Key result
Intra-arterial contrast reaches peak aortic attenuation ~65% faster than intravenous delivery using less volume.
Why the study?
Intraoperative CT imaging with endovascular intra-arterial contrast may provide higher attenuation with lower contrast volumes than intravenous administration, but comparative data are needed.
Does intra-arterial contrast administration improve organ-specific CT abdominal imaging attenuation compared to intravenous administration in a swine model?
Does intra-arterial contrast administration improve organ-specific CT abdominal imaging attenuation compared to intravenous administration in a swine model?
Absolute Event Rate: 8% vs 23%
p-value: p=<.001
Intra-arterial contrast administration provides superior contrast-to-noise ratio and faster peak attenuation with half the contrast volume compared to intravenous administration in a swine model.
Should not yet change human CT protocols; leaves open translation of intra-arterial contrast for abdominal imaging.
Intraoperative computed tomography (CT) imaging with endovascular delivery of intra-arterial (IA) contrast could potentially provide higher attenuation with lower contrast volumes than intravenous (IV) administration. We aimed to compare IA and IV contrast use for organ-specific CT abdominal imaging. Five anesthetized swine had external jugular and brachial artery access with ascending aortic pigtail placement. An IV protocol was 100 mL at 5 mL/sec over 20 sec vs 50 mL of IA contrast at 5 mL/sec over 10 sec. Region-of-interest markers were applied to anatomical regions to measure attenuation (HU) over time. IA and IV contrast protocols achieved adequate aortic opacification (IA, 455 ± 289 vs IV, 450 ± 114 HU). The IA contrast aortic attenuation curve reached peak attenuation compared with IV contrast (IA, 8 vs 23 sec; P < .001). Time to peak attenuation was similar between IA and IV contrast in the portal vein (IA, 38 vs IV, 42 sec, P = .25). IA administration achieved a superior contrast-to-noise ratio (CNR) in less time compared with IV (R 2 = .94; P < .001). IA contrast achieved adequate opacification with less bolus broadening and a superior CNR compared with IV contrast while using a smaller contrast volume for directed organ-directed imaging.
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Treffalls et al. (2023) studied Intraoperative CT imaging (n=5). Intra-arterial (IA) contrast vs. Intravenous (IV) contrast was evaluated on Time to peak aortic attenuation (p=<.001). Intra-arterial contrast administration achieved peak aortic attenuation significantly faster than intravenous contrast (8 vs 23 sec; P<.001) using half the contrast volume.
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