title: Shaped-bolus protocol reduces contrast medium volume in abdominal CT while maintaining image quality.
abstract: OBJECTIVE
  To prospectively assess whether bolus shaping to exponentially decrease the contrast medium injection rate leads to alteration in image validity or renal function.
  
  
  METHODS
  In this prospective study, patients alternatively received 100 ml contrast medium versus 75 ml via bolus shaping. Image quality was assessed via measurement of attenuation values in the aorta, liver, and spleen and also blinded subjective assessment of image sharpness, low contrast detectability, image noise, and overall quality. Renal function was assessed by change in creatinine levels up to 72 hours post-contrast medium administration.
  
  
  RESULTS
  Of 190 abdominal computed tomography (CT) studies performed in the 3-month period, 98 received the 75 ml dose. There was no significant difference in renal function or objective image quality with a significant improvement in image sharpness in the 100 ml group.
  
  
  CONCLUSIONS
  By using bolus-shaping software, it is possible to maintain objective image quality while reducing the contrast medium load to the patient. This has significant implications regarding clinical practice in decreasing cost and risks associated with iodinated contrast media.
authors.affiliation: Department of Radiology, Mayo General Hospital, Castlebar, County Mayo, Ireland. Electronic address: paddynavin@yahoo.co.uk.
authors.forename: P
authors.initials: P
authors.lastname: Navin
authors.affiliation: Department of Radiology, Mayo General Hospital, Castlebar, County Mayo, Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: Murray
authors.affiliation: Department of Radiology, Mayo General Hospital, Castlebar, County Mayo, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: Nandikumar
authors.affiliation: Department of General Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Waldron
authors.affiliation: Department of Physics, Saolta University Healthcare Group, Galway, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Tuohy
authors.affiliation: Department of Radiology, Mayo General Hospital, Castlebar, County Mayo, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Casey
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000517:prevention & control; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003198:Computer Simulation; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D008954:Models, Biological; D015588:Observer Variation; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis* / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods; D011856:Radiographic Image Enhancement / Q000379:methods; D011860:Radiography, Abdominal / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007455:Iodine