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. 2021 Jun;11(6):2598-2609.
doi: 10.21037/qims-20-500.

Low dose contrast media in step-and-shoot coronary angiography with third-generation dual-source computed tomography: feasibility of using 30 mL of contrast media in patients with body surface area <1.7 m2

Liang Jin  1 , Bing Jie  2 , Yiyi Gao  1 , An'qi Jiang  1 , Tingwen Weng  3 , Ming Li  1   4
Affiliations

Low dose contrast media in step-and-shoot coronary angiography with third-generation dual-source computed tomography: feasibility of using 30 mL of contrast media in patients with body surface area <1.7 m2

Liang Jin et al. Quant Imaging Med Surg. 2021 Jun.

Abstract

Background: Reducing contrast media volume in coronary computed tomography angiography minimizes the risk of adverse events but may compromise diagnostic image quality. We aimed to evaluate coronary computed tomography angiography's diagnostic image quality while using 30 mL of contrast media in patients with a body surface area <1.7 m2.

Methods: This prospective study included patients who underwent coronary computed tomography angiography from May 2018 to June 2019. The patients were divided into a low-dose group, who received 30 mL of contrast media, and a routine-dose group, who received contrast media based on body weight. Patient characteristics, coronary computed tomography angiography results, and quantitative and qualitative image results were assessed and compared.

Results: In total, 103 patients with a body surface area <1.7 m2 were 53 in the low-dose group and 50 in the routine-dose group. Sex, age, body surface area, body weight, and heart rate were similar between the groups (P>0.05). A contrast media volume of 30±0 mL was used for the low-dose group, and 41.62±4.59 mL was used for the routine-dose group. The low-dose group's computed tomography values were significantly different from those of the routine-dose group (P<0.05). The radiologists demonstrated agreement regarding diagnostic image quality and accuracy (kappa =0.91 and 0.85, respectively).

Conclusions: Using 30 mL of contrast media for coronary computed tomography angiography in patients with a body surface area <1.7 m2 provided a suitable diagnostic image quality for coronary artery disease diagnosis. Although radiation doses were similar between the groups, the decreased contrast media volume was likely beneficial for the patients.

Keywords: Contrast media; body surface area; computed tomography angiography; coronary angiography; coronary artery disease.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-500). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of the patients involved in this study. CCTA, coronary computed tomography angiography; CM, contrast media.
Figure 2
Figure 2
(A-D) A 67-year-old female patient with chest pain and a body surface area (BSA) of 1.60 m2, body mass index (BMI) of 28.51 kg/m2, 30 mL of contrast media (CM), and a flow rate of 3.5 mL/s. (A) The computed tomography (CT) value of the opening of the coronary sinus was 562 HU. Curved planar reconstruction images of the right coronary artery (B), left anterior descending artery (C), and left circumflex artery (D) are shown. (A1-D1) A 43-year-old male patient with chest pain with a BSA of 1.68 m2, BMI of 28.89 kg/m2, 59.5 mL of CM, and a flow rate of 5.5 mL/s. (A1) The CT value of the opening of the coronary sinus was 503 HU. Curved planar reconstruction images of the right coronary artery (B1), left anterior descending artery (C1), and left circumflex artery (D1) are shown.
Figure 3
Figure 3
Distribution of tube voltages of all patients in both groups. LD, low dose; RD, regular dose.
Figure 4
Figure 4
Correlations among computed tomography (CT), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) values and body surface area (BSA) for the two groups. LD, low dose; RD, regular dose.
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Comment in

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