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2119. Optimization of Contrast Material Administration for Coronary Computed Tomography Angiography Using a Software-based Test-bolus Evaluation
Authors * Denotes Presenting Author
  1. Rock Savage *; Medical University of South Carolina
  2. Andreas Fischer; Medical University of South Carolina
  3. Akos Varga-Szemes; Medical University of South Carolina
  4. Tilman Emrich; Medical University of South Carolina
  5. Richard Bayer; Medical University of South Carolina
  6. Thomas Flohr; Siemens Healthcare
  7. U. Joseph Schoepf; Medical University of South Carolina
Objective:
The aim of this study was to evaluate the performance of software for the individual optimization of contrast material administration and scan delay for coronary computed tomography angiography (CCTA).

Materials and Methods:
This prospective, single-center study was approved by the university institutional review board. Thirty-two patients (mean age: 62.1 ± 16.0 years) with clinically indicated CCTA were examined with a dedicated software to determine the optimal delay time of contrast media administration depending on the individual cardiac output. Contrast attenuation, signal-to-noise (SNR), and contrast-to-noise ratios (CNR) were evaluated in the major coronary arteries, both ventricles, and ascending aorta. Two non-affiliated radiologists independently assessed overall image quality, reader confidence, and image artifacts. Results were compared to a matched control group using test bolus peak attenuation plus 4 seconds as scan delay.

Results:
Mean scan delay was 6.9 seconds (p < 0.001). Contrast attenuation, SNR, and CNR values were significantly different in the right ventricle, pulmonary artery and superior vena cava (p < 0.001, p < 0.001, p < 0.027) whereas attenuation in the coronary arteries, left ventricle, and ascending aorta showed no significant differences (p = 0.138, p = 0.106, p = 0.09). Qualitative image evaluation indicated significantly better results using the test bolus evaluation software (p < 0.001).

Conclusion:
Optimization of contrast material administration and scan delay using dedicated software support may improve quantitative and qualitative image quality for CCTA.