Contrast media dose adjustment to allometric parameters of body mass in multiphasic CT of the liver: A comparison of different metrics

Janek, Elmar; Edl, Dominik; Taflinski, Adrian; Talakić, Emina; Adelsmayr, Gabriel; Janisch, Michael; Igrec, Jasminka; Quehenberger, Franz; Fuchsjäger, Michael; Schöllnast, Helmut

doi:10.1016/j.ejrad.2021.109778

Cited by 2 publications

(4 citation statements)

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“…Literature documents numerous methods to customize CM doses, however none are recognized as standard or preferred [ 1 , 8 ]. Lean body mass (LBM), defined as the difference between TBW and body fat weight, is suggested as one appropriate CM administration strategy [ 9 ]. CM dose based on LBM decreases CM doses while consistently improving image quality, as it corrects for high body fat percentage (BFP) by correlating with extracellular fluid volumes [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…CM dose based on LBM decreases CM doses while consistently improving image quality, as it corrects for high body fat percentage (BFP) by correlating with extracellular fluid volumes [ 10 ]. LBM can be calculated using the James method, the Boer method, and bioelectric impedance analysis (BIA) [ 6 , 9 , 11 ]. For obese patients, the Boer formula is more consistent and reliable [ 7 ] as the James method underestimates CM doses in this population and is therefore not appropriate in patients with body mass index (BMI) above approximately 40 kg/m 2 [ 6 , 9 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…LBM can be calculated using the James method, the Boer method, and bioelectric impedance analysis (BIA) [ 6 , 9 , 11 ]. For obese patients, the Boer formula is more consistent and reliable [ 7 ] as the James method underestimates CM doses in this population and is therefore not appropriate in patients with body mass index (BMI) above approximately 40 kg/m 2 [ 6 , 9 , 11 ]. BIA is considered the standard for evaluating body composition and BFP, measuring conduction of an electrical current through intracellular and extracellular water [ 6 , 12 ]; however, it relies on constant patient hydration and may be inaccurate if a patient is NPO (Nothing by Mouth) prior to scanning [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, there is an increased focus on the reduction and personalization of CM doses to ensure adequate image quality. Current research on patient-tailored CM dosage focuses mostly on abdominal protocols [ 1 , 4 , 9 , 18 ] without examining the impact of these methods in evaluation of the chest. In this setting, we aimed to investigate the impact of body composition data on various CM dose calculations.…”

Section: Introductionmentioning

confidence: 99%

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Strategies for calculating contrast media dose for chest CT

Henning¹,

Gunn²,

Arenas³

et al. 2023

Eur Radiol Exp

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Background Total body weight (TBW) is a frequently used contrast media (CM) strategy for dose calculation in enhanced CT, yet it is suboptimal as it lacks consideration of patient characteristics, such as body fat percentage (BFP) and muscle mass. Alternative CM dosage strategies are suggested by the literature. Our objectives were to analyze the CM dose impact when adjusting to body composition using methods of obtaining lean body mass (LBM) and body surface area (BSA) along with its correlation with demographic factors in contrast enhanced chest CT examinations. Methods Eighty-nine adult patients referred for CM thoracic CT were retrospectively included, categorized as either normal, muscular, or overweight. Patient body composition data was used to calculate the CM dose according to LBM or BSA. LBM was calculated with the James method, Boer method, and bioelectric impedance (BIA). BSA was calculated using the Mostellar formula. We then correlated the corresponding CM doses with demographic factors. Results BIA demonstrated the highest and lowest calculated CM dose in muscular and overweight groups respectively, compared to other strategies. For the normal group, the lowest calculated CM dose was achieved using TBW. The calculated CM dose was more closely correlated with BFP using the BIA method. Conclusions The BIA method is more adaptive to variations in patient body habitus especially in muscular and overweight patients and is most closely correlated to patient demographics. This study could support utilizing the BIA method for calculating LBM for a body-tailored CM dose protocol for enhanced chest CT examinations. Relevance statement The BIA-based method is adaptive to variations in body habitus especially in muscular and overweight patients and is closely correlated to patient demographics for contrast-enhanced chest CT. Key points • Calculations based on BIA showed the largest variation in CM dose. • Lean body weight using BIA demonstrated the strongest correlation to patient demographics. • Lean body weight BIA protocol may be considered for CM dosing in chest CT. Graphical Abstract

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