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European Radiology

, Volume 29, Issue 12, pp 6581–6590 | Cite as

Intra-individual consistency of spectral detector CT-enabled iodine quantification of the vascular and renal blood pool

  • Simon Lennartz
  • Nuran Abdullayev
  • David Zopfs
  • Jan Borggrefe
  • Victor-Frederic Neuhaus
  • Thorsten Persigehl
  • Stefan Haneder
  • Nils Große HokampEmail author
Computed Tomography
  • 119 Downloads

Abstract

Objectives

The objective of this study was to evaluate the intra-individual, longitudinal consistency of iodine measurements regarding the vascular and renal blood pool in patients that underwent repetitive spectral detector computed tomography (SDCT) examinations to evaluate their utility for oncologic imaging.

Methods

Seventy-nine patients with two (n = 53) or three (n = 26) clinically indicated biphasic SDCT scans of the abdomen were retrospectively included. ROI-based measurements of Hounsfield unit (HU) attenuation in conventional images and iodine concentration were performed by an experienced radiologist in the following regions (two ROIs each): abdominal aorta, vena cava inferior, portal vein, and renal cortices. Modified variation coefficients (MVCs) were computed to assess intra-individual longitudinal between the different time points.

Results

Variation of HU attenuation and iodine concentration measurements was significantly lower in the venous than in the arterial phase images (attenuation/iodine concentration: arterial − 4.2/− 3.9, venous 0.4/1.0; p ≤ 0.05). Regarding attenuation in conventional images of the arterial phase, the median MVC was − 1.8 (− 20.5–21.3) % within the aorta and − 6.5 (− 44.0–25.0) % within the renal cortex while in the portal venous phase, it was 0.62 (− 11.1–11.7) % and − 1.6 (− 16.2–10.6) %, respectively. Regarding iodine concentration, MVC for arterial phase was − 2.5 (− 22.9–28.4) % within the aorta and − 5.8 (− 55.9–29.6) % within the renal cortex. The referring MVCs of the portal venous phase were − 0.7 (− 17.9–16.9) % and − 2.6 (− 17.6–12.5) %.

Conclusions

Intra-individual iodine quantification of the vascular and cortical renal blood pool at different time points works most accurately in venous phase images whereas measurements conducted in arterial phase images underlay greater variability.

Key Points

There is an intra-individual, physiological variation in iodine map measurements from dual-energy computed tomography.

This variation is smaller in venous phase examinations compared with arterial phase and therefore venous phase images should be preferred to minimize this intra-individual variation.

Care has to be taken, when considering iodine measurements for clinical decision-making, particularly in the context of oncologic initial or follow-up imaging.

Keywords

Contrast media Kidney Tomography, X-ray computed Aorta Vena cava, inferior 

Abbreviations

ANOVA

Analysis of variances

AP

Anterior-posterior

CI

Conventional images

CT

Computed tomography

CTDIvol

Volumetric computed tomography dose index

DE

Effective diameter

DECT

Dual-energy computed tomography

HU

Hounsfield units

IC

Iodine concentration

ICC

Intraclass correlation coefficient

IM

Iodine maps

LAT

Lateral

MVC

Modified variation coefficient

RADS

Reporting and data storage system

RECIST

Response evaluation criteria in solid tumors

RIS

Radiological information system

ROI

Region of interest

SDCT

Spectral detector computed tomography

Notes

Funding

This study was funded by the Else Kröner-Fresenius-Stiftung (Grant 2018_EKMS.34 to Dr. Nils Große Hokamp).

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Dr. Nils Große Hokamp.

Conflict of interest

SL received research and travel support outside this specific project from Philips Healthcare. JB, DM received speaker’s honoraria from Philips Healthcare. NGH received speaker’s honoraria and travel support from Philips Healthcare. All other authors: nothing to disclose.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• Retrospective

• Observational

• Performed at one institution

Supplementary material

330_2019_6266_MOESM1_ESM.docx (1.6 mb)
ESM 1 (DOCX 1650 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  1. 1.Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional RadiologyUniversity of CologneCologneGermany
  2. 2.Else Kröner Forschungskolleg Clonal Evolution in CancerUniversity Hospital CologneCologneGermany

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