastases: detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined. Radiology 239:131–138PubMedCrossRef Onishi H, Murakami T, Kim T et al (2006) Hepatic metastases: detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined. Radiology 239:131–138PubMedCrossRef
3.
Zurück zum Zitat Yamashita Y, Komohara Y, Takahashi M et al (2000) Abdominal helical CT: evaluation of optimal doses of intravenous contrast material–a prospective randomized study. Radiology 216:718–723PubMed Yamashita Y, Komohara Y, Takahashi M et al (2000) Abdominal helical CT: evaluation of optimal doses of intravenous contrast material–a prospective randomized study. Radiology 216:718–723PubMed
4.
Zurück zum Zitat Awai K, Takada K, Onishi H, Hori S (2002) Aortic and hepatic enhancement and tumor-to-liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology 224:757–763PubMedCrossRef Awai K, Takada K, Onishi H, Hori S (2002) Aortic and hepatic enhancement and tumor-to-liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology 224:757–763PubMedCrossRef
5.
Zurück zum Zitat Behrendt FF, Pietsch H, Jost G et al (2010) Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT. Eur Radiol 20:1644–1650PubMedCrossRef Behrendt FF, Pietsch H, Jost G et al (2010) Intra-individual comparison of different contrast media concentrations (300 mg, 370 mg and 400 mg iodine) in MDCT. Eur Radiol 20:1644–1650PubMedCrossRef
6.
Zurück zum Zitat Foley WD, Hoffmann RG, Quiroz FA, Kahn CE Jr, Perret RS (1994) Hepatic helical CT: contrast material injection protocol. Radiology 192:367–371PubMed Foley WD, Hoffmann RG, Quiroz FA, Kahn CE Jr, Perret RS (1994) Hepatic helical CT: contrast material injection protocol. Radiology 192:367–371PubMed
7.
Zurück zum Zitat Tublin ME, Tessler FN, Cheng SL, Peters TL, McGovern PC (1999) Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology 210:97–101PubMed Tublin ME, Tessler FN, Cheng SL, Peters TL, McGovern PC (1999) Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology 210:97–101PubMed
8.
Zurück zum Zitat Kanematsu M, Goshima S, Kondo H et al (2005) Optimizing scan delays of fixed duration contrast injection in contrast-enhanced biphasic multidetector-row CT for the liver and the detection of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr 29:195–201PubMedCrossRef Kanematsu M, Goshima S, Kondo H et al (2005) Optimizing scan delays of fixed duration contrast injection in contrast-enhanced biphasic multidetector-row CT for the liver and the detection of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr 29:195–201PubMedCrossRef
9.
Zurück zum Zitat Goshima S, Kanematsu M, Kondo H et al (2006) MDCT of the liver and hypervascular hepatocellular carcinomas: optimizing scan delays for bolus-tracking techniques of hepatic arterial and portal venous phases. AJR Am J Roentgenol 187:W25–W32PubMedCrossRef Goshima S, Kanematsu M, Kondo H et al (2006) MDCT of the liver and hypervascular hepatocellular carcinomas: optimizing scan delays for bolus-tracking techniques of hepatic arterial and portal venous phases. AJR Am J Roentgenol 187:W25–W32PubMedCrossRef
10.
Zurück zum Zitat Heiken JP, Brink JA, McClennan BL, Sagel SS, Crowe TM, Gaines MV (1995) Dynamic incremental CT: effect of volume and concentration of contrast material and patient weight on hepatic enhancement. Radiology 195:353–357PubMed Heiken JP, Brink JA, McClennan BL, Sagel SS, Crowe TM, Gaines MV (1995) Dynamic incremental CT: effect of volume and concentration of contrast material and patient weight on hepatic enhancement. Radiology 195:353–357PubMed
11.
Zurück zum Zitat Desai GS, Uppot RN, Yu EW, Kambadakone AR, Sahani DV (2012) Impact of iterative reconstruction on image quality and radiation dose in multidetector CT of large body size adults. Eur Radiol 22:1631–1640PubMedCrossRef Desai GS, Uppot RN, Yu EW, Kambadakone AR, Sahani DV (2012) Impact of iterative reconstruction on image quality and radiation dose in multidetector CT of large body size adults. Eur Radiol 22:1631–1640PubMedCrossRef
12.
Zurück zum Zitat Ho LM, Nelson RC, Delong DM (2007) Determining contrast medium dose and rate on basis of lean body weight: does this strategy improve patient-to-patient uniformity of hepatic enhancement during multi-detector row CT? Radiology 243:431–437PubMedCrossRef Ho LM, Nelson RC, Delong DM (2007) Determining contrast medium dose and rate on basis of lean body weight: does this strategy improve patient-to-patient uniformity of hepatic enhancement during multi-detector row CT? Radiology 243:431–437PubMedCrossRef
13.
Zurück zum Zitat Kondo H, Kanematsu M, Goshima S et al (2011) Aortic and hepatic enhancement at multidetector CT: evaluation of optimal iodine dose determined by lean body weight. Eur J Radiol 80:e273–e277PubMedCrossRef Kondo H, Kanematsu M, Goshima S et al (2011) Aortic and hepatic enhancement at multidetector CT: evaluation of optimal iodine dose determined by lean body weight. Eur J Radiol 80:e273–e277PubMedCrossRef
14.
Zurück zum Zitat Bae KT, Heiken JP, Brink JA (1998) Aortic and hepatic contrast medium enhancement at CT. Part II. Effect of reduced cardiac output in a porcine model. Radiology 207:657–662PubMed Bae KT, Heiken JP, Brink JA (1998) Aortic and hepatic contrast medium enhancement at CT. Part II. Effect of reduced cardiac output in a porcine model. Radiology 207:657–662PubMed
15.
Zurück zum Zitat Dean PB, Violante MR, Mahoney JA (1980) Hepatic CT contrast enhancement: effect of dose, duration of infusion, and time elapsed following infusion. Invest Radiol 15:158–161PubMedCrossRef Dean PB, Violante MR, Mahoney JA (1980) Hepatic CT contrast enhancement: effect of dose, duration of infusion, and time elapsed following infusion. Invest Radiol 15:158–161PubMedCrossRef
16.
Zurück zum Zitat Kormano M, Partanen K, Soimakallio S, Kivimaki T (1983) Dynamic contrast enhancement of the upper abdomen: effect of contrast medium and body weight. Invest Radiol 18:364–367PubMedCrossRef Kormano M, Partanen K, Soimakallio S, Kivimaki T (1983) Dynamic contrast enhancement of the upper abdomen: effect of contrast medium and body weight. Invest Radiol 18:364–367PubMedCrossRef
17.
Zurück zum Zitat Berland LL, Lee JY (1988) Comparison of contrast media injection rates and volumes for hepatic dynamic incremented computed tomography. Invest Radiol 23:918–922PubMedCrossRef Berland LL, Lee JY (1988) Comparison of contrast media injection rates and volumes for hepatic dynamic incremented computed tomography. Invest Radiol 23:918–922PubMedCrossRef
18.
Zurück zum Zitat Chambers TP, Baron RL, Lush RM (1994) Hepatic CT enhancement. Part I. Alterations in the volume of contrast material within the same patients. Radiology 193:513–517PubMed Chambers TP, Baron RL, Lush RM (1994) Hepatic CT enhancement. Part I. Alterations in the volume of contrast material within the same patients. Radiology 193:513–517PubMed
19.
Zurück zum Zitat Small WC, Nelson RC, Bernardino ME, Brummer LT (1994) Contrast-enhanced spiral CT of the liver: effect of different amounts and injection rates of contrast material on early contrast enhancement. AJR Am J Roentgenol 163:87–92PubMedCrossRef Small WC, Nelson RC, Bernardino ME, Brummer LT (1994) Contrast-enhanced spiral CT of the liver: effect of different amounts and injection rates of contrast material on early contrast enhancement. AJR Am J Roentgenol 163:87–92PubMedCrossRef
20.
Zurück zum Zitat Platt JF, Reige KA, Ellis JH (1999) Aortic enhancement during abdominal CT angiography: correlation with test injections, flow rates, and patient demographics. AJR Am J Roentgenol 172:53–56PubMedCrossRef Platt JF, Reige KA, Ellis JH (1999) Aortic enhancement during abdominal CT angiography: correlation with test injections, flow rates, and patient demographics. AJR Am J Roentgenol 172:53–56PubMedCrossRef
21.
Zurück zum Zitat Bae KT (2003) Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology 227:809–816PubMedCrossRef Bae KT (2003) Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology 227:809–816PubMedCrossRef
22.
Zurück zum Zitat Bae KT, Heiken JP (2005) Scan and contrast administration principles of MDCT. Eur Radiol 15(Suppl 5):E46–E59PubMed Bae KT, Heiken JP (2005) Scan and contrast administration principles of MDCT. Eur Radiol 15(Suppl 5):E46–E59PubMed
23.
Zurück zum Zitat Kondo H, Kanematsu M, Goshima S et al (2008) Abdominal multidetector CT in patients with varying body fat percentages: estimation of optimal contrast material dose. Radiology 249:872–877PubMedCrossRef Kondo H, Kanematsu M, Goshima S et al (2008) Abdominal multidetector CT in patients with varying body fat percentages: estimation of optimal contrast material dose. Radiology 249:872–877PubMedCrossRef
24.
Zurück zum Zitat Bae KT, Heiken JP, Brink JA (1998) Aortic and hepatic contrast medium enhancement at CT. Part I. Prediction with a computer model. Radiology 207:647–655PubMed Bae KT, Heiken JP, Brink JA (1998) Aortic and hepatic contrast medium enhancement at CT. Part I. Prediction with a computer model. Radiology 207:647–655PubMed
25.
Zurück zum Zitat Kondo H, Kanematsu M, Goshima S et al (2010) Body size indexes for optimizing iodine dose for aortic and hepatic enhancement at multidetector CT: comparison of total body weight, lean body weight, and blood volume. Radiology 254:163–169PubMedCrossRef Kondo H, Kanematsu M, Goshima S et al (2010) Body size indexes for optimizing iodine dose for aortic and hepatic enhancement at multidetector CT: comparison of total body weight, lean body weight, and blood volume. Radiology 254:163–169PubMedCrossRef
26.
Zurück zum Zitat Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 93:62–66PubMedCrossRef Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 93:62–66PubMedCrossRef
27.
Zurück zum Zitat Bae KT, Seeck BA, Hildebolt CF et al (2008) Contrast enhancement in cardiovascular MDCT: effect of body weight, height, body surface area, body mass index, and obesity. AJR Am J Roentgenol 190:777–784PubMedCrossRef Bae KT, Seeck BA, Hildebolt CF et al (2008) Contrast enhancement in cardiovascular MDCT: effect of body weight, height, body surface area, body mass index, and obesity. AJR Am J Roentgenol 190:777–784PubMedCrossRef
28.
Zurück zum Zitat Yanaga Y, Awai K, Nakaura T et al (2010) Contrast material injection protocol with the dose adjusted to the body surface area for MDCT aortography. AJR Am J Roentgenol 194:903–908PubMedCrossRef Yanaga Y, Awai K, Nakaura T et al (2010) Contrast material injection protocol with the dose adjusted to the body surface area for MDCT aortography. AJR Am J Roentgenol 194:903–908PubMedCrossRef
29.
Zurück zum Zitat Onishi H, Murakami T, Kim T et al (2010) Abdominal multi-detector row CT: Effectiveness of determining contrast medium dose on basis of body surface area. Eur J Radiol 80:643-647 Onishi H, Murakami T, Kim T et al (2010) Abdominal multi-detector row CT: Effectiveness of determining contrast medium dose on basis of body surface area. Eur J Radiol 80:643-647
30.
Zurück zum Zitat Svensson A, Nouhad J, Cederlund K et al (2012) Hepatic contrast medium enhancement at computed tomography and its correlation with various body size measures. Acta Radiol 53:601–606PubMedCrossRef Svensson A, Nouhad J, Cederlund K et al (2012) Hepatic contrast medium enhancement at computed tomography and its correlation with various body size measures. Acta Radiol 53:601–606PubMedCrossRef
31.
Zurück zum Zitat Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657PubMedCrossRef Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649–657PubMedCrossRef
32.
Zurück zum Zitat Kouno T, Katsumata N, Mukai H, Ando M, Watanabe T (2003) Standardization of the body surface area (BSA) formula to calculate the dose of anticancer agents in Japan. Jpn J Clin Oncol 33:309–313PubMedCrossRef Kouno T, Katsumata N, Mukai H, Ando M, Watanabe T (2003) Standardization of the body surface area (BSA) formula to calculate the dose of anticancer agents in Japan. Jpn J Clin Oncol 33:309–313PubMedCrossRef
33.
Zurück zum Zitat Fleiss JL (1986) The design and analysis of clinical experiments. Wiley, New York, pp 51–59 Fleiss JL (1986) The design and analysis of clinical experiments. Wiley, New York, pp 51–59
34.
Zurück zum Zitat Gleeson TG, Bulugahapitiya S (2004) Contrast-induced nephropathy. AJR Am J Roentgenol 183:1673–1689PubMedCrossRef Gleeson TG, Bulugahapitiya S (2004) Contrast-induced nephropathy. AJR Am J Roentgenol 183:1673–1689PubMedCrossRef
Metadaten
Titel
Body size indices to determine iodine mass with contrast-enhanced multi-detector computed tomography of the upper abdomen: does body surface area outperform total body weight or lean body weight?
verfasst von
Hiroshi Kondo
Masayuki Kanematsu
Satoshi Goshima
Haruo Watanabe
Hiroshi Kawada
Noriyuki Moriyama
Kyongtae T. Bae
Publikationsdatum
01.07.2013
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 7/2013
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-013-2808-z

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