Using patient-specific contrast enhancement optimizer simulation software during the transcatheter aortic valve implantation-computed tomography angiography in patients with aortic stenosis

Abstract

Abstract Purpose: This study assessed whether patient-specific contrast enhancement optimizer simulation software (p-COP) can reduce the contrast material (CM) dose compared with the conventional body weight (BW)-tailored scan protocol during transcatheter aortic valve implantation-computed tomography angiography (TAVI-CTA) in patients with aortic stenosis. Methods: We used the CM injection protocol selected by the p-COP in group A (n = 30). The p-COP uses an algorithm that includes data on an individual patient’s cardiac output. Group B (n = 30) was assigned the conventional BW-tailored CM injection protocol. We compared CM dose, amount of CM, injection rates, and computed tomography (CT) value in the abdominal aorta between the two groups and classified them as acceptable (>280 Hounsfield units (HU)) or unacceptable (<279 HU) based on the optimal CT value for TAVI-CTA. Results: Group A received 56.2 ml CM and 2.6 ml/sec of injection, and group B received 76.9 ml CM and 3.4 ml/sec of injection (p < 0.01). The CT value for the abdominal aorta at the celiac level was 287.0 HU in group A and 301.7HU in group B (p = 0.46). The rate of CT value for acceptable (280 HU or more) and unacceptable (less than 280 HU) were 22 and 8 patients in group A, and 24 and 6 patients in group B, respectively (p = 0.76). Conclusion: The p-COP reduced the CM dosage, and the injection rate was approximately 30% in patients with aortic stenosis compared with the BW-tailored scan protocol during TAVI-CTA.