Improved image-quality consistency in coronary CT angiography using a test-bolus-based individually tailored contrast medium injection protocol.

Abstract:

AIM:To develop and validate a test bolus (TB)-based quantitative model to create an individualised contrast medium injection protocol for use at coronary computed tomography angiography (CCTA) to improve patient-to-patient uniformity of intracoronary attenuation. MATERIALS AND METHODS:In the model-building phase, 175 patients who underwent CCTA using a traditional contrast medium injection protocol were recruited. A personalised injection equation was proposed according to the relationship between aortic enhancement and the haemodynamic parameters obtained from the TB. In the model-validation phase, a target aortic enhancement of 350 HU was set. Two hundred and fifteen additional CCTA examinations were performed using the proposed personalised injection model. Comparisons of inter-individual variability between the traditional and the proposed personalised injection protocol were performed. RESULTS:In the model-building phase, a high positive correlation between aortic enhancement and the haemodynamic parameters obtained from the TB was found. As a result, a personalised injection equation was determined using linear regression. In the model-validation phase, the average aortic enhancement was 350.5 HU, without significant differences from the preset level. Using the TB-based personalised injection protocol, inter-individual variability of aortic enhancement was significantly reduced (71.8 versus 38.9 HU, p<0.001) and patients who were scanned at 100 kVp had a reduction in the average contrast medium flow rate from 4.1 to 3.2 ml/s (p<0.001). CONCLUSIONS:The proposed TB-based injection protocol can achieve a desired preset and stable aortic enhancement.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Zhu X,Zhu Y,Liu W,Yang G,Su Z,Tang L,Xu Y

doi

10.1016/j.crad.2016.04.001

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

1113-9

issue

11

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(16)30026-5

journal_volume

71

pub_type

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