Customised weight-based volume contrast media protocol in CT of chest, abdomen and pelvis examination

Lilian Poh Poh Yap; Jeannie Hsiu Ding Wong; Nadia Fareeda Muhammad Gowdh; Wei Lin Ng; Eric Chung; Ravi Chanthriga Eturajulu; Sue Anne Manushya Kaur Foo; Anushya Vijayananthan; Fadhli Mohamed Sani

doi:10.1016/j.jmir.2021.01.003

Customised weight-based volume contrast media protocol in CT of chest, abdomen and pelvis examination

J Med Imaging Radiat Sci. 2021 Jun;52(2):257-264. doi: 10.1016/j.jmir.2021.01.003. Epub 2021 Jan 30.

Authors

Lilian Poh Poh Yap¹, Jeannie Hsiu Ding Wong², Nadia Fareeda Muhammad Gowdh³, Wei Lin Ng³, Eric Chung³, Ravi Chanthriga Eturajulu¹, Sue Anne Manushya Kaur Foo⁴, Anushya Vijayananthan³, Fadhli Mohamed Sani³

Affiliations

¹ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Biomedical Imaging, University of Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia; Research Unit of Biomedical Imaging, University of Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia.
² Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address: jeannie_wong80@um.edu.my.
³ Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Biomedical Imaging, University of Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia.
⁴ Department of Biomedical Imaging, University of Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia; Research Unit of Biomedical Imaging, University of Malaya Medical Centre, Lembah Pantai, 59100 Kuala Lumpur, Malaysia.

PMID: 33531272
DOI: 10.1016/j.jmir.2021.01.003

Abstract

Introduction: Fixed volume (FV) contrast media administration during CT examination is the standard practice in most healthcare institutions. We aim to validate a customised weight-based volume (WBV) method and compare it to the conventional FV methods, introduced in a regional setting.

Methods: 220 patients underwent CT of the chest, abdomen and pelvis (CAP) using a standard FV protocol, and subsequently, a customised 1.0 mL/kg WBV protocol within one year. Both image sets were assessed for contrast enhancement using CT attenuation at selected regions-of-interest (ROIs). The visual image quality was evaluated by three radiologists using a 4-point Likert scale. Quantitative CT attenuation was correlated with the visual quality assessment to determine the HU's enhancement indicative of the image quality grades. Contrast media usage was calculated to estimate cost-savings from both protocols.

Results: Mean patient age was 61 ± 14 years, and weight was 56.1 ± 8.7 kg. FV protocol produced higher contrast enhancement than WBV, p < 0.001. CT images' overall contrast enhancement was negatively correlated with body weight for FV protocol while the WBV protocol produced more consistent enhancement across different body weight. More than 90% of the images from both protocols were graded "Excellent". WBV protocol also enabled a 28% cost reduction with cost savings of US$1238.

Conclusion: The customised WBV protocol produced CT images which were comparable to FV protocol for CT CAP examinations. A median CT value of 100 HU can be an indicator of good image quality for the WBV protocol.

Keywords: Contrast enhancement; Contrast media; Cost-savings; Image quality; Single-phase CT; Weight-based.

MeSH terms

Abdomen*
Aged
Contrast Media*
Humans
Middle Aged
Pelvis / diagnostic imaging
Prospective Studies
Tomography, X-Ray Computed

Substances

Contrast Media