Objective
To assess the effectiveness of low contrast volume (LCV) chest CT performed with multiple
contrast agents on multivendor CT with varying scanning techniques.
Methods
The study included 361 patients (65 ± 15 years; M: F 173:188) who underwent LCV chest
CT on one of the six 64–256 detector-row CT scanners using single-energy (SECT) or
dual-energy (DECT) modes. All patients were scanned with either a fixed-LCV (LCVf,
n = 103) or weight-based LCV (LCVw, n = 258) protocol. Two thoracic radiologists independently assessed all LCV CT and
patients’ prior standard contrast volume (SCV, n = 263) chest CT for optimality of contrast enhancement in thoracic vasculature, cardiac
chambers, and in pleuro-parenchymal and mediastinal abnormalities. CT attenuations
were recorded in the main pulmonary trunk, ascending, and descending thoracic aorta.
To assess the interobserver agreement, pulmonary arterial enhancement was divided
into two groups: optimal or suboptimal.
Results
There was no significant difference among patients’ BMI (p = 0.883) in the three groups. DECT had a significantly higher aortic arterial enhancement
(250 ± 99HU vs 228 ± 76 HU for SECT, p < 0.001). Optimal enhancement was present in 558 of 624 chest CT (89.4%), whereas
66 of 624 chest CT with suboptimal enhancement was noted in 48 of 258 LCVw (18.6%)
and 14 of 103 LCVf (13.6%). Most patients with suboptimal enhancement with LCVw injection
protocol were overweight/obese (30/48; 62.5%), (p < 0.001).
Conclusion
LCV chest CT can be performed across complex multivendor, multicontrast media, multiscanner,
and multiprotocol CT practices. However, LCV chest CT examinations can result in suboptimal
contrast enhancement in patients with larger body habitus.
Key Words
Abbreviations:
Iodinated contrast media ((ICM)), Contrast-enhanced computed tomography ((CECT)), American College of Radiology ((ACR)), Dual energy ((DECT)), Low ICM volume ((LCV)), Human Insurance Portability and Accountability Act ((HIPAA)), Standard contrast volume ((SCV)), Weight-based LCV ((LCVw)), Fixed LCV ((LCVf)), Regions of interest ((ROI)), Ascending aorta ((AA)), Descending ((DA)), Right atrium ((RA)), Right ventricle ((RV)), Left atrium ((LA)), Left ventricle ((LV)), Main pulmonary artery (MPA), Lobar pulmonary artery ((LPA)), Segmental pulmonary artery ((SPA)), Subsegmental pulmonary artery ((SSPA))To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 09, 2023
Accepted:
March 17,
2023
Received in revised form:
March 16,
2023
Received:
December 19,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
