Optimization of Cardiac MSCT Contrast Injection Protocols: Dependency of the Main Bolus Contrast Density on Test Bolus Parameters and Patients’ Body Weight

Rist, Carsten; Becker, Christoph R.; Kirchin, Miles A.; Johnson, Thorsten R.; Busch, Stefanie; Bae, Kyongtae Ty; Leber, Alexander W.; Reiser, Maximilian F.; Nikolaou, Konstantin

doi:10.1016/j.acra.2007.08.005

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Volume 15, Issue 1 , Pages 49-57, January 2008

Optimization of Cardiac MSCT Contrast Injection Protocols:

Dependency of the Main Bolus Contrast Density on Test Bolus Parameters and Patients’ Body Weight

Carsten Rist
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
- Address correspondence to: C.R.
Christoph R. Becker
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
Miles A. Kirchin
- Worldwide Medical Affairs, Bracco Imaging SpA, Milan, Italy
Thorsten R. Johnson
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
Stefanie Busch
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
Kyongtae Ty Bae
- Department of Radiology, University of Pittsburgh, School of Medicine, Pittsburgh, PA.
Alexander W. Leber
- Department of Cardiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
Maximilian F. Reiser
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany
Konstantin Nikolaou
- Department of Clinical Radiology, University Hospitals – Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany

Received 4 June 2007; accepted 3 August 2007.

Rationale and Objectives

Our aim was to evaluate the correlation of test bolus (TB) curve parameters with main bolus (MB) contrast density for cardiac 16-slice computed tomography, and to correlate observed enhancement with patient body weight.

Materials and Methods

Sixty patients with known or suspected coronary artery disease were included in a prospective double-blind study. Contrast material containing 300 mg iodine/mL (Iomeprol 300; Imeron 300, Bracco Imaging SpA, Milan, Italy) and 400 mg iodine/mL (Iomeprol 400; Imeron 400) was injected at a rate of 1 g of iodine/second. Contrast densities (Hounsfield units) of the MB were determined in the left cardiac system. The peak density (PD) of maximum attenuation and the area under the curve (AUC) of the TB curve were calculated for each patient. The dependency of MB contrast attenuation on these parameters and on patient body weight was evaluated.

Results

Positive correlations (r = 0.52 and r = 0.56, respectively; P < .0001) were obtained between the PD and AUC of the TB curve with the mean density of the MB. Stronger correlations (r = 0.63 and r = 0.64, respectively; P < .0001) between PD and AUC of the TB curve and MB attenuation were found when patient body weight was included in the analysis.

Conclusions

Strong correlation of the PD and AUC of the TB curve with the mean density of the MB is observed when patient body weight is considered. Contrast injection protocols may be optimized, and variations of MB contrast density in the left ventricle and main coronary arteries reduced, by taking these TB parameters and the weight of the patient into account.

Key Words: Computed tomography, test bolus, main bolus, body weight, coronary CTA