J Korean Soc Radiol.  2017 May;76(5):337-345. 10.3348/jksr.2017.76.5.337.

Analysis of the Effects of Different Iodine Concentrations on the Characterization of Small Renal Lesions Detected by Multidetector Computed Tomography Scan: A Pilot Study

• Lee HJ
• Kim SY
• Cho JY
• Hwang SI
• Moon MH
• Kim SH

• KMID: 2377037
• DOI: http://doi.org/10.3348/jksr.2017.76.5.337

Abstract

PURPOSE
Our objective was to compare the effects of different iodine concentrations on characterizing small renal lesions.
MATERIALS AND METHODS
Thirty-eight patients were enrolled in this study. All patients underwent an initial CT scan using 370 mgI/mL iodinated contrast media. Patients were then randomized into two groups for a follow-up CT. Group A (n = 19) received 250 mgI/mL iodinated contrast media, and group B (n = 19) received 300 mgI/mL contrast media. The mean Hounsfield units (HU values) of small renal lesions with a maximum size of less than 2 cm were calculated. Signal to noise ratios (SNR values) were likewise evaluated. Three uroradiologists assessed the lesion's conspicuity and the diagnostic influence of the artifact's proximity to the adjacent renal parenchyma.
RESULTS
In group A, there were significant differences between the HU values of renal lesions and those of the adjacent renal parenchyma between the initial and follow-up CT. Conversely, in group B, there was no significant difference. Moreover, SNR values showed no statistically significant difference between both groups. Regarding lesion conspicuity, only one reader identified a significant difference (p = 0.032) in group A; whereas in group B, there was no statistical difference. The artifact's proximity to the adjacent renal parenchyma did not appear to have any diagnostic influence on differentiating the two (p < 0.05).
CONCLUSION
In evaluating small renal lesions, 300 mgI/mL instead of 370 mgI/mL contrast media can be used; however, it is important to note that the use of 250 mgI/mL contrast media may reveal different results from that of 370 mgI/mL contrast media.

MeSH Terms

Contrast Media
Diagnostic Imaging
Follow-Up Studies
Humans
Iodine*
Kidney
Multidetector Computed Tomography*
Pilot Projects*
Signal-To-Noise Ratio
Tomography, X-Ray Computed
Contrast Media
Iodine

Figure

• 

  Fig. 1. Flow chart demonstrating the included patients. 38 patients underwent CT examination after injection of 370 mgI/mL contrast media. Subsequently, for the followup CT, the patients were randomized into two groups. Group A (n = 19) underwent their followup CT after injection of 250 mgI/mL contrast media, and group B (n = 19) underwent CT examination after injection of 300 mgI/mL contrast media.

• 

  Fig. 2. Small renal lesion of a 54-year-old male patient; imaged using 370 mgI/mL (A) and 250 mgI/mL contrast medium (B). A. The HU of the small renal lesion, imaged with 370 mgI/mL of contrast medium, was 50. B. The HU of the same lesion, imaged with 250 mgI/mL of contrast medium, was 18.1. There was a significant difference in the HUs of the small renal lesions in group A. HU = Hounsfield unit

• 

  Fig. 3. A small renal lesion of a 41-year-old male patient; imaged using 370 mgI/mL (A) and 300 mgI/mL of contrast medium (B). A. The HU of the small renal lesion, imaged with 370 mgI/mL of contrast medium, was 5.0. B. The HU of the same lesion, imaged with 300 mgI/mL of contrast medium, was 7.0. There was no significant difference in the HUs of the small renal lesions in group B. HU = Hounsfield unit

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