Minimizing Contrast Dose in CT Angiography While Maintaining Diagnostic Quality
Main Article Content
Keywords
Computed Tomography Angiography, Contrast Media, Contrast-Induced Nephropathy, Allergic Reactions, Renal Impairment, Patient Safety.
Abstract
Computed tomography angiography (CTA) is a widely used imaging modality for the diagnosis and evaluation of various vascular diseases. However, the use of iodinated contrast media in CTA poses potential risks, such as contrast-induced nephropathy (CIN), especially in patients with impaired renal function. Therefore, minimizing contrast dose while maintaining diagnostic quality is crucial for patient safety and optimal imaging outcomes. This paper explores various strategies and techniques to reduce contrast dose in CTA, including patient-specific protocols, low-kV imaging, dual-energy CT, and iterative reconstruction algorithms, while ensuring the preservation of diagnostic quality
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Tao, S. M., Wichmann, J. L., Schoepf, U. J., Fuller, S. R., Lu, G. M., & Zhang, L. J. (2016). Contrast-induced nephropathy in CT: incidence, risk factors and strategies for prevention. European radiology, 26, 3310-3318.
Thor, D., Brismar, T. B., & Fischer, M. A. (2015). Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study. Medical physics, 42(9), 5100-5109.
Welvaert, M., & Rosseel, Y. (2013). On the definition of signal-to-noise ratio and contrast-to-noise ratio for fMRI data. PloS one, 8(11), e77089.
Willemink, M. J., Persson, M., Pourmorteza, A., Pelc, N. J., & Fleischmann, D. (2018). Photon-counting CT: technical principles and clinical prospects. Radiology, 289(2), 293-312.
Wu, Y. W., Leow, K. S., Zhu, Y., & Tan, C. H. (2016). Prevention and management of adverse reactions induced by iodinated contrast media. Ann Acad Med Singapore, 45(4), 157-164.
Azzalini, L., Abbara, S., & Ghoshhajra, B. B. (2014). Ultra-low contrast computed tomographic angiography (CTA) with 20-mL total dose for transcatheter aortic valve implantation (TAVI) planning. Journal of computer assisted tomography, 38(1), 105-109.
Beregi, J., & Greffier, J. (2019). Low and ultra-low dose radiation in CT: opportunities and limitations (Vol. 100, pp. 63-64): Elsevier.
Boyd, B., Zamora, C. A., & Castillo, M. (2017). Managing adverse reactions to contrast agents. Magnetic Resonance Imaging Clinics, 25(4), 737-742.
Chiu, T.-M., & Chu, S.-Y. (2022). Hypersensitivity reactions to iodinated contrast media. Biomedicines, 10(5), 1036.
Corbett, T. (2020). Radiation dose reduction strategies in coronary CTA. Radiologic technology, 91(4), 404-406.
de Bustillo Llorente, E. M., & de Miguel Balsa, E. (2019). Radiological iodinated contrast-induced nephropathy. Revista Clínica Española (English Edition), 219(7), 403-410.
De Cecco, C. N., & Schoepf, U. J. (2018). New contrast injection strategies for low kV and keV imaging. Applied Radiology, 47(1), 7-11.
De Zordo, T., Plank, F., & Feuchtner, G. (2012). Radiation Dose in Coronary CT Angiography: How High is it and What Can be Done to Keep it Low? Current Cardiovascular Imaging Reports, 5, 292-300.
Faggioni, L., & Gabelloni, M. (2016). Iodine concentration and optimization in computed tomography angiography: current issues. Investigative Radiology, 51(12), 816-822.
Ginat, D. T., & Gupta, R. (2014). Advances in computed tomography imaging technology. Annual review of biomedical engineering, 16, 431-453.
Greffier, J., Frandon, J., Larbi, A., Beregi, J., & Pereira, F. (2020). CT iterative reconstruction algorithms: a task-based image quality assessment. European radiology, 30, 487-500.
Kaliyaperumal, Y., Sivadasan, S., & Aiyalu, R. (2023). Contrast-Induced Nephropathy: An Overview. Dr. Sulaiman Al Habib Medical Journal, 5(4), 118-127.
Lell, M. M., Jost, G., Korporaal, J. G., Mahnken, A. H., Flohr, T. G., Uder, M., & Pietsch, H. (2015). Optimizing contrast media injection protocols in state-of-the art computed tomographic angiography. Investigative Radiology, 50(3), 161-167.
Mamoulakis, C., Tsarouhas, K., Fragkiadoulaki, I., Heretis, I., Wilks, M. F., Spandidos, D. A., . . . Tsatsakis, A. (2017). Contrast-induced nephropathy: Basic concepts, pathophysiological implications and prevention strategies. Pharmacology & therapeutics, 180, 99-112.
McCollough, C. H., & Rajiah, P. S. (2023). Milestones in CT: past, present, and future. Radiology, 309(1), e230803.
Mihl, C., Kok, M., Altintas, S., Kietselaer, B. L., Turek, J., Wildberger, J. E., & Das, M. (2016). Evaluation of individually body weight adapted contrast media injection in coronary CT-angiography. European journal of radiology, 85(4), 830-836.
Nicol, E. D., Norgaard, B. L., Blanke, P., Ahmadi, A., Weir-McCall, J., Horvat, P. M., . . . Leipsic, J. (2019). The future of cardiovascular computed tomography: advanced analytics and clinical insights. Cardiovascular Imaging, 12(6), 1058-1072.
Perrin, T., Descombes, E., & Cook, S. (2012). Contrast-induced nephropathy in invasive cardiology: incidence, pathophysiology, diagnosis, prevention and prognosis. Swiss medical weekly, 142, w13608.
Richards, C. E., & Obaid, D. R. (2019). Low-dose radiation advances in coronary computed tomography angiography in the diagnosis of coronary artery disease. Current Cardiology Reviews, 15(4), 304-315.
Schopp, J. G., Iyer, R. S., Wang, C. L., Petscavage, J. M., Paladin, A. M., Bush, W. H., & Dighe, M. K. (2013). Allergic reactions to iodinated contrast media: premedication considerations for patients at risk. Emergency radiology, 20, 299-306.
Sonali, G., Pradeep, G., Nishant, G., Harpreet, S., & Vivek, K. (2018). Contrast-Induced Nephropathy: Current practice. J Urol Neph St, 1(1).
Srinivas-Rao, S., Cao, J., Marin, D., & Kambadakone, A. (2023). Dual-energy computed tomography to photon counting computed tomography: emerging technological innovations. Radiologic Clinics, 61(6), 933-944.
Tabari, A., Gee, M. S., Singh, R., Lim, R., Nimkin, K., Primak, A., . . . Kalra, M. K. (2020). Reducing radiation dose and contrast medium volume with application of dual-energy CT in children and young adults. AJR Am J Roentgenol, 214(6), 1199-1205.
Tan, S. K., Ng, K. H., Yeong, C. H., Aman, R. R. A. R., Sani, F. M., Aziz, Y. F. A., & Sun, Z. (2019). Personalized administration of contrast medium with high delivery rate in low tube voltage coronary computed tomography angiography. Quantitative imaging in medicine and surgery, 9(4), 552.
Tao, S. M., Wichmann, J. L., Schoepf, U. J., Fuller, S. R., Lu, G. M., & Zhang, L. J. (2016). Contrast-induced nephropathy in CT: incidence, risk factors and strategies for prevention. European radiology, 26, 3310-3318.
Thor, D., Brismar, T. B., & Fischer, M. A. (2015). Low tube voltage dual source computed tomography to reduce contrast media doses in adult abdomen examinations: A phantom study. Medical physics, 42(9), 5100-5109.
Welvaert, M., & Rosseel, Y. (2013). On the definition of signal-to-noise ratio and contrast-to-noise ratio for fMRI data. PloS one, 8(11), e77089.
Willemink, M. J., Persson, M., Pourmorteza, A., Pelc, N. J., & Fleischmann, D. (2018). Photon-counting CT: technical principles and clinical prospects. Radiology, 289(2), 293-312.
Wu, Y. W., Leow, K. S., Zhu, Y., & Tan, C. H. (2016). Prevention and management of adverse reactions induced by iodinated contrast media. Ann Acad Med Singapore, 45(4), 157-164.
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Published
Feb 9, 2023
Article Details
How to Cite
Yasser Ahmad Alahmad,Maher Mohammed Abdulrahman Alotaibi,Saeed Mesfer Bin Muidh Al Mutlaq, Abdulaziz Khalid Marzoq Almuatiri,Saud Fohaid Alqahtani,Khaled Mohammed A Almoadi,Bandar Mohammad Alajmi, Rashed Saad Alqahtani. (2023). Minimizing Contrast Dose in CT Angiography While Maintaining Diagnostic Quality. Journal of Population Therapeutics and Clinical Pharmacology, 30(2), 448–458. https://doi.org/10.53555/jptcp.v30i2.4891
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