Contrast optimization in CT angiography

Abstract

This paper compares different contrast injection techniques for optimizing vessel contrast in CT angiography (CTA). The optimal vessel contrast shall be defined as constant strong enhancement confined to the scanning interval. This "plateau enhancement" guarantees high-quality CTA images and should therefore be approximated during every CTA examination by an appropriate contrast injection protocol. With well-established injection techniques such as the standard bolus technique (constant uniphasic contrast bolus for all patients) or adjustment of the scan delay, considerable individual differences in the arterial enhancement can be observed, and a nondiagnostic examination or an inefficient use of contrast agent might be the result in a particular patient. Therefore, two sophisticated mathematical models have recently been developed for analyzing the individual enhancement characteristics. These models can be exploited to predict the arterial enhancement for any given intravenous contrast bolus in any patient and to optimize the contrast bolus in order to approach the ideal "plateau enhancement." These techniques have to prove their effectiveness in larger clinical series.