Prospective multicenter study on personalized and optimized MDCT contrast protocols: results on liver enhancement

Zanca, Federica; Brat, Hugues; Pujadas, Pilar; Racine, Damien; Dufour, B; Fournier, Dominique; Rizk, Benoît

doi:10.1007/s00330-021-07953-3

Cited by 6 publications

(12 citation statements)

References 34 publications

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“…In the present study, when dosed according to TBW, all the dogs had hepatic enhancement > 60 HU; this would equate to overenhancement in humans 14 . When contrast was dosed according to LBW, 5 of the 12 dogs in this study had hepatic enhancement < 50 HU, which is considered insufficient opacification in humans 3,4,24 .…”

Section: Discussionmentioning

confidence: 55%

“…3 In the present study, when dosed according to TBW, all the dogs had hepatic enhancement > 60 HU; this would equate to overenhancement in humans. 14 When contrast was dosed according to LBW, 5 of the 12 dogs in this study had hepatic enhancement < 50 HU, which is considered insufficient opacification in humans. 3,4,24 However, the enhancement was above 30 HU in all the dogs, which is the cut-off for inadequate enhancement in humans, when the conspicuity of lesions will be diminished.…”

Section: Ta B L Ementioning

confidence: 87%

“…In people, patient‐to‐patient liver enhancement uniformity is essential for lesion assessment, accuracy, and reporting confidence in diagnostic and follow‐up CT examinations 14 . Multiple human studies have explored the use of LBW as an alternative metric to TBW in CM dosing 11,14,22–24 .…”

Section: Discussionmentioning

confidence: 99%

“…Two studies showed that the use of LBW (rather than TBW) resulted in a more precise estimation of iodine dose to achieve consistent hepatic enhancement with reduced patient‐to‐patient variability 12,22 . Zanca and coauthors also found that a fat‐free mass‐based protocol yielded similar findings and significantly reduced iodine load 14 . Based on reports in the human literature and findings from the present study, TBW may not be the optimal body size index for determining CM dose, particularly in obese patients with abundant body fat and thus relatively smaller vascular and interstitial spaces for their body weight 3 …”

Section: Discussionmentioning

confidence: 99%

“…In people, patient-to-patient liver enhancement uniformity is essential for lesion assessment, accuracy, and reporting confidence in diagnostic and follow-up CT examinations. 14 Multiple human studies have explored the use of LBW as an alternative metric to TBW in CM dosing. 11,14,[22][23][24] These studies show contradicting results, with some reporting no difference in enhancement or interpatient variability Excellent: contrast enhancement provided optimal information to make a radiologic diagnosis.…”

Section: Physiologic Parametersmentioning

confidence: 99%

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Lean body weight‐adjusted intravenous iodinated contrast dose for abdominal CT in dogs reduces interpatient enhancement variability while providing diagnostic quality organ enhancement

Kan¹,

Milne²,

Tyrrell³

et al. 2022

Vet Radiology Ultrasound

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Contrast‐enhanced computed tomography (CECT) is increasingly used to screen for abdominal pathology in dogs, and the contrast dose used is commonly calculated as a linear function of total body weight (TBW). Body fat is not metabolically active and contributes little to dispersing or diluting contrast medium (CM) in the blood. This prospective, analytic, cross‐section design pilot study aimed to establish the feasibility of intravenous CM dosed according to lean body weight (LBW) for abdominal CECT in dogs compared to TBW. We hypothesized that when dosing intravenous CM according to LBW, studies will remain at diagnostic quality, there will be a reduced interindividual contrast enhancement (CE) variability, and there will be less change to heart rate and blood pressure in dogs compared to when administering CM calculated on TBW. Twelve dogs had two CECT studies with contrast doses according to TBW and LBW at least 8 weeks apart. Interindividual organ and vessel CE variability, diagnostic quality of the studies, and changes in physiological status were compared between protocols. The LBW‐based protocol provided less variability in the CE of most organs and vessels (except the aorta). When dosed according to LBW, liver enhancement was positively associated with grams of iodine per kg TBW during the portal venous phase (P = 0.046). There was no significant difference in physiological parameters after CM administration between dosing protocols. Our conclusion is that a CM dose based on LBW for abdominal CECT lowers interindividual CE variability and is effective at maintaining studies of diagnostic quality.

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Section: Discussionmentioning

confidence: 55%