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Jayamani N, Pothiawala S, Ong HB, Low Choon Seng AS, Mohamed Afif A, Arumugam Z, Sung CT, Teck FC, Liang HC. Clinical audit of the image quality and customised contrast volume using P3T contrast injection software versus standard injection protocol in CT coronary angiography. Radiography (Lond) 2024; 30:1144-1150. [PMID: 38824873 DOI: 10.1016/j.radi.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
INTRODUCTION The implications of shorter scan time and lower tube voltage in the dual-source CT coronary angiography (CTCA) scan protocol necessitate the adaptation of contrast media (CM) injection parameters. This audit evaluates the coronary arteries' vascular attenuation and image quality by comparing the personalised patient protocol technology (P3T) contrast injection software with standard injection protocol. The secondary aim is to determine the relationship between CM volume and the patient's weight. METHODOLOGY A Siemens Somatom Definition Force CT Unit was used to scan 30 sets of patients between August 2020 and October 2020. Patients were selected retrospectively and separated into Standard Injection and P3T injection protocols. An experienced radiologist blinded to the groups reviewed the coronary vessels' contrast enhancement and image quality. RESULTS Overall, the mean HU of all the main coronary artery vessels obtained from P3T injection software reached above 350 HU and was diagnostically sufficient. The mean attenuation at the proximal region of RCA in the 80-99 kg weight category was significantly higher in the P3T injection software than the standard injection protocol (p < 0.001). The CM volume proposed by P3T injection software for 40-59 kg was approximately 57 ± 5 mls, while 75 ml was used for the standard injection protocol. CONCLUSION P3T injection software in CTCA resulted in an adequate diagnostic attenuation of coronary arteries (>350HU) in all weight groups, most effectively in the higher weight group, while maintaining diagnostic image quality. Further, the P3T software reduces CM volumes in lower-weight patients. IMPLICATIONS P3T software enables reducing CM volume in lower-weight patients while improving vascular enhancement in CTCA scans in higher-weight patients.
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Affiliation(s)
- N Jayamani
- Department of Radiography, Singapore General Hospital, Singapore.
| | - S Pothiawala
- Department of Emergency Medicine, Woodlands Health, Singapore
| | - H B Ong
- Department of Radiography, Singapore General Hospital, Singapore
| | | | - A Mohamed Afif
- Department of Radiography, Singapore General Hospital, Singapore
| | - Z Arumugam
- Department of Radiography, Singapore General Hospital, Singapore
| | - C T Sung
- Department of Radiography, Singapore General Hospital, Singapore
| | - F C Teck
- Department of Radiography, Singapore General Hospital, Singapore
| | - H C Liang
- Department of Radiography, Singapore General Hospital, Singapore
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Duan Y, Yao J, Jiang Y, Sun W, Li F. A retrospective study of non-equidistant interstitial brain CT perfusion scanning and prediction of time to peak. Heliyon 2024; 10:e24758. [PMID: 38312599 PMCID: PMC10835286 DOI: 10.1016/j.heliyon.2024.e24758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/16/2023] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
Background Eexploring the limits of CT cranial perfusion scan acquisition intervals and predicting time to peak. Methods A retrospective analysis was conducted on 45 patients with suspected stroke who underwent brain CTP scans. Different sampling intervals were set based on the TDC. The patients were divided into four groups: Group 1 underwent continuous scanning with a uniform interval of 1.5 s; Group 2 had a uniform interval of 3 s; Group 3 had a 1.5-s interval between arterial and venous peak vertices with 1 point retained before and after the peak for 1.5 s and with a remaining acquisition interval of 4.5 s; and Group 4 had a uniform interval of 4.5 s. Statistical analysis was performed on the perfusion parameters of each group. Additionally, in 286 patients who underwent head and neck CTA examinations, the peak time of contrast medium was recorded, and the peak time was predicted based on factors such as age, height, weight, heart rate, systolic blood pressure, diastolic blood pressure, triglycerides, and total cholesterol. The results compared with Group 1 and Group 2, as well as Group 1 and Group 3, the P values of CBF, CBV, MTT, and Tmax in the left and right cerebral hemispheres of healthy subjects and in the infarct and noninfarct areas of patients were all >0.05. A comparison between Group 1 and Group 4 showed that right cerebral hemisphere CBF and CBV, left cerebral hemisphere CBF, CBV, and Tmax, infarct area CBV and Tmax, and noninfarct area CBF, CBV, and MTT had P values > 0.05, while other groups all had P values < 0.05. Bland‒Altman analysis showed that the perfusion parameters in Group 1 were consistent with those in Group 2, and those in Group 1 were consistent with those in Group 3. The radiation doses in the second and third groups were lower, and the dose in the third group was lower than that in the second group. Conclusion Continuous acquisition between the peak points of the arterial and venous phases, with 1 point reserved before and after the peak and a 4.5-s interval for the rest, represents the maximum time interval for CTP scanning and can effectively reduce the radiation dose. The formula Tmax (s) = 0.290 × height (cm) - 0.226 × heart rate (times/min) + 0.216 × age (years) - 1.901 × triglycerides (mmol/L) - 0.061 × systolic blood pressure (mmHg) - 7.216 (R2 = 0.449, F = 17.905, P < 0.01) was established for predicting time to peak enhancement.
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Affiliation(s)
- Yaxin Duan
- Department of Radiology, Tianjin Medical University General Hospital, 300070, China
| | - Jia Yao
- Department of Radiology, Tianjin Medical University General Hospital, 300070, China
| | - Yingjian Jiang
- Department of Radiology, Tianjin Medical University General Hospital, 300070, China
| | - Wen Sun
- Department of Radiology, Tianjin Medical University General Hospital, 300070, China
| | - Fengtan Li
- Department of Radiology, Tianjin Medical University General Hospital, 300070, China
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Jin L, Jie B, Gao Y, Jiang A, Weng T, Li M. Low dose contrast media in step-and-shoot coronary angiography with third-generation dual-source computed tomography: feasibility of using 30 mL of contrast media in patients with body surface area <1.7 m 2. Quant Imaging Med Surg 2021; 11:2598-2609. [PMID: 34079726 DOI: 10.21037/qims-20-500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Reducing contrast media volume in coronary computed tomography angiography minimizes the risk of adverse events but may compromise diagnostic image quality. We aimed to evaluate coronary computed tomography angiography's diagnostic image quality while using 30 mL of contrast media in patients with a body surface area <1.7 m2. Methods This prospective study included patients who underwent coronary computed tomography angiography from May 2018 to June 2019. The patients were divided into a low-dose group, who received 30 mL of contrast media, and a routine-dose group, who received contrast media based on body weight. Patient characteristics, coronary computed tomography angiography results, and quantitative and qualitative image results were assessed and compared. Results In total, 103 patients with a body surface area <1.7 m2 were 53 in the low-dose group and 50 in the routine-dose group. Sex, age, body surface area, body weight, and heart rate were similar between the groups (P>0.05). A contrast media volume of 30±0 mL was used for the low-dose group, and 41.62±4.59 mL was used for the routine-dose group. The low-dose group's computed tomography values were significantly different from those of the routine-dose group (P<0.05). The radiologists demonstrated agreement regarding diagnostic image quality and accuracy (kappa =0.91 and 0.85, respectively). Conclusions Using 30 mL of contrast media for coronary computed tomography angiography in patients with a body surface area <1.7 m2 provided a suitable diagnostic image quality for coronary artery disease diagnosis. Although radiation doses were similar between the groups, the decreased contrast media volume was likely beneficial for the patients.
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Affiliation(s)
- Liang Jin
- Radiology Department, Huadong Hospital, affiliated with Fudan University, Shanghai, China
| | - Bing Jie
- Radiology Department, Shanghai Pulmonary Hospital, Affiliated with Tongji University, Shanghai, China
| | - Yiyi Gao
- Radiology Department, Huadong Hospital, affiliated with Fudan University, Shanghai, China
| | - An'qi Jiang
- Radiology Department, Huadong Hospital, affiliated with Fudan University, Shanghai, China
| | - Tingwen Weng
- Cardiology Department, Huadong Hospital, Affiliated with Fudan University, Shanghai, China
| | - Ming Li
- Radiology Department, Huadong Hospital, affiliated with Fudan University, Shanghai, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, China
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Zhu X, Yu Y, Xu D, Zhang H, Tang L. Coronary angiography using second-generation dual source computed tomography: Feasibility of low dose and low flow rate to achieve appropriate individual contrast enhancement using a test bolus-based contrast medium protocol-A CONSORT compliant article. Medicine (Baltimore) 2018; 97:e11425. [PMID: 30024514 PMCID: PMC6086535 DOI: 10.1097/md.0000000000011425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Improved contrast enhancement consistency can be achieved using an individualized contrast media (CM) protocol. This study aimed to assess the feasibility of a low-dose, low-flow rate CM protocol to achieve appropriate individual contrast enhancement using a newly advocated individualized test bolus-based protocol for second-generation dual-source computed tomography angiography.CM containing iodine (370 mg I/mL) was used in this study. A CM flow rate of 3.5 mL/s for patients with a body mass index (BMI) <25.0 kg/m, and 4.5 mL/s for those with BMI ≥25.0 kg/m was used in group 1 (n = 189). An individualized test-bolus based contrast injection protocol was then derived from the information gained from the test bolus and coronary enhancements in group 1. The proposed individualized test-bolus based CM injection protocol was applied in group 2 (n = 219). Ascending aortic attenuations (AAo) were measured and compared with both groups.The contrast enhancement consistency of AAo in group 2 improved significantly (31.8 vs 56.3 Hounsfield units [HU]; P < .001). The number of patients in group 2 with a contrast flow rate ≤3 mL/s was 63 (28.8%), with 77 (35.2%) using a contrast dose ≤40 mL. In group 2, no significant differences in mean AAo were found among subgroups with contrast flow rates ≤3.0, 3.1 to 4.0, 4.1 to 5.0 and >5.0 mL/s (351, 344, 346, and 348 HU, respectively), nor among subgroups with contrast doses ≤40, 41 to 50, 51 to 60, and >60 mL (349, 345, 344, and 350 HU, respectively).Improved individual contrast enhancement uniformity can be achieved using an individualized CM protocol tailored to a test bolus. Approximately, one-third of patients received CM at a flow rate of no more than 3 mL/s and a total dose of no more than 40 mL.
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Affiliation(s)
- Xiaomei Zhu
- Radiological Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Yusheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Jiangning District
| | - Dinghu Xu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Jiangning District
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Jiangning District
| | - Lijun Tang
- Radiological Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
- Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Yang X, Huang W, Liu W, Zhu Y, Xu Y, Yang G, Tang L, Zhu X. The Influence of Contrast Agent's Osmolarity on Iodine Delivery Protocol in Coronary Computed Tomography Angiography: Comparison Between Iso-Osmolar Iodixanol-320 and Low-Osmolar Iomeprol-370. J Comput Assist Tomogr 2017; 42:62-67. [PMID: 28708716 DOI: 10.1097/rct.0000000000000651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aims to assess whether iodine-contained contrast agents with different osmolarity affect iodine delivery protocol during coronary computed tomography angiography (CCTA). METHODS Patients who underwent CCTA were randomized to receive contrast media either iodixanol-320 (iso-osmolar group) or iopromide-370 (low-osmolar group). Contrast protocols were recorded. Tube voltage of 100 kV was chosen for patients with body mass index of less than or equal to 25 (n = 224) and tube voltage of 120 kV for patients with body mass index of greater than 25 (n = 165). Both groups applied automatic current modulation technique. Mean contrast enhancement of the ascending aorta, left main coronary artery, and descending aorta was calculated. Simulated contrast flow rate and iodine delivery rate (IDR) to reach a mean contrast enhancement level of 350 HU were calculated. RESULTS A total of the 389 patients were enrolled in the study. To achieve the same contrast enhancement of 350 HU, iso-osmolar group required higher simulated contrast flow rate (3.90 vs 3.62 mL/s, P = 0.017) but lower simulated IDR (1.34 vs 1.25 g/s, P = 0.024) compared with low-osmolar group. CONCLUSIONS To maintain a similar level of contrast enhancement during CCTA, iodixanol-320 needs larger contrast flow rate with lower IDR compared with low-osmolar iopromide-370.
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Aortic and Hepatic Contrast Enhancement During Hepatic-Arterial and Portal Venous Phase Computed Tomography Scanning: Multivariate Linear Regression Analysis Using Age, Sex, Total Body Weight, Height, and Cardiac Output. J Comput Assist Tomogr 2017; 41:309-314. [PMID: 27759599 DOI: 10.1097/rct.0000000000000513] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We evaluated the effect of the age, sex, total body weight (TBW), height (HT) and cardiac output (CO) of patients on aortic and hepatic contrast enhancement during hepatic-arterial phase (HAP) and portal venous phase (PVP) computed tomography (CT) scanning. METHODS This prospective study received institutional review board approval; prior informed consent to participate was obtained from all 168 patients. All were examined using our routine protocol; the contrast material was 600 mg/kg iodine. Cardiac output was measured with a portable electrical velocimeter within 5 minutes of starting the CT scan. We calculated contrast enhancement (per gram of iodine: [INCREMENT]HU/gI) of the abdominal aorta during the HAP and of the liver parenchyma during the PVP. We performed univariate and multivariate linear regression analysis between all patient characteristics and the [INCREMENT]HU/gI of aortic- and liver parenchymal enhancement. RESULTS Univariate linear regression analysis demonstrated statistically significant correlations between the [INCREMENT]HU/gI and the age, sex, TBW, HT, and CO (all P < 0.001). However, multivariate linear regression analysis showed that only the TBW and CO were of independent predictive value (P < 0.001). Also, only the CO was independently and negatively related to aortic enhancement during HAP and to liver parenchymal enhancement when the contrast material injection protocol was adjusted for the TBW (P < 0.001). CONCLUSION By multivariate linear regression analysis only the TBW and CO were significantly correlated with aortic and liver parenchymal enhancement; the age, sex, and HT were not. The CO was the only independent factor affecting aortic and liver parenchymal enhancement at hepatic CT when the protocol was adjusted for the TBW.
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Moradi M, Hashemi P, Momeni M. The influence of cardiac function on coronary arterial enhancement at coronary computed tomography angiography: A cross-sectional study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:132. [PMID: 28331518 PMCID: PMC5348831 DOI: 10.4103/1735-1995.196614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/14/2016] [Accepted: 09/06/2016] [Indexed: 01/16/2023]
Abstract
Background: The purpose of this study was to evaluate the influence of ejection fraction (EF) on peak aortic time (PAT) and peak aortic enhancement (PAE) during coronary computed tomography angiography (CTA). Materials and Methods: One-hundred and twenty patients (64 men, 56 women) underwent measurement of coronary CTA with a measurement of EF within 3 months of coronary CTA. Pearson's correlation coefficient analysis was used to investigate the relationships between EF, PAT and PAE, and peak attenuation of all coronary arteries. Results: The range of EF was (25%–70%) (mean: 55 ± 7.7). The range of PAT and PAE of ascending aorta on bolus test was 13–31 s (mean: 19.3 ± 2) and 153–435 HU (mean: 235 ± 40.6), respectively. Mean peak attenuation of ascending aorta, right coronary artery, left coronary artery, left circumflex artery, and left anterior descending were (561 ± 119), (476 ± 109), (505 ± 108), (467 ± 113), and (473 ± 104), respectively. There was a negative correlation between EF and PAT (r = −0.266, P = 0.003); however, there was no significant correlation between EF and PAE (r = −0.027, P = 0.767). In addition, there was no significant correlation between EF and the peak attenuation of coronary arteries. Conclusion: PAT was related to EF, but there was no relationship between PAE and EF. One of the explanation is that the left ventricular EF used for our study was assessed with echocardiography which is used roughly estimation of EF with interval of 5%–10% and may cause confounding results.
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Affiliation(s)
- Maryam Moradi
- Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peiman Hashemi
- Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Momeni
- Department of Radiology and Imaging, Isfahan University of Medical Sciences, Isfahan, Iran
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Zhu X, Zhu Y, Liu W, Yang G, Su Z, Tang L, Xu Y. Improved image-quality consistency in coronary CT angiography using a test-bolus-based individually tailored contrast medium injection protocol. Clin Radiol 2016; 71:1113-9. [PMID: 27170220 DOI: 10.1016/j.crad.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 02/20/2016] [Accepted: 04/01/2016] [Indexed: 11/20/2022]
Abstract
AIM To develop and validate a test bolus (TB)-based quantitative model to create an individualised contrast medium injection protocol for use at coronary computed tomography angiography (CCTA) to improve patient-to-patient uniformity of intracoronary attenuation. MATERIALS AND METHODS In the model-building phase, 175 patients who underwent CCTA using a traditional contrast medium injection protocol were recruited. A personalised injection equation was proposed according to the relationship between aortic enhancement and the haemodynamic parameters obtained from the TB. In the model-validation phase, a target aortic enhancement of 350 HU was set. Two hundred and fifteen additional CCTA examinations were performed using the proposed personalised injection model. Comparisons of inter-individual variability between the traditional and the proposed personalised injection protocol were performed. RESULTS In the model-building phase, a high positive correlation between aortic enhancement and the haemodynamic parameters obtained from the TB was found. As a result, a personalised injection equation was determined using linear regression. In the model-validation phase, the average aortic enhancement was 350.5 HU, without significant differences from the preset level. Using the TB-based personalised injection protocol, inter-individual variability of aortic enhancement was significantly reduced (71.8 versus 38.9 HU, p<0.001) and patients who were scanned at 100 kVp had a reduction in the average contrast medium flow rate from 4.1 to 3.2 ml/s (p<0.001). CONCLUSIONS The proposed TB-based injection protocol can achieve a desired preset and stable aortic enhancement.
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Affiliation(s)
- X Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Y Zhu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - W Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - G Yang
- Lab. of Image Science & Technology, School of Computer Science and Engineering, Southeast University, 2 Sipailou, Nanjing 210096, Jiangsu, China
| | - Z Su
- GE Healthcare, 12f Building A, E-town International Center, No. 10 Ronghua Road, Business Development Area, Beijing, 100176, China
| | - L Tang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Y Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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Zhu X, Shi Z, Zhu Y, Liu W, Yang G, Yu T, Tang L, Xu Y. Individually adapted tube current selection and contrast medium injection protocol of coronary CT angiography based on test bolus parameters: a feasibility study. Acta Radiol 2015; 56:666-72. [PMID: 24938658 DOI: 10.1177/0284185114536156] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/28/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND Test bolus is mostly used to determine the starting point of a full cardiac scanning with respect to injection of a larger bolus of contrast material. So far there are limited data demonstrating the feasibility of using information obtained from a test bolus to adjust contrast delivery protocols and tube current individually during coronary computed tomography angiography (CCTA). PURPOSE To evaluate the feasibility of individually adapted tube current selection and contrast injection protocols of CCTA based on test bolus parameters. MATERIAL AND METHODS Test bolus followed by CCTA was performed in 93 patients at 100 kV and in 81 patients at 120 kV, respectively. Simulated attenuation of the descending aorta (SimDA) of CCTA was calculated at a fixed contrast injection rate of 4 mL/s. Univariate and multivariate comparisons were performed to identify associations of SimDA and image noise of CCTA (NoiseCCTA) with test bolus information and patient-related factors including body weight (BW), body mass index (BMI), and body surface area (BSA). RESULTS Compared with BW, BMI, and BSA, SimDA was more closely related to the peak time of left ventricle and peak enhancement of right ventricle obtained from test bolus (r = 0.495 and r = 0.642 for 100 and 120 kV protocol, respectively). Similarly, NoiseTB was much more closely related to NoiseCCTA (r = 0.740 and r = 0.630 for 100 and 120 kV protocol, respectively) when compared with BW, BMI, and BSA. CONCLUSION It is feasible to individually adapt tube current and contrast injection protocol of CCTA based on the information of test bolus.
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Affiliation(s)
- Xiaomei Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Zhaofei Shi
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yinsu Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Wangyan Liu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Guanyu Yang
- Laboratory of Image Science & Technology, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu, PR China
| | - Tongfu Yu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Lijun Tang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
| | - Yi Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, PR China
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An individualized contrast material injection protocol with respect to patient-related factors for dual-source CT coronary angiography. Clin Radiol 2014; 69:e86-92. [DOI: 10.1016/j.crad.2013.09.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 08/11/2013] [Accepted: 09/20/2013] [Indexed: 11/22/2022]
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Zhu X, Zhu Y, Xu H, Yang G, Tang L, Xu Y. Dual-source CT coronary angiography involving injection protocol with iodine load tailored to patient body weight and body mass index: estimation of optimal contrast material dose. Acta Radiol 2013; 54:149-55. [PMID: 23171529 DOI: 10.1258/ar.2012.120362] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Body mass index (BMI) has a positive linear influence on arterial attenuation at coronary CT angiography involving injection protocol with dose linearly tailored to body weight (BW). Excessive contrast material may inadvertently be given in heavier patients when the dose is determined by BW only. PURPOSE To investigate the effect of injection protocol with dose of contrast material (CM) tailored to BW and BMI on coronary arterial attenuation, contrast-to-noise ratio, and image noise at dual-source CT coronary angiography (DSCT-CA). MATERIAL AND METHODS A total of 233 consecutive patients (mean age, 60.2 years) undergoing DSCT-CA were included. Image acquisition protocol was standardized (120 kV, 380 mAs, and retrospective electrocardiograph-triggered DSCT-CA). CM dosage calculation was randomly categorized into groups: a BW group and a BW-BMI group. CM flow rate in both groups was calculated as dosage divided by scan time plus 8 s. Correlations between BW, BMI, and attenuations of ascending aorta (AA) above coronary ostia, left main coronary artery (LM), proximal right coronary artery (RCA), left anterior descending (LAD), and left circumflex artery (LCX), contrast to noise ratio of LM (LMCNR) and RCA (RCACNR), and image noise were evaluated with simple linear regression for two groups individually. RESULTS In BW group, attenuations of AA and coronary arteries showed positive linear correlations to BW and BMI. In contrast, no relationships were found in BW-BMI group. LMCNR and RCACNR were inversely determined by BW and BMI in both groups. Image noise increased with BW and BMI increasing in two groups. CONCLUSION BMI has a positive linear influence on arterial attenuation with fixed iodine per BW. The injection protocol with CM dose tailored to BW and BMI is reasonable during DSCT-CA.
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Affiliation(s)
- Xiaomei Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Yinsu Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Hai Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Guanyu Yang
- Laboratory of Image Science & Technology, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu, China
| | - Lijun Tang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
| | - Yi Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu
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Konno M, Hosokai Y, Usui A, Abe M, Tateishi T, Kawasumi Y, Tsuda M, Ota H, Takase K, Saito H. Cardiac output obtained from test bolus injections as a factor in contrast injection rate revision of following coronary CT angiography. Acta Radiol 2012; 53:1107-11. [PMID: 22993270 DOI: 10.1258/ar.2012.120276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Optimal contrast enhancement is crucial for the detection of coronary artery stenoses and atherosclerotic changes in coronary CT angiography (CTA). PURPOSE To demonstrate the feasibility of using the cardiac output (CO) obtained from the test bolus injection data-set (COtest) as a factor in contrast injection rate revision of the following coronary CTA. MATERIAL AND METHODS The test bolus injection data-sets of 52 consecutive coronary CTAs were examined. COtest was calculated from the test bolus data-set. Aortic peak enhancement (APE) was measured on the following coronary CTA. We simulated the APE at a fixed contrast injection rate of 4 mL/s (simAPE) in each patient. RESULTS The ranges of COtest and simAPE were 2.82-7.56 L/min and 194-527 Hounsfield Units, respectively. There was a significant negative correlation (R = -0.802, P < 0.001) between simAPE and COtest. CONCLUSION COtest can be used for injection rate revision on coronary CTA.
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Affiliation(s)
- Masahiko Konno
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
- Yamagata Prefecture Comprehensive Rehabilitation and Education Center, Yamagata
| | - Yoshiyuki Hosokai
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
| | - Akihito Usui
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
| | - Mitsuya Abe
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
| | - Toshiki Tateishi
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
| | - Yusuke Kawasumi
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
| | - Masashi Tsuda
- Division of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hideki Ota
- Division of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Kei Takase
- Division of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Haruo Saito
- Division of Diagnostic Image Analysis, Graduate School of Medicine, Tohoku University, Miyagi
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Kidoh M, Nakaura T, Awai K, Utsunomiya D, Sakaino N, Harada K, Uemura S, Yamashita Y. Compact-bolus dynamic CT protocol with a test bolus technique in 64-MDCT coronary angiography: comparison of fixed injection rate and duration protocol. Jpn J Radiol 2012. [DOI: 10.1007/s11604-012-0158-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Zhu X, Zhu Y, Xu H, Tang L, Xu Y. The influence of body mass index and gender on coronary arterial attenuation with fixed iodine load per body weight at dual-source CT coronary angiography. Acta Radiol 2012; 53:637-42. [PMID: 22798383 DOI: 10.1258/ar.2012.110657] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Most of current coronary CT angiography protocols are not adapted to body weight (BW) or cardiac output and no literature about influence of gender on coronary attenuation are reported with administration of a fixed iodine load per BW. PURPOSE To determine the influence of body mass index (BMI) and gender on coronary arterial attenuation if contrast material dose is linearly adjusted to a patient's BW at dual-source CT coronary angiography (DSCT-CA). MATERIAL AND METHODS A total of 207 consecutive patients (mean age 60.6 years) undergoing DSCT-CA were included. Contrast material (370 mg I/mL) dose calculation was randomly categorized into two groups (Group 1: 1.10 mL/kg for men and women; Group 2: men 1.10 mL/kg, women 0.99 mL/kg) and flow rate was calculated as dose was divided by scan time plus 8 s. Mean arterial attenuations between men and women were compared with respect to attenuations of ascending aorta (AA) above coronary ostia, left main coronary artery (LM), proximal segments of right coronary artery (RCA), left anterior descending (LAD), and left circumflex artery (LCX) in two groups, respectively. Attenuations of coronary arteries were correlated with BW and BMI with simple linear regression. RESULTS The mean attenuations of AA, LM, RCA, LAD, and LCX were 407.8 ± 53.6 HU, 412.6 ± 55.4 HU, 411.4 ± 64.3 HU, 399.1 ± 56.7 HU, and 399.1 ± 60.2 HU, respectively, and there were no significant differences between men and women in group 1 (AA, P = 0.571; LM, P = 0.670; RCA, P = 0.737; LAD, P = 0.439, and LCX, P = 0.888). In group 2, the mean attenuations of AA, LM, RCA, LAD, and LCX in men were significantly higher than those in women (AA, P = 0.008; LM, P = 0.025; RCA, P = 0.017; LAD, P = 0.015, and LCX, P = 0.002). Positive linear regression between BW and attenuations of AA (R(2) = 0.047, P = 0.02), LM (R(2) = 0.036, P = 0.04), RCA (R(2) = 0.080, P < 0.01), LAD (R(2) = 0.078, P < 0.01), and LCX (R(2) = 0.033, P = 0.05) was found in group 1, suggesting that attenuations of coronary arteries increased in heavier patients. Similarly, there was positive linear regression between BMI and attenuations of AA (R(2) = 0.117, P < 0.01), LM (R(2) = 0.090, P < 0.01), RCA (R(2) = 0.138, P < 0.01), LAD (R(2) = 0.111, P < 0.01), and LCX (R(2) = 0.078, P < 0.01). CONCLUSION Men and women have similar coronary attenuations with a fixed iodine load per BW. BMI has a positive linear influence on arterial attenuation at DSCT-CA involving injection protocol with dose linearly tailored to BW. Excessive contrast material may inadvertently be given in heavier patients when the dose is determined by BW only. Contrast material dose may need to be tailored individually by BW and BMI.
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Affiliation(s)
- Xiaomei Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yinsu Zhu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hai Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lijun Tang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yi Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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15
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Shorter delay time reduces interpatient variability in coronary enhancement in coronary CT angiography using the bolus tracking method with 320-row CT. Int J Cardiovasc Imaging 2012; 29:185-90. [DOI: 10.1007/s10554-012-0045-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 03/26/2012] [Indexed: 02/05/2023]
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16
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Zhu X, Chen W, Li M, Xu Y, Xu H, Zhu Y, Wang D, Tang L. Contrast material injection protocol with the flow rate adjusted to the heart rate for dual source CT coronary angiography. Int J Cardiovasc Imaging 2011; 28:1557-65. [DOI: 10.1007/s10554-011-9950-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Accepted: 09/19/2011] [Indexed: 01/17/2023]
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