Peristaltic Contrast Media Injection Improved Image Quality and Decreased Radiation and Contrast Dose When Compared With Direct Drive Injection During Liver Computed Tomography.

Purpose The aim of this study was to compare hepatic vascular and parenchymal image quality between direct and peristaltic contrast injectors during hepatic computed tomography (HCT). Methods Patients (n = 171) who underwent enhanced HCT and had both contrast media protocols and injector systems were included; group A: direct-drive injector with fixed 100 mL contrast volume (CV), and group B: peristaltic injector with weight-based CV. Opacification, contrast-to-noise ratio, signal-to-noise ratio, radiation dose, and CV for liver parenchyma and vessels in both groups were compared by paired t test and Pearson correlation. Receiver operating characteristic curve, visual grading characteristics, and Cohen kappa were used. Results Contrast-to-noise ratio: compared with hepatic vein for functional liver, contrast-to-noise ratio was higher in group B (2.17 +/- 0.83) than group A (1.82 +/- 0.63); portal vein: higher in group B (2.281 +/- 0.96) than group A (2.00 +/- 0.66). Signal-to-noise ratio for functional liver was higher in group B (5.79 +/- 1.58 Hounsfield units) than group A (4.81 +/- 1.53 Hounsfield units). Radiation dose and contrast media were lower in group B (1.98 +/- 0.92 mSv) (89.51 +/- 15.49 mL) compared with group A (2.77 +/- 1.03 mSv) (100 +/- 1.00 mL). Receiver operating characteristic curve demonstrated increased reader in group B (95% confidence interval, 0.524-1.0) than group A (95% confidence interval, 0.545-1.0). Group B had increased revenue up to 58% compared with group A. Conclusions Image quality improvement is achieved with lower CV and radiation dose when using peristaltic injector with weight-based CV in HCT.