Computed tomography image quality in patients with primary hepatocellular carcinoma: intraindividual comparison of contrast agent concentrations

Front Med (Lausanne). 2024 Oct 16:11:1460505. doi: 10.3389/fmed.2024.1460505. eCollection 2024.

Abstract

Objective: This study aimed to assess the impact of the different concentrations of iodine contrast agents used on the quality of computed tomography (CT) images obtained intraindividually in hepatocellular carcinoma patients.

Methods: In this retrospective study, data from a cohort of 29 patients diagnosed with primary hepatocellular carcinoma who had undergone two preoperative CT-enhanced examinations within a 3-month timeframe were analyzed. Each patient was randomly assigned to receive either a low-concentration contrast agent (300 mg I/mL iohexol) or a high-concentration contrast agent (350 mg I/mL iohexol) for the first scan and the alternative contrast agent for the second scan. CT images of different liver regions of each patient were compared between low-and high-concentration scans using their before-and-after control design. Subjective image quality scores for portal vein images were also assessed.

Results: The findings of this study indicate that patients in the high-concentration group presented significantly elevated CT values across various anatomical regions, including the liver parenchyma, abdominal aorta, and hepatic portal vein, compared to those in the low-concentration group (p < 0.05). Moreover, the high-concentration group demonstrated superior subjective image ratings (p < 0.05). Nevertheless, there was no statistically significant difference in the CT values observed in liver cancer parenchyma scans at different phases between the two groups (p > 0.05).

Conclusion: In summary, using a high-concentration iodine contrast agent is efficient in enhancing the visual clarity of the liver parenchyma, the aorta, and the portal vein in individuals diagnosed with primary hepatocellular carcinoma.

Keywords: comparative study; computed tomography; contrast agent; hepatocellular carcinoma; iodine concentration.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by research grants from the National Natural Science Foundation of China (No. 81760305 and No. 81641066), the Open Project of NHC Key Laboratory of Thalassemia Medicine (No. GJWJWDP202306), the Natural Science Foundation of Guangxi Zhuang Autonomous Region (No. 2023GXNSFAA026009), the Key Laboratory of Children’s Disease Research in Guangxi’s Colleges and Universities, the Education Department of Guangxi Zhuang Autonomous Region (No. GXCDR2023001), the Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (No. S2022072), and the Advanced Innovation Teams and Xinghu Scholars Program of Guangxi Medical University (No. 202110598039).