An Individually Optimized Protocol of Contrast Medium Injection in Enhanced CT Scan for Liver Imaging

Abstract

Objective To investigate the effectiveness of a new individualized contrast medium injection protocol for enhanced liver CT scan. Methods 324 patients who underwent plain and dual phase enhanced liver CT were randomly assigned to 2 groups: G1 (n = 224, individualized contrast medium injection protocol); G2 (n = 100, standard contrast medium injection with a dose of 1.5 ml/kg). CT values and ΔHU (CT values difference between plain and enhanced CT) of liver parenchyma and tumor-liver contrast (TLC) during hepatic arterial phase (HAP) and portal venous phase (PVP) and contrast medium dose were measured. The tumor conspicuity of hepatocellular carcinoma (HCC) between two groups was independently evaluated by two radiologists. Results The mean contrast medium dose of G1 was statistically lower than that of G2. There were no significantly statistical differences in CT values and ΔHU of liver parenchyma during HAP, TLC values during HAP, and PVP between two groups. The CT values and ΔHU of liver parenchyma during PVP of G2 were significantly higher than those of G1. Two independent radiologists were both in substantial conformity in grading tumor conspicuity. Conclusion Using the individually optimized injection protocol might reduce contrast medium dose without impacting on the imaging quality in enhanced liver CT.

Impact of artificial intelligence on clinical radiography practice: Futuristic prospects in a low resource setting

“…Although, this is already happening, it is on a very limited scale, currently. There is also the possibility of contrast volume being determined by AI tools based on patient parameters 21 and in some cases contrast media could be eliminated altogether by AI systems by introducing synthetic contrast enhancement approaches. 22 Moreover, radiographer reporting is well established [23][24][25] with positive outcomes.…”

Artificial intelligence in diagnostic imaging: impact on the radiography profession

“…Consequently, this is an important aspect of the radiographer's role, but research suggests that isocentric positioning and scout image analysis in CT, alongside MR plane and volume calculations, are areas that may be automatable by AI systems. 34,35 There is also potential for optimizing contrast volume and injection rates based on patient parameters using intelligent systems, 36 as well as the possibility of using no contrast at all via synthetic contrast enhancement, 37 thereby embracing the ethos of personalized and individualized healthcare. Within the context of treatment planning and therapeutic radiography, deep learning systems may also be used to plan treatment regions by autosegmenting tumors 38 and individualizing radiotherapy dose 39 benefitting patient care and potentially reducing unintended treatment outcomes.…”

An evaluation of DNA double strand break formation and excreted guanine species post whole body PET/CT procedure

“…One hour before the PET/CT procedure 8 MBq/kg 18 F-FDG was injected intravenously, patients were instructed to empty their bladder in the radioactive toilet before the scan in the GE Discovery 690 PET/CT scanner [ 23 ]. Patients were positioned inside the scanner for contrast-enhanced WB PET/CT examination, and were injected with Iohexol, Omnipaque 300 based on the patient body weight at dose of 84.57 ± 16.69 ml and flow rate of 2–4 ml/s (GE Healthcare; Shanghai co., Ltd. Shanghai, China) [ 24 ]. A scout scan (in which the patient first undergoes an ‘overview’ or ‘scout’ scan procedure during which X-ray projection data are obtained to identify the axial extent of the CT and PET study), breath-holding lung CT, WB CT and PET (from head to mid-thigh) and low-dose cine CT (provides cross-sectional millisecond tomography that is used for the correction of motion due to diaphragmatic movement) were obtained in an arms-up position and the imaging parameters for WB CT were followed according to our previous study [ 22 ].…”