Quantitative distribution of iodinated contrast media in body computed tomography: data from a large reference cohort
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COMPUTED TOMOGRAPHY
Quantitative distribution of iodinated contrast media in body computed tomography: data from a large reference cohort David Zopfs 1 & Josefine Graffe 2 & Robert Peter Reimer 1 & Sebastian Schäfer 3 & Thorsten Persigehl 1 & David Maintz 1 & Jan Borggrefe 1 & Stefan Haneder 1 & Simon Lennartz 1,4 & Nils Große Hokamp 1 Received: 16 April 2020 / Revised: 27 July 2020 / Accepted: 15 September 2020 # The Author(s) 2020
Abstract Objectives Dual-energy computed tomography allows for an accurate and reliable quantification of iodine. However, data on physiological distribution of iodine concentration (IC) is still sparse. This study aims to establish guidance for IC in abdominal organs and important anatomical landmarks using a large cohort of individuals without radiological tumor burden. Methods Five hundred seventy-one oncologic, portal venous phase dual-layer spectral detector CT studies of the chest and abdomen without tumor burden at time point of imaging confirmed by > 3-month follow-up were included. ROI were placed in parenchymatous organs (n = 25), lymph nodes (n = 6), and vessels (n = 3) with a minimum of two measurements per landmark. ROI were placed on conventional images and pasted to iodine maps to retrieve absolute IC. Normalization to the abdominal aorta was conducted to obtain iodine perfusion ratios. Bivariate regression analysis, t tests, and ANOVA with Tukey-Kramer post hoc test were used for statistical analysis. Results Absolute IC showed a broad scatter and varied with body mass index, between different age groups and between the sexes in parenchymatous organs, lymph nodes, and vessels (range 0.0 ± 0.0 mg/ml–6.6 ± 1.3 mg/ml). Unlike absolute IC, iodine perfusion ratios did not show dependency on body mass index; however, significant differences between the sexes and age groups persisted, showing a tendency towards decreased perfusion ratios in elderly patients (e.g., liver 18–44 years/≥ 64 years: 0.50 ± 0.11/0.43 ± 0.10, p ≤ 0.05). Conclusions Distribution of IC obtained from a large-scale cohort is provided. As significant differences between sexes and age groups were found, this should be taken into account when obtaining quantitative iodine concentrations and applying iodine thresholds. Key Points • Absolute iodine concentration showed a broad variation and differed between body mass index, age groups, and between the sexes in parenchymatous organs, lymph nodes, and vessels. • The iodine perfusion ratios did not show dependency on body mass index while significant differences between sexes and age groups persisted. • Provided guidance values may serve as reference when aiming to differentiate healthy and abnormal tissue based on iodine perfusion ratios. Keywords Contrast media . Reference values . Tomography, X-ray computed . Tumor burden . Biomarkers, tumor
* Nils Große Hokamp [email protected] 1
University Cologne, Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, Cologne, Germany
2
Faculty of Medici
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