title: Contrast Media Administration in Coronary Computed Tomography Angiography - A Systematic Review.
abstract: BackgroundVarious different injection parameters influence enhancement of the coronary arteries. There is no consensus in the literature regarding the optimal contrast media (CM) injection protocol. The aim of this study is to provide an update on the effect of different CM injection parameters on the coronary attenuation in coronary computed tomographic angiography (CCTA).MethodStudies published between January 2001 and May 2014 identified by Pubmed, Embase and MEDLINE were evaluated. Using predefined inclusion criteria and a data extraction form, the content of each eligible study was assessed. Initially, 2551 potential studies were identified. After applying our criteria, 36 studies were found to be eligible. Studies were systematically assessed for quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-II checklist.ResultsExtracted data proved to be heterogeneous and often incomplete. The injection protocol and outcome of the included publications were very diverse and results are difficult to compare. Based on the extracted data, it remains unclear which of the injection parameters is the most important determinant for adequate attenuation. It is likely that one parameter which combines multiple parameters (e. g. IDR) will be the most suitable determinant of coronary attenuation in CCTA protocols.ConclusionResearch should be directed towards determining the influence of different injection parameters and defining individualized optimal IDRs tailored to patient-related factors (ideally in large randomized trials).Key points· This systematic review provides insight into decisive factors on coronary attenuation.. · Different and contradicting outcomes are reported on coronary attenuation in CCTA.. · One parameter combining multiple parameters (IDR) is likely decisive in coronary attenuation.. · Research should aim at defining individualized optimal IDRs tailored to individual factors.. · Future directions should be tailored towards the influence of different injection parameters..Citation Format· Mihl C, Maas M, Turek J et al. Contrast Media Administration in Coronary Computed Tomography Angiography - A Systematic Review. Fortschr Röntgenstr 2017; 189: 312 - 325.
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Casper
authors.initials: C
authors.lastname: Mihl
authors.affiliation: Radiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: Maas
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Jakub
authors.initials: J
authors.lastname: Turek
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Anna
authors.initials: A
authors.lastname: Seehofnerova
authors.affiliation: Radiation Oncology (MAASTRO), GROW school for Oncology and Developmental Biology, Maastricht, Netherlands.
authors.forename: Ralph T H
authors.initials: RT
authors.lastname: Leijenaar
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Kok
authors.affiliation: Radiology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Marc B I
authors.initials: MB
authors.lastname: Lobbes
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Maastricht University Medical Center, Maastricht University CARIM School for Cardiovascular Diseases, Maastricht, Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
mesh_terms: D000072226:Computed Tomography Angiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D019317:Evidence-Based Medicine; D006801:Humans; D007269:Injections, Intra-Arterial / Q000401:mortality*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media