Individually tailored contrast enhancement in CT pulmonary angiography

Hendriks, Babs M. F.; Kok, Madeleine; Mihl, Casper; Bekkers, Sebastiaan C.A.M.; Wildberger, Joachim E.; Das, Marco

doi:10.1259/bjr.20150850

Cited by 33 publications

(40 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Current literature advocates for flow rates in CTPA not below 1.2 g iodine / second [30]. Though our reconstruction algorithm results in an almost twofold CNR increase, we reduced the flow rate to 0.6 g iodine / second in the low CM dose group.…”

Section: Methodsmentioning

confidence: 95%

Dual Energy CT Pulmonary Angiography with 6g Iodine—A Propensity Score-Matched Study

et al. 2016

View full text Add to dashboard Cite

ObjectiveTo evaluate the performance of low contrast media (CM) dose dual-energy computed tomography pulmonary angiography (CTPA) with advanced monoenergetic reconstructions in patients with suspected pulmonary embolism (PE).Materials and MethodsThe study had institutional review board approval; all patients gave written informed consent. Forty-one patients (25 men, 16 women, mean age 62.9±14.7 years) undergoing low CM dose (15ml, 6g iodine) dual-energy CTPA with advanced monoenergetic reconstructions were matched via propensity-scoring based on logistic regression analysis with a comparison group of 41 patients (24 men, 17 women, mean age 62.7±13.9 years) undergoing standard CM dose single-energy CTPA (80ml, 24g iodine). Subjective (noise, artifacts) and objective (attenuation, noise, contrast-to-noise ratio (CNR)) image quality was assessed by two blinded, independent readers. All patients underwent clinical follow-up after three months for evaluation of adverse events.ResultsInterrater agreement for subjective image quality in both groups ranged from fair to excellent (ICC: 0.46–0.84); agreement for objective image quality was excellent (ICC: 0.83–0.93). There was no significant difference regarding subjective noise (p = 0.15–0.72) and artifacts (p = 0.16–1) between the low and the standard CM dose group. There was no significant difference regarding CNR between the CM dose groups (p = 0.11–0.87). Seven of the 41 (17%) patients in the low and 5/41 (12%) in the standard CM dose group were diagnosed with PE (p = 0.32). No patient suffered from subsequent PE or PE-associated death during the follow-up period.ConclusionDual-energy CTPA with advanced monoenergetic reconstruction is feasible with 6g iodine and allows for the diagnosis and safe exclusion of central, lobar, and segmental PE.

show abstract

Section: Methodsmentioning

confidence: 95%

Dual Energy CT Pulmonary Angiography with 6g Iodine—A Propensity Score-Matched Study

et al. 2016

View full text Add to dashboard Cite

show abstract

“…A recent study has shown that pulmonary CTA should be performed in the resting expiratory position [25]. The image quality of pulmonary artery depiction in CTA can be further improved by using a weight-adapted contrast bolus [26]. Another possible solution would be to increase the injection duration, however at the cost of more contrast agent.…”

Section: Discussionmentioning

confidence: 99%

Coronary computed tomography angiography (CCTA): effect of bolus-tracking ROI positioning on image quality

Nebelung¹,

Brauer²,

Seppelt³

et al. 2020

Eur Radiol

View full text Add to dashboard Cite

Objectives The aim of the study was to evaluate the effect of bolus-tracking ROI positioning on coronary computed tomography angiography (CCTA) image quality. Methods In this retrospective monocentric study, all patients had undergone CCTA by step-and-shoot mode to rule out coronary artery disease within a cohort at intermediate risk. Two groups were formed, depending on ROI positioning (left atrium (LA) or ascending aorta (AA)). Each group contained 96 patients. To select pairs of patients, propensity score matching was used. Image quality with regard to coronary arteries as well as pulmonary arteries was evaluated using quantitative and qualitative scores. Results In terms of the coronary arteries, there was no significant difference between both groups using quantitative (SNR AA 14.92 vs. 15.46; p = 0.619 | SNR LM 19.80 vs. 20.30; p = 0.661 | SNR RCA 24.34 vs. 24.30; p = 0.767) or qualitative scores (4.25 vs. 4.29; p = 0.672), respectively. With regard to pulmonary arteries, we found significantly higher quantitative (SNR RPA 8.70 vs. 5.89; p < 0.001 | SNR LPA 9.06 vs. 6.25; p < 0.001) and qualitative scores (3.97 vs. 2.24; p < 0.001) for ROI positioning in the LA than for ROI positioning in the AA. Conclusions ROI positioning in the LA or the AA results in comparable image quality of CT coronary arteriography, while positioning in the LA leads to significantly higher image quality of the pulmonary arteries. These results support ROI positioning in the LA, which also facilitates triple-rule-out CT scanning. Key Points • ROI positioning in the left atrium or the ascending aorta leads to comparable image quality of the coronary arteries. • ROI positioning in the left atrium results in significantly higher image quality of the pulmonary arteries. • ROI positioning in the left atrium is feasible to perform triple-rule-out CTA.

show abstract

“…Recently, Hendriks et al (41) used protocols adjusted for patient weight and scan duration, employing automated software that calculates CM amount and flow rate and showed a substantial CM volume reduction in low-weight subjects compared with standard "fixed" protocols. Therefore, a solution could possibly be found in individualizing contrast application for each patient.…”

Section: Pulmonary Ctamentioning

confidence: 99%