Weight-based contrast administration in the computerized tomography evaluation of acute pulmonary embolism

Laurent, Lisa; Zamfirova, Ina; Sulo, Suela; Baral, Pesach

doi:10.1097/md.0000000000005972

Cited by 11 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For smaller patients, a lower dose of contrast can be used, with a study by Chen et al showing no statistical difference in the degree of opacification in the PA when using a 60 mL volume of contrast in comparison to 75 mL [27]. Typical contrast dosing between 60 mL and 150 mL have been quoted previously in the literature [28]. Therefore, weight-based contrast dosing can allow for a lower dose of contrast to be used without affecting CTPA study quality, thereby decreasing dose-dependent adverse reactions including acute kidney injury and overall financial cost of contrast use [29].…”

Section: Discussionmentioning

confidence: 99%

Weight-Adjusted Contrast Administration in the Computed Tomography Evaluation of Pulmonary Embolism

Ratnakanthan

Kavnoudias

Paul

et al. 2020

Journal of Medical Imaging and Radiation Sciences

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Weight-Adjusted Contrast Administration in the Computed Tomography Evaluation of Pulmonary Embolism

Ratnakanthan

Kavnoudias

Paul

et al. 2020

Journal of Medical Imaging and Radiation Sciences

View full text Add to dashboard Cite

“…Frush et al demonstrated that FV CM protocol yielded better contrast enhancement even though this method scored lower grade in qualitative assessment [21]. Regardless of the technique used, in achieving comparable vascular enhancement and satisfactory image quality, Laurent et al suggested that CM administration protocol should be individualised according to patient habitus [22].…”

Section: Discussionmentioning

confidence: 99%

Effect of different contrast administration protocols on contrast enhancement and image quality in CT scan

Ibrahim

Karim

Shuaib

et al. 2019

Preprint

View full text Add to dashboard Cite

Objective The aim of this study is to compare the effect of different contrast administration protocols practiced in Advanced Medical and Dental Institute, Universiti Sains Malaysia (Group A) and Hospital Pulau Pinang, Malaysia (Group B), on contrast enhancement and image quality in computed tomography scan. The two protocols were fixed time delay (FTD) with fixed volume (FV), and automatic bolus tracking (ABT) with weight based volume (WBV) contrast administration. Quantification of contrast enhancement’s magnitude in four different anatomical structures was measured in Hounsfield Unit (HU) and based on 5-point scale (1=poor, 5=excellent), the images were rated qualitatively.Results Mean enhancement values of all structures in Group B was higher compared to Group A (p = < 0.001). Mean of quality rating between the two groups was statistically not significant (p = 0.185). There was a weak correlation between HU values and administered contrast volume (r = 0.152). It can be concluded that FTD with FV protocol is non inferior to ABT with WBV protocol as it yielded higher degree of contrast enhancement. There was no significant difference between the two protocols in term of qualitative assessment although ABT with WBV protocol had higher mean grading in image quality.

show abstract

“…A primary determinant of vascular enhancement is the bolus volume, concentration, and rate of IV contrast media supplied prior to or during the CT acquisition. Many institutions use a fixed volume of contrast media for abdominal scans, but a growing number of studies suggest weight-based protocols offer more consistent image quality across a range of body weights, and at lower total contrast usage and cost [23][24][25][26]. Nevertheless, average blood volumes in women are lower than those in men for a given body size, and results presented here are consistent with past studies finding higher female aorta enhancement (291 ± 49 HU vs. 260 ± 55 HU) that was not accounted for by weight [27][28][29].…”

Section: Plos Onementioning

confidence: 99%

Variation in aorta attenuation in contrast-enhanced CT and its implications for calcification thresholds

Holcombe

Horbal²,

Ross³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Background CT contrast media improves vessel visualization but can also confound calcification measurements. We evaluated variance in aorta attenuation from varied contrast-enhancement scans, and quantified expected plaque detection errors when thresholding for calcification. Methods We measured aorta attenuation (AoHU) in central vessel regions from 10K abdominal CT scans and report AoHU relationships to contrast phase (non-contrast, arterial, venous, delayed), demographic variables (age, sex, weight), body location, and scan slice thickness. We also report expected plaque segmentation false-negative errors (plaque pixels misidentified as non-plaque pixels) and false-positive errors (vessel pixels falsely identified as plaque), comparing a uniform thresholding approach and a dynamic approach based on local mean/SD aorta attenuation. Results Females had higher AoHU than males in contrast-enhanced scans by 65/22/20 HU for arterial/venous/delayed phases (p < 0.001) but not in non-contrast scans (p > 0.05). Weight was negatively correlated with AoHU by 2.3HU/10kg but other predictors explained only small portions of intra-cohort variance (R2 < 0.1 in contrast-enhanced scans). Average AoHU differed by contrast phase, but considerable overlap was seen between distributions. Increasing uniform plaque thresholds from 130HU to 200HU/300HU/400HU produces respective false-negative plaque content losses of 35%/60%/75% from all scans with corresponding false-positive errors in arterial-phase scans of 95%/60%/15%. Dynamic segmentation at 3SD above mean AoHU reduces false-positive errors to 0.13% and false-negative errors to 8%, 25%, and 70% in delayed, venous, and arterial scans, respectively. Conclusion CT contrast produces heterogeneous aortic enhancements not readily determined by demographic or scan protocol factors. Uniform CT thresholds for calcified plaques incur high rates of pixel classification errors in contrast-enhanced scans which can be minimized using dynamic thresholds based on local aorta attenuation. Care should be taken to address these errors and sex-based biases in baseline attenuation when designing automatic calcification detection algorithms intended for broad use in contrast-enhanced CTs.

show abstract

Weight-based contrast administration in the computerized tomography evaluation of acute pulmonary embolism

Cited by 11 publications

References 12 publications

Weight-Adjusted Contrast Administration in the Computed Tomography Evaluation of Pulmonary Embolism

Weight-Adjusted Contrast Administration in the Computed Tomography Evaluation of Pulmonary Embolism

Effect of different contrast administration protocols on contrast enhancement and image quality in CT scan

Variation in aorta attenuation in contrast-enhanced CT and its implications for calcification thresholds

Contact Info

Product

Resources

About