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.