Quantitative prediction of contrast enhancement from test bolus data in cardiac MSCT

The purpose of this study was to evaluate a new algorithm for the prediction of contrast enhancement from test bolus data in cardiac multislice spiral computed tomography (MSCT). An algorithm for the prediction of contrast enhancement using test bolus data was developed. A total of 30 consecutive patients (15 male, 69.5 ± 9.6 years) underwent cardiac MSCT (12 × 0.75 mm, 120 kV, 500 mAs_eff.) with a biphasic contrast material injection protocol. Contrast timing was derived from a standard 20 ml test bolus injection. Based on the test bolus time attenuation curves, expected enhancement values were computed for the ascending and descending aorta and the pulmonary trunk and compared with measured data from the cardiac CT scan. At the level of the test bolus measurement in the ascending aorta, the corresponding attenuation values were 309.4 ± 49.6 Hounsfield Units (HU) for the predicted and 285.6 ± 42.6 HU for the measured attenuation, respectively. The mean deviation between predicted and measured CT values was 32.8 ± 48.2 HU (upper and lower limits of agreement 101.4/−53.8 HU), indicating a slight systematic tendency for overestimation. For 80% of the patients the prediction error was less than 50 HU. Prediction of contrast enhancement in cardiac MSCT from test bolus data is feasible with a relatively small mean deviation; 80% of the predictions were within a range that might be acceptable for routine clinical application.