Contrast medium administration with a body surface area protocol in step-and-shoot coronary computed tomography angiography with dual-source scanners

Abstract

We evaluated the feasibility and image quality of prospective electrocardiography (ECG)-triggered coronary computed tomography angiography (CCTA) using a body surface area (BSA) protocol for contrast-medium (CM) administration on both second- and third-generation scanners (Flash and Force CT), without using heart rate control. One-hundred-and-eighty patients with suspected coronary heart disease undergoing CCTA were divided into groups A (BSA protocol for CM on Flash CT), B (body mass index (BMI)-matched patients; BMI protocol for CM on Flash CT), and C (BMI-matched patients; BSA protocol for CM on Force CT). Patient characteristics, quantitative and qualitative measures, and radiation dose were compared between groups A and B, and A and C. Of the 180 patients, 99 were male (median age, 62 years). Average BSA in groups A, B, and C was 1.80 ± 0.17 m2, 1.74 ± 0.16 m2, and 1.64 ± 0.17 m2, respectively, with groups A and C differing significantly (P < 0.001). Contrast volume (50.50 ± 8.57 mL vs. 45.00 ± 6.18 mL) and injection rate (3.90 ± 0.44 mL/s vs. 3.63 ± 0.22 mL/s) differed significantly between groups A and C (P < 0.001). Groups A and C (both: all CT values > 250 HU, average scores > 4) achieved slightly lower diagnostic image quality than group B. The BSA protocol for CM administration was feasible in both Flash and Force CT, and therefore may be valuable in clinical practice.

Dedicated CCTA Followed by High-Pitch Scanning versus TRO-CT for Contrast Media and Radiation Dose Reduction: A Retrospective Study

“…In 2018, He et al demonstrated a surprisingly lower ED of 2.67 ± 0.98 mSv using a conversion factor of 0.014 mSv/(mGy × cm) but with a 16-cm wide-detector CT [ 13 ]. Compared with He et al’s study with less exposure time of the 16-cm coverage detector [ 13 , 15 ], our study demonstrated that TRO-CTA could be achieved by a dedicated step-and-shoot CCTA that combines the short scan time of high-pitch scan; both of them were widely reported to achieve a lower radiation dose with good image quality [ 16 , 17 , 18 , 19 ], and the step-and-shoot CCTA with AVTS has been adaptive to higher heart rate [ 20 , 21 ]. In addition, the tube voltage at Sn100 of CS reportedly achieves a lower radiation dose without influencing the accuracy of the calcium score [ 22 , 23 ].…”

Artificial Intelligence-Based Prediction of Contrast Medium Doses for Computed Tomography Angiography Using Optimized Clinical Parameter Sets

“…10,11 Others vary the dose for each patient individually based on physiological parameters such as body surface area. [12][13][14] Similar to these approaches, our CDSS is based on physiological parameters; however, laboratory values and other clinical parameters are also taken into consideration, so that in contrast to the aforementioned works 22 relevant parameters are acquired and used. The result of our system classifies a patient into nonexcessive image contrast/ CM dose (class 1) and excessive image contrast/ CM dose (class 2).…”