The Optimal Body Size Index with Which to Determine Iodine Dose for Hepatic Dynamic CT: A Prospective Multicenter Study.

Abstract

To identify the body size parameter that exhibits the best correlation with aortic and hepatic enhancement at hepatic dynamic computed tomography (CT) in a large patient population enrolled in a multicenter study. This prospective study was approved by the ethics committee of each of the 31 participating institutions where 1342 patients were enrolled between April 2012 and September 2013. All patients provided either written or oral informed consent. All patients underwent hepatic dynamic CT, which included preenhanced, hepatic arterial phase (HAP), and portal venous phase (PVP) scanning, performed with the routine scanning protocol of each institution. Changes in CT number (in Hounsfield units) per gram of iodine in the aorta (eA/I) and liver (eL/I) during HAP and PVP scanning were recorded for each patient. Hierarchical multivariate linear regression analysis was performed in which the outcome variable was either eA/I or eL/I; the independent variables were age, sex, one body size parameter (height, body weight, body mass index, lean body weight [LBW], or body surface area), and liver function (aspartate aminotransferase, albumin, and total bilirubin levels). A two-level hierarchical model in which patients were level 1 and the institution was level 2 was used. Hierarchical multivariate linear regression analysis revealed that in the population not stratified by sex, body size was significantly correlated with eA/I and eL/I (P < .001) and that LBW exhibited the strongest correlation with eA/I and eL/I (r = -0.561 and r = -0.601, respectively). Sex-stratified analysis showed that LBW was more strongly correlated with eA/I and eL/I in women (r = -0.779 and r = -0.948, respectively) than in men (r = -0.500 and r = -0.494, respectively) or in the nonstratified total population. Among body size parameters, LBW exhibited the strongest correlation with aortic and hepatic enhancement, especially in women.