[Comparison of Contrast Enhancement between Bolus-tracking and Test-bolus Methods on Coronary CT Angiography]

To compare the contrast enhancement between bolus-tracking (BT) and test-bolus (TB) methods in coronary computed tomography angiography (CCTA).

We enrolled 300 patients who underwent CCTA by BT (245 mg I/kg main bolus) or TB (77.4 mg I/kg test bolus with 245 mg I/kg main bolus) methods. In group BT (n=150), scanning was started automatically 5-second after contrast enhancement exceeded a predefined threshold of 150 Hounsfield units (HU). In group TB (n=150), TB peak attenuation plus 2-second was used as a delay. We recorded the CT number in the ascending aorta and determined whether the CT number was equivalent in two groups. For the equivalence test, we adopted 70 HU as the equivalence margin. The standard deviation (SD) in the CT number and the rate of patients with an acceptable CT number were compared. We also compared total iodine dose and total dose length product (DLP).

The CT number of the ascending aorta was 437.6±68.9 HU in group BT and 438.9±69.7 HU in group TB; the 95% confidence interval for the difference between the groups was from -11.6 to 20.2 HU and within the range of the equivalence margins. The SD of the CT number and the rate of patients with acceptable CT number did not differ significantly between the two groups (p=0.857 and p=0.614, respectively). Total iodine dose in group TB was significantly higher than in group BT (p<0.001), and total DLP was not statistically significant (p=0.197).

The contrast enhancement between BT and TB methods in CCTA was equivalent, and the distribution was not significantly different between the two groups.