Generic placeholder image

Current Cardiology Reviews

Editor-in-Chief

ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Review Article

Basic Concepts of Contrast Injection Protocols for Coronary Computed Tomography Angiography

Author(s): Seitaro Oda*, Daisuke Utsunomiya, Takeshi Nakaura, Masafumi Kidoh, Yoshinori Funama, Kenichi Tsujita and Yasuyuki Yamashita

Volume 15, Issue 1, 2019

Page: [24 - 29] Pages: 6

DOI: 10.2174/1573403X14666180918102031

Price: $65

Abstract

Background: Coronary Computed Tomography Angiography (CTA) has become one of the most important diagnostic imaging modalities for the evaluation of coronary artery diseases. During coronary computed CTA, sufficient vascular enhancement is essential for the accurate detection and evaluation of lesions in the coronary arteries. To obtain optimal contrast enhancement and perform appropriate clinical coronary CTA, physicians, radiologists, and radiology technologists should acquire a basic knowledge of contrast injection protocols.

Conclusion: This review article summarizes the basic concepts of contrast injection protocols for coronary CTA.

Keywords: CT angiography, computed tomography, ECG, physicians, radiologists, radiology technologists.

Graphical Abstract
[1]
Budoff MJ, Dowe D, Jollis JG, et al. Diagnostic performance of 64-multidetector-row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: Results from the prospective multicenter ACCURACY (Assessment by Coronary Computed Tomographic Angiography of Individuals Undergoing Invasive Coronary Angiography) trial. J Am Coll Cardiol 2008; 52(21): 1724-32.
[2]
Miller JM, Rochitte CE, Dewey M, et al. Diagnostic performance of coronary angiography by 64-row CT. N Engl J Med 2008; 359(22): 2324-36.
[3]
Cademartiri F, Mollet NR, Lemos PA, et al. Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography. Am J Roentgenol 2006; 187(4): W430-3.
[4]
Cademartiri F, Mollet NR, Runza G, et al. Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomography: Observations in an ex vivo model of coronary computed tomography angiography. Eur Radiol 2005; 15(7): 1426-31.
[5]
Cademartiri F, Maffei E, Palumbo AA, et al. Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography. Eur Radiol 2008; 18(3): 576-83.
[6]
Fei X, Du X, Yang Q, et al. 64-MDCT coronary angiography: Phantom study of effects of vascular attenuation on detection of coronary stenosis. Am J Roentgenol 2008; 191(1): 43-9.
[7]
Becker CR, Hong C, Knez A, et al. Optimal contrast application for cardiac 4-detector-row computed tomography. Invest Radiol 2003; 38(11): 690-4.
[8]
Hausleiter J, Meyer TS, Martuscelli E, et al. Image quality and radiation exposure with prospectively ECG-triggered axial scanning for coronary CT angiography: The multicenter, multivendor, randomized PROTECTION-III study. JACC Cardiovasc Imaging 2012; 5(5): 484-93.
[9]
Utsunomiya D, Tanaka R, Yoshioka K, et al. Relationship between diverse patient body size- and image acquisition-related factors, and quantitative and qualitative image quality in coronary computed tomography angiography: A multicenter observational study. Jpn J Radiol 2016; 34(8): 548-55.
[10]
Abbara S, Blanke P, Maroules CD, et al. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 2016; 10(6): 435-49.
[11]
Tatsugami F, Kanamoto T, Nakai G, et al. Reduction of the total injection volume of contrast material with a short injection duration in 64-detector row CT coronary angiography. Br J Radiol 2010; 83(985): 35-9.
[12]
Nakaura T, Awai K, Yauaga Y, et al. Contrast injection protocols for coronary computed tomography angiography using a 64-detector scanner: Comparison between patient weight-adjusted- and fixed iodine-dose protocols. Investigat Radiol 2008; 43(7): 512-9.
[13]
McDonald RJ, McDonald JS, Newhouse JH, Davenport MS. Controversies in contrast material-induced acute kidney injury: Closing in on the truth? Radiology 2015; 277(3): 627-32.
[14]
Committee on Drugs and Contrast Media. American College of Radiology, (ACR) Website. Manual on contrast media, v. 10.3 Available at:. https://www.acr.org/Quality-Safety/Resources/Contrast- Manual [accessed on: February 19, 2018].
[15]
Nakayama Y, Awai K, Funama Y, et al. Abdominal CT with low tube voltage: Preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology 2005; 237(3): 945-51.
[16]
Oda S, Utsunomiya D, Funama Y, et al. A hybrid iterative reconstruction algorithm that improves the image quality of low-tube-voltage coronary CT angiography. Am J Roentgenol 2012; 198(5): 1126-31.
[17]
Nakaura T, Nakamura S, Maruyama N, et al. Low contrast agent and radiation dose protocol for hepatic dynamic CT of thin adults at 256-detector row CT: Effect of low tube voltage and hybrid iterative reconstruction algorithm on image quality. Radiology 2012; 264(2): 445-54.
[18]
Oda S, Utsunomiya D, Funama Y, et al. Evaluation of deep vein thrombosis with reduced radiation and contrast material dose at computed tomography venography: Clinical application of a combined iterative reconstruction and low-tube-voltage technique. Circ J 2012; 76(11): 2614-22.
[19]
Utsunomiya D, Oda S, Funama Y, et al. Comparison of standard- and low-tube voltage MDCT angiography in patients with peripheral arterial disease. Eur Radiol 2010; 20(11): 2758-65.
[20]
Yamamura S, Oda S, Imuta M, et al. Reducing the radiation dose for CT colonography: Effect of low tube voltage and iterative reconstruction. Acad Radiol 2016; 23(2): 155-62.
[21]
Yamamura S, Oda S, Utsunomiya D, et al. Dynamic computed tomography of locally advanced pancreatic cancer: Effect of low tube voltage and a hybrid iterative reconstruction algorithm on image quality. J Comput Assist Tomogr 2013; 37(5): 790-6.
[22]
Itatani R, Oda S, Utsunomiya D, et al. Reduction in radiation and contrast medium dose via optimization of low-kilovoltage CT protocols using a hybrid iterative reconstruction algorithm at 256-slice body CT: Phantom study and clinical correlation. Clin Radiol 2013; 68(3): e128-35.
[23]
Oda S, Weissman G, Vembar M, Weigold WG. Iterative model reconstruction: Improved image quality of low-tube-voltage prospective ECG-gated coronary CT angiography images at 256-slice CT. Eur J Radiol 2014; 83(8): 1408-15.
[24]
Oda S, Utsunomiya D, Yuki H, et al. Low contrast and radiation dose coronary CT angiography using a 320-row system and a refined contrast injection and timing method. J Cardiovasc Comput Tomogr 2015; 9(1): 19-27.
[25]
Kidoh M, Nakaura T, Funama Y, et al. Paradoxical effect of cardiac output on arterial enhancement at computed tomography: Does cardiac output reduction simply result in an increase in aortic peak enhancement? J Comput Assist Tomogr 2017; 41(3): 349-53.
[26]
Bae KT. Intravenous contrast medium administration and scan timing at CT: Considerations and approaches. Radiology 2010; 256(1): 32-61.
[27]
de Monye C, Cademartiri F, de Weert TT, Siepman DA, Dippel DW, van Der Lugt A. Sixteen-detector row CT angiography of carotid arteries: Comparison of different volumes of contrast material with and without a bolus chaser. Radiology 2005; 237(2): 555-62.
[28]
Cademartiri F, Mollet N, van der Lugt A, et al. Non-invasive 16-row multislice CT coronary angiography: Usefulness of saline chaser. Eur Radiol 2004; 14(2): 178-83.
[29]
Kim DJ, Kim TH, Kim SJ, et al. Saline flush effect for enhancement of aorta and coronary arteries at multidetector CT coronary angiography. Radiology 2008; 246(1): 110-5.
[30]
Behrendt FF, Bruners P, Keil S, et al. Effect of different saline chaser volumes and flow rates on intravascular contrast enhancement in CT using a circulation phantom. Eur J Radiol 2010; 73(3): 688-93.
[31]
Utsunomiya D, Awai K, Sakamoto T, et al. Cardiac 16-MDCT for anatomic and functional analysis: Assessment of a biphasic contrast injection protocol. Am J Roentgenol 2006; 187(3): 638-44.
[32]
Cademartiri F, Nieman K, van der Lugt A, et al. Intravenous contrast material administration at 16-detector row helical CT coronary angiography: Test bolus versus bolus-tracking technique. Radiology 2004; 233(3): 817-23.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy