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Optimal Contrast Dose for Depiction of Hypervascular Hepatocellular Carcinoma at Dynamic CT Using 64-MDCT

¹ Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556 Japan.
² Department of Radiological Sciences, School of Health Sciences, Kumamoto University, Kumamoto, Japan.

OBJECTIVE. The objective of our study was to investigate prospectively the optimal contrast dose for the depiction of hypervascular hepatocellular carcinoma (HCC) during the hepatic arterial phase (HAP) at dynamic CT using a 64-MDCT scanner.

SUBJECTS AND METHODS. The study included 135 patients with known or suspected HCC who underwent dynamic CT on a 64-detector scanner and 47 were found to have 71 hypervascular HCCs. The patients were randomly assigned to one of three protocols: A contrast dose of 450, 525, or 600 mg I/kg of body weight was delivered over 30 seconds in protocols A, B, and C, respectively. We measured the tumor–liver contrast (TLC) during HAP in the three groups and compared the results. Two radiologists qualitatively evaluated tumor conspicuity during HAP using a 3-point scale; their results were compared.

RESULTS. The TLC in protocols A, B, and C was 26.5, 38.4, and 52.3 H, respectively; the difference was significant between protocols A and B (p = 0.05), A and C (p < 0.01), and B and C (p = 0.02). In our qualitative analysis of tumor conspicuity, the mean score for protocols A, B, and C was 1.6, 2.3, and 2.7, respectively; there was a significant difference between protocols A and B and A and C, but not between protocols B and C.

CONCLUSION. The administration of a total iodine dose of 525 mg or more per kilogram of body weight is desirable for the good or excellent depiction of hypervascular HCC, although the administration of 450 mg I/kg of body weight can depict hypervascular HCC.

Keywords: dynamic CT • hepatic hemodynamics • hepatocellular carcinoma • liver disease • MDCT

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