Abstract
BackgroundPatient body size represents the main determinant of parenchymal enhancement and by adjusting the contrast media (CM) dose to patient weight may be a more appropriate approach to avoid a patient over dosage of CM. To compare the performance of fixed-dose and lean body weight (LBW)-adapted contrast media dosing protocols, in terms of image quality and parenchymal enhancement.ResultsOne-hundred cancer patients undergoing multiphasic abdominal CT were prospectively enrolled in this multicentric study and randomly divided in two groups: patients in fixed-dose group (n = 50) received 120 mL of CM while in LBW group (n = 50) the amount of CM was computed according to the patient’s LBW. LBW protocol group received a significantly lower amount of CM (103.47 ± 17.65 mL vs. 120.00 ± 0.00 mL, p < 0.001). Arterial kidney signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) and pancreatic CNR were significantly higher in LBW group (all p ≤ 0.004). LBW group provided significantly higher arterial liver, kidney, and pancreatic contrast enhancement index (CEI) and portal venous phase kidney CEI (all p ≤ 0.002). Significantly lower portal vein SNR and CNR were observed in LBW-Group (all p ≤ 0.020).ConclusionsLBW-adapted CM administration for abdominal CT reduces the volume of injected CM and improves both image quality and parenchymal enhancement.
Highlights
Patient body size represents the main determinant of parenchymal enhancement and by adjusting the contrast media (CM) dose to patient weight may be a more appropriate approach to avoid a patient over dosage of CM
Patient body size is known to be a major determinant of parenchymal enhancement, and it has been shown that adjusting the contrast media (CM) dose to patient weight may be a more appropriate approach than administering a fixed dose of CM, allowing to reduce inter-patient variability and unnecessary healthcare costs related to CM over dosage [1,2,3,4,5,6]
Our results showed that tailoring the CM volume according to lean body weight (LBW) provides higher parenchymal enhancement of abdominal organs than using a fixed CM volume
Summary
Patient body size represents the main determinant of parenchymal enhancement and by adjusting the contrast media (CM) dose to patient weight may be a more appropriate approach to avoid a patient over dosage of CM. There are no general recommendations or established guidelines regarding the CM dosing method necessary to optimize parenchymal enhancement for abdominopelvic CT studies, and fixed-dose CM injection protocols are still commonly used for clinical practice in many institutions [7, 8] Due this lack of standardization, multiple weightadapted CM dosing regimens have been proposed, based on a large variety of body size indexes, including total body weight (TBW), body mass index (BMI), lean body weight (LBW), and body surface area (BSA), but no consensus on has been reached so far [9,10,11,12,13]. Differences in body fat percentage between men and women may result in excessive amount of CM being administered to women, when dosing CM according to TBW [16, 17]
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