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

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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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

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Funding

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

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Authors and Affiliations

  1. Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany

    Simon Lennartz, Nuran Abdullayev, David Zopfs, Jan Borggrefe, Victor-Frederic Neuhaus, Thorsten Persigehl, Stefan Haneder & Nils Große Hokamp

  2. Else Kröner Forschungskolleg Clonal Evolution in Cancer, University Hospital Cologne, Weyertal 115b, 50931, Cologne, Germany

    Simon Lennartz

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  1. Simon Lennartz
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  2. Nuran Abdullayev
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Correspondence to Nils Große Hokamp.

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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.

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Written informed consent was waived by the Institutional Review Board.

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Institutional Review Board approval was obtained.

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Lennartz, S., Abdullayev, N., Zopfs, D. et al. Intra-individual consistency of spectral detector CT-enabled iodine quantification of the vascular and renal blood pool. Eur Radiol 29, 6581–6590 (2019). https://doi.org/10.1007/s00330-019-06266-w

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  • DOI: https://doi.org/10.1007/s00330-019-06266-w

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