Pulmonary Embolism: Prospective Comparison of Iso-osmolar and Low-Osmolarity Nonionic Contrast Agents for Contrast Enhancement at CT Angiography

Bédard, Justine; Blais, Christian; Patenaude, Yves; Monga, Ernest

doi:10.1148/radiol.2343031811

Cited by 18 publications

(6 citation statements)

References 21 publications

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“…CM doses in the same range have also been reported for four-channel [4][5][6][7][8][9][10][11], eight-channel and 16-channel multidetector CT (MDCT) [9,12,13]. After exchanging our single-slice CT for a 16-channel MDCT, we have been able to reduce the standard CM dose from 45 g to 25 g iodine, i.e.…”

Section: Introductionsupporting

confidence: 69%

“…We were able to identify five CTPA investigations, all using 120-140 kVp, performed to diagnose APE and reporting attenuation values within the pulmonary arteries [10][11][12][13]27]. These were analysed regarding number of patients, body weight, number of detector channels, X-ray tube potential, scan delay from start of CM injection or automatic bolus tracking, CM parameters, and reported pulmonary artery density.…”

Section: Literature Reviewmentioning

confidence: 99%

“…The same practice seems to prevail with four-slice, eight-slice and 16-slice CT scanners [4][5][6][7][8][9][10][11][12][13]. However, central blood volume is inversely related to arterial enhancement and correlates with body weight [15].…”

Section: Weight-adapted Contrast Media Dosing and Injection Durationmentioning

confidence: 99%

“…Dosing of CM, irrespective of body size, appears to be common standard clinical practice [4][5][6][7][8][9][10][11][12][13]. However, central blood volume correlates with body weight (BW), and CM injection protocols tailored to patient weight and constant injection duration have been shown to reduce interindividual differences of arterial enhancement [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients

Holmquist

Nyman

2006

Eur Radiol

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The aim of this study was to assess the feasibility of minimising contrast-medium (CM) doses using 80-peak kilovoltage (kVp) 16-channel multidetector computed tomography (MDCT) with CM dose tailored to body weight, when diagnosing pulmonary embolism (PE) in azotaemic patients. Twenty-nine patients (68-93 years; 38-79 kg) with an estimated glomerular filtration rate of 12-49 ml/min underwent 80 kVp MDCT at a median dose of 200 mg iodine (I)/kg and 15 s injection time. Pulmonary artery (PA) enhancement where compared with our own reference material using 320 mg I/kg at 120 kVp and with reported figures in the literature at 120-140 kVp and a 42 g iodine CM dose. Median (1st and 3rd quartiles) values regarding CM dose were 12.2 (9.9-12.8) g iodine; density of left main and lower lobe segmental PA 339 (275-395) Hounsfield units (HU) and 354 (321-442) HU, respectively. Those enhancement values were similar to those obtained from the reference population at 120 kVp and those reported in the literature at 120-140 kVp. One patient had a transient increase in plasma creatinine. Three months' follow-up revealed deep venous thrombosis among 1/18 patients with negative results from computed tomography (CT). We conclude that 80 kVp 16-channel MDCT to diagnose PE in azotaemic patients may be performed with markedly reduced CM doses, implying a lesser risk for CM-induced nephropathy.

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Section: Introductionsupporting

confidence: 69%

Section: Literature Reviewmentioning

confidence: 99%

Section: Weight-adapted Contrast Media Dosing and Injection Durationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients

Holmquist

Nyman

2006

Eur Radiol

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“…Furthermore, differences between maximum and minimum enhancement were significantly larger in group 1 (10). Previous studies on contrast material delivery dynamics have focused on the enhancement profiles in a single vascular territory, that is, the aorta (10,12) or the pulmonary arteries (7,13,14). To our knowledge, a single-injection CT angiographic protocol that would provide uniform and simultaneous enhancement along the z-axis in coronary, thoracic aortic, and pulmonary arterial vasculature has not been described.…”

Section: Discussionmentioning

confidence: 93%

Atypical Chest Pain: Coronary, Aortic, and Pulmonary Vasculature Enhancement at Biphasic Single-Injection 64-Section CT Angiography

Vrachliotis¹,

Bis²,

Haidary³

et al. 2007

Radiology

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MDCT for suspected pulmonary embolism: multi-institutional survey of 16-MDCT data acquisition protocols

2006

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The purpose of this study was to determine the extent to which a consensus exists on multidetector row computed tomography (MDCT) protocol parameters for suspected pulmonary embolism (PE). In August of 2004, a questionnaire addressing a number of body MDCT protocols was mailed to 99 fellows of the Society of Computed Body Tomography, representing a total of 46 institutions. In May 2005, this was followed up with a second mailing. The survey requested details pertaining to protocols for the most advanced MDCT scanner in the department. The overall survey response rate of 37% (17/46) yielded 15 protocols for 16-MDCT imaging of suspected PE. This data was tabulated and revealed a consensus for the use of bolus tracking, rapid contrast infusion, caudo-cranial scanning, the narrowest detector row collimation, and thin (<2 mm) reconstruction sections. However, contrast infusion timing, contrast concentration, and implementation of radiation dose modulation were variable. This compilation of protocols reflects recently published studies advocating the use of narrow acquisition collimation and reconstruction sections for MDCT of suspected PE. Future studies are necessary to elucidate the optimal intravenous contrast infusion parameters and further assess the efficacy of reduced radiation dose protocols.

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Pulmonary Embolism: Prospective Comparison of Iso-osmolar and Low-Osmolarity Nonionic Contrast Agents for Contrast Enhancement at CT Angiography

Abstract: Use of an iso-osmolar contrast agent at multi-detector row CT angiography to exclude pulmonary embolism did not significantly improve enhancement quality when this feature was compared with that of a low-osmolarity contrast agent.

Cited by 18 publications

References 21 publications

Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients

Eighty-peak kilovoltage 16-channel multidetector computed tomography and reduced contrast-medium doses tailored to body weight to diagnose pulmonary embolism in azotaemic patients

Atypical Chest Pain: Coronary, Aortic, and Pulmonary Vasculature Enhancement at Biphasic Single-Injection 64-Section CT Angiography

MDCT for suspected pulmonary embolism: multi-institutional survey of 16-MDCT data acquisition protocols

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