Reduced Contrast Volume and Radiation Dose During Computed Tomography of the Pancreas: Timing-Specific Contrast Media Protocol

Rationale and Objective To investigate the opacification of the pancreatic vasculature and parenchyma during computed tomography utilizing a patient-specific contrast formula. Materials and Methods This hybrid prospective and retrospective study was approved by the institution review board. In 220 consecutive patients, pancreatic CT was performed with one of two protocols: protocol A, 100 mL of contrast material injected via timed bolus triggering technique; or protocol B, employing a patient-specific contrast media protocol specifically timed at the gastroduodenal artery; both protocols employed 4.5 mL/s contrast media and 100 mL saline chaser. Attenuation of pancreatic parenchymal, arterial, and venous vasculature supplying the pancreas was measured. Effective dose was calculated. Data were compared to the independent two-sample t test. Receiver operating characteristic, visual grading characteristic, and Cohens’ kappa analyses were performed. Results Mean pancreatic density measurements in each of the pancreatic segments during the arterial and venous phase were significantly higher in Protocol B (mean ± standard deviation, art: 96.59 HU ± 27.37; venous: 91.28 HU ± 20.88) compared to A (art: 77.86 HU ± 21.14; venous: 73.99 HU ± 14.75) ( p p p p p p p p p p Conclusion Timing-specific contrast media protocol enhances image quality at reduced contrast volume and radiation dose during computed tomography of the pancreas.