Strategies to Reduce Contrast Medium in Spectral CT Pulmonary Angiography

University Hospital, Akershus330 enrolled

Overview

The purpose of this study is to assess the effect of three different strategies to inject at reduced volume of contrast medium in Computed Tomography Pulmonary Angiography (CTPA). 330 patients referred for CTPA are randomized to receive either a low-concentration, a low-volume or a saline-diluted injection. Effects on the level and homogeneity of contrast enhancement are measured and compared between groups.

Spectral detector CT facilitates large reductions in contrast medium in vascular CT examinations. To our knowledge, no studies have so far compared different strategies to inject this reduced contrast dose. The purpose of this study is to assess the effect of three different strategies to inject at reduced volume of contrast medium in Computed Tomography Pulmonary Angiography (CTPA). 330 patients referred for clinically indicated CTPA are randomized to receive either a low-concentration, a low-volume or a saline-diluted injection. All patients receive the same amount of iodine (140 mg/kg). Effects on the level and homogeneity of contrast enhancement, image noise, contrast-to-noise-ratio and signal-to-noise-ratio are measured in the CT images and the results are compared between groups.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

TRIPLE

Enrollment

330

Conditions

Pulmonary Embolism

Interventions

Low iodine Spectral Detector CT Pulmonary AngiographyDIAGNOSTIC_TEST

Low iodine Spectral Detector CT Pulmonary Angiography

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Inpatients and outpatients with kidney function (eGFR) allowing for safe administration of contrast dose (as calculated with the OmniVis calculator). * Patients with clinical suspicion of disease of PE * Referral to CTPA diagnosis, treatment planning or follow-up. * Peripheral venous catheter (PVC) =/\< 18 G Exclusion Criteria: * Contraindication to iodinated contrast medium * Age \< 18 years * Lack of informed consent * Pregnancy

Locations (1)

Akershus University Hospital

Lørenskog, Akershus, Norway

Outcomes

Primary Outcomes

Contrast enhancement (Vascular attenuation)

Contrast enhancement measured as attenuation in the pulmonary artery Branches on the acquired CTPA examination

Time frame: Measured on the CT images from the examination performed at enrollment

Secondary Outcomes

Homogeneity of contrast enhancement (image noise)

Homogeneity of contrast enhancement is measured as the standard deviation of attenuation in the pulmonary artery branches (equals image noise).

Time frame: Measured on the CT images from the examination performed at enrollment

Contrast to noise ratio (CNR)

CNR is measured as (Vascular attenuation - Muscular attenuation) / Image noise

Time frame: Measured on the CT images from the examination performed at enrollment

Signal to noise ratio (SNR)

SNR is measured as Vascular attenuation / Image noise

Time frame: Measured on the CT images from the examination performed at enrollment

Data from ClinicalTrials.gov

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