European Radiology

, Volume 23, Issue 7, pp 1970–1977 | Cite as

Contrast medium injection protocol adjusted for body surface area in combined PET/CT

  • Florian F. Behrendt
  • Marilou Rebière
  • Andreas Goedicke
  • Hubertus Pietsch
  • Karin Palmowski
  • Christiane K. Kuhl
  • Felix M. Mottaghy
  • Frederik A. Verburg
Nuclear Medicine



To evaluate the effect of contrast medium dose adjustment for body surface area (BSA) compared with a fixed-dose protocol in combined positron emission tomography (PET) and computed tomography (CT) (PET/CT).


One hundred and twenty patients were prospectively included for 18F-2-deoxy-fluor-glucose (18F-FDG)-PET/CT consisting of a non-enhanced and a venous contrast-enhanced CT, both used for PET attenuation correction. The first 60 consecutive patients received a fixed 148-ml contrast medium dose. The second 60 patients received a dose that was based on their calculated BSA. Mean and maximum standardised FDG uptake (SUVmean and SUVmax) and contrast enhancement (HU) were measured at multiple anatomical sites and PET reconstructions were evaluated visually for image quality.


A decrease in the variance of contrast enhancement in the BSA group compared with the fixed-dose group was seen at all anatomical sites. Comparison of tracer uptake SUVmean and SUVmax between the fixed and the BSA group revealed no significant differences at all anatomical sites (all P > 0.05). Comparison of the overall image quality scores between the fixed and the BSA group showed no significant difference (P = 0.753).


BSA adjustment results in increased interpatient homogeneity of contrast enhancement without affecting PET values. In combined PET/CT, a BSA adjusted contrast medium protocol should be used preferably.

Key Points

Intravenous contrast medium is essential for many applications of PET/CT

Body surface area adjustment of contrast medium helps standardise contrast enhancement

Underdosing or overdosing of contrast medium will be reduced

PET image quality is not influenced

BSA adjusted contrast medium protocol should be used preferably in combined PET/CT


PET/CT Body Surface Area Attenuation Correction Contrast Medium SUV 



This study was supported by an unrestricted grant from Bayer Healthcare AG, Berlin, Germany.

Hubertus Pietsch is an employee of Bayer Healthcare. Andreas Goedicke is an employee of Philips Technologie GmbH, Innovative Technologies, Research Laboratories, Aachen, Germany.

Patients from the fixed-dose protocol group were also included in a previous study from us, but the data of these patients were analysed again referring to the new objective of this study. Furthermore, patients from the BSA group were not included in any study before.


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Florian F. Behrendt
    • 1
  • Marilou Rebière
    • 1
  • Andreas Goedicke
    • 1
    • 2
  • Hubertus Pietsch
    • 3
  • Karin Palmowski
    • 4
    • 5
  • Christiane K. Kuhl
    • 6
  • Felix M. Mottaghy
    • 1
    • 7
  • Frederik A. Verburg
    • 1
    • 7
  1. 1.Department of Nuclear MedicineRWTH Aachen UniversityAachenGermany
  2. 2.Innovative Technologies, Research LaboratoriesPhilips Technologie GmbHAachenGermany
  3. 3.Contrast Media ResearchBayer Healthcare AGBerlinGermany
  4. 4.Department of Experimental Molecular ImagingUniversity Hospital RWTH AachenAachenGermany
  5. 5.Medical Clinic IRWTH Aachen UniversityAachenGermany
  6. 6.Department of RadiologyRWTH Aachen UniversityAachenGermany
  7. 7.Department of Nuclear MedicineMaastricht University Medical CenterMaastrichtThe Netherlands

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