Computed Tomography Arteriograms (CTA) Volume Dose Reduction Study
- Conditions
- Aortic and Arterial AnomaliesAortic AneurysmContrast Induced Nephropathy
- Interventions
- Drug: Low Dose Contrast (Omnipaque) 40mLDrug: Low Dose Contrast (Omnipaque) 50 mL
- Registration Number
- NCT02669784
- Lead Sponsor
- Milton S. Hershey Medical Center
- Brief Summary
The purpose of the study is to determine if the dose of contrast (Omnipaque) administered for Computed Tomography Arteriograms (CTA) can be reduced without degradation of image quality. The hypothesis is that there is no difference in image quality using ultra-low dose contrast in CTA exams compared to routine, standard of care dose exams.
- Detailed Description
Any adult patient age 18 and above, scheduled for routine CTA (Computed Tomography Arteriograms) of the chest or chest, abdomen and pelvis meeting inclusion criteria and not meeting any exclusion criteria will be included in the study. The patient will be administered a low dose of intravenous contrast based on the study examination as described below.
CTA of the chest: 40 mL of intravenous contrast (Omnipaque) at a rate of 5mL/sec. A region of interest (ROI) to trigger the scan will be placed in the aortic arch. If scan is performed using high pitch helical mode, the scan delay will be increased by 2 seconds.
CTA of the chest and abdomen or CTA of the chest, abdomen and pelvis: 50 mL of intravenous contrast (Omnipaque) at a rate 5mL/sec. A region of interest (ROI) to trigger the scan will be placed in the aortic arch. If scan is performed using high pitch helical mode, the scan delay will be increased by 2 seconds.
Following the examination, the primary investigator (PI) or team members will evaluate the images obtained with low contrast dose and each patient's prior CTA examination performed with routine contrast dose, 100mL at a rate of 4mL/sec. This will be done by quantitative and qualitative measures. For the quantitative portion, the PI or team members will place regions of interest on predetermined arterial locations to obtain measure the degree of opacification. For qualitative measurement, the images will be presented in a blind fashion to two thoracic trained board certified radiologists and a board certified interventional radiologist to determine the quality of the images based on a Likert numerical scale. Qualitative and quantitative data for the images obtained with low contrast dose and those for the prior CTA examinations performed with routine contrast dose will be compared. This data along with details of the scan protocol (dose, dose rate, scanning parameters etc.) and demographic data (such as sex, age and BMI at the time of examination) will be recorded.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 34
- Any adult patient scheduled for a computed tomographic arteriogram (CTA) of the chest or chest, abdomen and pelvis who had undergone a prior CTA performed with the standard contrast dose (100 mL) at this institution will be included in the study
- The follow-up scan will be routine standard of care, no emergency imaging patient will be approached for this research
- Patients with no prior CTA imaging for comparison
- Any pediatric patient (age <18)
- BMI >40
- Inability to follow instructions
- Allergy to intravenous contrast
- GFR less than 30 mL/min/1.73 m2
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Low Dose Contrast (40mL) Low Dose Contrast (Omnipaque) 40mL CTA of the chest: 40 mL of intravenous contrast at a rate of 5mL/sec. A region of interest (ROI) to trigger the scan will be placed in the aortic arch. If scan is performed using high pitch helical mode, the scan delay will be increased by 2 seconds. The Low Dose scan will then be compared to the standard of care high dose scan of the same area taken at a previous date. Low Dose Contrast (50mL) Low Dose Contrast (Omnipaque) 50 mL CTA of the abdomen OR or CTA of the chest and abdomen or CTA of the abdomen and pelvis or CTA of the chest, abdomen and pelvis: 50 mL of intravenous contrast at a rate 5mL/sec. A region of interest (ROI) to trigger the scan will be placed in the aortic arch. If scan is performed using high pitch helical mode, the scan delay will be increased by 2 seconds. The Low Dose scan will then be compared to the standard of care high dose scan of the same area taken at a previous date.
- Primary Outcome Measures
Name Time Method Ascending Sinotubular Junction Measurement At 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. Measurement was taken at the ascending aorta near the sinotubular junction.
Descending Thoracic Aorta Measurement 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. A measurement was taken from the distal abdominal aorta prior to the bifurcation.
Celiac Measurement 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. A measurement was taken from the proximal abdominal aorta at the level of the celiac axis.
Burfication Measurement 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. A measurement was taken from the distal abdominal aorta prior to the bifurcation.
Left Common Femoral Artery Measurement 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. A measurement was taken from the right common femoral artery.
Right Common Femoral Artery Measurement 30 days Following image acquisition, quantitative analysis was performed by measurement of the attenuation of the contrast bolus by use of Hounsfield Units. A measurement was taken from the right common femoral artery.
CTA Vessel Opacification Grading 1 30 days 5 Point Grading Scale was used to determine CTA Vessel Opacification by a Board Certified Radiologist.
1. Poor opacification with no difference in attenuation of the lumen compared to the wall of the vessel. Non diagnostic.
2. Decreased opacification. Little to no difference in attenuation between the lumen and the wall. Non diagnostic.
3. Moderate opacification of the lumen of the vessel. Diagnostic study.
4. Good opacification of the lumen of the vessel.
5. Excellent opacification of the lumen of the vessel with distinct difference in attenuation of the wall and lumen of the vessel.CTA Vessel Opacification Grading 2 30 days 5 Point Grading Scale was used to determine CTA Vessel Opacification by a second Board Certified Radiologist.
1. Poor opacification with no difference in attenuation of the lumen compared to the wall of the vessel. Non diagnostic.
2. Decreased opacification. Little to no difference in attenuation between the lumen and the wall. Non diagnostic.
3. Moderate opacification of the lumen of the vessel. Diagnostic
4. Good opacification of the lumen of the vessel.
5. Excellent opacification of the lumen of the vessel with distinct difference in attenuation of the wall and lumen of the vessel.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Penn State Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States