Comparison between a fixed-dose contrast protocol and a weight-based contrast dosing protocol in abdominal CT.

Area of Science:

• Radiology
• Medical Imaging
• Computed Tomography

Background:

• Fixed-dose iodinated contrast protocols may lead to variable enhancement in abdominal CT.
• Patient weight significantly influences radiodensity and contrast enhancement with fixed-dose protocols.

Purpose of the Study:

• To compare fixed-dose intravenous iodinated contrast medium protocols with weight-based dosing for abdominal CT.
• To evaluate objective and subjective contrast enhancement consistency across different patient weights.

Main Methods:

• Compared three protocols: fixed-dose, full-dose weight-based, and reduced-dose weight-based contrast administration.
• Measured radiodensity in major vessels and organs (portal vein, aorta, spleen, liver).
• Subjectively assessed image quality and enhancement using a Likert scale by independent consultants.

Main Results:

• Weight-based dosing demonstrated consistent vessel and organ enhancement, independent of patient weight.
• Full-dose weight-based protocols improved subjective image quality, reducing excessive enhancement compared to fixed-dose.
• Weight-based protocols used less contrast medium overall, with no evidence of contrast-induced acute kidney injury (CIAKI).

Conclusions:

• Weight-based contrast medium dosing optimizes enhancement and image quality in abdominal CT.
• This approach can reduce contrast volume and potentially mitigate risks like CIAKI.
• Standardized dose reduction strategies for patients with renal impairment may be feasible.