Dual energy CT ventilation imaging after aerosol inhalation of iodinated contrast medium in rabbits

Abstract

Purpose: To assess the feasibility of dual energy CT (DECT) after aerosol inhalation of iodinated contrast medium for the evaluation of ventilation function in rabbits with airway obstruction.

Materials and methods: The study was approved by our institutional animal experimental committee and performed according to animal care guidelines. Airway obstruction was created by injecting gelatin sponge into the right bronchus of 6 New Zealand rabbits. One additional rabbit served as control without airway obstruction. All 7 rabbits then underwent inhalation of aerosol iodinated contrast medium for 5 min, followed by DECT of the lungs from which ventilation CT images were created. CT number and overlay value (calculated iodine enhancement on the ventilation images in hounsfield unit) of the obstructed and non-obstructed lung lobes were measured at 80-kVp, 140-kVp, and weighted average 120-kVp. Immediately after DECT scan, the rabbits were sacrificed, the lungs were removed and detailed pathological examination of the locations and parenchymal changes of the obstructed lung lobes were performed and correlated with DECT ventilation imaging findings.

Results: Data from one rabbit with airway obstruction were excluded because of post-procedure pneumatothorax. Seventeen normal lung lobes without airway obstruction proven by histopathology had nearly homogeneous ventilation, while 13 abnormal lung lobes had ventilation defects on DECT ventilation images. CT numbers and overlay values of the normal (CT number, -737.77 ± 71.46 HU, -768.84 ± 73.86 HU, -731.86 ± 65.92 HU for 140-kVp, 80-kVp, and weighted average 120-kVp; overlay value, 46.58 ± 19.49 HU) and abnormal lung lobes (CT number, -183.58 ± 173.37 HU, -124.93 ± 242.23 HU, -166.07 ± 191.57 HU for 140-kVp, 80-kVp, and weighted average 120-kVp; overlay value, 0.00 ± 0.00 HU) were significantly different at 80-kVp, 140-kVp, and weighted average 120-kVp (P < 0.001 for all). Diffuse hemorrhage, inflammatory cell infiltration, and exudation were observed at histopathology in the obstructed lung lobes.

Conclusions: It is feasible to study regional lung ventilation function using DECT after aerosol inhalation of iodinated contrast medium in rabbit. The safety of inhalation of iodine contrast medium is unknown, and has to be investigated further before use of this new method in humans.