Improved Chest CT Diagnostic and Contrast Medium Administration

Study Overview
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Brief Summary
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Investigation of impact of using different CM approaches on contrast enhancement in chest Ct examinations - A prospective study

Detailed Description
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Continuing advances in computed tomography (CT) in the past decades such as short scanning times with multi-detector CT (MDCT) requires contrast medium (CM) administration to be precisely planned to ensure a diagnostically accurate CT scans. To improve the chest CT diagnostic, the contrast enhancement in the thoracic vessels shoulde be increased. The most important patient-related factors affecting the magnitude of vascular and parenchymal contrast enhancement are body weight. Historical practice has been to use a fixed volume of CM independent of body weight. Research has shown a clear relationship between vessel enhancement and patient weight, and that fixed CM volume technique is inappropriate, as smaller patients may receive excessive volume, and larger patients insufficient volume resulting in reduced image quality and poor diagnostic. In addition, excess CM can result in contrast induced adverse effects and nephropathy. To overcome these problems, it is essential to adjust the CM volume to the patient's total body weight and body composition. This adjustment can be done in different ways. The aim of this study is to identify which weight/body tailored CM administration is the best replacement for fixed CM administration in chest CT. The cost and procedure time will also be explored.

Official Title
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Improved Chest CT Diagnostic and Contrast Medium Administration

Conditions
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Pulmonary Disease

Intervention / Treatment
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* Other: Adopted contrast media amount by using different approaches


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing chest CT examination between August 2019 and September 2021 age > 18 years Exclusion Criteria: hemodynamic instability cardiac failure pacemaker renal insufficiency (estimated glomerular filtration rate <30 mL/min/1.73 m2) contraindications to contrast enhanced CT age < 18 years

Ages Eligible for Study
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Minimum Age: 19 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Two groups receiving contrast medium based on different approaches are included and compared with each other
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Fixed group<br>They received a fixed amount of contrast media prior to CT scan | Other: Adopted contrast media amount by using different approaches<br>* Using different contrast media approaches recommended by literature to explore the impact on the contrast enhancement in chest CT<br>|
| Active Comparator: body composition tailored group<br>They received a body tailored amount of contrast media prior to CT scan | Other: Adopted contrast media amount by using different approaches<br>* Using different contrast media approaches recommended by literature to explore the impact on the contrast enhancement in chest CT<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Contrast medium protocols in routine chest CT - A survey study | survey of what kind of contrast medium approaches are used in European hospitals | 15 months |