Browse > Article
http://dx.doi.org/10.7742/jksr.2021.15.5.575

Contrast Optimization using of Weight-based Injection Protocol in Pediatric Abdomen CT Examination  

Kim, Yung-Kyoon (Department of Radiology, Samsung Medical Center)
Han, Dong-Kyoon (Department of Radiologic Technology, Eulji University)
Publication Information
Journal of the Korean Society of Radiology / v.15, no.5, 2021 , pp. 575-584 More about this Journal
Abstract
The aim of this study was to achieve optimal portal phase while reducing contrast medium by applying weight-based dose protocol compared to standard fixed dose protocol to performing of pediatric abdominal CT examination. Discovery 750HD (General Electric Medical Systems, Milwaukee, USA) was used, and a total of 167 children consisting of 85 men and 82 women under the age of 18 were studied. The group in which the 300 mgI/ml(Xenetix, Guerbet, France) contrast medium was fixedly injected at twice body weight and the group injected with physiological saline while gradually decreasing the injection amount by 10% while applying the weight-based protocol were distinguished. Also, the CT number and SNR of abdominal organs were compared and evaluated while changing the scan delay time. Subjective image quality of enhancement and beam-hardening artifacts of around the heart was assessed with five-point criterion. The group adapted weight-based protocol with 20% reduction in contrast medium was most similar in contrast enhancement in the group with fixed injection at twice body weight. Furthermore, the group with a delay time of 20% had the highest contrast enhancement effect, and the difference in CT attenuation coefficient from the group scanned immediately after injection of the contrast media. Therefore, the appropriate delay time after injection of the contrast agent increased the contrast enhancement of the parenchymal organ. In addition, the weight-based injection protocol with normal saline reduced artifacts around the heart, and the effect of contrast enhancement could be maintained. In conclusion, it is possible to reduce dosage of contrast media through the application of weight-based injection protocols and appropriate latency, and to characterize optimal portal phase imaging on pediatric abdominal CT.
Keywords
Pediatric Abdominal CT; Iodine Enhancement; Weight Adapted Injection Protocol; Scan Delay Time;
Citations & Related Records
연도 인용수 순위
  • Reference
1 A. T. Trout, J. R. Dillman, J. H. Ellis, R. H. Cohan, P. J. Strouse, "Patterns of intravenous contrast material use and corticosteroid premedication in children--a survey of Society of Chairs of Radiology in Children's Hospitals (SCORCH) member institutions", Pediatric Radiology, Vol. 41, No. 10, pp. 1272-1283, 2011. http://dx.doi.org/10.1007/s00247-011-2112-5   DOI
2 M. Riccabona, "Application of a second-generation US contrast agent in infants and children--a European questionnaire-based survey", Pediatric Radiology, Vol. 42, No. 12, pp. 1471-1480, 2012. http://dx.doi.org/10.1007/s00247-012-2472-5   DOI
3 W. D. Foley, U. Kerimoglu, "Abdominal MDCT: liver, pancreas, and biliary tract", Seminars in Ultrasound, CT, & MRI, Vol. 25, No. 2, pp. 122-144, 2004. http://dx.doi.org/10.1016/j.sult.2003.12.001   DOI
4 Section on Radiology; American Academy of Pediatrics, "Diagnostic Imaging of Child Abuse", Pediatrics, Vol. 123, No. 5, pp. 1430-1435, 2009. http://dx.doi.org/10.1542/peds.2009-0558   DOI
5 D. P. Frush, "Pediatric abdominal CT angiography", Pediatric Radiology, Vol. 38, No. 2, pp. 259-266, 2008. http://dx.doi.org/10.1007/s00247-008-0795-z   DOI
6 M. J. Callahan, S. Servaes, E. Y. Lee, A. J. Towbin, S. J. Westra, D. P. Frush, "Practice patterns for the use of iodinated i.v. contrast media for pediatric CT studies: a survey of the Society for Pediatric Radiology", American Journal of Roentgenology, Vol. 202, No. 4, pp. 872-879, 2014. http://dx.doi.org/10.2214/AJR.13.11106   DOI
7 M. Kormano, K. Partanen, S. Soimakallio, T. Kivimaki, "Dynamic contrast enhancement of the upper abdomen: effect of contrast medium and body weight", Investigative Radiology, Vol. 18, No. 4, pp. 364-367, 1983. https://doi.org/10.1097/00004424-198307000-00013   DOI
8 K. T. Bae, "Intravenous contrast medium administration and scan timing at CT: considerations and approaches", Radiology, Vol. 256, No. 1, pp. 32-61, 2010. http://dx.doi.org/10.1148/radiol.10090908   DOI
9 S. McCarthy, A. A. Moss, "The use of a flow rate injector for contrast-enhanced computed tomography", Radiology, Vol. 151, No. 3, pp. 800, 1984. http://dx.doi.org/10.1148/radiology.151.3.6718744   DOI
10 H. W. Goo, "State-of-the-art CT imaging techniques for congenital heart diseas", Korean Journal of Radiology, Vol. 11, No. 1, pp. 4-18, 2010. http://dx.doi.org/10.3348/kjr.2010.11.1.4   DOI
11 H. Kondo, M. Kanematsu, S. Goshima, Y. Tomita, M. J. Kim, N. Moriyama, M. Onozuka, Y. Shiratori, K. T. Bae, "Body size indexes for optimizing iodine dose for aortic and hepatic enhancement at multidetector CT: comparison of total body weight, lean body weight, and blood volume", Radiology, Vol. 254, No. 1, pp. 163-169, 2010. https://doi.org/10.1148/radiol.09090369   DOI
12 Y. K. Kim, Y. M. Kim, "Optimization of Protocol for Injection of Iodinated Contrast Medium in Pediatric Thoracic CT Examination", Journal of the Korean Society of Radiology, Vol. 13, No. 6, pp. 879-887, 2019. https://doi.org/10.7742/jksr.2019.13.6.879   DOI
13 S. Itoh, M. Ikeda, M. Achiwa, T. Ota, H. Satake, T. Ishigaki, "Multiphase contrast-enhanced CT of the liver with a multislice CT scanner", European Radiology, Vol. 13, No. 5, pp. 1085-1094, 2003. http://dx.doi.org/10.1007/s00330-002-1607-8   DOI
14 M. J. Siegel, D. M. Balfe, B. L. McClennan, R. G. Levitt, "Clinical utility of CT in pediatric retroperitoneal disease: 5 years experience", American Journal of Roentgenology, Vol. 138, No. 6, pp. 1011-1017, 1982. http://dx.doi.org/10.2214/ajr.138.6.1011   DOI
15 J. F. Platt, K. A. Reige, J. H. Ellis "Aortic enhancement during abdominal CT angiography: correlation with test injections, flow rates, and patient demographics", American Journal of Roentgenology, Vol. 172, No. 1, pp. 53-56, 1999. https://doi.org/10.2214/ajr.172.1.9888738   DOI
16 J. K. Han, B. I. Choi, A. Y. Kim, S. J. Kim, "Contrast media in abdominal computed tomography: optimization of delivery methods", Korean Journal of Radiology, Vol. 2, No. 1, pp. 28-36, 2001. http://dx.doi.org/10.3348/kjr.2001.2.1.28   DOI
17 A. Tschugunow, M. Puesken, K. U. Juergens, F. Beyer, B. Buerke, H. Seifarth, W. Heindel, J. Wessling, "Optimization of scan delay for routine abdominal 64-slice CT with body weight-adapted application of contrast material", RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, Vol. 181, No. 7, pp. 683-690, 2009. http://dx.doi.org/10.1055/s-0028-1109201   DOI
18 K. Awai, M. Imuta, D. Utsunomiya, T. Nakaura, S. Shamima, K. Kawanaka, S. Hori, Y. Yamashita, "Contrast Enhancement for Whole-body Screening Using Multidetector Row Helical CT : Comparison between Uniphasic and Biphasic Injection Protocols", Radiation Medicine, Vol. 22, No. 5, pp. 303-309, 2004.
19 G. D. Rubin, M. J. Lane, D. A. Bloch, A. N. Leung, P. Starkm, "Optimization of thoracic spiral CT: effects of iodinated contrast medium concentration", Radiology, Vol. 201, No. 3, pp. 785-791, 1996. http://dx.doi.org/10.1148/radiology.201.3.8939232   DOI
20 M. Yang, X. M. Mo, J. Y. Jin, J. Zhang, B. Liu, M. Wu, G. J. Teng, "Image quality and radiation exposure in pediatric cardiovascular CT angiography from different injection sites", American Journal of Roentgenology, Vol. 196, No. 2, pp. 117-122, 2011. http://dx.doi.org/10.2214/AJR.10.4360   DOI
21 R. Rear, R. M. Bell, D. J. Hausenloy, "Contrast-induced nephropathy following angiography and cardiac interventions", Heart, Vol. 102, No. 8, pp. 638-648, 2016. https://doi.org/10.1136/heartjnl-2014-306962   DOI
22 A. J. George, N. E. Manghat, M. C. K. Hamilton "Comparison between a fixed-dose contrast protocol and a weight-based contrast dosing protocol in abdominal CT", Clinical Radiology, Vol. 71, No. 12, pp. 1314-1319, 2016. http://dx.doi.org/10.1016/j.crad.2016.07.009   DOI
23 D. Fleischmann "Use of high-concentration contrast media in multiple-detector-row CT: principles and rationale", European Radiology, Vol. 13, No. 5, pp. 14-20, 2003. http://dx.doi.org/10.1007/s00330-003-2097-z   DOI
24 R. M. Hammerstingl, T. J. Vogl, "Abdominal MDCT: protocols and contrast considerations", European Radiology Supplements, Vol. 15, No. 5, pp. 78-90, 2005. http://dx.doi.org/10.1007/s10406-005-0169-7   DOI
25 K. T. Bae, J. P. Heiken, J. A. Brink, "Aortic and hepatic peak enhancement at CT: effect of contrast medium injection rate--pharmacokinetic analysis and experimental porcine model", Radiology, Vol. 206, No. 2, pp. 455-464, 1998. http://dx.doi.org/10.1148/radiology.206.2.9457200   DOI