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Minimizing contrast media dose in CT pulmonary angiography with high-pitch technique
Department of Radiology, Örebro university Hospital, Region Örebro län, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Radiology.ORCID iD: 0000-0003-0137-9991
Department of Radiology, Örebro university Hospital, Region Örebro län, Örebro, Sweden.
Department of Radiology, Örebro university Hospital, Region Örebro län, Örebro, Sweden.
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2020 (English)In: British Journal of Radiology, ISSN 0007-1285, E-ISSN 1748-880X, Vol. 93, no 1111, article id 20190995Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To perform CT pulmonary angiography (CTPA) using a minimal amount of iodinated contrast media.

METHODS: 47 patients (25 females) with mean age 69 years (range 41-82 years) referred for contrast-enhanced chest CT were prospectively included in this Phase IV clinical drug trial. All participants underwent a study specific CTPA in addition to the chest CT. The participants received 80 mg I/kg body weight Iohexol contrast media using a preparatory saline bolus, a dual flow contrast/saline bolus and a saline flush, and a scanner protocol with 80 kVp dual source high-pitch mode. Three readers independently assessed the image quality on the 3-point scale non-diagnostic, adequate or good-excellent image quality. Additionally, the pulmonary arterial contrast opacification was measured.

RESULTS: On average, the patients received 16.8 ml Iohexol 350 mg I/mL (range 12-20 ml). Mean patient weight was 71 kg (range 50-85 kg). Identically for all readers, pulmonary embolism (PE) was detected in 1/47 participants. The median number of examinations visually scored concerning pulmonary embolism as good-excellent was 47/47 (range 44-47); adequate 0/47 (0-3) and non-diagnostic 0/47 (range 0-0). The proportion adequate or better examinations was for all readers 47/47, 100% [95% confidence interval 92-100%]. The mean attenuation ± standard deviation in the pulmonary trunk was 325 ± 72 Hounsfield unit (range 165-531 Hounsfield unit).

CONCLUSIONS: Diagnostic CTPA with 17 ml contrast media is possible in non-obese patients using low kVp, high pitch and carefully designed contrast media administration.

ADVANCES IN KNOWLEDGE: By combining several procedures in a CTPA protocol, the contrast media dose can be minimized.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020. Vol. 93, no 1111, article id 20190995
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:oru:diva-81984DOI: 10.1259/bjr.20190995ISI: 000542990000011PubMedID: 32436788Scopus ID: 2-s2.0-85086748143OAI: oai:DiVA.org:oru-81984DiVA, id: diva2:1431553
Note

Funding Agency:

Region Örebro län  OLL-883901 OLL-786141 OLL-684531 OLL-551791 OLL-523931

Available from: 2020-05-22 Created: 2020-05-22 Last updated: 2020-12-01Bibliographically approved

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Alshamari, MuhammedLidén, Mats

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