Computed Tomography Pulmonary Angiography and Venography with a Low Dose of Contrast Medium

Overview

Journal Radiol Phys Technol

Specialties Biophysics
Biotechnology
Radiology

Date 2018 Dec 12

PMID 30536083

Authors

Jun Nakane

Norinari Honda

Kazuhiro Tsuchiya

Affiliations

Soon will be listed here.

Abstract

The authors developed a method to ensure sufficient opacification of pulmonary vasculature for separate depiction of arteries and veins in three-dimensional form with a small dose of contrast medium utilizing a test injection to determine optimal timing of computed tomography (CT) scanning. The dose was determined by a simulation based on a pharmacokinetic model. The contrast medium was administered at a rate of 5.0 mL/s for 3 s, followed by helical scanning at the timing determined by a dynamic CT scanning following the test injection. Images of 20 consecutive patients acquired with a 64-row CT scanner were evaluated. Quality of vessel depiction was assessed on the basis of the following: HU values at the main pulmonary artery (MPA) and left atrium (LA), distance between the pleural surface and the distal end of the pulmonary vessels on three-dimensional CT pulmonary arteriography and venography (3D-CTPAV), and subjective visual assessment of quality of the 3D-CTPAV images. Time to generate the 3D-CTPAV images was recorded. The mean ± standard deviation (SD) of the HU values at MPA/LA and the distances to the pleural surface for pulmonary arteries/veins were 448.0 ± 123.1/277.3 ± 60.85 HU and 9.21 ± 3.60/10.7 ± 5.45 mm, respectively. The image quality was visually rated as excellent for all of the patients. The mean time ± SD to generate 3D-CTPAV images was 13.6 ± 6.7 min. In conclusion, three-dimensional images of the pulmonary vasculature can be created using 21 mL (including 6 mL for the test injection) of contrast medium.

References

Watanabe S, Arai K, Watanabe T, Koda W, Urayama H . Use of three-dimensional computed tomographic angiography of pulmonary vessels for lung resections. Ann Thorac Surg. 2003; 75(2):388-92; discussion 392. DOI: 10.1016/s0003-4975(02)04375-8. View

Masin-Spasovska J, Spasovski G, Dzikova S, Grcevska L, Petrusevska G, Lekovski L . Protocol biopsies in kidney transplant recipients: histologic findings as prognostic markers for graft function and outcome. Transplant Proc. 2005; 37(2):705-8. DOI: 10.1016/j.transproceed.2004.11.032. View

McKenna Jr R, Houck W, Fuller C . Video-assisted thoracic surgery lobectomy: experience with 1,100 cases. Ann Thorac Surg. 2006; 81(2):421-5. DOI: 10.1016/j.athoracsur.2005.07.078. View

Akiba T, Marushima H, Harada J, Kobayashi S, Morikawa T . Anomalous pulmonary vein detected using three-dimensional computed tomography in a patient with lung cancer undergoing thoracoscopic lobectomy. Gen Thorac Cardiovasc Surg. 2008; 56(8):413-6. DOI: 10.1007/s11748-008-0258-3. View

Fukuhara K, Akashi A, Nakane S, Tomita E . Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy. Eur J Cardiothorac Surg. 2008; 34(4):875-7. DOI: 10.1016/j.ejcts.2008.07.014. View

Vercellino M, Bezante G, Balbi M . Contrast medium induced nephropathy: new insights into prevention and risk management. Cardiovasc Hematol Agents Med Chem. 2009; 7(2):166-80. DOI: 10.2174/187152509787847083. View

Bae K . Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology. 2010; 256(1):32-61. DOI: 10.1148/radiol.10090908. View

Yamaguchi I, Kidoya E, Suzuki M, Kimura H . Optimizing scan timing of hepatic arterial phase by physiologic pharmacokinetic analysis in bolus-tracking technique by multi-detector row computed tomography. Radiol Phys Technol. 2010; 4(1):43-52. DOI: 10.1007/s12194-010-0105-y. View

Faggioni L, Neri E, Sbragia P, Pascale R, dErrico L, Caramella D . 80-kV pulmonary CT angiography with 40 mL of iodinated contrast material in lean patients: comparison of vascular enhancement with iodixanol (320 mg I/mL)and iomeprol (400 mg I/mL). AJR Am J Roentgenol. 2012; 199(6):1220-5. DOI: 10.2214/AJR.11.8122. View

10.

Lee S, Lee H, Kim J, Kang M, Goo J, Park C . Adaptive 4D volume perfusion CT of lung cancer: effects of computerized motion correction and the range of volume coverage on measurement reproducibility. AJR Am J Roentgenol. 2013; 200(6):W603-9. DOI: 10.2214/AJR.12.9458. View

11.

Tane S, Ohno Y, Hokka D, Ogawa H, Tauchi S, Nishio W . The efficacy of 320-detector row computed tomography for the assessment of preoperative pulmonary vasculature of candidates for pulmonary segmentectomy. Interact Cardiovasc Thorac Surg. 2013; 17(6):974-80. PMC: 3829506. DOI: 10.1093/icvts/ivt391. View

12.

Kawaguchi N, Kurata A, Kido T, Nishiyama Y, Kido T, Miyagawa M . Optimization of coronary attenuation in coronary computed tomography angiography using diluted contrast material. Circ J. 2013; 78(3):662-70. DOI: 10.1253/circj.cj-13-1101. View

13.

Ohtaki Y, Shimizu K . Anatomical thoracoscopic segmentectomy for lung cancer. Gen Thorac Cardiovasc Surg. 2014; 62(10):586-93. DOI: 10.1007/s11748-014-0409-7. View

14.

Lu G, Luo S, Meinel F, McQuiston A, Zhou C, Kong X . High-pitch computed tomography pulmonary angiography with iterative reconstruction at 80 kVp and 20 mL contrast agent volume. Eur Radiol. 2014; 24(12):3260-8. DOI: 10.1007/s00330-014-3365-9. View

15.

Hinrichs J, von Falck C, Hoeper M, Olsson K, Wacker F, Meyer B . Pulmonary Artery Imaging in Patients with Chronic Thromboembolic Pulmonary Hypertension: Comparison of Cone-Beam CT and 64-Row Multidetector CT. J Vasc Interv Radiol. 2016; 27(3):361-8.e2. DOI: 10.1016/j.jvir.2015.11.046. View

16.

Raczeck P, Minko P, Graeber S, Fries P, Seidel R, Buecker A . Influence of Respiratory Position on Contrast Attenuation in Pulmonary CT Angiography: A Prospective Randomized Clinical Trial. AJR Am J Roentgenol. 2016; 206(3):481-6. DOI: 10.2214/AJR.15.15176. View

17.

Chen-Yoshikawa T, Date H . Update on three-dimensional image reconstruction for preoperative simulation in thoracic surgery. J Thorac Dis. 2016; 8(Suppl 3):S295-301. PMC: 4783726. DOI: 10.3978/j.issn.2072-1439.2016.02.39. View

18.

Caruso D, Eid M, Schoepf U, De Santis D, Varga-Szemes A, Mangold S . Optimizing Contrast Media Injection Protocols in Computed Tomography Angiography at Different Tube Voltages: Evaluation in a Circulation Phantom. J Comput Assist Tomogr. 2017; 41(5):804-810. DOI: 10.1097/RCT.0000000000000613. View

19.

Fourdrain A, de Dominicis F, Blanchard C, Iquille J, Lafitte S, Beuvry P . Three-dimensional CT angiography of anatomic variations in the pulmonary arterial tree. Surg Radiol Anat. 2017; 40(1):45-53. DOI: 10.1007/s00276-017-1914-z. View

20.

Bae K, Heiken J, Brink J . Aortic and hepatic contrast medium enhancement at CT. Part I. Prediction with a computer model. Radiology. 1998; 207(3):647-55. DOI: 10.1148/radiology.207.3.9609886. View