The Image Quality and Diagnostic Performance of CT with Low-Concentration Iodine Contrast (240 mg Iodine/mL) for the Abdominal Organs

Moon-Hyung Choi, Young-Joon Lee, Seung-Eun Jung, Moon-Hyung Choi, Young-Joon Lee, Seung-Eun Jung

Abstract

Purpose: To evaluate the difference between CT examinations using 240 mgI/mL contrast material (CM) and 320 mgI/mL CM in the contrast enhancement of the abdominal organs and the diagnostic performance for focal hepatic lesions. Materials and methods: This retrospective study included 422 CT examinations, using 240 mgI/mL iohexol (Group A, 206 examinations) and 320 mgI/mL ioversol (Group B, 216 examinations), performed between April 2019 and May 2020. Two CT scanners (single-source CT (machine A) and dual-source CT (machine B)) were used to obtain CT images. Two radiologists independently drew regions of interest (ROIs) in the liver, pancreas, spleen, kidney, aorta, portal vein, and paraspinal muscle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for each organ. They evaluated the degree of subjective enhancement of the organs and detected/differentiated focal hepatic lesions. Results: The SNR, CNR, and subjective enhancement of most organs were significantly higher in Group B than in Group A (p < 0.05). The sensitivity and specificity for cysts and malignancy were higher than 85.0% in both groups. The sensitivity for hemangioma was lower in Group B (<75%) than in Group A. In Group A, the SNR and CNR were significantly higher in most organs with machine B than with machine A. Conclusion: Although the SNR and CNR of the abdominal organs were lower with 240 mgI/mL CM than with 320 mgI/mL CM, 240 mgI/mL CM was feasible for evaluating the liver. A CT scanner with more advanced specifications may be beneficial for examinations with 240 mgI/mL CM by using lower tube voltage.

Keywords: computed tomography; contrast media; enhancement; iodine concentration: image quality.

Conflict of interest statement

M.H.C. is currently receiving a research grant from Siemens Healthineers for the topic not related to the current research. For the remaining authors, none were declared.

Figures

Figure 1
Figure 1
Quantitative analysis of the CT images A radiologist draws multiple regions of interest in the liver, pancreas, spleen, portal vein, and aorta (a) and in the kidney and paraspinal muscle (b).
Figure 2
Figure 2
Differences in the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) between the two machines in each group SNR and CNR of the organs in Group A (a,b) and Group B (c,d), respectively. * p < 0.05; ** p < 0.01; *** p < 0.001.
Figure 2
Figure 2
Differences in the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) between the two machines in each group SNR and CNR of the organs in Group A (a,b) and Group B (c,d), respectively. * p < 0.05; ** p < 0.01; *** p < 0.001.
Figure 3
Figure 3
A 64-year-old female patient who underwent CT examinations using the same machine (machine B). An approximately 0.7-cm cyst is noted in liver segment 8 on both CT examinations with 240 mgI/mL contrast material (a) and 320 mgI/mL contrast material (b).

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