Contrast protocols based on lean body weight save supplies, reduce patient risk
Adjusting contrast dose based on a patient’s lean body weight provides the same image quality as other administration methods while also sparing supplies.
Compared to doses based on total body weight (TBW), lean body weight (LBW) protocols could save an average of 7.29 ml per patient, according to new data published in the European Journal of Radiology.
“Administration of CM based on total body weight may lead to overdosing in overweight patients, as an amount of CM does not contribute to tissue contrast enhancement,” corresponding author Marianna Gulizia, from the department of radiology and interventional radiology at Lausanne University Hospital in Switzerland, and colleagues explained. “This excess of CM injected leads to an increased risk of renal toxicity and unnecessary expense.”
Researchers conducted a meta-analysis on different contrast administration protocols to determine whether there was a superior method for achieving diagnostic quality while also preserving supplies. They compared methods that utilized LBW, TBW, fixed volume, body surface area and blood volume for abdominopelvic exams specifically. Liver and aortic enhancement were used as metrics of image quality.
A total of eight studies consisting of more than 2,000 articles were included. None of those studies indicated significant differences in liver parenchyma and aorta contrast enhancement between protocols using TBW or LBW. However, they did highlight significant differences in contrast volume utilization.
“This reduction in volume across all yearly examinations could potentially lead to enhanced patient safety against nephropathy induced by contrast media,” the group noted. “Furthermore, the reduction of contrast volume could have a positive environmental impact by decreasing the burden associated with the production and disposal of iodine-based contrast agents.”
What’s more, the reduction in contrast volume per exam could also result in substantial savings in supplies. The contrast shortage of 2022 served as a difficult lesson on the need to optimize its use and preserve supplies when feasible. Since then, many organizations have reevaluated their contrast protocols, several of them reporting on substantial savings that incurred as a result.
While the study’s findings indicate feasibility with LBW contrast protocols, the authors acknowledge that additional factors, such as advancing technologies in spectral imaging and AI, for example, were not considered in their work. They suggested that more research incorporating these factors is needed to understand the applicability of their findings.
The study abstract can be found here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.