Investigation of impact of using different CM approaches on contrast enhancement in chest Ct examinations - A prospective study

Continuing advances in computed tomography (CT) in the past decades such as short scanning times with multi-detector CT (MDCT) requires contrast medium (CM) administration to be precisely planned to ensure a diagnostically accurate CT scans. To improve the chest CT diagnostic, the contrast enhancement in the thoracic vessels shoulde be increased.

The most important patient-related factors affecting the magnitude of vascular and parenchymal contrast enhancement are body weight. Historical practice has been to use a fixed volume of CM independent of body weight. Research has shown a clear relationship between vessel enhancement and patient weight, and that fixed CM volume technique is inappropriate, as smaller patients may receive excessive volume, and larger patients insufficient volume resulting in reduced image quality and poor diagnostic. In addition, excess CM can result in contrast induced adverse effects and nephropathy. To overcome these problems, it is essential to adjust the CM volume to the patient's total body weight and body composition. This adjustment can be done in different ways. The aim of this study is to identify which weight/body tailored CM administration is the best replacement for fixed CM administration in chest CT. The cost and procedure time will also be explored.

Inclusion Criteria:

• patients undergoing chest CT examination between August 2019 and September 2021
• age > 18 years

Exclusion Criteria:

• hemodynamic instability
• cardiac failure
• pacemaker
• renal insufficiency (estimated glomerular filtration rate <30 mL/min/1.73 m2)
• contraindications to contrast enhanced CT
• age < 18 years

Patients receiving contrast enhanced chest CT examination