Hepatic enhancement at computed tomography: is there a dependence on body weight past institutional contrast dosing limits?. (February 2023)

• Record Type: Journal Article
• Authors: Kesen, Savas; Svensson, Anders; Thor, Daniel; Brismar, Torkel B.
• Is Part Of: Acta radiologica. Volume 64:Number 2(2023)
• Page Start: 435
• Page End: 440
• Publication Date: 2023-02
• Subjects: Liver -- computed tomography -- intravenous contrast agents; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/02841851221079014
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Although described in product monographs, the maximum contrast media (CM) dose at computed tomography (CT) varies among institutions. Purpose: To investigate whether an upper limit of 40 g of iodine in women and 50 g in men is sufficient or if there is a body weight (BW) dependence of mean hepatic enhancement (MHE) beyond those thresholds. Material and Methods: At our institution, CM injection duration is fixed to 30 s and dosed 600 mg iodine/kg up to 40 g in women and 50 g in men. Pre- and post-contrast hepatic attenuation values (HU) were retrospectively obtained in 200 women and 200 men with glomerular filtration rate >45 mL/min undergoing 18-flurodeoxyglucose PET-CT (18F-FDG PET-CT) of which half weighed below and half above those dose thresholds using iodixanol 320 mg iodine/mL or iomeprol 400 mg iodine/mL. The correlation between BW and MHE was assessed by simple linear regression. Results: Weight range was 41–120 kg in women and 47–137 kg in men. There was no significant relationship between MHE and BW in women receiving <40 g (r = −0.05, P = 0.63) or in men receiving <50 g (r = 0.18, P = 0.07). Above those thresholds there was an inverse relationship (r = −0.64, P <0.001 in women and r = −0.30, P <0.002 in men). There was no apparent upper limit where the dependence of hepatic MHE on BW decreased. Hepatosteatosis limited MHE. Conclusion: Adjusting CM to BW diminishes the dependence of MHE on BW. There was no apparent upper limit for the relationship between BW and MHE in heavier patients at CM-enhanced CT.