Individually adapted tube current selection and contrast medium injection protocol of coronary CT angiography based on test bolus parameters: a feasibility study

Abstract

It is feasible to individually adapt tube current and contrast injection protocol of CCTA based on the information of test bolus.

Determining Whether Tube Voltages and Contrast Flow Rates have an Impact on a Test Bolus-Based Contrast-Enhancement-Prediction Algorithm during Coronary CT Angiography

“…proposed algorithm is slightly influenced by TB study protocols, but 8 HU mis-estimations in coronary enhancement are negligible during CCTA. We did not find that age or BMI had an influence on this TB-based CEP algorithm, which is consistent with the findings of TB-based CEP algorithms proposed by Zhu et al [10] and Korporaal et al [11]. This could be explained by the fact that PEDAo and PTAAo, which are partially determined by patient-related factors including age, body weight, BMI, and heart rate, had been accounted for in the CEP algorithms.…”

“…A clinical study [19] observed that the correlation between aortic peak enhancement and cardiac output was superior to the correlation with body weight. Cardiac output is closely related to the time-attenuation curve obtained from a TB injection [10,20]. Zhu et al [10] held the view that cardiac output was inversely correlated to peak enhancement in the right ventricle and the time to peak enhancement in the left ventricle.…”

“…Cardiac output is closely related to the time-attenuation curve obtained from a TB injection [10,20]. Zhu et al [10] held the view that cardiac output was inversely correlated to peak enhancement in the right ventricle and the time to peak enhancement in the left ventricle. They also recommend TB-based CM injection protocols for tube voltages of 100 kV and 120 kV to achieve consistent arterial enhancement.…”

“…To optimize the consistency in intracoronary attenuations in a particular scanning protocol, a prediction of contrast enhancement should be available before the CCTA scan. Many patient-related factors influence the magnitude of coronary contrast enhancement in CCTA scans [7][8][9], and one of the most important patient-related factors is cardiac output [10]. If one considers a patient as a linear time-invariant system, information about a patient' s hemodynamic parameters can be obtained from a test bolus (TB) and could be used for enhancement prediction [11][12][13].…”

“…With technical improvements, a huge variety of contrast injection and CT scanning protocols have been introduced in CCTA practice [11,15]. Previous predictions of intracoronary attenuation were based on the same contrast injection and scanning protocols applied in the TB [10]. However, in the previous study, the contrast doses were approximately 20 mL with an injection duration of 5 seconds.…”