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Yoshida M, Matsumoto Y, Masuda T, Kikuhara Y, Kobayashi Y, Yoshiura T, Sato T. [Comparison of Contrast Enhancement between Bolus-tracking and Test-bolus Methods on Coronary CT Angiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2020; 76:579-585. [PMID: 32565515 DOI: 10.6009/jjrt.2020_jsrt_76.6.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare the contrast enhancement between bolus-tracking (BT) and test-bolus (TB) methods in coronary computed tomography angiography (CCTA). METHOD We enrolled 300 patients who underwent CCTA by BT (245 mg I/kg main bolus) or TB (77.4 mg I/kg test bolus with 245 mg I/kg main bolus) methods. In group BT (n=150), scanning was started automatically 5-second after contrast enhancement exceeded a predefined threshold of 150 Hounsfield units (HU). In group TB (n=150), TB peak attenuation plus 2-second was used as a delay. We recorded the CT number in the ascending aorta and determined whether the CT number was equivalent in two groups. For the equivalence test, we adopted 70 HU as the equivalence margin. The standard deviation (SD) in the CT number and the rate of patients with an acceptable CT number were compared. We also compared total iodine dose and total dose length product (DLP). RESULT The CT number of the ascending aorta was 437.6±68.9 HU in group BT and 438.9±69.7 HU in group TB; the 95% confidence interval for the difference between the groups was from -11.6 to 20.2 HU and within the range of the equivalence margins. The SD of the CT number and the rate of patients with acceptable CT number did not differ significantly between the two groups (p=0.857 and p=0.614, respectively). Total iodine dose in group TB was significantly higher than in group BT (p<0.001), and total DLP was not statistically significant (p=0.197). CONCLUSION The contrast enhancement between BT and TB methods in CCTA was equivalent, and the distribution was not significantly different between the two groups.
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Affiliation(s)
- Masato Yoshida
- Department of Radiological Technology, Tsuchiya General Hospital
| | - Yoriaki Matsumoto
- Department of Radiological Technology, Tsuchiya General Hospital.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital.,Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Yukari Kikuhara
- Department of Radiological Technology, Tsuchiya General Hospital
| | - Yukie Kobayashi
- Department of Radiological Technology, Tsuchiya General Hospital
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Masuda T, Nakaura T, Funama Y, Sato T, Higaki T, Kiguchi M, Matsumoto Y, Yamashita Y, Imada N, Awai K. Development and Validation of Generalized Linear Regression Models to Predict Vessel Enhancement on Coronary CT Angiography. Korean J Radiol 2018; 19:1021-1030. [PMID: 30386134 PMCID: PMC6201979 DOI: 10.3348/kjr.2018.19.6.1021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 04/24/2018] [Indexed: 11/25/2022] Open
Abstract
Objective We evaluated the effect of various patient characteristics and time-density curve
(TDC)-factors on the test bolus-affected vessel enhancement on coronary computed
tomography angiography (CCTA). We also assessed the value of generalized linear
regression models (GLMs) for predicting enhancement on CCTA. Materials and Methods We performed univariate and multivariate regression analysis to evaluate the effect of
patient characteristics and to compare contrast enhancement per gram of iodine on test
bolus (ΔHUTEST) and CCTA (ΔHUCCTA). We developed GLMs to predict
ΔHUCCTA. GLMs including independent variables were validated with 6-fold
cross-validation using the correlation coefficient and Bland–Altman analysis. Results In multivariate analysis, only total body weight (TBW) and ΔHUTEST maintained
their independent predictive value (p < 0.001). In validation
analysis, the highest correlation coefficient between ΔHUCCTA and the prediction
values was seen in the GLM (r = 0.75), followed by TDC
(r = 0.69) and TBW (r = 0.62). The lowest
Bland–Altman limit of agreement was observed with GLM-3 (mean difference,
−0.0 ± 5.1 Hounsfield units/grams of iodine [HU/gI]; 95% confidence
interval [CI], −10.1, 10.1), followed by ΔHUCCTA (−0.0 ± 5.9
HU/gI; 95% CI, −11.9, 11.9) and TBW (1.1 ± 6.2 HU/gI; 95% CI,
−11.2, 13.4). Conclusion We demonstrated that the patient's TBW and ΔHUTEST significantly affected
contrast enhancement on CCTA images and that the combined use of clinical information
and test bolus results is useful for predicting aortic enhancement.
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Affiliation(s)
- Takanori Masuda
- Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan.,Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556, Japan
| | - Yoshinori Funama
- Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-0811, Japan
| | - Tomoyasu Sato
- Department of Diagnostic Radiology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan
| | - Toru Higaki
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masao Kiguchi
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Yoriaki Matsumoto
- Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan
| | - Yukari Yamashita
- Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan
| | - Naoyuki Imada
- Department of Radiological Technology, Tsuchiya General Hospital, Hiroshima 730-8655, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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Prediction of aortic enhancement on coronary CTA images using a test bolus of diluted contrast material. Acad Radiol 2014; 21:1542-6. [PMID: 25442352 DOI: 10.1016/j.acra.2014.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 07/01/2014] [Accepted: 07/07/2014] [Indexed: 02/06/2023]
Abstract
RATIONALE AND OBJECTIVES The purpose of our study was to compare test bolus techniques using undiluted or diluted contrast material for their ability to predict aortic enhancement on coronary computed tomographic angiography (c-CTA) images. MATERIALS AND METHODS We divided 200 consecutive patients who underwent c-CTA on a 64-MDCT scanner into two groups. In group A (n = 100), we used a test bolus of undiluted contrast material and in group B (n = 100), the contrast material was diluted. The injection volume was body weight × 0.2 (contrast material 100%) in group A and body weight × 0.7 (contrast material 30%, saline 70%) in group B. We then compared the CT number in the ascending aorta on c-CTA images obtained with undiluted and diluted contrast media to the CT number on c-CTA images. RESULTS The mean CT number in the ascending aorta was significantly higher in group B than group A (217.1 vs. 157.4 HU, P < .001). There was a significant difference in the correlation between the CT number of the ascending aorta on c-CTA images and on images acquired with the test bolus using undiluted or diluted test bolus (P < .001). In group B, the correlation had a strong positive linear relationship (r = 0.72, P < .001), whereas in group A the positive linear relationship was weak (r = 0.36). CONCLUSIONS The test bolus with diluted contrast material was useful for predicting aortic enhancement before c-CTA scanning.
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Baxa J, Vendiš T, Moláček J, Stěpánková L, Flohr T, Schmidt B, Korporaal JG, Ferda J. Low contrast volume run-off CT angiography with optimized scan time based on double-level test bolus technique--feasibility study. Eur J Radiol 2013; 83:e147-55. [PMID: 24380637 DOI: 10.1016/j.ejrad.2013.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 12/03/2013] [Accepted: 12/05/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE To verify the technical feasibility of low contrast volume (40 mL) run-off CT angiography (run-off CTA) with the individual scan time optimization based on double-level test bolus technique. MATERIALS AND METHODS A prospective study of 92 consecutive patients who underwent run-off CTA performed with 40 mL of contrast medium (injection rate of 6 mL/s) and optimized scan times on a second generation of dual-source CT. Individual optimized scan times were calculated from aortopopliteal transit times obtained on the basis of double-level test bolus technique--the single injection of 10 mL test bolus and dynamic acquisitions in two levels (abdominal aorta and popliteal arteries). Intraluminal attenuation (HU) was measured in 6 levels (aorta, iliac, femoral and popliteal arteries, middle and distal lower-legs) and subjective quality (3-point score) was assessed. Relations of image quality, test bolus parameters and arterial circulation involvement were analyzed. RESULTS High mean attenuation (HU) values (468; 437; 442; 440; 342; 274) and quality score in all monitored levels was achieved. In 91 patients (0.99) the sufficient diagnostic quality (score 1-2) in aorta, iliac and femoral arteries was determined. A total of 6 patients (0.07) were not evaluable in distal lower-legs. Only the weak indirect correlation of image quality and test-bolus parameters was proved in iliac, femoral and popliteal levels (r values: -0.263, -0.298 and -0.254). The statistically significant difference of the test-bolus parameters and image quality was proved in patients with occlusive and aneurysmal disease. CONCLUSION We proved the technical feasibility and sufficient quality of run-off CTA with low volume of contrast medium and optimized scan time according to aortopopliteal transit time calculated from double-level test bolus.
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Affiliation(s)
- Jan Baxa
- Department of Imaging Methods, University Hospital and Charles University Medical School in Pilsen, Czech Republic.
| | - Tomáš Vendiš
- Department of Imaging Methods, University Hospital and Charles University Medical School in Pilsen, Czech Republic
| | - Jiří Moláček
- Department of Surgery, University Hospital and Charles University Medical School in Pilsen, Czech Republic
| | - Lucie Stěpánková
- Department of Internal Medicine, University Hospital and Charles University Medical School in Pilsen, Czech Republic
| | - Thomas Flohr
- Siemens Healthcare, Computed Tomography Division, Forchheim, Germany
| | - Bernhard Schmidt
- Siemens Healthcare, Computed Tomography Division, Forchheim, Germany
| | | | - Jiří Ferda
- Department of Imaging Methods, University Hospital and Charles University Medical School in Pilsen, Czech Republic
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Chen Y, Xue H, Jin ZY, Zhang J, Sun H, Wang X, Zhang ZH, Zhang DM, Lu GM, Zhang ZQ, Schoepf UJ, Bucher AM, Wolla CD, Wang Y. 128-slice acceletated-pitch dual energy CT angiography of the head and neck: comparison of different low contrast medium volumes. PLoS One 2013; 8:e80939. [PMID: 24260516 PMCID: PMC3834309 DOI: 10.1371/journal.pone.0080939] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 10/08/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our study aims to evaluate the image quality and feasibility of 128-slice dual-energy CTA (DE-CTA) for supra-aortic arteries using reduced amounts of contrast medium (CM). METHODS A prospective study was performed in 54 patients receiving CTA of the head and neck with a 128-slice dual-source CT system. Patients were randomized into two groups with a volume of either 40 mL of CM (Group I) or 50 mL of CM (Group II). Arterial and venous enhancements were recorded for quantitative assessment. Qualitative assessments for images without bone removal (BR) were based on a) the visualization of the circle of Willis and b) streak artifacts due to residual CM in the subclavian or internal jugular veins ipsilateral to injection of CM. Qualitative assessment of dual-energy images using BR was based on the presence of bone remnants and vessel integrity. Quantitative data was compared using the Student t test. The χ(2) test was used for the qualitative measurements of streak artifacts in veins while the Mann-Whitney U test was used for the qualitative measurements of images with BR. RESULTS Arterial and venous attenuation was significantly higher in Group II (P=0.000). Image quality regarding the circle of Willis was excellent in both groups (3.90±0.30 for Group I and 4.00±0 for Group II) . Imaging of the internal jugular veins was scored higher in Group I (1.87±0.72) compared with Group II (1.48±0.51) (P=0.021). Within Group I using BR, mean scores for bone remnants did not differ significantly (P>0.05) but mean scores of vessel integrity (P<0.05) did. CONCLUSIONS Contrast-enhanced head and neck CTA is feasible using a scan protocol with low amounts of contrast medium (40 mL) on a 128-slice dual-energy CTA. The 40-mL protocol provides satisfactory image quality before and after dual-energy bone-removal post-processing.
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Affiliation(s)
- Yu Chen
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (HX); (ZYJ)
| | - Zheng-yu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (HX); (ZYJ)
| | - Jie Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hao Sun
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuan Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhu-hua Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Da-ming Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Guang-ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu, China
| | - Zhao-qi Zhang
- Department of Radiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases and Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - U. Joseph Schoepf
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Andreas M. Bucher
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Christopher D. Wolla
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Yun Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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