Objectives: Iodinated contrast media (ICM) could be more appropriately dosed on patient lean body weight (LBW) than on total body weight (TBW). Methods: After Ethics Committee approval, trial registration NCT03384979, patients aged ≥ 18 years scheduled for multiphasic abdominal CT were randomised for ICM dose to LBW group (0.63 gI/kg of LBW) or TBW group (0.44 gI/kg of TBW). Abdominal 64-row CT was performed using 120 kVp, 100-200 mAs, rotation time 0.5 s, pitch 1, Iopamidol (370 mgI/mL), and flow rate 3 mL/s. Levene, Mann-Whitney U, and χ2 tests were used. The primary endpoint was liver contrast enhancement (LCE). Results: Of 335 enrolled patients, 17 were screening failures; 44 dropped out after randomisation; 274 patients were analysed (133 LBW group, 141 TBW group). The median age of LBW group (66 years) was slightly lower than that of TBW group (70 years). Although the median ICM-injected volume was comparable between groups, its variability was larger in the former (interquartile range 27 mL versus 21 mL, p = 0.01). The same was for unenhanced liver density (IQR 10 versus 7 HU) (p = 0.02). Median LCE was 40 (35-46) HU in the LBW group and 40 (35-44) HU in the TBW group, without significant difference for median (p = 0.41) and variability (p = 0.23). Suboptimal LCE (< 40 HU) was found in 64/133 (48%) patients in the LBW group and 69/141 (49%) in the TBW group, but no examination needed repeating. Conclusions: The calculation of the ICM volume to be administered for abdominal CT based on the LBW does not imply a more consistent LCE.

Lean body weight versus total body weight to calculate the iodinated contrast media volume in abdominal CT : a randomised controlled trial / M. Zanardo, F.M. Doniselli, A. Esseridou, M. Agrò, N.A.R. Panarisi, C.B. Monti, G. Di Leo, F. Sardanelli. - In: INSIGHTS INTO IMAGING. - ISSN 1869-4101. - 11:1(2020 Dec 09), pp. 132.1-132.8. [10.1186/s13244-020-00920-4]

Lean body weight versus total body weight to calculate the iodinated contrast media volume in abdominal CT : a randomised controlled trial

Zanardo, Moreno;Doniselli, Fabio Martino;Esseridou, Anastassia;Agrò, Massimiliano;Panarisi, Nicol Antonina Rita;Monti, Caterina Beatrice;Sardanelli, Francesco
2020-12-09

Abstract

Objectives: Iodinated contrast media (ICM) could be more appropriately dosed on patient lean body weight (LBW) than on total body weight (TBW). Methods: After Ethics Committee approval, trial registration NCT03384979, patients aged ≥ 18 years scheduled for multiphasic abdominal CT were randomised for ICM dose to LBW group (0.63 gI/kg of LBW) or TBW group (0.44 gI/kg of TBW). Abdominal 64-row CT was performed using 120 kVp, 100-200 mAs, rotation time 0.5 s, pitch 1, Iopamidol (370 mgI/mL), and flow rate 3 mL/s. Levene, Mann-Whitney U, and χ2 tests were used. The primary endpoint was liver contrast enhancement (LCE). Results: Of 335 enrolled patients, 17 were screening failures; 44 dropped out after randomisation; 274 patients were analysed (133 LBW group, 141 TBW group). The median age of LBW group (66 years) was slightly lower than that of TBW group (70 years). Although the median ICM-injected volume was comparable between groups, its variability was larger in the former (interquartile range 27 mL versus 21 mL, p = 0.01). The same was for unenhanced liver density (IQR 10 versus 7 HU) (p = 0.02). Median LCE was 40 (35-46) HU in the LBW group and 40 (35-44) HU in the TBW group, without significant difference for median (p = 0.41) and variability (p = 0.23). Suboptimal LCE (< 40 HU) was found in 64/133 (48%) patients in the LBW group and 69/141 (49%) in the TBW group, but no examination needed repeating. Conclusions: The calculation of the ICM volume to be administered for abdominal CT based on the LBW does not imply a more consistent LCE.
Abdomen; Body composition; Body weight; Contrast media; Tomography (x-ray computed)
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/50 - Scienze Tecniche Mediche Applicate
INSIGHTS INTO IMAGING
Article (author)
File in questo prodotto:
File Dimensione Formato  
Zanardo_et_al-2020-Insights_into_Imaging.pdf

accesso aperto

1.41 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/797743
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact