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Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering

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Abstract

In patients with large total blood volume contrast material (CM) dilution decreases coronary attenuation in CT coronary angiography (CTCA). As increased blood volume is well paralleled by body surface area (BSA) we assessed a BSA-adapted CM protocol to compensate for dilution effects. Low-dose CTCA with prospective ECG-triggering was performed in 80 patients with a BSA-adapted CM bolus ranging 40–105 ml and injection rate ranging 3.5–5.0 ml/s for a BSA of <1.70 to ≥2.5 m2. Eighty control patients matched for BSA who had previously undergone routine CTCA with a fixed CM protocol of 80 ml at 5 ml/s served as reference group. The average vessel attenuation from the proximal right (RCA) and the left main coronary artery (LMA) was assessed. Correlation of BSA with vessel attenuation was assessed in both groups. BSA-matching of all patients was successful (BSA-adapted group 1.98 ± 0.15 m2, range 1.66–2.39 m2 versus reference group 1.98 ± 0.17 m2, range 1.59–2.38 m2; P = 0.74). Mean CM bolus was significantly smaller in the BSA-adapted versus the reference group (70.9 ± 14.1 vs. 80.0 ± 0 ml, P < 0.001). There was no correlation in the BSA-adapted group (r = −0.07, P = 0.53, SEE = 0.15), while coronary attenuation was inversely related to BSA in the reference group (r = −0.59, P < 0.001, SEE = 0.14). We have successfully validated a BSA-adapted contrast material protocol which results in a comparable coronary contrast enhancement independent of individual BSA. This was achieved despite a significant reduction in the overall contrast material amount.

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Acknowledgments

The study was supported by a grant from the Swiss National Science Foundation and by the ZIHP (Zurich Center for Integrative Human Physiology, University of Zurich, Switzerland).

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Authors and Affiliations

  1. Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland

    Aju P. Pazhenkottil, Lars Husmann, Ronny R. Buechel, Bernhard A. Herzog, René Nkoulou, Irene A. Burger, Andrea Vetterli, Ines Valenta, Jelena R. Ghadri, Patrick von Schulthess & Philipp A. Kaufmann

  2. Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland

    Philipp A. Kaufmann

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  1. Aju P. Pazhenkottil
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  2. Lars Husmann
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  3. Ronny R. Buechel
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  4. Bernhard A. Herzog
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  5. René Nkoulou
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  6. Irene A. Burger
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  8. Ines Valenta
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  9. Jelena R. Ghadri
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  10. Patrick von Schulthess
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  11. Philipp A. Kaufmann
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Correspondence to Philipp A. Kaufmann.

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Pazhenkottil, A.P., Husmann, L., Buechel, R.R. et al. Validation of a new contrast material protocol adapted to body surface area for optimized low-dose CT coronary angiography with prospective ECG-triggering. Int J Cardiovasc Imaging 26, 591–597 (2010). https://doi.org/10.1007/s10554-010-9594-3

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  • DOI: https://doi.org/10.1007/s10554-010-9594-3

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