Customised weight-based volume contrast media protocol for multiphase abdominal computed tomography

Lilian Poh Poh Yap; Fadhli Mohamed Sani; Eric Chung; Nadia Fareeda Muhammad Gowdh; Wei Lin Ng; Jeannie Hsiu Ding Wong

doi:10.4103/singaporemedj.SMJ-2021-461

Customised weight-based volume contrast media protocol for multiphase abdominal computed tomography

Singapore Med J. 2024 Feb 2. doi: 10.4103/singaporemedj.SMJ-2021-461. Online ahead of print.

Authors

Lilian Poh Poh Yap^{1

2}, Fadhli Mohamed Sani^{1

2}, Eric Chung^{1

2}, Nadia Fareeda Muhammad Gowdh^{1

2}, Wei Lin Ng^{1

2}, Jeannie Hsiu Ding Wong^{1

2}

Affiliations

¹ Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
² Department of Biomedical Imaging, Universiti Malaya Medical Centre, Lembah Pantai, Kuala Lumpur, Malaysia.

PMID: 38305361
DOI: 10.4103/singaporemedj.SMJ-2021-461

Abstract

Introduction: Multiphase computed tomography (CT) using fixed volume contrast media may lead to high radiation exposure and toxicity in patients with low body weight. We evaluated a customised weight-based protocol for multiphase CT in terms of radiation exposure, image quality and cost savings.

Methods: A total of 224 patients were recruited. An optimised CT protocol was applied using 100 kV and 1 mL/kg of contrast media dosing. The image quality and radiation dose exposure of this CT protocol were compared to those of a standard 120 kV, 80 mL fixed volume protocol. The radiation dose information and CT Hounsfield units were recorded. The signal-to-noise ratio, contrast-to-noise ratio (CNR) and figure of merit (FOM) were used as comparison metrics. The images were assessed for contrast opacification and visual quality by two radiologists. The renal function, contrast media volume and cost were also evaluated.

Results: The median effective dose was lowered by 16% in the optimised protocol, while the arterial phase images achieved significantly higher CNR and FOM. The radiologists' evaluation showed more than 97% absolute agreement with no significant differences in image quality. No significant differences were found in the pre- and post-CT estimated glomerular filtration rate. However, contrast media usage was significantly reduced by 1,680 mL, with an overall cost savings of USD 421 in the optimised protocol.

Conclusion: The optimised weight-based protocol is cost-efficient and lowers radiation dose while maintaining overall contrast enhancement and image quality.