Strategies to Reduce Contrast Medium in Spectral CT Pulmonary Angiography
- Conditions
- Pulmonary Embolism
- Interventions
- Diagnostic Test: Low iodine Spectral Detector CT Pulmonary Angiography
- Registration Number
- NCT05592444
- Lead Sponsor
- University Hospital, Akershus
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 330
- 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
- Contraindication to iodinated contrast medium
- Age < 18 years
- Lack of informed consent
- Pregnancy
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Low concentration Low iodine Spectral Detector CT Pulmonary Angiography Patients receive a contrast medium with an iodine concentration of 140 mg/ml. The volume is 1 ml/kg which result in a dose of 140 mg/kg. Maximal dose of contrast medium is 90 ml i.e. 12.6 g of iodine. Saline Dilution Low iodine Spectral Detector CT Pulmonary Angiography Patients receive a contrast medium with an iodine concentration of 350 mg/ml. The contrast medium is diluted 1:1 with saline. The injected volume is 0.8 ml/kg which result in a dose of 140 mg/kg. Maximal dose of contrast medium is 72 ml i.e. 12.6 g of iodine. Low volume Low iodine Spectral Detector CT Pulmonary Angiography Patients receive a contrast medium with an iodine concentration 350 of mg/ml. The volume is 0.4 ml/kg which result in a dose of 140 mg/kg. Maximal dose of contrast medium is 36 ml i.e. 12.6 g of iodine.
- Primary Outcome Measures
Name Time Method Contrast enhancement (Vascular attenuation) Measured on the CT images from the examination performed at enrollment Contrast enhancement measured as attenuation in the pulmonary artery Branches on the acquired CTPA examination
- Secondary Outcome Measures
Name Time Method Contrast to noise ratio (CNR) Measured on the CT images from the examination performed at enrollment CNR is measured as (Vascular attenuation - Muscular attenuation) / Image noise
Homogeneity of contrast enhancement (image noise) Measured on the CT images from the examination performed at enrollment Homogeneity of contrast enhancement is measured as the standard deviation of attenuation in the pulmonary artery branches (equals image noise).
Signal to noise ratio (SNR) Measured on the CT images from the examination performed at enrollment SNR is measured as Vascular attenuation / Image noise
Trial Locations
- Locations (1)
Akershus University Hospital
🇳🇴Lørenskog, Viken, Norway