Impact of individually tailored contrast medium on vascular attenuation in chest CT: a randomized controlled trial.

BACKGROUND

Individually tailored contrast medium (CM) may improve vascular image quality in chest computed tomography (CT).

PURPOSE: To evaluate vascular attenuation in chest CT by comparing CM dose calculations using lean body mass (LBM) and body surface area (BSA) with a fixed-dose protocol.

MATERIAL AND

METHODS

Patients referred for contrast-enhanced chest CT were categorized as either normal, muscular, or overweight. Patients were accordingly randomized into three CM dosing protocols: fixed-dose group (n = 87), LBM group (n = 92), and BSA group (n = 93).

RESULTS

Of the patients, 94% in the fixed-dose group, 99% in the LBM group, and 98% in the BSA group achieved optimal vascular attenuation. In the overweight category, lower attenuation was demonstrated in the fixed-dose group compared to the LBM group (P = 0.032) and the BSA group (P = 0.010). In the fixed-dose group, vascular attenuation showed a negative correlation with total body weight for all body composition categories. In the LBM group, a positive correlation was observed between attenuation and total body weight in the muscular category (P = 0.041), while a negative correlation was noted for the overweight category in the BSA group (P = 0.049).

CONCLUSION

Fixed-dose CM protocol exhibited larger variations in vascular attenuation between patients of various body weights and body compositions compared to tailored CM doses based on LBM and BSA.