64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement

Marin, Daniele; Nelson, Rendon C.; Guerrisi, Antonino; Barnhart, Huiman X.; Schindera, Sebastian T.; Passariello, Roberto; Catalano, Carlo

doi:10.1007/s00330-011-2139-x

Cited by 14 publications

(2 citation statements)

References 31 publications

(43 reference statements)

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“…This is due to the fact that ICM monomers tends to dilute when administered intravascularly due to its high osmolality which is approximately 3 fold that of blood (290 mOsm K −1 g −1 water) resulting in a decrease in contrast attenuation [17,18]. Whereas ICM dimers are less diluted when administered intravascular than monomers due to its lower osmolality which is almost isosmolar to blood, but at the cost of higher viscosity relative to blood [17,19]. Nevertheless, vascular opacification varies significantly according to different parameters, with different opinions in the literature and limited studies investigating them in a single clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Balancing act between quantitative and qualitative image quality between nonionic iodinated dimer and monomer at various vessel sizes during computed tomography: a phantom study

Karout

Asmar

Naffaa

et al. 2020

Biomed. Phys. Eng. Express

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Purpose: Investigate the impact of nonionic dimer and monomer on iodine quantification in different vessel sizes when employing a vascular specific phantom and varying iodinated contrast media (ICM) concentrations during computed tomography (CT). Materials and Methods: We created a vascular specific phantom (30 cm) to simulate human blood vessel diameters (25 cylinders of different diameters: 10×9mm, 10×12mm and 5×21mm). The phantom was filled with two ICM separately: Group: Iohexol(monomer)350 mg ml −1 and B: Iodixanol(Dimer)320 mg ml −1 . Cylinders of same size were filled with increasing ICM concentration(10%-100%) while large cylinders were filled in quartiles (25%-100%). Phantom was scanned with different tube potential (80-140kVp), current (50-400mAs), reconstruction method [filtered back projection (FBP), hybrid-based iterative reconstruction (HBIR) and model-based iterative reconstruction (MBIR)] for each ICM. Chi-square was employed to compare mean opacification, contrast/noise ratio (CNR) and noise. Qualitative analysis was assessed by Visual grading characteristic (VGC) and Cohens-kappa analyses. Results: At 80 and140kVp significant difference in opacification between Group A (2054±1040HU and 1696±1027HU) and B (2169±1105HU and 1568±1034HU) was demonstrated (p<0.001). However, at 100 and 120kVp no difference was noted (p>0.05). When comparing image noise, it was higher in Group A compared to B (p<0.05). CNR was higher in Group B (119.99±126.10HU) than A (107.09±102.56HU) (p<0.0001). VGC: Group A outperformed B in image opacification in all vessel sizes and ICM concentrations except at medium vessels with concentration group 2(0.4-0.6 mg ml −1 ). Cohens'-kappa: agreement in opacification between each ICM group and iodine concentration 1(0-0.3 mg ml −1 ): κ=0.253 and 0.014 respectively, concentration 2(0.4-0.6 mg ml −1 ):κ=−0.017 and −0.005 respectively and concentration 3(0.7-1 mg ml −1 ):κ=0.031 and 0.115 respectively. Conclusion: Nonionic dimer (Iodixanol) surpasses monomer (Iohexol) in quantitative image quality assessment by having lower image noise and higher CNR during CT.

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Section: Introductionmentioning

confidence: 99%

Balancing act between quantitative and qualitative image quality between nonionic iodinated dimer and monomer at various vessel sizes during computed tomography: a phantom study

Karout

Asmar

Naffaa

et al. 2020

Biomed. Phys. Eng. Express

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“…The procedure pushes the bolus further into the blood circulation, decreasing the amount of contrast material in the anatomic locations where it is not required. Therefore, accumulation of contrast material in the peripheral vein and injection tubing, which can occur with the use of MDCT and the reduced scanning time in CT imaging, is prevented by applying the saline chaser technique [56789]. Studies conducted on this topic report that reducing the amount of contrast material does not decrease vascular enhancement.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of a saline chaser to reduce contrast material dose in abdominal CT of normal dogs

et al. 2019

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Use of a saline chaser has been reported to allow reduction of contrast dose and artifacts during computed tomography (CT) examination in humans. This study assesses the extent of contrast dose by using a saline chaser in abdominal CT scans of normal dogs. Five beagles underwent abdominal CT scans. Three protocols were applied: 600 mg I/kg iohexol without saline chaser (protocol 1), 30% lower dose of iohexol (420 mg I/kg) followed by a 10 mL saline chaser (protocol 2), and 40% lower dose of iohexol (360 mg I/kg) followed by a 10 mL saline chaser (protocol 3). Attenuation values were obtained from aorta, portal vein, and liver parenchyma. The maximum enhancement values (MEVs) in protocol 2 were significantly higher than those in protocols 1 and 3 in the aorta; no difference was seen in the portal vein in all protocols. The liver parenchymal MEVs in protocols 1 and 2 were significantly higher than those obtained in protocol 3. In this study, the use of a saline chaser and a reduced dose of contrast material did not affect vessel enhancement. In conclusion, use of a saline chaser for abdominal CT of dogs is recommended because it allows a 30% reduction of contrast dose without decreasing vascular and hepatic parenchymal enhancement.

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Contrast media injection protocol for portovenous phase abdominal CT: does a fixed injection duration improve hepatic enhancement over a fixed injection rate?

Costa

Peet

2021

Abdom Radiol

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64-section multidetector CT of the upper abdomen: optimization of a saline chaser injection protocol for improved vascular and parenchymal contrast enhancement

Abstract: Injecting a saline chaser at high flow rates yields significantly higher peak aortic and pancreatic enhancement, with a slight longer time-to-peak enhancement.

Cited by 14 publications

References 31 publications

Balancing act between quantitative and qualitative image quality between nonionic iodinated dimer and monomer at various vessel sizes during computed tomography: a phantom study

Balancing act between quantitative and qualitative image quality between nonionic iodinated dimer and monomer at various vessel sizes during computed tomography: a phantom study

Usefulness of a saline chaser to reduce contrast material dose in abdominal CT of normal dogs

Contrast media injection protocol for portovenous phase abdominal CT: does a fixed injection duration improve hepatic enhancement over a fixed injection rate?

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