Individualized Delay for Abdominal Computed Tomography Angiography Bolus-Tracking Based on Sequential Monitoring: Increased Aortic Contrast Permits Decreased Injection Rate and Lower Iodine Dose

J Comput Assist Tomogr. 2019 Jul/Aug;43(4):612-618. doi: 10.1097/RCT.0000000000000874.

Abstract

Objective: The aim of this study was to determine if computed tomography (CT) angiography using an individualized transition delay (CTA-ID) would facilitate reductions in injection rate and iodine dose.

Methods: The CTA-ID was performed in 20 patients with routine injection rate and iodine dose; 20 patients with injection rate lowered by 1 mL/s; and 40 patients with injection rate lowered by 1 mL/s with 29% less iodine. Routine CTAs in the same or size-matched patients served as controls. Diagnostic image quality and intra-arterial CT numbers were assessed.

Results: The median transition delay between aortic threshold and CTA-ID image acquisition was significantly longer than with conventional bolus tracking (mean increase, 13.3 seconds; P < 0.0001), with image quality being the same or better. Intra-arterial CT numbers were 200 Hounsfield units or greater for 80 of 80 CTA-ID, but not for 6 of 49 (12%) internal control or for 11 of 80 (14%) size-matched control patients.

Conclusion: The CTA-ID bolus-tracking software alters transition delays to permit diagnostic CTA examinations despite slower injection rate and less iodine.

MeSH terms

  • Abdomen* / blood supply
  • Abdomen* / diagnostic imaging
  • Aged
  • Aorta / diagnostic imaging*
  • Computed Tomography Angiography* / methods
  • Computed Tomography Angiography* / statistics & numerical data
  • Contrast Media* / administration & dosage
  • Contrast Media* / therapeutic use
  • Humans
  • Iodine* / administration & dosage
  • Iodine* / therapeutic use
  • Male
  • Radiography, Abdominal
  • Retrospective Studies
  • Time Factors

Substances

  • Contrast Media
  • Iodine