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

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.