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Indirect CT venography of the lower extremities: impact of scan delay and patient factors on contrast enhancement and examination quality.

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Title: Indirect CT venography of the lower extremities: impact of scan delay and patient factors on contrast enhancement and examination quality.
Authors: Tran, Thien Trung1,2 t.t.tran@medisin.uio.no, Kristiansen, Cathrine Helgestad2,3, Thomas, Owen4, Roy, Sumit2, Haidl, Felix5, Ashraf, Haseem1,2, Kløw, Nils Einar1,6, Stavem, Knut1,4,7, Lauritzen, Peter M.2,6
Source: European Radiology. Nov2022, Vol. 32 Issue 11, p7946-7955. 10p. 1 Diagram, 3 Charts, 3 Graphs.
Subjects: Venography, Thrombophlebitis, Systolic blood pressure, Heart beat, Cardiac output
Abstract: Objectives: Indirect computed tomography venography (CTV) is often the next imaging modality for deep vein thrombosis (DVT) when sonography is inconclusive. Our aim was to investigate the impact of scan delay and patient factors on contrast enhancement (CE) and examination quality in CTV. Methods: Patients with clinical suspicion or clinical mimics of DVT in one large hospital were enrolled. Age, sex, body weight, height, heart rate, systolic blood pressure and cardiac output were registered. CTV of the popliteal veins was obtained at 30 s intervals at 30–210 s delays. The proportions of examinations with CE exceeding predefined cut-offs were estimated and subjective examination quality was rated. Changes in CE with time, and associations between patient factors and time to peak contrast enhancement (TPCE) were modelled with mixed effects non-linear and linear regression, respectively. Results: The CE increased with increasing scan delay and reached a plateau from 120 to 210 s. The percentages of examinations achieving enhancement above cut-offs across all thresholds from 70 to 100 HU were higher at 120 s compared to 90 s (p < 0.001). After 120 s, there were no differences across scan delays for any thresholds. No patient factors showed a significant effect on TPCE. The percentage of examinations rated as acceptable was higher at 120 s compared to 90 s (p < 0.001). After 120 s, there were no statistically significant differences across scan delays. Conclusions: No patient factors were associated with TPCE in CTV. A fixed scan delay of 120–210 s yielded the best examination quality. Key Points: • Contrast enhancement reached a plateau at scan delay between 90 and 120 s. • A scan delay of 120–210 s yielded the best examination quality. • No patient factors were associated with time to peak contrast enhancement. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Indirect CT venography of the lower extremities: impact of scan delay and patient factors on contrast enhancement and examination quality.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Tran%2C+Thien+Trung%22&quot;&gt;Tran, Thien Trung&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;i&gt; t.t.tran@medisin.uio.no&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kristiansen%2C+Cathrine+Helgestad%22&quot;&gt;Kristiansen, Cathrine Helgestad&lt;/searchLink&gt;&lt;relatesTo&gt;2,3&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Thomas%2C+Owen%22&quot;&gt;Thomas, Owen&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Roy%2C+Sumit%22&quot;&gt;Roy, Sumit&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Haidl%2C+Felix%22&quot;&gt;Haidl, Felix&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ashraf%2C+Haseem%22&quot;&gt;Ashraf, Haseem&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kl&#248;w%2C+Nils+Einar%22&quot;&gt;Kl&#248;w, Nils Einar&lt;/searchLink&gt;&lt;relatesTo&gt;1,6&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Stavem%2C+Knut%22&quot;&gt;Stavem, Knut&lt;/searchLink&gt;&lt;relatesTo&gt;1,4,7&lt;/relatesTo&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lauritzen%2C+Peter+M%2E%22&quot;&gt;Lauritzen, Peter M.&lt;/searchLink&gt;&lt;relatesTo&gt;2,6&lt;/relatesTo&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Nov2022, Vol. 32 Issue 11, p7946-7955. 10p. 1 Diagram, 3 Charts, 3 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Venography%22&quot;&gt;Venography&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Thrombophlebitis%22&quot;&gt;Thrombophlebitis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Systolic+blood+pressure%22&quot;&gt;Systolic blood pressure&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Heart+beat%22&quot;&gt;Heart beat&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cardiac+output%22&quot;&gt;Cardiac output&lt;/searchLink&gt;
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  Data: Objectives: Indirect computed tomography venography (CTV) is often the next imaging modality for deep vein thrombosis (DVT) when sonography is inconclusive. Our aim was to investigate the impact of scan delay and patient factors on contrast enhancement (CE) and examination quality in CTV. Methods: Patients with clinical suspicion or clinical mimics of DVT in one large hospital were enrolled. Age, sex, body weight, height, heart rate, systolic blood pressure and cardiac output were registered. CTV of the popliteal veins was obtained at 30 s intervals at 30–210 s delays. The proportions of examinations with CE exceeding predefined cut-offs were estimated and subjective examination quality was rated. Changes in CE with time, and associations between patient factors and time to peak contrast enhancement (TPCE) were modelled with mixed effects non-linear and linear regression, respectively. Results: The CE increased with increasing scan delay and reached a plateau from 120 to 210 s. The percentages of examinations achieving enhancement above cut-offs across all thresholds from 70 to 100 HU were higher at 120 s compared to 90 s (p &lt; 0.001). After 120 s, there were no differences across scan delays for any thresholds. No patient factors showed a significant effect on TPCE. The percentage of examinations rated as acceptable was higher at 120 s compared to 90 s (p &lt; 0.001). After 120 s, there were no statistically significant differences across scan delays. Conclusions: No patient factors were associated with TPCE in CTV. A fixed scan delay of 120–210 s yielded the best examination quality. Key Points: • Contrast enhancement reached a plateau at scan delay between 90 and 120 s. • A scan delay of 120–210 s yielded the best examination quality. • No patient factors were associated with time to peak contrast enhancement. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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