Should we dose contrast medium on lean body weight?

VRU 633(6): 719-728

Author

Ryan Appleby
May 29, 2023

Study: The study is a prospective, analytic, cross-section design pilot study that aimed to establish the feasibility of intravenous contrast medium (CM) dosed according to lean body weight (LBW) for abdominal contrast-enhanced computed tomography (CECT) in dogs compared to total body weight (TBW). The hypothesis was that when dosing intravenous CM according to LBW, studies will remain at diagnostic quality, there will be a reduced interindividual contrast enhancement (CE) variability, and there will be less change to heart rate and blood pressure in dogs compared to when administering CM calculated on TBW.

Methods: Twelve dogs had two CECT studies with contrast doses according to TBW and LBW at least 8 weeks apart. Interindividual organ and vessel CE variability, diagnostic quality of the studies, and changes in physiological status were compared between protocols.

Results: The LBW-based protocol provided less variability in the CE of most organs and vessels (except the aorta). When dosed according to LBW, liver enhancement was positively associated with grams of iodine per kg TBW during the portal venous phase. There was no significant difference in physiological parameters after CM administration between dosing protocols.

Conclusion: The conclusion is that a CM dose based on LBW for abdominal CECT lowers interindividual CE variability and is effective at maintaining studies of diagnostic quality.

Transverse abdominal CT images obtained at the level of the celiac artery during the portal venous phase in the study dosed according to A, TBW and B, LBW. This patient was scored as having excellent contrast enhancement in all the assessed organs and vessels by both radiologists in the studies dosed according to TBW and LBW. Collimation thickness: 1.2 mm; interval index: 1.5 mm; pitch: 1.3; tube rotation time: 0.6 s; mA: 55 kVp: 110; soft tissue window width: 350 HU, level: 40 HU

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