Feasibility of Low-volume Injections of Contrast Material with a Body Weight–Adapted Iodine-Dose Protocol in 320-Detector Row Coronary CT Angiography

Tatsugami, Fuminari; Matsuki, Mitsuru; Inada, Yuji; Kanazawa, Shuji; Nakai, Go; Takeda, Yoshihiro; Morita, Hideaki; Takada, Haruhiko; Ashida, Kenji; Yoshikawa, Shushi; Fukumura, Katsunori; Narumi, Yasuo

doi:10.1016/j.acra.2009.09.010

Cited by 41 publications

(27 citation statements)

References 20 publications

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“…Tatsugami et al [21] reported that, with a body weightadapted iodine-dose protocol using a 120-kV tube voltage, a mean contrast material volume of 41.5 ± 5.5 ml was sufficient for one-beat coronary angiography. Another study by Hein et al [33] showed that diagnostic image quality could be achieved with 40 ml of contrast material in CCTA with normal body weight, cardiac function, and low heart rate.…”

Section: Discussionmentioning

confidence: 99%

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320-row CT coronary angiography: effect of 100-kV tube voltages on image quality, contrast volume, and radiation dose

Zhang

et al. 2010

Int J Cardiovasc Imaging

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To prospectively evaluate image quality parameters, contrast volume and radiation dose at the 100-kilovolt (kV) setting during coronary computed tomographic angiography (CCTA) on a 320-row computed tomography scanner. We enrolled 107 consecutive patients with a heart rate <65 beats per minute (bpm) undergoing prospective electrocardiogram (ECG)-triggered CCTA. Forty patients with a body mass index (BMI) <25 kg/m(2) were scanned using 100-kV tube voltage settings, while 67 patients were scanned using 120-kV protocols. Image quality was assessed by two readers unaware of patient information and scan parameters. Attenuation in the aorta and perivascular fat tissue and image noise were measured. Contrast-to-noise ratios (CNRs) and contrast material volumes were calculated. The effective radiation doses were estimated using a chest conversion coefficient (0.017). Diagnostic image quality was achieved in 98.2% of coronary segments with 100-kV CCTA and 98.6% of coronary segments with 120-kV CCTA, with no significant differences in image quality scores for each coronary segment. Vessel attenuation, image noise, and CNR were not significantly different between the 100- and 120-kV protocols. Mean contrast injection rate and mean material volume were significantly lower for the 100-kV CCTA (4.35 ± 0.28 ml/s and 53.13 ± 3.77 ml, respectively) than for the 120-kV CCTA (5.16 ± 0.21 ml/s and 62.40 ± 3.66 ml respectively; P < 0.001). The effective radiation dose was 2.12 ± 0.19 mSv for 100-kV CCTA, a reduction of 54% compared to 4.61 ± 0.82 mSv for 120-kV CCTA. A 100-kV CCTA can be implemented in patients with a BMI < 25 kg/m(2). The 100-kV setting allows significant reductions in contrast material volume and effective radiation dose while maintaining adequate diagnostic image quality.

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Section: Discussionmentioning

confidence: 99%

“…Several studies on 320-row CCTA [19,21] have shown excellent image quality with relatively low radiation exposure. Nevertheless, to the best of our knowledge, the impact of using the 100-kV voltage setting on image quality, contrast material volume, and radiation dose in 320-row CCTA has not yet been addressed.…”

Section: Introductionmentioning

confidence: 98%

320-row CT coronary angiography: effect of 100-kV tube voltages on image quality, contrast volume, and radiation dose

Zhang

et al. 2010

Int J Cardiovasc Imaging

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“…A patient's body weight-adjusted volume of nonionic contrast material (iodine 245 mg/kg) was injected into the antecubital vein over a fixed duration of 10 seconds, followed by 20 mL of 0.9% saline solution chaser at the same flow rate 15, 18) .…”

Section: Methodsmentioning

confidence: 99%

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Urabe

Yamamoto

Kitagawa

et al. 2016

JAT

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Aims: In a new-generation computed tomography (CT) scanner, coronary artery calcium (CAC) scores were measured using 3.0-mm slice reconstruction images originally acquired with 0.5 mm thickness scans in a single beat. This study investigated the usefulness of thin-slice (0.5 mm) reconstruction for identifying small calcifications in coronary arteries and evaluated the association with coronary plaques and stenosis compared to conventional 3.0-mm reconstruction images.Methods: We evaluated 132 patients with zero CAC scores in conventional 3.0-mm Agatston method using a 320-slice CT. Then, 0.5-mm slice reconstruction was performed to identify small calcifications. The presence of stenosis and coronary plaques was assessed using coronary CT angiography.Results: In total, 22 small calcifications were identified in 18 patients. There were 28 (21%) patients with any (≥ 25%) stenosis (34 lesions). Forty-seven coronary plaques were found in 33 patients (25%), including 7 calcified plaques in 7 patients (5%), 34 noncalcified plaques in 27 patients (20%), and 6 partially calcified plaques in 5 patients (4%). Patients with small calcifications had a significantly higher prevalence of noncalcified or partially calcified plaques (83% vs 14%; p < 0.001) and obstructive stenosis (33% vs 5.2%; p < 0.001) compared to those without small calcifications. The addition of small calcifications to the coronary risk factors when diagnosing stenosis significantly improved the diagnostic value.Conclusion: Small calcifications detected by thin-slice 0.5-mm reconstruction are useful for distinguishing coronary atherosclerotic lesions in patients with zero CAC scores from conventional CT reconstruction.

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“…Within the period of inclusion, a gradual decrease in total injected CM volume is noted, as earlier publications make mention of a total injected CM volume of 140 ml [15,44,45], whereas more recent publications reported CM injection protocols with total injected CM volumes below 40 ml [69,70,74,75]. Subsequently, the TID has substantially lowered from anywhere between 44 -56 g [15,44,45] to less than 15 g (range: 11.1 -56.0 g) [7,47,60 …”

Section: Resultsmentioning

confidence: 70%

Contrast Media Administration in Coronary Computed Tomography Angiography – A Systematic Review

Mihl

Maas

Turek

et al. 2017

Fortschr Röntgenstr

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Feasibility of Low-volume Injections of Contrast Material with a Body Weight–Adapted Iodine-Dose Protocol in 320-Detector Row Coronary CT Angiography

Cited by 41 publications

References 20 publications

320-row CT coronary angiography: effect of 100-kV tube voltages on image quality, contrast volume, and radiation dose

320-row CT coronary angiography: effect of 100-kV tube voltages on image quality, contrast volume, and radiation dose

Identifying Small Coronary Calcification in Non-Contrast 0.5-mm Slice Reconstruction to Diagnose Coronary Artery Disease in Patients with a Conventional Zero Coronary Artery Calcium Score

Contrast Media Administration in Coronary Computed Tomography Angiography – A Systematic Review

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