Scholarlink

Background <p>Cardiac computed tomography angiography (CTA) for congenital heart disease (CHD) can be technically challenging, particularly in low-volume centers. Real-time radiologist supervision can strain resources and impact productivity.</p> Objective <p>To evaluate a standardized, delay-corrected test-bolus timing method for cardiac CTA for CHD.</p> Materials and methods <p>We performed a retrospective review of cardiac CTA examinations (November 2020 to August 2022), comparing a delay-corrected test-bolus timing cohort to a manually triggered control cohort (institutional standard protocol during the study period). We measured quantitative enhancement (HU) at six regions of interest and assessed aorto-pulmonary differentiation. Continuous variables were compared using Welch <i>t</i>-tests; non-inferiority was assessed using one-sided 95% confidence intervals (margin -50 HU).</p> Results <p>We analyzed 318 examinations (test-bolus <i>n</i>=98; control <i>n</i>=220). In a pooled non-inferiority analysis (margin -50 HU), the test-bolus method met non-inferiority for absolute aortic enhancement (difference +24.1 HU; one-sided 95% CI lower bound −22.7 HU). For left-sided examinations at 80 kVp, mean aorto-pulmonary separation was greater with test-bolus timing (264.0±225.8 HU) than with manual triggering (40.2±192.3 HU; <i>P</i>&lt;0.001), indicating greater preferential enhancement of the systemic circulation when intended. For both-sided goals at 80 kVp, mean aorto-pulmonary enhancement differences did not differ significantly between groups (<i>P</i>=0.082); median values near 0 in both cohorts were consistent with generally balanced enhancement. Results for both-sided goals at 100 kVp were reported descriptively because of the small test-bolus subgroup size.</p> Conclusion <p>A patient-specific, real-time physiology-based, internally derived test-bolus framework uses measured contrast dynamics to prescribe scan timing, enabling reliable congenital cardiac CTA with diagnostic-quality target-vessel enhancement across a range of clinical goals.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Revisiting test bolus: a plug-and-play solution for cardiac CTA timing

  • 期刊论文

  • 发表日期：

    2026年7月18日

查看全文
  • Juan C. Infante,
  • Brenden Maag,
  • Monica Epelman,
  • Marty McGraw,
  • Peace Madueme

摘要

Background

Cardiac computed tomography angiography (CTA) for congenital heart disease (CHD) can be technically challenging, particularly in low-volume centers. Real-time radiologist supervision can strain resources and impact productivity.

Objective

To evaluate a standardized, delay-corrected test-bolus timing method for cardiac CTA for CHD.

Materials and methods

We performed a retrospective review of cardiac CTA examinations (November 2020 to August 2022), comparing a delay-corrected test-bolus timing cohort to a manually triggered control cohort (institutional standard protocol during the study period). We measured quantitative enhancement (HU) at six regions of interest and assessed aorto-pulmonary differentiation. Continuous variables were compared using Welch t-tests; non-inferiority was assessed using one-sided 95% confidence intervals (margin -50 HU).

Results

We analyzed 318 examinations (test-bolus n=98; control n=220). In a pooled non-inferiority analysis (margin -50 HU), the test-bolus method met non-inferiority for absolute aortic enhancement (difference +24.1 HU; one-sided 95% CI lower bound −22.7 HU). For left-sided examinations at 80 kVp, mean aorto-pulmonary separation was greater with test-bolus timing (264.0±225.8 HU) than with manual triggering (40.2±192.3 HU; P<0.001), indicating greater preferential enhancement of the systemic circulation when intended. For both-sided goals at 80 kVp, mean aorto-pulmonary enhancement differences did not differ significantly between groups (P=0.082); median values near 0 in both cohorts were consistent with generally balanced enhancement. Results for both-sided goals at 100 kVp were reported descriptively because of the small test-bolus subgroup size.

Conclusion

A patient-specific, real-time physiology-based, internally derived test-bolus framework uses measured contrast dynamics to prescribe scan timing, enabling reliable congenital cardiac CTA with diagnostic-quality target-vessel enhancement across a range of clinical goals.

Graphical Abstract