{"title":"The impact of body compositions on contrast medium enhancement in chest CT: a randomised controlled trial.","authors":"Mette Karen Henning, Trond Mogens Aaløkken, Anne Catrine Martinsen, Safora Johansen","doi":"10.1259/bjro.20230054","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare a fixed-volume contrast medium (CM) protocol with a combined total body weight (TBW) and body composition-tailored protocol in chest CT.</p><p><strong>Methods and materials: </strong>Patients referred for routine contrast enhanced chest CT were prospectively categorised as normal, muscular or overweight. Patients were accordingly randomised into two groups; Group 1 received a fixed CM protocol. Group 2 received CM volume according to a body composition-tailored protocol. Objective image quality comparisons between protocols and body compositions were performed. Differences between groups and correlation were analysed using <i>t</i>-test and Pearson's <i>r</i>.</p><p><strong>Results: </strong>A total of 179 patients were included: 87 in Group 1 (mean age, 51 ± 17 years); and 92 in Group 2 (mean age, 52 ± 17 years). Compared to Group 2, Group 1 showed lower vascular attenuation in muscular (mean 346 Hounsfield unit (HU) <i>vs</i> 396 HU; <i>p</i> = 0.004) and overweight categories (mean 342 HU <i>vs</i> 367 HU; <i>p</i> = 0.12), while normal category patients showed increased attenuation (385 <i>vs</i> 367; <i>p</i> = 0.61). In Group 1, strongest correlation was found between attenuation and TBW in muscular (<i>r</i> = -.49, <i>p</i> = 0.009) and waist circumference in overweight patients (<i>r</i> = -.50, <i>p</i> = 0.005). In Group 2, no significant correlations were found for the same body size parameters. In Group 1, 13% of the overweight patients was below 250 HU (<i>p</i> = 0.053).</p><p><strong>Conclusion: </strong>A combined TBW and body composition-tailored CM protocol in chest CT resulted in more homogenous enhancement and fewer outliers compared to a fixed-volume protocol.</p><p><strong>Advances in knowledge: </strong>This is, to our knowledge, the first study to investigate the impact of various body compositions on contrast medium enhancement in chest CT.</p>","PeriodicalId":72419,"journal":{"name":"BJR open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630975/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BJR open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1259/bjro.20230054","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To compare a fixed-volume contrast medium (CM) protocol with a combined total body weight (TBW) and body composition-tailored protocol in chest CT.
Methods and materials: Patients referred for routine contrast enhanced chest CT were prospectively categorised as normal, muscular or overweight. Patients were accordingly randomised into two groups; Group 1 received a fixed CM protocol. Group 2 received CM volume according to a body composition-tailored protocol. Objective image quality comparisons between protocols and body compositions were performed. Differences between groups and correlation were analysed using t-test and Pearson's r.
Results: A total of 179 patients were included: 87 in Group 1 (mean age, 51 ± 17 years); and 92 in Group 2 (mean age, 52 ± 17 years). Compared to Group 2, Group 1 showed lower vascular attenuation in muscular (mean 346 Hounsfield unit (HU) vs 396 HU; p = 0.004) and overweight categories (mean 342 HU vs 367 HU; p = 0.12), while normal category patients showed increased attenuation (385 vs 367; p = 0.61). In Group 1, strongest correlation was found between attenuation and TBW in muscular (r = -.49, p = 0.009) and waist circumference in overweight patients (r = -.50, p = 0.005). In Group 2, no significant correlations were found for the same body size parameters. In Group 1, 13% of the overweight patients was below 250 HU (p = 0.053).
Conclusion: A combined TBW and body composition-tailored CM protocol in chest CT resulted in more homogenous enhancement and fewer outliers compared to a fixed-volume protocol.
Advances in knowledge: This is, to our knowledge, the first study to investigate the impact of various body compositions on contrast medium enhancement in chest CT.
目的：比较胸部CT中固定体积造影剂（CM）方案与综合总体重（TBW）和身体成分定制方案。方法和材料：常规胸部CT增强扫描的患者前瞻性地分为正常、肌肉发达或超重。患者被随机分为两组；第1组收到一个固定的CM协议。第2组根据身体成分定制方案接受CM体积。对方案和身体成分之间的图像质量进行了客观比较。使用t检验和Pearson’s r分析各组之间的差异和相关性。结果：共有179名患者被纳入：第1组87名（平均年龄51±17岁）；第2组92例（平均年龄52±17岁）。与第2组相比，第1组的肌肉血管衰减较低（平均346 Hounsfield单位（HU）vs 396 HU；p=0.004）和超重类别（平均342 HU vs 367 HU；p=0.012），而正常类别患者的衰减增加（385 vs 367；p=0.061）。在第1组中，肌肉衰减与TBW（r=-0.49，p=0.009）和超重患者的腰围（r=-0.50，p=0.005）之间的相关性最强。在第2组中，对于相同的体型参数，没有发现显著的相关性。在第1组中，13%的超重患者低于250HU（p=0.053）。结论：与固定体积方案相比，TBW和身体成分定制的CM方案在胸部CT中产生了更均匀的增强和更少的异常值。知识进步：据我们所知，这是第一项研究各种身体成分对胸部CT造影剂增强的影响的研究。
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