Reduced Contrast Volume and Radiation Dose During Computed Tomography of the Pancreas

Saade, Charbel; Chokr, Jad; Naffaa, Lena; Faraj, Walid; Shamseddine, Ali; Mukherji, Deborah; Sayegh, Skye El; Assi, Rita; Haydar, Ali

doi:10.1016/j.acra.2018.05.027

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…For each of the CT scans, an individual effective dose (E ff [mSv]) was calculated from the doselength products (DLP [mGy × cm]), which were recorded from the patient protocol. A normalized conversion factor (k [mSv/mGy × cm]) for the chest -0.014 mSv/mGy × cm -was used to calculate the E ff : [16] E ff = DLP × k. [4]…”

Section: Radiation Dose Measurementmentioning

confidence: 99%

“…[1] Since this efficacy is largely dependent on effective contrast media volume (CMV) administration, studies have been extensively conducted on contrast administration protocols. [2][3][4][5][6][7][8] These studies have found that visualization of the pulmonary vasculature is significantly improved when using a simple patientspecific formula, [1,7,9] which also allows CMV to be reduced along with the potential risk of contrastinduced nephropathy. [1] Studies performed on adult patients with normal pulmonary functioning demonstrated an air/tissue relationship approaching a 7:3 ratio of air to lung parenchyma; [10] other studies noticed that an increase in total lung volume is concomitant with an increase in the volume of pulmonary blood and pulmonary extravascular water.…”

Section: Introductionmentioning

confidence: 99%

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Contrast media volume is significantly related to patient lung volume during CT pulmonary angiography when employing a patient-specific contrast protocol

et al. 2020

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Aim: The purpose of this study is to investigate the relationship between contrast media volume and patient lung volume when employing a patient-specific contrast media formula during pulmonary computed tomography angiography (CTA). Materials and methods: IRB approved this retrospective study. CTA of the pulmonary arteries was performed on 200 patients with suspected pulmonary embolism (PE). The contrast media volume (CMV) was calculted by employing a patient-specific contrast formula. Lung volume was quantified employing semi-automated lung software that calculated lung volumes (intellispace -Philips). The mean cross-sectional opacification profile of central and peripheral pulmonary arteries and veins were measured for each patient and arteriovenous contrast ratio (AVCR) calculated for each lung segment. Mean body mass index (BMI) and lung volume were quantified. Receiver operating (ROC) and visual grading characteristics (VGC) measured reader confidence in emboli detection and image quality respectively. Inter and intra-observer variations were investigated employing Cohen’s kappa methodology. Results: Results showed that the mean pulmonary arterial opacification of the main pulmonary circulation (343.88±73HU), right lung; upper (316.51±23HU), middle (312.5±39HU) and lower (315.23±65HU) lobes and left; upper (318.76±83HU), and lower (321.91±12HU) lobes. The mean venous opacification of all pulmonary veins was below 182±72HU. AVCR was observed at all anatomic locations (p<0.0002) where this ratio was calculated. Moreover, larger volumes of contrast significantly correlated with larger lung volumes (r=0.89, p<0.03) and radiation dose (p<0.03). VGC and ROC analysis demonstrated increased area under the curve: 0.831 and 0.99 respectively (p<0.02). Inter-observer variation was observed as excellent (κ = 0.71). Conclusion: We conclude that increased CMV is significantly correlated to increased patient lung volume and radiation dose when employing a patient-specific contrast formula. The effects patient habitus is highlighted.

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Section: Radiation Dose Measurementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Contrast media volume is significantly related to patient lung volume during CT pulmonary angiography when employing a patient-specific contrast protocol

et al. 2020

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“…In the setting of coronary CTA, high-density structures like calci cation or stents are subject to artefacts, increased image noise and decreased image quality which can affect diagnostic performance (11)(12)(13)(14)(15). Despite extensive research, there is a lack of accurate comparison or head-to-head studies between the images produced by MBIR and the hybrid techniques.…”

Section: Introductionmentioning

confidence: 99%

Comparing model based iterative reconstruction to hybrid based iterative reconstruction in stenosis detection during ECG-gated coronary CTA

Maroun

Ghosn

Serban

et al. 2022

Preprint

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Purpose: To compare the quantitative and qualitative image quality of hybrid (HBIR) and model based (MBIR) iterative reconstruction during coronary Computed Tomography Angiography (CTA). Materials and Methods: Institutional review board approved this retrospective study. Patients (n=200) underwent a single coronary CTA with two iterative reconstruction techniques. Group A employed HBIR and group B employed MBIR. Quantitative and qualitative image quality was compared for each group. The mean attenuation values and signal-to-noise ratio (SNR) of each group were compared. Visual grading characteristics (VGC) and Cohen’s Kappa methodology were measured employing an image quality scoring system for coronary CTA. Receiver operating (JAFROC) and stenosis severity were compared with conventional coronary angiography. A p-value <0.05 was considered statistically significant. Results: Mean attenuation values (HU) in the HBIR group were significantly greater in the cusp (564.18±118.71) and left coronary (517.59±118.63) whilst in the MBIR group, the right coronary (531.67±138.93), left anterior descending (529.82±120.6) and left circumflex (538.32±132.94) arteries were significantly higher (p<0.001). The SNR was significantly greater in MBIR (5.32±1.1) compared to HBIR (3.64±0.8) (p<0.0001), with MBIR being superior to HBIR in the total and individual segments of the coronary arteries. VGC image quality assessment demonstrated that readers preferred HBIR over MBIR (p<0.001). Analysis of JAFROC data demonstrated a significant difference in detection of coronary stenosis in RCA (p<0.021), LCA (p<0.0001) and LD (p<0.0001) with HBIR showing overall smaller variability range compared to MBIR. Conclusion: When comparing quantitative and qualitative image quality, MBIR was superior in the former, whilst HBIR was superior in the later. Coronary artery stenosis assessment demonstrated less variability in diagnosis when using HBIR compared to MBIR. This highlights the need for careful attention when employing iterative reconstruction in order not to impact clinical outcomes.

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“…[1][2][3][4] Scan and contrast media (CM) protocols have been optimized and individualized based on patient characteristics and clinical indications to improve image quality and to reduce the amount of CM used. [3][4][5][6][7][8][9][10][11][12][13] Other aspects that should be considered regarding the usage of intravenous CM are patient comfort and safety.…”

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confidence: 99%

Influence of Contrast Media Temperature and Concentration on Patient Comfort and Safety in Computed Tomography

Stammen,

Mihl,

Vandewall

et al. 2024

Invest Radiol

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Background Previous research on the necessity to reduce the viscosity of contrast media (CM) by either prewarming CM before injection during computed tomography (CT) or by using less concentrated CM has yielded conflicting results. In addition, there is limited evidence on patient comfort. Objectives The aim of the study was to examine if prewarming CM, with varying CM concentrations, is superior to CM at room temperature, with respect to patient comfort and safety in CT. Materials and Methods All elective patients scheduled for contrast-enhanced CT scans at Maastricht University Medical Center+ between October 27, 2021 and October 31, 2022 were eligible for inclusion when a questionnaire evaluating patient comfort was completed. This 1-year period was divided into 4 intervals (4 groups): group 1 (370 mg I/mL, 37°C), group 2 (370 mg I/mL, room temperature), group 3 (300 mg I/mL, 37°C), and group 4 (300 mg I/mL, room temperature). All CT scans were performed using state of the art equipment (Siemens Healthineers; SOMATOM Force and SOMATOM Definition AS, Forchheim, Germany). Contrast media injections were performed using a dual-head power injector (Stellant; Bayer Healthcare, Berlin, Germany) and individualized to body weight and/or tube voltage, depending on the CM protocols. After the CT scan, patients completed a questionnaire covering the primary outcomes comfort, pain, and adverse events such as feelings of heat, nausea, vomiting, itchiness, urticaria, difficulty breathing, dizziness, goosebumps, or an odd taste. Technicians were asked to report any adverse events, including extravasation and allergic-like reactions. The secondary outcome involved attenuation (in Hounsfield unit, HU), which was evaluated by assessing the HU of the coronary arteries for vascular CT, and liver enhancement in portal venous CT. The Kruskal-Wallis test was used for continuous scale outcomes and χ2 tests for examining adverse events. Results Results showed no significant differences examining comfort score (P = 0.054), pain sensation (P = 0.469), extravasation (P = 0.542), or allergic-like reaction (P = 0.253). Significant differences among the 4 groups were found with respect to heat sensation and dizziness (P = 0.005 and P = 0.047, respectively), showing small effect sizes. All other adverse effects showed no significant results. No significant differences were observed in coronary attenuation among the 4 groups in coronary CT angiography (P = 0.113). When analyzing attenuation in portal venous CT scans, significant differences were found among the 4 groups (P = 0.008). Conclusions Administrating prewarmed CM is nonsuperior compared with CM at room temperature in relation to patient comfort and safety, regardless of CM concentration. These findings suggest that prewarming CM before usage is unnecessary, which will improve the efficiency of daily clinical workflow and brings environmentally friendly benefits.

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Reduced Contrast Volume and Radiation Dose During Computed Tomography of the Pancreas

Cited by 5 publications

References 21 publications

Contrast media volume is significantly related to patient lung volume during CT pulmonary angiography when employing a patient-specific contrast protocol

Contrast media volume is significantly related to patient lung volume during CT pulmonary angiography when employing a patient-specific contrast protocol

Comparing model based iterative reconstruction to hybrid based iterative reconstruction in stenosis detection during ECG-gated coronary CTA

Influence of Contrast Media Temperature and Concentration on Patient Comfort and Safety in Computed Tomography

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