Helical liver CT with computer-assisted bolus-tracking technology: is it possible to predict which patients will not achieve a threshold of enhancement?

Published

Journal Article

PURPOSE: To determine how often a prescribed threshold of hepatic contrast material enhancement is not reached at helical computed tomography (CT) of the liver in patients in a tertiary teaching hospital-based practice and which variables are predictive of failure. MATERIALS AND METHODS: Hepatic helical CT was performed in 250 consecutive patients with computer-assisted bolus-tracking technology after either mechanical injection at 3 mL/sec (n = 177) or manual injection (n = 73) of 150 mL of iopamidol. Demographic variables were recorded. After 17 seconds, low-milliamperage monitoring scans were obtained every 6 seconds until hepatic enhancement of 50 HU over baseline was achieved. Time-enhancement curves were reviewed. RESULTS: The threshold was not reached by 60 seconds in 88 patients (35%; default group). The success and default groups were similar in most variables and differed only in weight (P = .002), patient status (inpatient, outpatient, or emergency department; P < .001), and injection type (mechanical vs manual; P < .001). Ten patients (4%) did not achieve the threshold because of inappropriate placement of elliptic regions of interest. CONCLUSION: By using computer-assisted bolus-tracking technology, 35% of patients in a tertiary teaching hospital-based practice will not achieve a threshold of 50 HU above baseline by 60 seconds after injection initiation and will require the use of a set delay. Failures are more frequent in patients who are heavy and in inpatients. No historic or demographic factors are strongly predictive of failure.

Full Text

Duke Authors

Cited Authors

  • Paulson, EK; Fisher, AJ; DeLong, DM; Parker, DD; Nelson, RC

Published Date

  • December 1998

Published In

Volume / Issue

  • 209 / 3

Start / End Page

  • 787 - 792

PubMed ID

  • 9844675

Pubmed Central ID

  • 9844675

International Standard Serial Number (ISSN)

  • 0033-8419

Digital Object Identifier (DOI)

  • 10.1148/radiology.209.3.9844675

Language

  • eng

Conference Location

  • United States