Individualized Delay for Abdominal Computed Tomography Angiography Bolus-Tracking Based on Sequential Monitoring: Increased Aortic Contrast Permits Decreased Injection Rate and Lower Iodine Dose

Ralf Gutjahr, Joel G. Fletcher, Yong S. Lee, Ahmed F. Halaweish, Vighnesh Suresh, Nikkole M. Weber, Terri J. Vrtiska, Eric E. Williamson, Bernhard Schmidt, Cynthia H. McCollough

Research output: Contribution to journalArticle


Objective: The aim of this study was to determine if computed tomography (CT) angiography using an individualized transition delay (CTA-ID) would facilitate reductions in injection rate and iodine dose. Methods: The CTA-ID was performed in 20 patients with routine injection rate and iodine dose; 20 patients with injection rate lowered by 1 mL/s; and 40 patients with injection rate lowered by 1 mL/s with 29% less iodine. Routine CTAs in the same or size-matched patients served as controls. Diagnostic image quality and intra-arterial CT numbers were assessed. Results: The median transition delay between aortic threshold and CTA-ID image acquisition was significantly longer than with conventional bolus tracking (mean increase, 13.3 seconds; P < 0.0001), with image quality being the same or better. Intra-arterial CT numbers were 200 Hounsfield units or greater for 80 of 80 CTA-ID, but not for 6 of 49 (12%) internal control or for 11 of 80 (14%) size-matched control patients. Conclusion: The CTA-ID bolus-tracking software alters transition delays to permit diagnostic CTA examinations despite slower injection rate and less iodine.

Original languageEnglish (US)
Pages (from-to)612-618
Number of pages7
JournalJournal of computer assisted tomography
Issue number4
StatePublished - Jul 1 2019



  • computed tomography angiography
  • iodinated contrast
  • population biological variation
  • x-ray computed tomography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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