Minimizing contrast agent dosage in CT angiography using a saline chaser with a low trigger threshold

Area of Science:

• Radiology
• Cardiovascular Imaging
• Medical Imaging Technology

Background:

• Computed tomography angiography (CTA) is a primary diagnostic tool for cardiovascular diseases (CVD).
• Iodinated contrast agents used in CTA carry potential patient risks.
• Minimizing contrast agent administration is crucial for patient safety in CTA procedures.

Purpose of the Study:

• To develop and assess a novel CTA protocol integrating a saline chaser strategy and low-threshold triggering.
• To evaluate the feasibility and practicality of this new protocol in reducing contrast agent volume.
• To demonstrate the effectiveness of the novel protocol in minimizing iodine intake and associated risks.

Main Methods:

• A novel CTA protocol combining a saline chaser strategy and low-threshold triggering was designed.
• Eighty patients were randomly assigned to either the conventional or novel CTA protocol group.
• Key assessments included iodine intake, radiation dose, image quality (SNR, CNR), and superior vena cava (SVC) artefacts.

Main Results:

• The novel CTA protocol achieved a 20% reduction in iodine intake compared to the conventional group (P < 0.05).
• No significant differences were found in signal-to-noise ratio (SNR) or contrast-to-noise ratio (CNR) between groups.
• Fewer superior vena cava artefacts were observed with the novel protocol, while subjective image quality remained consistent.

Conclusions:

• The combined saline chaser and low-threshold triggering strategy is a viable approach for CTA.
• This novel CTA protocol significantly reduces iodinated contrast agent utilization.
• The new protocol effectively minimizes superior vena cava artefacts, enhancing patient safety.