Low contrast dose protocol involving a 100kVp tube voltage for hypervascular hepatocellular carcinoma in patients with renal dysfunction.

Abstract

To evaluate the feasibility of a 20% reduced contrast dose hepatic arterial phase (HAP) CT for hypervascular hepatocellular carcinoma (HCC) with 100 kVp. The study included 97 patients with hypervascular HCC who underwent dynamic CT, including HAP scanning. The 54 patients had an estimated glomerular filtration rate (eGFR) of ≥60 were scanned with our conventional 120 kVp protocol. The other 43 patients (eGFR<60) underwent scans using a tube voltage of 100 kVp and a 20% reduced contrast dose. We compared the estimated effective dose, image noise, tumor-liver contrast (TLC), and contrast-to-noise ratio (CNR) in the hepatic arterial phase between the two groups using the Student's t test. Estimated effective dose and image noise were not significantly different between these groups (p = 0.67 and p = 0.20, respectively). The TLC and CNR were significantly higher for the 100 kVp protocol than for the 120 kVp protocol (52.2 HU ± 17.4 vs 40.8 HU ± 18.6, p < 0.01 and 6.8 ± 2.6 vs 5.5 ± 2.4, p = 0.01, respectively). For hepatic arterial phase CT of hypervascular HCC, 100 kVp scan allows a 20% reduction in the contrast dose without reduction in image quality compared with a standard 120 kVp CT protocol.