Implementation of patient-tailored contrast volumes based on body surface area and heart rate harmonizes contrast enhancement and reduces contrast load in small patients in portal venous phase abdominal CT

Eur J Radiol. 2019 Dec:121:108630. doi: 10.1016/j.ejrad.2019.07.031. Epub 2019 Aug 4.

Abstract

Purpose: The aim of this study was to evaluate the impact of a patient-tailored contrast volume protocol on portal venous phase abdominal CT-images compared to a fixed volume protocol in daily radiological practice.

Method: Data of 77 patients who underwent two contrast-enhanced CT-examinations were collected. The first examination was performed with a fixed contrast volume (95 ml), the follow-up examination was performed with a patient-tailored contrast volume based on patient's BSA and heart rate. The patient-tailored volume was calculated by a software application integrated in the interface of the injection pump. Two independent radiologists assessed subjective and objective image quality. Differences in enhancement and contrast volumes between both protocols were analysed.

Results: Despite a significant contrast volume reduction in women and in patients with low to normal BMI, enhancement was more consistent over different BMI-categories in the patient-tailored contrast volume protocol and there was no significant difference in subjective image quality between both injection protocols.

Conclusions: A patient-tailored contrast volume protocol based on BSA and heart rate can be considered in daily radiological practice to decrease contrast volumes in women and in low to normal BMI patients and to achieve more consistent contrast enhancement across different BMI-categories in venous phase abdominal CT.

Keywords: Abdominal imaging; Contrast injection protocols; Contrast media; Image quality; Multi-detector computed tomography; Personalised medicine.

MeSH terms

  • Algorithms
  • Body Surface Area*
  • Contrast Media / administration & dosage*
  • Female
  • Heart Rate / physiology*
  • Humans
  • Male
  • Middle Aged
  • Portal Vein / diagnostic imaging*
  • Radiographic Image Enhancement / methods*
  • Radiography, Abdominal / methods
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*

Substances

  • Contrast Media