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Contrast volume in pediatric patients

ANNELIES RAPPAPORT

Does contrast volume for children reduces on PCCT versus normal CT?

On CT Siemens Edge I used these parameters:

1.4 mL/kg for children weighing 3–5 kg
1.2 mL/kg for 5–10 kg
1.1 mL/kg for 10–20 kg
1.0 mL/kg for 20–30 kg
0.9 mL/kg for 30–50 kg

Can I use these on new Alpha Prime CT or do I have to adjust contrast volume?

Protocols

Pediatric

Comments

Abby Morris

Hey! I'm at a pediatric facility and we're currently working to reduce our contrast dose after getting the alpha. You're a bit ahead of us because right now we use 2mL/kg for all weight ranges and we're trying to cut down from that. We've had success without any impact on image quality going at 1.4 for the kids under around 30kg and 1 mL/kg for the kids over 50kg. For our soft tissue imaging, we recon at 60kev and have not had to adjust that yet. I'm interested to know what you find, but your original doses should be just fine for the alpha and you might be able to cut down from there.

ANNELIES RAPPAPORT

Thanks for the information!! We don't have a large pediatric workflow; so will try to adjust wherever necessary!!

Marcel Dijkshoorn

@ANNELIES RAPPAPORT & @Abby Morris

I would say that in general you do not need to go above 1ml/ml for single bolus venous parenchyma injections.

Lower is certainly possible but you may run into problems in some protocols. Then we should also be more specific and discuss media concentration and further scan protocol parameters like scanmode and split bolus variants.

For instance compare 3 acquisitions:

70kV Quantum will give you T3D (53 keV) image output
120kV QuantumPlus 0.4 will give you 55-60 keV depending on tissue of interest setting.
120kV Dual source UHR 0.2 acquisition will give T3D (67 keV) image output.

If you give them all the same iodine load then you will get much lower iodine HU on the 3rd option.

So if you want to have a ''one value fits-all'' protocol you need an iodine load sufficient for 67 keV. However, most protocols are performed with option 1 or 2, so there is room for further specification.

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