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Patient-specific contrast injection protocols for cardiovascular multidetector row computed tomography.

Uma D Numburi1, George P Chatzimavroudis, Arthur E Stillman

  • 1Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, USA.

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Patient-specific contrast injections improve cardiovascular CT imaging by creating uniform enhancement and reducing artifacts. This method offers better results than standard injections, especially for certain patient groups.

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Area of Science:

  • Radiology
  • Medical Imaging
  • Cardiovascular Imaging

Background:

  • Cardiovascular multidetector row computed tomography (MDCT) requires optimal contrast enhancement for diagnostic accuracy.
  • Standard uniphasic contrast injections can lead to variable enhancement and artifacts, impacting image quality.

Purpose of the Study:

  • To develop and evaluate patient-specific multiphasic contrast injection protocols for uniform enhancement in cardiovascular MDCT.
  • To compare the efficacy of patient-specific injections against standard uniphasic injections in terms of image uniformity and artifact reduction.

Main Methods:

  • Sixty-two patients underwent ECG-gated spiral MDCT, divided into a standard uniphasic injection group (n=30) and a patient-specific multiphasic injection group (n=32).
  • For the patient-specific group, a "gray box" transfer function was determined using a test bolus to tailor injections for achieving target enhancement (250 HU) in the left heart.
  • Intraindividual and interindividual enhancement variation, along with superior vena cava (SVC) artifacts, were assessed.

Main Results:

  • Patient-specific multiphasic injections significantly reduced intraindividual enhancement variation compared to uniphasic injections (P < 0.05).
  • While interindividual variation was also reduced, the difference was not statistically significant.
  • SVC artifacts were significantly decreased in thinner patients (<83 kg) receiving patient-specific injections.

Conclusions:

  • Patient-specific multiphasic contrast injections enhance cardiovascular MDCT image uniformity in the left heart.
  • This tailored approach offers superior results over standard uniphasic injections by minimizing enhancement variability.
  • The method also demonstrates a benefit in reducing SVC artifacts for specific patient demographics.