Prediction of Aortic Enhancement on Coronary CTA Images Using a Test Bolus of Diluted Contrast Material

Masuda, Takanori; Funama, Yoshinori; Imada, Naoyuki; Sato, Tomoyasu; Yamagami, Takuji; Tatsugami, Fuminari; Awai, Kazuo

doi:10.1016/j.acra.2014.07.002

Cited by 13 publications

(17 citation statements)

References 18 publications

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“…A timing bolus method with the injection of a diluted contrast medium was introduced. The amount of contrast medium during the test injection ranged from 0.2 mL/kg to 0.3 mL/kg [3,10] and the injection duration was the same as for the main bolus. The relationship between the predicted and actual coronary enhancement was better when diluted contrast medium was used than with undiluted contrast medium [10].…”

Section: Discussionmentioning

confidence: 99%

“…The amount of contrast medium during the test injection ranged from 0.2 mL/kg to 0.3 mL/kg [3,10] and the injection duration was the same as for the main bolus. The relationship between the predicted and actual coronary enhancement was better when diluted contrast medium was used than with undiluted contrast medium [10]. Coronary CTA with the amount of contrast medium calculated from the time density curve of the diluted contrast medium method resulted in smaller interpatient variability and more patients within optimal enhancement than the body weight adjusted protocol [3,14].…”

Section: Discussionmentioning

confidence: 99%

“…Another approach for optimizing the dose of contrast medium to achieve the target enhancement is to use the test bolus data [10]. As the peak enhancement (PE) of the main bolus can be predicted from the PE of the test bolus, an optimal amount of contrast medium could be calculated.…”

Section: Introductionmentioning

confidence: 99%

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Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data

Tomizawa

Chou

Matsuoka

et al. 2019

Cardiovasc Imaging Asia

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To derive and validate a formula to predict the optimal amount of contrast medium for coronary CT angiography (CTA) from CT perfusion (CTP) data during comprehensive cardiac CT. Materials and Methods: The derivation and validation group consisted of 196 and 41 patients, respectively. Dynamic CTP was performed under adenosine triphosphate stress of 0.14 mg/kg/min, followed by rest coronary CTA. Time to peak (TTP) and peak enhancement (PE) in the left ventricle during CTP was recorded. The amount of contrast medium during CTA was 0.8×body weight (kg) in the derivation group. A formula to determine the amount of contrast medium needed to achieve an enhancement of 370 Hounsfield unit (HU) in CTA was derived using TTP, PE, body weight, and heart rate. The amount of contrast medium required during CTA in the validation group was determined by this formula. Results: The mean amount of contrast medium during CTA did not differ between the derivation and validation groups (49.3±8.0 mL vs. 47.9±12.9 mL, p=0.39). The mean coronary artery enhancement was slightly lower in the validation group (400±55 HU vs. 380±46 HU, p=0.03) with smaller interpatient variability (p=0.02) than in the derivation group. The proportion of patients with an optimal enhancement of 320 HU to 420 HU significantly increased from 54% to 75% (p=0.01) when the formula was used. Conclusion: Adjusting the amount of contrast medium using dynamic CTP data could reduce the interpatient variability of coronary enhancement during comprehensive cardiac CT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data

Tomizawa

Chou

Matsuoka

et al. 2019

Cardiovasc Imaging Asia

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“…To predict aortic CT number, past CT images with follow-up examination may be utilized if the same injection method is employed. In addition, the use of test bolus scan with diluted contrast medium may be useful (Masuda et al 2014). Because, a strong correlation was found between aortic CT numbers on images obtained with a test bolus using diluted contrast material and subsequently acquired coronary CTA images.…”

Section: Discussionmentioning

confidence: 99%

Radiation dose reduction based on CNR index with low-tube voltage scan for pediatric CT scan: experimental study using anthropomorphic phantoms

et al. 2016

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BackgroundTo figure out the relationship between image noise and contrast noise ratio (CNR) at different tube voltages, using anthropomorphic new-born and 1-year-old phantoms, and to discuss the feasibility of radiation dose reduction, based on the obtained CNR index from image noise. We performed helical scans of the anthropomorphic new-born and 1-year-old phantoms. The CT numbers of the simulated aorta and image noise of the simulated mediastinum were measured; then CNR was calculated on 80, 100, and 120-kVp images reconstructed with filtered back projection (FBP) and iterative reconstruction (IR). We also measured the center and surface dose in the case of CNR of 14 using radio-photoluminescence glass dosimeters.ResultsThe CT number of the simulated aorta was increased with decreasing tube voltage from 120 to 80 kVp (362.5–535.1 HU for the new-born, 358.9–532.6 HU for the 1-year-old). At CNR of 14, the center dose was 0.4, 0.6 and 0.9 mGy at FBP and 0.5, 0.6 and 0.9 mGy at IR and with the new-born phantom acquired at 80, 100 and 120 kVp, respectively. The center dose for FBP image was reduced by 56% at 80 kVp, 34% at 100 kVp for the new-born and 36% at 80 kVp, 22% at 100 kVp for the 1-year-old compared with that at 120 kVp. We obtained a relationship between image noise and CNR at different tube voltages using the anthropomorphic new-born and 1-year-old phantoms.ConclusionThe use of index of CNR with low-tube voltage may achieve further radiation dose reduction in pediatric CT examination.

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“…Therefore, the predicted ΔHUCCTA in the following equation of a given ΔHUTEST (model 1) was calculated as follows: where ΔHU/gI ave (ΔHUCCTA ave ) is the average of ΔHUCCTA (HU/grams of iodine [gI]), ΔHU/gI test-ave (ΔHUTESTave) is the average of ΔHUTEST, and ΔHU/gI test (ΔHUTEST) is a given ΔHUTEST (HU/gI). Previous reports have suggested that body size parameters, such as TBW, are inversely correlated to the enhancement by the fixed amount of contrast material ( 12 19 ). Therefore, the predicted ΔHUCCTA of a given TBW (model 2) was determined as follows: where ΔHU/gI ave is the average of ΔHUCCTA (HU/gI), TBW ave (TBW ave ) is the average of TBW (kg), and TBW is a given TBW (kg).…”

Section: Methodsmentioning

confidence: 99%

Development and Validation of Generalized Linear Regression Models to Predict Vessel Enhancement on Coronary CT Angiography

et al. 2018

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ObjectiveWe 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 MethodsWe 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.ResultsIn 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).ConclusionWe 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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Prediction of Aortic Enhancement on Coronary CTA Images Using a Test Bolus of Diluted Contrast Material

Cited by 13 publications

References 18 publications

Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data

Optimizing Contrast Medium Injection for Coronary CT Angiography Using Myocardial CT Perfusion Data

Radiation dose reduction based on CNR index with low-tube voltage scan for pediatric CT scan: experimental study using anthropomorphic phantoms

Development and Validation of Generalized Linear Regression Models to Predict Vessel Enhancement on Coronary CT Angiography

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