Top

Published in:

01-01-2011

Optimizing scan timing of hepatic arterial phase by physiologic pharmacokinetic analysis in bolus-tracking technique by multi-detector row computed tomography

Authors: Isao Yamaguchi, Eiji Kidoya, Masayuki Suzuki, Hirohiko Kimura

Published in: Radiological Physics and Technology | Issue 1/2011

Abstract

Our aim in this study was to determine an optimal delay time of hepatic arterial phase (HAP) imaging of hypervascular hepatocellular carcinomas (HCCs) in dynamic contrast-enhanced MDCT (DCE-CT) by use of the bolus-tracking method. The time-enhancement curves (TECs) of the aorta and the contrast of the hepatic arterial and portal system (APC) in the pharmacokinetic analysis were calculated. The clinical study included 41 patients with known or suspected HCC who underwent DCE-CT. The TECs of the aorta and the tumor–liver contrast (TLC) in the clinical study were calculated. On pharmacokinetic analysis, the peak aortic enhancement and the peak APC simulated under conditions of an injection duration of 30 s and an iodine load of 500 mg I/kg body weight were observed 18.5 and 22.5 s, respectively, after the trigger threshold (increased CT value 100 Hounsfield units), respectively. In the clinical study, the peak aortic enhancement and the peak TLC were observed 17.2 and 24.8 s after the trigger threshold, respectively. The optimal delay times until peak aortic enhancement and peak HAP were 15–17 and 19–21 s after the trigger threshold, respectively, under the following conditions: injection dose, 500 mg I/kg body weight; injection duration, 30 s; acquisition time, 5 s; and the trigger threshold. In addition, the peak TLC was achieved 4–7 s after the time to peak aortic enhancement.

Fujita M, Kuroda C, Kumatani T, Yoshioka H, Kuriyama K, Inoue E, Kasugai H, Sasaki Y. Comparison between conventional and spiral CT in patients with hypervascular hepatocellular carcinoma. Eur J Radiol. 1994;18:134–6.CrossRefPubMed

Kim T, Murakami T, Oi H, Matsushita M, Kishimoto H, Igarashi H, Nakamura H, Okamura J. Detection of hypervascular hepatocellular carcinoma by dynamic MRI and dynamic spiral CT. J Comput Assist Tomogr. 1995;19:948–54.CrossRefPubMed

Choi BI, Cho JM, Han JK, Choi DS, Han MC. Spiral CT for the detection of hepatocellular carcinomas: relative value of arterial- and late-phase scanning. Abdom Imaging. 1996;21:440–4.CrossRefPubMed

Oliver JH 3rd, Baron RL, Federle MP, Rockette HE Jr. Detecting hepatocellular carcinoma: value of unenhanced or arterial phase CT imaging or both used in conjunction with conventional portal venous phase contrast-enhanced CT imaging. AJR Am J Roentgenol. 1996;167:71–7.PubMed

Baron RL, Oliver JH III, Dodd GD III, Nalesnik M, Holbert BL, Carr B. Hepatocellular carcinoma: evaluation with biphasic, contrast-enhanced, helical CT. Radiology. 1996;199:505–11.PubMed

Lee HM, Lu DS, Krasny RM, Busuttil R, Kadell B, Lucas J. Hepatic lesion characterization in cirrhosis: significance of arterial hypervascularity on dual-phase helical CT. AJR Am J Roentgenol. 1997;169:125–30.PubMed

Kanematsu M, Oliver JH 3rd, Carr B, Baron RL. Hepatocellular carcinoma: the role of helical biphasic contrast-enhanced CT versus CT during arterial portography. Radiology. 1997;205:75–80.PubMed

Mitsuzaki K, Yamashita Y, Ogata I, Nishiharu T, Urata J, Takahashi M. Multiple-phase helical CT of the liver for detecting small hepatomas in patients with liver cirrhosis: contrast-injection protocol and optimal timing. AJR Am J Roentgenol. 1996;167:753–7.PubMed

Yamashita Y, Komohara Y, Takahashi M, Uchida M, Hayabuchi N, Shimizu T, Narabayashi I. Abdominal helical CT: evaluation of optimal doses of intravenous contrast material—a prospective randomized study. Radiology. 2000;216:718–23.PubMed

10.

Kim S, Kim JH, Han JK, Lee KH, Min BG. Prediction of optimal injection protocol for tumor detection in contrast-enhanced dynamic hepatic CT using simulation of lesion-to-liver contrast difference. Comput Med Imaging Graph. 2000;24:317–27.CrossRefPubMed

11.

Yanaga Y, Awai K, Nakaura T, Namimoto T, Oda S, Funama Y, Yamashita Y. Optimal contrast dose for depiction of hypervascular hepatocellular carcinoma at dynamic CT using 64-MDCT. AJR Am J Roentgenol. 2008;190:1003–9.CrossRefPubMed

12.

Sultana S, Morishita S, Awai K, Kawanaka K, Ohyama Y, Nakayama Y, Imuta M, Arakawa A, Yamashita Y. Evaluation of hypervascular hepatocellular carcinoma in cirrhotic liver by means of helical CT: comparison of different contrast medium concentrations within the same patient. Radiat Med. 2003;21:239–45.PubMed

13.

Itoh S, Ikeda M, Achiwa M, Satake H, Ota T, Ishigaki T. Multiphase contrast-enhanced CT of the liver with a multislice CT scanner: effects of iodine concentration and delivery rate. Radiat Med. 2005;23:61–9.PubMed

14.

Awai K, Takada K, Onishi H, Hori S. Aortic and hepatic enhancement and tumor-to-liver contrast: analysis of the effect of different concentrations of contrast material at multi-detector row helical CT. Radiology. 2002;224:757–63.CrossRefPubMed

15.

Awai K, Inoue M, Yagyu Y, Watanabe M, Sano T, Nin S, Koike R, Nishimura Y, Yamashita Y. Moderate versus high concentration of contrast material for aortic and hepatic enhancement and tumor-to-liver contrast at multi-detector row CT. Radiology. 2004;233:682–8.CrossRefPubMed

16.

Furuta A, Ito K, Fujita T, Koike S, Shimizu A, Matsunaga N. Hepatic enhancement in multiphasic contrast-enhanced MDCT: comparison of high- and low-iodine-concentration contrast medium in same patients with chronic liver disease. AJR Am J Roentgenol. 2004;183:157–62.PubMed

17.

Tsurusaki M, Sugimoto K, Fujii M, Sugimura K. Multi-detector row helical CT of the liver: quantitative assessment of iodine concentration of intravenous contrast material on multiphasic CT—a prospective randomized study. Radiat Med. 2004;22:239–45.PubMed

18.

Tozaki M, Naruo K, Fukuda K. Dynamic contrast-enhanced MDCT of the liver: analysis of the effect of different iodine concentrations with the same total iodine dose in the same chronic liver disease patients. Radiat Med. 2005;23:533–8.PubMed

19.

Yagyu Y, Awai K, Inoue M, Watai R, Sano T, Hasegawa H, Nishimura Y. MDCT of hypervascular hepatocellular carcinomas: a prospective study using contrast materials with different iodine concentrations. AJR Am J Roentgenol. 2005;184:1535–40.PubMed

20.

Foley WD, Hoffmann RG, Quiroz FA, Kahn CE Jr, Perret RS. Hepatic helical CT: contrast material injection protocol. Radiology. 1994;192:367–71.PubMed

21.

Bae KT, Heiken JP, Brink JA. Aortic and hepatic peak enhancement at CT: effect of contrast medium injection rate–pharmacokinetic analysis and experimental porcine model. Radiology. 1998;206:455–64.PubMed

22.

Tublin ME, Tessler FN, Cheng SL, Peters TL, McGovern PC. Effect of injection rate of contrast medium on pancreatic and hepatic helical CT. Radiology. 1999;210:97–101.PubMed

23.

Shimizu T, Misaki T, Yamamoto K, Sueyoshi K, Narabayashi I. Helical CT of the liver with computer-assisted bolus-tracking technology: scan delay of arterial phase scanning and effect of flow rates. J Comput Assist Tomogr. 2000;24:219–23.CrossRefPubMed

24.

Mehnert F, Pereira PL, Trubenbach J, Kopp AF, Claussen CD. Biphasic spiral CT of the liver: automatic bolus tracking or time delay? Eur Radiol. 2001;11:427–31.CrossRefPubMed

25.

Murakami T, Kim T, Takamura M, Hori M, Takahashi S, Federle MP, Tsuda K, Osuga K, Kawata S, Nakamura H, Kudo M. Hypervascular hepatocellular carcinoma: detection with double arterial phase multi-detector row helical CT. Radiology. 2001;218:763–7.PubMed

26.

Sandstede JJ, Tschammler A, Beer M, Vogelsang C, Wittenberg G, Hahn D. Optimization of automatic bolus tracking for timing of the arterial phase of helical liver CT. Eur Radiol. 2001;11:1396–400.CrossRefPubMed

27.

Kim T, Murakami T, Hori M, Takamura M, Takahashi S, Okada A, Kawata S, Cruz M, Federle MP, Nakamura H. Small hypervascular hepatocellular carcinoma revealed by double arterial phase CT performed with single breath-hold scanning and automatic bolus tracking. AJR Am J Roentgenol. 2002;178:899–904.PubMed

28.

Murakami T, Kim T, Kawata S, Kanematsu M, Federle MP, Hori M, Okada A, Kumano S, Sugihara E, Tomoda K, Nakamura H. Evaluation of optimal timing of arterial phase imaging for the detection of hypervascular hepatocellular carcinoma by using triple arterial phase imaging with multidetector-row helical computed tomography. Invest Radiol. 2003;38:497–503.CrossRefPubMed

29.

Zhao H, Zhou KR, Yan FH. Role of multiphase scans by multirow-detector helical CT in detecting small hepatocellular carcinoma. World J Gastroenterol. 2003;9:2198–201.PubMed

30.

Itoh S, Ikeda M, Achiwa M, Satake H, Iwano S, Ishigaki T. Late-arterial and portal-venous phase imaging of the liver with a multislice CT scanner in patients without circulatory disturbances: automatic bolus tracking or empirical scan delay? Eur Radiol. 2004;14:1665–73.CrossRefPubMed

31.

Kanematsu M, Goshima S, Kondo H, Nishibori H, Kato H, Yokoyama R, Miyoshi T, Hoshi H, Onozuka M, Moriyama N. Optimizing scan delays of fixed duration contrast injection in contrast-enhanced biphasic multidetector-row CT for the liver and the detection of hypervascular hepatocellular carcinoma. J Comput Assist Tomogr. 2005;29:195–201.CrossRefPubMed

32.

Goshima S, Kanematsu M, Kondo H, Yokoyama R, Miyoshi T, Nishibori H, Kato H, Hoshi H, Onozuka M, Moriyama N. MDCT of the liver and hypervascular hepatocellular carcinomas: optimizing scan delays for bolus-tracking techniques of hepatic arterial and portal venous phases. AJR Am J Roentgenol. 2006;187:W25–32.CrossRefPubMed

33.

Kim MJ, Choi JY, Lim JS, Kim JY, Kim JH, Oh YT, Yoo EH, Chung JJ, Kim KW. Optimal scan window for detection of hypervascular hepatocellular carcinomas during MDCT examination. AJR Am J Roentgenol. 2006;187:198–206.CrossRefPubMed

34.

Murakami T, Onishi H, Mikami K, Iannaccone R, Federle MP, Kim T, Hori M, Okada A, Marukawa T, Higashihara H, Passariello R, Nakamura H. Determining the optimal timing for early arterial phase hepatic CT imaging by measuring abdominal aortic enhancement in variable contrast injection protocols. J Comput Assist Tomogr. 2006;30:206–11.CrossRefPubMed

35.

Sultana S, Awai K, Nakayama Y, Nakaura T, Liu D, Hatemura M, Funama Y, Morishita S, Yamashita Y. Hypervascular hepatocellular carcinomas: bolus tracking with a 40-detector CT scanner to time arterial phase imaging. Radiology. 2007;243:140–7.CrossRefPubMed

36.

Huang JS, Pan HB, Chou CP, Liang HL, Yeh LR, Yang TL, Liu SI. Optimizing scanning phases in detecting small (<2 cm) hepatocellular carcinoma: whole-liver dynamic study with multidetector row CT. J Comput Assist Tomogr. 2008;32:341–6.CrossRefPubMed

37.

Freeny PC, Baron RL, Teefey SA. Hepatocellular carcinoma: reduced frequency of typical findings with dynamic contrast-enhanced CT in a non-Asian population. Radiology. 1992;182:143–8.PubMed

38.

Stevens WR, Johnson CD, Stephens DH, Batts KP. CT findings in hepatocellular carcinoma: correlation of tumor characteristics with causative factors, tumor size, and histologic tumor grade. Radiology. 1994;191:531–7.PubMed

39.

Bae KT, Heiken JP, Brink JA. Aortic and hepatic contrast medium enhancement at CT. Part I. Prediction with a computer model. Radiology. 1998;207:647–55.PubMed

40.

Bae KT, Tran HQ, Heiken JP. Multiphasic injection method for uniform prolonged vascular enhancement at CT angiography: pharmacokinetic analysis and experimental porcine model. Radiology. 2000;216:872–80.PubMed

41.

Bae KT. Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology. 2003;227:809–16.CrossRefPubMed

42.

Yamaguchi I, Hayashi H, Suzuki M, Ichikawa K, Kidoya E, Kimura H. Operation of bolus tracking system for prediction of aortic peak enhancement at multidetector row computed tomography: pharmacokinetic analysis and clinical study. Radiat Med. 2008;26:278–86.CrossRefPubMed

43.

Olsson B, Aulie A, Sveen K, Andrew E. Human pharmacokinetics of iohexol. A new nonionic contrast medium. Invest Radiol. 1983;18(2):177–82.CrossRefPubMed

44.

Yamaguchi I, Kidoya E, Suzuki M, Kimura H. Evaluation of required saline volume in dynamic contrast-enhanced computed tomography using saline flush technique. Comput Med Imaging Graph. 2009;33:23–8.CrossRefPubMed

45.

Ogawa R, Fujita T, Fukuda Y. Blood volume studies in healthy Japanese adults. Respir Circ. 1970;18:833–8.

46.

Guyton AC, Hall JE. Textbook of medical physiology. 9th edition. Philadelphia: Saunders. Japanese edition: Tokyo: Igaku-Shoin. 1999.

47.

Davies B, Morris T. Physiological parameters in laboratory animals and humans. Pharm Res. 1993;10:1093–5.CrossRefPubMed

48.

Ueda K, Matsui O, Kawamori Y, Nakanuma Y, Kadoya M, Yoshikawa J, Gabata T, Nonomura A, Takashima T. Hypervascular hepatocellular carcinoma: evaluation of hemodynamics with dynamic CT during hepatic arteriography. Radiology. 1998;206:161–6.PubMed

Title: Optimizing scan timing of hepatic arterial phase by physiologic pharmacokinetic analysis in bolus-tracking technique by multi-detector row computed tomography
Authors: Isao Yamaguchi
Eiji Kidoya
Masayuki Suzuki
Hirohiko Kimura
Publication date: 01-01-2011
Publisher: Springer Japan
Published in: Radiological Physics and Technology / Issue 1/2011
Print ISSN: 1865-0333
Electronic ISSN: 1865-0341
DOI: https://doi.org/10.1007/s12194-010-0105-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Optimizing scan timing of hepatic arterial phase by physiologic pharmacokinetic analysis in bolus-tracking technique by multi-detector row computed tomography

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2011

Skin shift and its effect on navigation accuracy in image-guided neurosurgery

Overlap of radiation field and radiation field shape in cardiac catheterization

Clinical usefulness of temporal subtraction method in screening digital chest radiography with a mobile computed radiography system

Automated segmentation method of white matter and gray matter regions with multiple sclerosis lesions in MR images

Calculation of air-kerma rate of diagnostic X-ray generators

Development of identification of the central sulcus in brain magnetic resonance imaging