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Patient body weight-tailored contrast medium injection protocol for the craniocervical vessels: a prospective computed tomography study.

Kessler R, Hegenscheid K, Fleck S, Khaw A, Kirsch M, Hosten N, Langner S - PLoS ONE (2014)

Bottom Line: ME, SNR, and CNR were the same for 1.5 ml/kg and 1.0 ml/kg (p≥0.24), and both had higher values compared to 0.5 ml/kg (p≤0.043/p≤0.028).In patients with BMI>25, 1.5 ml/kg and 1.0 ml/kg produced higher ME than standard dose (p<0.001/p = 0.008), but ME in patients with BMI>25 did not differ between group 1 and group 2 (p = 0.673).Craniocervical CTA with a body weight-tailored CM dose of 1.0 ml/kg (270 mg iodine/ml) reduces iodine load in patients weighing <80 kg while producing ME similar to standard dose and improves ME in patients with BMI>25.

View Article: PubMed Central - PubMed

Affiliation: Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.

ABSTRACT

Objectives: To evaluate body weight-tailored contrast medium (CM) administration for computed tomography angiography (CTA) of the craniocervical vessels.

Methods: Institutional review board approval was obtained, and all patients gave written informed consent. Sixty patients were consecutively assigned to one of three dose groups (20 patients per group) with CM doses of Visipaque 270® (iodixanol 270 mg/ml) tailored to body weight at doses of 1.5, 1.0, or 0.5 ml/kg. Region-of-interest (ROI) analysis of maximum enhancement (ME) was conducted, and signal-to-noise-ratios (SNR) and contrast-to-noise-ratios (CNR) were calculated. Retrospective comparison was performed with three matched control groups examined with a standard CM dose (80 ml of Visipaque 270®). Image quality was rated by two neuroradiologists blinded to the CM dose used. Interrater reliability was calculated using kappa statistics.

Results: Body weight/BMI and ME were inversely correlated in the three control groups receiving the standard dose (r = -0.544/-0.597/-0.542/r = -0.358/r = -0.424/r = -0.280). Compared to standard dose, 1.5 ml/kg produced higher ME, SNR, and CNR in the anterior circulation (p≤0.038), 1.0 ml/kg had higher ME in cervical and medium-sized cerebral arteries (p≤0.034), and 0.5 ml/kg had lower ME, SNR and CNR for medium-sized cerebral arteries (p≤0.049). ME, SNR, and CNR were the same for 1.5 ml/kg and 1.0 ml/kg (p≥0.24), and both had higher values compared to 0.5 ml/kg (p≤0.043/p≤0.028). In patients with BMI>25, 1.5 ml/kg and 1.0 ml/kg produced higher ME than standard dose (p<0.001/p = 0.008), but ME in patients with BMI>25 did not differ between group 1 and group 2 (p = 0.673). In patients with BMI≤25, 1.5 ml/kg and 1.0 ml/kg produced ME comparable to standard dose (p = 0.132/p = 0.403). Regardless of patient weight, 0.5 ml/kg yielded lower ME than standard dose (p = 0.019/0.002).

Conclusions: Craniocervical CTA with a body weight-tailored CM dose of 1.0 ml/kg (270 mg iodine/ml) reduces iodine load in patients weighing <80 kg while producing ME similar to standard dose and improves ME in patients with BMI>25.

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Related in: MedlinePlus

Correlation of body weight/BMI and ME in the MCA.Scatterplots show relationship between patient body weight (BW) (kg) as well as BMI (kg/m2) and ME of MCA (HU) for the three controls (A, C) and for the three groups (B, D). Lines are regression lines. Spearman's rank correlation coefficients (r) and p-values are provided in the lower right corner.
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pone-0088867-g001: Correlation of body weight/BMI and ME in the MCA.Scatterplots show relationship between patient body weight (BW) (kg) as well as BMI (kg/m2) and ME of MCA (HU) for the three controls (A, C) and for the three groups (B, D). Lines are regression lines. Spearman's rank correlation coefficients (r) and p-values are provided in the lower right corner.

Mentions: Figure 1 presents scatterplots of the relationship between patient body weight as well as BMI and ME in the MCA for the controls and the body weight-tailored groups. For the control groups, Spearman's rank correlation coefficient (r) between body weight and ME of the MCA was r = −0.544 (p = 0.013) for control 1, r = −0.597 (p = 0.005) for control 2, and r = −0.542 (p = 0.014) for control 3, indicating moderate statistically significant inverse correlation in all three controls. Values for the correlation of BMI and ME in the control groups were comparable with r = −0.358 (p = 0.121) for control 1, r = −0.424 (p = 0.062) for control 2, and r = −0.280 (p = 0.232) for control 3. For the body weight-tailored groups, Spearman's rank correlation coefficient (r) between body weight and ME of the MCA was r = −0.310 (p = 0.184) for group 1 (1.5 ml/kg), r = 0.025 (p = 0.917) for group 2 (1.0 ml/kg), and r = 0.142 (p = 0.550) for group 3 (0.5 ml/kg), indicating a weak inverse correlation for group 1 (1.5 ml/kg) and a very weak direct correlation for group 2 (1.0 ml/kg) and group 3 (0.5 ml/kg) with no statistical significance for any of the three groups. Similar values were found for the correlation of BMI and ME in the body weight-tailored groups with r = −0.144 (p = 0.545) for group 1 (1.5 ml/kg), r = 0.153 (p = 0.518) for group 2 (1.0 ml/kg) and r = 0.021 (p = 0.930) for group 3 (0.5 ml/kg).


Patient body weight-tailored contrast medium injection protocol for the craniocervical vessels: a prospective computed tomography study.

Kessler R, Hegenscheid K, Fleck S, Khaw A, Kirsch M, Hosten N, Langner S - PLoS ONE (2014)

Correlation of body weight/BMI and ME in the MCA.Scatterplots show relationship between patient body weight (BW) (kg) as well as BMI (kg/m2) and ME of MCA (HU) for the three controls (A, C) and for the three groups (B, D). Lines are regression lines. Spearman's rank correlation coefficients (r) and p-values are provided in the lower right corner.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928316&req=5

pone-0088867-g001: Correlation of body weight/BMI and ME in the MCA.Scatterplots show relationship between patient body weight (BW) (kg) as well as BMI (kg/m2) and ME of MCA (HU) for the three controls (A, C) and for the three groups (B, D). Lines are regression lines. Spearman's rank correlation coefficients (r) and p-values are provided in the lower right corner.
Mentions: Figure 1 presents scatterplots of the relationship between patient body weight as well as BMI and ME in the MCA for the controls and the body weight-tailored groups. For the control groups, Spearman's rank correlation coefficient (r) between body weight and ME of the MCA was r = −0.544 (p = 0.013) for control 1, r = −0.597 (p = 0.005) for control 2, and r = −0.542 (p = 0.014) for control 3, indicating moderate statistically significant inverse correlation in all three controls. Values for the correlation of BMI and ME in the control groups were comparable with r = −0.358 (p = 0.121) for control 1, r = −0.424 (p = 0.062) for control 2, and r = −0.280 (p = 0.232) for control 3. For the body weight-tailored groups, Spearman's rank correlation coefficient (r) between body weight and ME of the MCA was r = −0.310 (p = 0.184) for group 1 (1.5 ml/kg), r = 0.025 (p = 0.917) for group 2 (1.0 ml/kg), and r = 0.142 (p = 0.550) for group 3 (0.5 ml/kg), indicating a weak inverse correlation for group 1 (1.5 ml/kg) and a very weak direct correlation for group 2 (1.0 ml/kg) and group 3 (0.5 ml/kg) with no statistical significance for any of the three groups. Similar values were found for the correlation of BMI and ME in the body weight-tailored groups with r = −0.144 (p = 0.545) for group 1 (1.5 ml/kg), r = 0.153 (p = 0.518) for group 2 (1.0 ml/kg) and r = 0.021 (p = 0.930) for group 3 (0.5 ml/kg).

Bottom Line: ME, SNR, and CNR were the same for 1.5 ml/kg and 1.0 ml/kg (p≥0.24), and both had higher values compared to 0.5 ml/kg (p≤0.043/p≤0.028).In patients with BMI>25, 1.5 ml/kg and 1.0 ml/kg produced higher ME than standard dose (p<0.001/p = 0.008), but ME in patients with BMI>25 did not differ between group 1 and group 2 (p = 0.673).Craniocervical CTA with a body weight-tailored CM dose of 1.0 ml/kg (270 mg iodine/ml) reduces iodine load in patients weighing <80 kg while producing ME similar to standard dose and improves ME in patients with BMI>25.

View Article: PubMed Central - PubMed

Affiliation: Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.

ABSTRACT

Objectives: To evaluate body weight-tailored contrast medium (CM) administration for computed tomography angiography (CTA) of the craniocervical vessels.

Methods: Institutional review board approval was obtained, and all patients gave written informed consent. Sixty patients were consecutively assigned to one of three dose groups (20 patients per group) with CM doses of Visipaque 270® (iodixanol 270 mg/ml) tailored to body weight at doses of 1.5, 1.0, or 0.5 ml/kg. Region-of-interest (ROI) analysis of maximum enhancement (ME) was conducted, and signal-to-noise-ratios (SNR) and contrast-to-noise-ratios (CNR) were calculated. Retrospective comparison was performed with three matched control groups examined with a standard CM dose (80 ml of Visipaque 270®). Image quality was rated by two neuroradiologists blinded to the CM dose used. Interrater reliability was calculated using kappa statistics.

Results: Body weight/BMI and ME were inversely correlated in the three control groups receiving the standard dose (r = -0.544/-0.597/-0.542/r = -0.358/r = -0.424/r = -0.280). Compared to standard dose, 1.5 ml/kg produced higher ME, SNR, and CNR in the anterior circulation (p≤0.038), 1.0 ml/kg had higher ME in cervical and medium-sized cerebral arteries (p≤0.034), and 0.5 ml/kg had lower ME, SNR and CNR for medium-sized cerebral arteries (p≤0.049). ME, SNR, and CNR were the same for 1.5 ml/kg and 1.0 ml/kg (p≥0.24), and both had higher values compared to 0.5 ml/kg (p≤0.043/p≤0.028). In patients with BMI>25, 1.5 ml/kg and 1.0 ml/kg produced higher ME than standard dose (p<0.001/p = 0.008), but ME in patients with BMI>25 did not differ between group 1 and group 2 (p = 0.673). In patients with BMI≤25, 1.5 ml/kg and 1.0 ml/kg produced ME comparable to standard dose (p = 0.132/p = 0.403). Regardless of patient weight, 0.5 ml/kg yielded lower ME than standard dose (p = 0.019/0.002).

Conclusions: Craniocervical CTA with a body weight-tailored CM dose of 1.0 ml/kg (270 mg iodine/ml) reduces iodine load in patients weighing <80 kg while producing ME similar to standard dose and improves ME in patients with BMI>25.

Show MeSH
Related in: MedlinePlus