Prospective study comparing two iodine concentrations for multidetector computed tomography of the pancreas

The authors sought to determine the influence of two different iodine concentrations of nonionic contrast media (cm) on contrast enhancement in pancreatic computed tomography angiography (CTA).

Sixty patients with clinically suspected or known pancreatic disease underwent pancreatic CTA. The patients were randomly assigned to group A (n = 30) and group B (n = 30). The contrast agent was injected with iodine concentrations of 400 mg I/ml (Iomeron 400) in group A and 300 mg I/ml (Iopamidol 300) in group B with the same total iodine dose (36 g). Arterial and portal venous phase contrast enhancement of the vessels, organs and pancreatic masses was measured, and blinded qualitative image assessment was performed by two expert radiologists.

In the arterial and portal venous phase, the highly concentrated cm led to significantly greater enhancement in the abdominal main vessels, pancreas and pancreatic carcinoma than did the low concentrated cm. No statistically significant attenuation differences were measured between pancreatic carcinomas and the pancreatic parenchyma in the arterial and portal venous phase between group A and B. The overall trend for both readers was to assign higher scores to group A than group B.

The higher iodine concentration leads to greater contrast enhancement of abdominal vessels and organs in pancreatic CTA. Detection and demarcation of hypovascular pancreatic carcinoma was not found to be improved by the higher iodine concentration.