Iomeron

All CT examinations were performed with a 320-detector row CT scanner (Aquilion ONE GENESIS, Canon Medical). For each CT, the main parameters were as follows: helical acquisition, 0.5 mm × 80 rows; beam pitch, 0.813; gantry rotation time, 0.35 s; matrix, 512 × 512; and field of view, 320 mm. Tube voltage was 120 kVp, 100 kVp, or 80 kVp. Automatic tube-current modulation (SUREExposure™ 3D, Canon Medical) was used for all CTs. The noise-index settings were based on our initial experience in clinical practice and on the manufacturer’s recommendations. Reconstruction parameters were 1.0-mm slice thickness and 0.8-mm gap. Table 1 lists the acquisition and reconstruction parameters. In accordance with our standard CTA protocol involving subtraction, all patients received a fixed 65-mL intravenous bolus of Iomeron, 350 mg iodine per mL (Bracco Imaging, Courcouronnes, France), followed by a 50-mL bolus of saline at an injection rate of 4 mL/s for both. Image acquisition was triggered using a predefined threshold of aortic-arch attenuation. Each CT scan was reconstructed using both H-IR (AIDR 3D) with a standard FC43 kernel and DLR with beam-hardening correction (AiCE Body Sharp).

CT studies were performed using a 64-section multidetector CT scanner (Lightspeed VCT 64; GE Healthcare, Milwaukee, WI, USA). The scans were carried out using the following parameters: 5 mm section thickness (reconstructed with a 2 mm thickness, with an overlap of 1 mm), pitch of 5.5, 120 kV, and 130–181 mA. The exams were performed with a first unenhanced acquisition followed by the administration of 90–140 mL (according to patient weight) of the tri-iodinated nonionic contrast agent Iomeron® (Bracco, Milan, Italy [350 mg iodine per mL]) at a flow rate of 2–3 mL/s into an antecubital vein by using an automated power injector. The study was acquired in portal-venous phase using bolus tracking; a Region Of Interest (ROI) was placed over the descending aorta and a threshold of 150 HU was selected. Once this had been reached, a multiphasic study was performed with scans acquired in late arterial phase (after 25–30 s), portal venous phase (after 45–60 s), and delayed phase (after 180–300 s). Moreover, multiplanar reformation on sagittal, para-coronal, and para-axial planes, oriented on the rectal axis, might be obtained, provided useful information in most challenging cases, where surgery determined a substantial alteration of normal anatomy.

In this retrospective study, patients who had undergone a head/neck CTA for a follow‐up of a head and neck malignancy, or for staging of tumors located in other regions than head and neck, were included in the study. Head/neck scans were acquired in a helical mode in craniocaudal direction at 120 kV tube voltage where Iomeron 300 mg/mL (Bracco Imaging SpA, Milan, Italy) had been used as an intravenous contrast agent. Exclusion criteria for this radiologic study comprised of lymphadenopathy or lymph node dissection in the CTA report, insufficient image quality, presence of tumor, or metastatic disease or unclear origin of the submental artery.
In total 52 CTA scans (n = 23 male, n = 29 female) of satisfactory imaging quality were included to assess 100 sides (n = 48 bilateral, n = 4 unilateral) for lymph node anatomical features. The mean age of the group was 61.77 ± 13.78 years. The mean body mass index was 26.68 ± 4.86 kg/m².

Patient installation was often difficult because of deformities and sometimes required use of cushions. Tourniquets were placed around thighs and calves in order to obtain better opacification of the main vessels rather than superficial vessels.
CT was performed with a scanner (SOMATOM Definition AS, Siemens Healthineers) after a biphasic iodinated solution injection (iomeprol, Iomeron® 400 mg/ml, Bracco Imaging) including a first injection of 120 ml at the rate of 1.5 ml/s immediately followed by a second injection of 80 ml at the rate of 3 ml/s. CT acquisition was performed with a collimation of 128 × 0.625 mm and was triggered 135 s after the start of injection. Voltage was 120 kV and amperage 300 mAs/slice. Rotation time was 0.5 s/rotation.
Multiplanar reconstructions were performed as well as bone and vessels volume rendering 3D images.