An individualized contrast material injection protocol with respect to patient-related factors for dual-source CT coronary angiography

Abstract

To optimize contrast media (CM) injection protocols by individually tailoring the dose to the patient's body weight (BW), body mass index (BMI) and heart rate (HR) at dual-source computed tomography coronary angiography (DSCT-CA). A total of 423 patients were prospectively enrolled and were randomly assigned to four groups. The control group received 80 ml CM at 5 ml/s. For the HR-optimized group, the injection duration was the same as the scan duration plus 8 s. In the Body-optimized group, the dose of CM was tailored to BW and BMI. In the HR + Body-optimized group, CM protocols tailored to body size and scan duration were applied. Individual variability of arterial attenuation and incidence of arterial over-opacification (attenuation >500 HU) in the four groups were compared. Correlations between BW, BMI, HR, and arterial attenuations were evaluated in the four groups, respectively. Reduced individual variability of arterial attenuation and a significantly lower incidence of arterial over-opacification were found in the Body-optimized group and HR + Body-optimized group. Arterial attenuation was inversely correlated with BW, BMI, and HR in the control group, inversely correlated with BW and BMI in the HR-optimized group, and inversely correlated with HR in the Body-optimized group. In the HR + Body-optimized group, arterial attenuation was not significantly correlated with BW, BMI, or HR respectively. CM protocols individually tailored to BW, BMI, and HR can lead to reduced individual variability and a lower incidence of over-opacification of arterial attenuation, but also can reduce the influence of BW, BMI, and HR on arterial attenuations at DSCT-CA.