Comparison between a fixed-dose contrast protocol and a weight-based contrast dosing protocol in abdominal CT

George, Armia; Manghat, Nathan; Hamilton, M.C.K.

doi:10.1016/j.crad.2016.07.009

Cited by 29 publications

(33 citation statements)

References 10 publications

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“…Dermed vil pasienter med lik vekt, men ulik kroppskomposisjon, behøve ulike mengder kontrastmiddel. Når det tas hensyn til både kroppskomposisjon og vekt, kan det gi en mer nøyaktig tilnaerming av ønsket kontrastmiddeloppladning i målområdet hos flere pasienter (1,(9)(10)(11).…”

Section: Introduksjonunclassified

“…En studie fra 1995 (15) har gått ut fra optimal oppladning i leveren, og konkluderer med at dette bør vaere en økning på 50-60 Hounsfield-enheter (HU), fra de originale HUverdiene i målorganet. Disse verdiene har i senere tid blitt brukt i andre studier (1,(9)(10)(11). En oversiktsartikkel fra 2009 (16) har utarbeidet tabeller for anbefalte mengder kontrastmiddel ut fra kroppsvekt og kroppskomposisjon, for å oppnå en optimal oppladning i leveren ved en økning på 50-60 HU.…”

Section: Introduksjonunclassified

“…Dette støttes av studien til Bae (1), som konkluderer med at kun bruk av kroppsvekt i utregning av kontrastmiddelmengden ikke er optimalt for overvektige personer.To av respondentene bruker fast mengde i sine leverundersøkelser. En vektbasert utregning av kontrastmengder vil ifølge studier gi bedre objektiv kontrastoppladning i organer og blodårer, samt subjektivt bedre bildekvalitet(10). Dermed kan det tenkes at respondentene som tar i bruk vektbasert utregningsmetode for kontrastmiddelmengde vil ha bedre bildekvalitet på bildene sine sammenlignet med de to respondentene som tar i bruk fast mengde.Hvis vi sammenligner kontrastmiddelmengdene som ville blitt gitt til eksempelpasientene med hverandre, ser vi noen faktorer som går igjen.…”

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Contrast media routines in Norwegian hospitals – a mapping study

Dalen¹,

Høynes²,

Rusandu³

2019

RadOpen

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Introduction Optimal contrast enhancement in the organ of interest is crucial for the image quality of a CT examination. Potential side effects of contrast media range from mild to potentially severe. The use of the smallest possible amount, without compromising the image quality, is therefore preferable considering patient safety. Different methods of calculations, that consider different factors, are used to calculate the relevant amount. Our project focuses on the contrast media used in a "CT liver" examination among the public hospitals in Norway, and we wish to present the differences in contrast media routines.Methods Inquiries were sent to every public hospital that have a CT-lab in Norway, asking for their liver protocol, also including a short questionnaire. Eight example patients with different characteristics (sex, weight and body composition) were created. Information from the protocols and the questionnaires were used to calculate the amount of contrast media each of the hospitals would give to each example patient. Previous studies were used to calculate the recommended amounts of contrast media based on patient safety and optimal image quality. ResultsCalculations show differences between 66% and 117% (from lowest to highest amount) of contrast media given to the example patients. Out of the 30 participating hospitals, 6 use software, 17 use weight tables, 2 use fixed amounts and 5 use weight tables that takes body composition into consideration as their methods of calculating the amount of contrast media. None would have given more than the recommended amounts, considering patient safety, while between 6,7% and 36,7% would have given less than the recommended amounts, considering image quality. Conclusion The results show significant differences in contrast media usage among Norwegian hospitals. In conclusion, there is room for improvement and standardization of contrast media routines. Optimization of contrast media routines will benefit both patient safety, image quality and cost.

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Contrast media routines in Norwegian hospitals – a mapping study

Dalen¹,

Høynes²,

Rusandu³

2019

RadOpen

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“…Therefore, on the premise of ensuring the quality and display capability of CT images, reasonable reduction in contrast medium dose may effectively prevent and reduce the incidence of adverse effects associated with enhanced CT scans. Various methods had been previously proposed to reduce the contrast medium dose, including individualized weight-based protocols [ 4 – 8 ], adjustment on the injection time or flow rate of contrast administration [ 9 – 11 ], and the use of additional saline flush [ 12 – 14 ]. Out of the various options, previous reports had demonstrated that personalized weight-based contrast medium injection protocol is an ideal method to reasonably reduce the injection dose of contrast medium [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

An Individually Optimized Protocol of Contrast Medium Injection in Enhanced CT Scan for Liver Imaging

Feng

Zhu

Peng

et al. 2017

Contrast Media & Molecular Imaging

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Objective To investigate the effectiveness of a new individualized contrast medium injection protocol for enhanced liver CT scan. Methods 324 patients who underwent plain and dual phase enhanced liver CT were randomly assigned to 2 groups: G1 (n = 224, individualized contrast medium injection protocol); G2 (n = 100, standard contrast medium injection with a dose of 1.5 ml/kg). CT values and ΔHU (CT values difference between plain and enhanced CT) of liver parenchyma and tumor-liver contrast (TLC) during hepatic arterial phase (HAP) and portal venous phase (PVP) and contrast medium dose were measured. The tumor conspicuity of hepatocellular carcinoma (HCC) between two groups was independently evaluated by two radiologists. Results The mean contrast medium dose of G1 was statistically lower than that of G2. There were no significantly statistical differences in CT values and ΔHU of liver parenchyma during HAP, TLC values during HAP, and PVP between two groups. The CT values and ΔHU of liver parenchyma during PVP of G2 were significantly higher than those of G1. Two independent radiologists were both in substantial conformity in grading tumor conspicuity. Conclusion Using the individually optimized injection protocol might reduce contrast medium dose without impacting on the imaging quality in enhanced liver CT.

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“…It is therefore pertinent to consider how authority innovation-decisions affect the adoption of a new practice. For instance, several studies have shown that the use of weight-based iodinated contrast medium for patients undergoing computed tomography scans produces adequate enhancement; it is cost effective and has significant benefits to patients who are vulnerable to kidney-related complications (George, Manghat, & Hamilton, 2016;Lamby et al, 2017;Perrin et al, 2018;Takahashi et al, 2018). If a Band 5 or 6 radiographer became aware of this innovation, that individual cannot single-handedly apply it in practice because it requires certain managerial decisions to be taken in purchasing of new equipment to support the practice.…”

Section: Decision Making and Implementation Of A New Practice By Radimentioning

confidence: 99%

Barriers to Research Utilisation amongst Diagnostic Radiographers in the UK

Gyimah¹

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Introduction: Lack of research uptake and utilisation compared to other Allied Health Professions prompted the publications of four consecutive research strategies by the Society and College of Radiographers in attempts to bridge the gap. Aims: The aim of this study was to find out perceived barriers to research utilisation amongst diagnostic radiographers in the UK. Methods: A descriptive cross-sectional survey was conducted in 2016. A random sample was used to select 1,080 radiographers who were sent a link to the web-based questionnaire. Results: The response rate was 72.8%. Most radiographers were Band 6 (n=296, 47.0%) holders. The commonly identified perceived barriers to research utilisation included lack of time for research-related activities, how to develop research questions, find relevant literature and lack of authority to change practice. It was found that 142(50.7%) of BSc and 26(44.0%) of MSc had difficulty in finding relevant literature. Interestingly, 20(40%) of the Band 8 radiographers perceived themselves to lack the authority to change practice. In the area of practice category, sonographers (n=35, 57.4%) were more likely to perceive themselves to lack authority in changing their practice. While there was a positive attitude to research utilisation, 198(31.4%) held the view that research was not in their scope of practice. A further 127(20.2%) felt radiologists and physicists should review research that were relevant to their practice. It emerged that highest educational qualification was associated with a higher probability of knowledge of research skills and attitude to research utilisation. Conclusions: The study concludes that dissemination mechanisms to facilitate research utilisation are lacking. Radiology service managers and the Society and College of Radiographers have key roles to play in research utilisation in terms of time allocation and training in research skills.

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Comparison between a fixed-dose contrast protocol and a weight-based contrast dosing protocol in abdominal CT

Cited by 29 publications

References 10 publications

Contrast media routines in Norwegian hospitals – a mapping study

Contrast media routines in Norwegian hospitals – a mapping study

An Individually Optimized Protocol of Contrast Medium Injection in Enhanced CT Scan for Liver Imaging

Barriers to Research Utilisation amongst Diagnostic Radiographers in the UK

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