TY - JOUR
T1 - Patient-tailored contrast delivery protocols for computed tomography coronary angiography
T2 - Lower contrast dose and better image quality
AU - Van Den Boogert, Thomas P.W.
AU - Lopes, Ricardo R.
AU - Lobe, Nick H.J.
AU - Verwest, Tim A.
AU - Stoker, Jaap
AU - Henriques, José P.
AU - Marquering, Henk A.
AU - Planken, R. Nils
N1 - Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Purpose: The first objective of this study was to evaluate the efficacy of a patient-tailored contrast delivery protocol for coronary computed tomography angiography (CTCA), in terms of diagnostic coronary attenuation and total iodine load (TIL), by adjusting the iodine delivery rate (IDR) via dilution for body weight and tube voltage (kV), as compared with a protocol with a fixed bolus of contrast in a clinical setting. The secondary objective was to assess the association between the test-bolus data and luminal attenuation in CTCA. Materials and Methods: Patients who underwent CTCA with fixed IDR contrast delivery (cohort 1) or with IDR adjusted for body weight and kV settings (70 to 120 kV) (cohort 2) were included, and compared for intravascular luminal attenuation and TIL. The association between intravascular luminal attenuation and test-bolus scan data was investigated with linear regression. Results: In cohort 1 (176 patients), the mean luminal attenuation differed markedly between kV categories, whereas in cohort 2 (154 patients), there were no marked differences. The mean TIL reduced significantly (20.1±1.2 g in cohort 1, 17.7±3.0 g in cohort 2, P<0.001). The peak height of the test-bolus scan was independently associated with luminal attenuation in the ascending aorta, with a 0.58 HU increase per HU peak-height increase (SE=0.18, P<0.001). Conclusion: Clinical implementation of a patient-tailored contrast delivery protocol for CTCA, adjusted for body weight and kV, improves luminal attenuation and significantly reduces the TIL. The peak height of the test-bolus scan is associated with luminal attenuation in the ascending aorta in the CTCA scan.
AB - Purpose: The first objective of this study was to evaluate the efficacy of a patient-tailored contrast delivery protocol for coronary computed tomography angiography (CTCA), in terms of diagnostic coronary attenuation and total iodine load (TIL), by adjusting the iodine delivery rate (IDR) via dilution for body weight and tube voltage (kV), as compared with a protocol with a fixed bolus of contrast in a clinical setting. The secondary objective was to assess the association between the test-bolus data and luminal attenuation in CTCA. Materials and Methods: Patients who underwent CTCA with fixed IDR contrast delivery (cohort 1) or with IDR adjusted for body weight and kV settings (70 to 120 kV) (cohort 2) were included, and compared for intravascular luminal attenuation and TIL. The association between intravascular luminal attenuation and test-bolus scan data was investigated with linear regression. Results: In cohort 1 (176 patients), the mean luminal attenuation differed markedly between kV categories, whereas in cohort 2 (154 patients), there were no marked differences. The mean TIL reduced significantly (20.1±1.2 g in cohort 1, 17.7±3.0 g in cohort 2, P<0.001). The peak height of the test-bolus scan was independently associated with luminal attenuation in the ascending aorta, with a 0.58 HU increase per HU peak-height increase (SE=0.18, P<0.001). Conclusion: Clinical implementation of a patient-tailored contrast delivery protocol for CTCA, adjusted for body weight and kV, improves luminal attenuation and significantly reduces the TIL. The peak height of the test-bolus scan is associated with luminal attenuation in the ascending aorta in the CTCA scan.
KW - computed tomography angiography
KW - computed tomography coronary angiography
KW - contrast enhancement
KW - iodine delivery rate
KW - patient-tailored contrast delivery
UR - http://www.scopus.com/inward/record.url?scp=85110896102&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/RTI.0000000000000593
DO - https://doi.org/10.1097/RTI.0000000000000593
M3 - Article
C2 - 34269752
SN - 0883-5993
VL - 36
SP - 353
EP - 359
JO - Journal of thoracic imaging
JF - Journal of thoracic imaging
IS - 6
ER -