Implementation of patient-tailored contrast volumes based on body surface area and heart rate harmonizes contrast enhancement and reduces contrast load in small patients in portal venous phase abdominal CT

• Published in: European journal of radiology Vol. 121; p. 108630
• Main Authors: Walgraeve, M.-S., Pyfferoen, L., Van De Moortele, K., Zanca, F., Bielen, D., Casselman, J.W.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.12.2019
• Subjects: Abdominal imaging; Algorithms; Body Surface Area; Contrast injection protocols; Contrast media; Contrast Media - administration & dosage; Female; Heart Rate - physiology; Humans; Image quality; Male; Middle Aged; Multi-detector computed tomography; Personalised medicine; Portal Vein - diagnostic imaging; Radiographic Image Enhancement - methods; Radiography, Abdominal - methods; Retrospective Studies; Tomography, X-Ray Computed - methods; eGFR; LBW; PACS; ICC; TBW; IQR; MDCT; HU; ROI; Image quality; CT; BSA; Contrast injection protocols; Multi-detector computed tomography; Abdominal imaging; Personalised medicine; keV; Contrast media; BMI; WHO
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2019.07.031

•Fixed contrast volumes lead to highly variable interpatient contrast enhancement.•Injection protocols should be personalized for uniform and consistent enhancement.•Patient-tailored contrast volumes based on BSA harmonize interpatient enhancement.•Subjective image quality is preserved using patient-tailored volumes.•Patient-tailored volumes can lead to volume reductions in small patients. The aim of this study was to evaluate the impact of a patient-tailored contrast volume protocol on portal venous phase abdominal CT-images compared to a fixed volume protocol in daily radiological practice. Data of 77 patients who underwent two contrast-enhanced CT-examinations were collected. The first examination was performed with a fixed contrast volume (95 ml), the follow-up examination was performed with a patient-tailored contrast volume based on patient’s BSA and heart rate. The patient-tailored volume was calculated by a software application integrated in the interface of the injection pump. Two independent radiologists assessed subjective and objective image quality. Differences in enhancement and contrast volumes between both protocols were analysed. Despite a significant contrast volume reduction in women and in patients with low to normal BMI, enhancement was more consistent over different BMI-categories in the patient-tailored contrast volume protocol and there was no significant difference in subjective image quality between both injection protocols. A patient-tailored contrast volume protocol based on BSA and heart rate can be considered in daily radiological practice to decrease contrast volumes in women and in low to normal BMI patients and to achieve more consistent contrast enhancement across different BMI-categories in venous phase abdominal CT.