Becker Judith, Huber Adrian, Bette Stefanie, Rubeck Anna, Arndt Tim Tobias, Müller Gernot, Risch Franka, Canalini Luca, Wollny Claudia, Schwarz Florian, Scheurig-Muenkler Christian, Kroencke Thomas, Decker Josua A
Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.
Department of Computational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, Germany.
Eur Radiol. 2025 Jul;35(7):3729-3738. doi: 10.1007/s00330-024-11329-8. Epub 2025 Jan 9.
The purpose of this study was to evaluate whether the iodine contrast in blood and solid organs differs between men and women and to evaluate the effect of BMI, height, weight, and blood volume (BV) on sex-specific contrast in staging CT.
Patients receiving a venous-phase thoracoabdominal Photon-Counting Detector CT (PCD-CT) scan with 100- or 120-mL CM between 08/2021 and 01/2022 were retrospectively included in this single-center study. Image analysis was performed by measuring iodine contrast in the liver, portal vein, spleen, left atrium, left ventricle, pulmonary trunk, ascending and descending aorta on spectral PCD-CT datasets. Univariable and multivariable analyses were performed to assess the impact of sex, age, BMI, height, weight, and BV on the iodine contrast.
A total of 274 patients were included (mean age 68 years ± 12 SD, 168 men). Iodine contrast in organs and blood attenuation was significantly higher in women when using the same volume of CM. Sex, age, BMI, height, weight, and BV significantly influenced iodine contrast. After adjusting for confounding variables, sex remained a significant factor, with women having higher parenchymal and vascular iodine contrast.
Standardized or weight-adapted use of CM in venous-phase thoracoabdominal CT scans results in significantly higher contrast in women compared to men. Customizing the CM dose to the patient's BV could result in a similar contrast between sexes. This approach has the potential to reduce the amount of CM, resulting in cost savings, and to decrease the risks associated with CM, particularly for the female sex.
Question This study addresses whether current standardized iodinated contrast media protocols lead to systematically higher iodine enhancement in women than in men during thoracoabdominal CT. Findings Women consistently show greater iodine enhancement in blood and abdominal organs compared to BMI-matched men when receiving identical volumes of contrast media. Clinical relevance Adjusting contrast media dosage based on blood volume in venous-phase CT scans could equalize parenchymal and intravascular iodine enhancement across sexes. This approach may reduce unnecessary contrast exposure in women, lower associated risks, and optimize healthcare resource allocation.
本研究旨在评估男性和女性血液及实体器官中的碘造影剂是否存在差异，并评估体重指数（BMI）、身高、体重和血容量（BV）对分期CT中性别特异性造影剂的影响。
回顾性纳入2021年8月至2022年1月期间接受静脉期胸腹光子计数探测器CT（PCD-CT）扫描且使用100或120毫升对比剂（CM）的患者，该研究为单中心研究。通过测量光谱PCD-CT数据集中肝脏、门静脉、脾脏、左心房、左心室、肺动脉干、升主动脉和降主动脉中的碘造影剂进行图像分析。进行单变量和多变量分析以评估性别、年龄、BMI、身高、体重和BV对碘造影剂的影响。
共纳入274例患者（平均年龄68岁±12标准差，男性168例）。使用相同体积的CM时，女性器官中的碘造影剂和血液衰减明显更高。性别、年龄、BMI、身高、体重和BV对碘造影剂有显著影响。在调整混杂变量后，性别仍然是一个显著因素，女性的实质和血管碘造影剂更高。
在静脉期胸腹CT扫描中，标准化或根据体重调整使用CM，女性的造影剂明显高于男性。根据患者的BV定制CM剂量可能会使两性之间的造影剂相似。这种方法有可能减少CM的用量，从而节省成本，并降低与CM相关的风险，尤其是对女性而言。
问题 本研究探讨了当前标准化碘化造影剂方案在胸腹CT检查期间是否会导致女性的碘增强系统地高于男性。研究结果 在接受相同体积造影剂时，与BMI匹配的男性相比，女性在血液和腹部器官中的碘增强始终更大。临床意义 在静脉期CT扫描中根据血容量调整造影剂剂量可以使两性之间的实质和血管内碘增强相等。这种方法可能会减少女性不必要的造影剂暴露，降低相关风险，并优化医疗资源分配。
