Iodine accumulation of the liver in patients treated with amiodarone can be unmasked using material decomposition from multiphase spectral-detector CT

Sci Rep. 2020 Apr 24;10(1):6994. doi: 10.1038/s41598-020-64002-7.

Abstract

Amiodarone accumulates in the liver, where it increases x-ray attenuation due to its iodine content. We evaluated liver attenuation in patients treated and not treated with amiodarone using true-non-contrast (TNC) and virtual-non-contrast (VNC) images acquired with spectral-detector-CT (SDCT). 142 patients, of which 21 have been treated with amiodarone, receiving SDCT-examinations (unenhanced-chest CT [TNC], CT-angiography of chest and abdomen [CTA-Chest, CTA-Abdomen]) were included. TNC, CTA-Chest, CTA-Abdomen, and corresponding VNC-images (VNC-Chest, VNC-Abdomen) were reconstructed. Liver-attenuation-index (LAI) was calculated as difference between liver- and spleen-attenuation. Liver-attenuation and LAI derived from TNC-images of patients receiving amiodarone were higher. Contrary to TNC, liver-attenuation and LAI were not higher in amiodarone patients in VNC-Chest and in VNC-Abdomen. To verify these initial results, a phantom scan was performed and an additional patient cohort included, both confirming that VNC is viable of accurately subtracting iodine of hepatic amiodarone-deposits. This might help to monitor liver-attenuation more accurately and thereby detect liver steatosis as a sign of liver damage earlier as well as to verify amiodarone accumulation in the liver.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amiodarone / therapeutic use*
  • Computed Tomography Angiography
  • Fatty Liver / drug therapy
  • Fatty Liver / metabolism
  • Female
  • Humans
  • Iodine / metabolism*
  • Liver / drug effects
  • Liver / metabolism*
  • Liver Diseases / drug therapy
  • Liver Diseases / metabolism
  • Male
  • Tomography, X-Ray Computed

Substances

  • Iodine
  • Amiodarone