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Novel contrast-injection protocol for coronary computed tomographic angiography: contrast-injection protocol customized according to the patient’s time-attenuation response

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Abstract

We developed a new individually customized contrast-injection protocol for coronary computed tomography (CT) angiography based on the time-attenuation response in a test bolus, and investigated its clinical applicability. We scanned 60 patients with suspected coronary diseases using a 64-detector CT scanner, who were randomly assigned to one of two protocols. In protocol 1 (P1), we estimated the contrast dose to yield a peak aortic attenuation of 400 HU based on the time-attenuation response to a small test-bolus injection (0.3 ml/kg body weight) delivered over 9 s. Then we administered a customized contrast dose over 9 s. In protocol 2 (P2), the dose was tailored to the patient’s body weight; this group received 0.7 ml/kg body weight with an injection duration of 9 s. We compared the two protocols for dose of contrast medium, peak attenuation, variations in attenuation values of the ascending aorta, and the success rate of adequate attenuation (250–350 HU) of the coronary arteries. The contrast dose was significantly smaller in P1 than in P2 (36.9 ± 9.2 vs 43.1 ± 7.0 ml, P < 0.01). Peak aortic attenuation was significantly less under P1 than under P2 (384.1 ± 25.0 vs 413.5 ± 45.7, P < 0.01). The mean variation (standard deviation) of the attenuation values was smaller in P1 than in P2 (25.0 vs 45.7, P < 0.01). The success rate of adequate attenuation of the coronary arteries was significantly higher with P1 than with P2 (85.0 vs 65.8 %, P < 0.01). P1 facilitated a reduction in the contrast dose, reduced the individual variations in peak aortic attenuation, and achieved optimal coronary CT attenuation (250–350 HU) more frequently than P2.

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Authors and Affiliations

  1. Diagnostic Radiology, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto, 863-0046, Japan

    Masafumi Kidoh, Takeshi Nakaura & Shinichi Nakamura

  2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan

    Masafumi Kidoh, Takeshi Nakaura, Shinichi Nakamura, Daisuke Utsunomiya, Tomohiro Namimoto & Yasuyuki Yamashita

  3. Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Kazuo Awai

  4. Department of Surgery, Amakusa Medical Center, Kameba 854-1, Amakusa, Kumamoto, 863-0046, Japan

    Kazunori Harada

Authors
  1. Masafumi Kidoh
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  2. Takeshi Nakaura
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  3. Shinichi Nakamura
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  4. Kazuo Awai
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  5. Daisuke Utsunomiya
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  8. Yasuyuki Yamashita
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Correspondence to Masafumi Kidoh.

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Kidoh, M., Nakaura, T., Nakamura, S. et al. Novel contrast-injection protocol for coronary computed tomographic angiography: contrast-injection protocol customized according to the patient’s time-attenuation response. Heart Vessels 29, 149–155 (2014). https://doi.org/10.1007/s00380-013-0338-x

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  • DOI: https://doi.org/10.1007/s00380-013-0338-x

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