Optimizing contrast medium injection protocol individually with body weight for high-pitch prospective ECG-triggering coronary CT angiography

Abstract

To individually optimize contrast medium protocol for high-pitch prospective ECG-triggering coronary CT angiography using body weight. Ninety patients undergoing high-pitch coronary CT angiography were randomly assigned to 3 contrast medium injection protocols with bolus tracking technique: Group A, 0.7 ml CM per kg patient weight (ml/kg); Group B, 0.6 ml/kg; Group C, 0.5 ml/kg. Each group had 30 patients. The CT values of superior vena cava (SVC), pulmonary artery (PA), ascending aorta (AA), left atrium (LA), left ventricle (LV), left main artery (LM) and proximal segment of right coronary artery (RCA) were measured. The image quality of coronary artery was evaluated on per-segment basis using a 4-point scale (1-excellent, 4-non-diagnosis). The CT value was not significantly different on AA (p = 0.735), LM (p = 0.764), and proximal segment of RCA (p = 0.991). The CT value was significantly different on SVC, PA, LA and LV (all p < 0.05). The mean image quality score was 1.6 ± 0.1, 1.6 ± 0.1 and 1.6 ± 0.1 (p = 0.217). The volume of CM was 47 ± 8, 44 ± 8 and 36 ± 6 ml for 3 groups (p < 0.001). The effective radiation dose was 0.88 ± 0.04, 0.87 ± 0.06, and 0.85 ± 0.07 mSv for 3 groups. Contrast medium could be reduced to 0.5 ml/kg for high-pitch coronary CT angiography without compromising diagnostic image quality, which associated ~50 % reduction of total contrast volume compared with standard contrast protocol with test bolus technique.