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Comparison of Iodinated Contrast Doses Based on Total Body Weight and Lean Body Weight in Pediatric Patients: Impact

L A O da Silva1, F D C B Braga2, M R R Cardoso3

  • 1São José do Rio Preto Medical School (FAMERP), São José do Rio Preto, São Paulo, Brazil.

Radiography (London, England : 1995)
|August 7, 2026
PubMed

Insights

Lean body weight (LBW) dosing in pediatric CT may reduce contrast volume without impacting image quality. This approach could lead to more personalized contrast administration, potentially lowering risks associated with contrast exposure.

Area of Science:

  • Radiology
  • Pediatric Imaging
  • Medical Physics

Background:

  • Traditional iodinated contrast dosing in pediatric CT relies on total body weight (TBW), potentially leading to overadministration, especially in obese children.
  • Lean body weight (LBW)-based protocols, promising in adults, are understudied in pediatric populations.
  • This study addresses the need for optimized contrast dosing in pediatric abdominal CT.

Purpose of the Study:

  • To compare contrast volume requirements and hepatic enhancement quality using LBW-based, TBW-based, and a control group (CG) dosing protocol.
  • To evaluate the efficacy of LBW-based dosing in pediatric abdominal CT.
  • To determine if LBW dosing can reduce contrast volume without compromising diagnostic image quality.

Main Methods:

  • Prospective study of 66 pediatric patients (0-16 years) undergoing contrast-enhanced abdominal CT.
  • Random assignment to three groups: LBW-based dosing (n=23), TBW-based dosing (n=20), and institutional control protocol (n=23).
  • Statistical analysis using Kruskal-Wallis, ANOVA, and other relevant tests to compare contrast volumes and hepatic enhancement (Hounsfield Units).

Main Results:

  • The LBW group received lower median contrast volumes (27 mL) compared to TBW (34.5 mL) and CG (40 mL) groups.
  • These volume reductions did not statistically significantly compromise hepatic enhancement (552 ± 139 HU in LBW vs. CG).
  • No statistically significant differences in contrast volume between groups were observed (P > 0.05).

Conclusions:

  • LBW is a potentially useful parameter for estimating contrast dose in pediatric abdominal CT.
  • LBW-based dosing may reduce administered contrast volumes while maintaining diagnostic image quality.
  • Early evidence suggests LBW dosing supports individualized contrast administration in pediatric CT, potentially reducing exposure-related risks.
Abstract

Keywords:
AbdomenComputed tomographyPediatric radiologyTotal body weightcontrast medialean body weight

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