Weight-based contrast media volume reduction in lower limb computed tomography angiography: a prospective feasibility...

Area of Science:

• Radiology
• Medical Imaging
• Vascular Imaging

Background:

• Computed tomography lower-limb angiography (CT LLA) is crucial for diagnosing peripheral arterial disease.
• Standard fixed-dose contrast protocols may lead to excessive iodine exposure.
• Optimizing contrast administration is essential for diagnostic accuracy and patient safety.

Purpose of the Study:

• To compare the image quality of a weight-based contrast protocol versus a standard fixed-dose protocol for CT LLA.
• To determine if a weight-based approach can reduce contrast volume without compromising diagnostic adequacy.
• To assess the cost-effectiveness of weight-based contrast protocols.

Main Methods:

• A prospective study comparing 105 patients (weight-based protocol) with 25 patients (standard fixed-dose protocol).
• Objective image quality parameters (attenuation, noise, SNR, CNR) and subjective image quality (Likert scale) were assessed.
• Statistical analysis using the Mann-Whitney U test for between-group comparisons.

Main Results:

• Weight-based protocols achieved significant contrast volume reduction (16.7%-33.3%).
• No significant differences in arterial attenuation or SNR were observed between groups.
• While CNR was slightly higher in the standard group, all examinations were diagnostically adequate.
• Arterial attenuation and image noise, not contrast volume, were the primary determinants of image quality.

Conclusions:

• Weight-based contrast protocols are effective in reducing contrast volume and associated costs for CT LLA.
• This approach maintains diagnostically acceptable image quality, offering a feasible alternative to fixed-dose protocols.
• Weight-based protocols represent a safe and efficient strategy for evaluating peripheral arterial disease.