Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2016; 8(7): 693-699
Published online Jul 28, 2016. doi: 10.4329/wjr.v8.i7.693
Value of liver computed tomography with iodixanol 270, 80 kVp and iterative reconstruction
Diomidis Botsikas, Isabelle Barnaure, Sylvain Terraz, Christoph D Becker, Anastasia Kalovidouri, Xavier Montet
Diomidis Botsikas, Isabelle Barnaure, Sylvain Terraz, Christoph D Becker, Anastasia Kalovidouri, Xavier Montet, Department of Radiology, Geneva University Hospital, 1205 Geneva, Switzerland
Isabelle Barnaure, Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
Author contributions: Botsikas D designed and performed the research and wrote the paper; Barnaure I contributed to the analysis, provided clinical advice and supervised the report; Terraz S, Becker CD, Kalovidouri A and Montet X provided clinical advice and supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Geneva University Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Diomidis Botsikas, MD, Department of Radiology, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. diomidis.botsikas@hcuge.ch
Telephone: +41-79-5532512 Fax: +41-022-3724186
Received: January 28, 2016
Peer-review started: February 1, 2016
First decision: March 24, 2016
Revised: April 20, 2016
Accepted: May 10, 2016
Article in press: May 11, 2016
Published online: July 28, 2016
Abstract

AIM: To evaluate the image quality of hepatic multidetector computed tomography (MDCT) with dynamic contrast enhancement.

METHODS: It uses iodixanol 270 mg/mL (Visipaque 270) and 80 kVp acquisitions reconstructed with sinogram affirmed iterative reconstruction (SAFIRE®) in comparison with a standard MDCT protocol. Fifty-three consecutive patients with known or suspected hepatocellular carcinoma underwent 55 CT examinations, with two different four-phase CT protocols. The first group of 30 patients underwent a standard 120 kVp acquisition after injection of Iohexol 350 mg/mL (Accupaque 350®) and reconstructed with filtered back projection. The second group of 25 patients underwent a dual-energy CT at 80-140 kVp with iodixanol 270. The 80 kVp component of the second group was reconstructed iteratively (SAFIRE®-Siemens). All hyperdense and hypodense hepatic lesions ≥ 5 mm were identified with both protocols. Aorta and portal vessels/liver parenchyma contrast to noise ratio (CNR) in arterial phase, hypervascular lesion/liver parenchyma CNR in arterial phase, hypodense lesion/liver parenchyma CNR in portal and late phase were calculated in both groups.

RESULTS: Aorta/liver and focal lesions altogether/liver CNR were higher for the second protocol (P = 0.0078 and 0.0346). Hypervascular lesions/liver CNR was not statistically different (P = 0.86). Hypodense lesion/liver CNR in the portal phase was significantly higher for the second group (P = 0.0107). Hypodense lesion/liver CNR in the late phase was the same for both groups (P = 0.9926).

CONCLUSION: MDCT imaging with 80 kVp with iterative reconstruction and iodixanol 270 yields equal or even better image quality.

Keywords: Multiphasic dynamic liver computed tomography, Low-kVp computed tomography, Iso-osmolar iodine contrast agent, Low iodine concentration contrast agent, Iterative reconstruction

Core tip: The purpose of this retrospective study was to evaluate the efficiency of hepatic multidetector computed tomography (MDCT) with dynamic contrast enhancement using iodixanol 270 mg/mL and 80 kVp acquisitions reconstructed with sinogram affirmed iterative reconstruction in comparison with a standard protocol using Iohexol 350 mg/mL and 120 kVp acquisitions. MDCT imaging with 80 kVp with iterative reconstruction and iodixanol 270 yields equal or even better image quality. The proposed MDCT protocol with less iodine load and lower radiation dose may thus be applied for liver imaging in patients with impaired renal or cardiac function but also in the general population.