Introduction to a focus group on the subject of Multidetector CT and the use of high concentration, low volume contrast.
Stuart E. Mirvis, MD, FACR
Professor of Radiology in the Diagnostic Imaging Department,
University of Maryland Medical Center, Baltimore, MD
and Editor-in-Chief of
The introduction and increasing availability of multidetector
computed tomography (MDCT) has brought about some wonderful
improvements in the overall quality of CT images and has expanded
the application of CT to new areas, particularly vascular imaging.
With the improvement in technology comes the inevitable alteration
in scanning techniques needed to maximize the benefit of the new
imaging capabilities. So the tried-and-true approaches to
single-slice helical scanning must make way for a new set of
parameters tailored to multidetector scanners. Given the shorter
scanning times permitted by MDCT, the appropriate timing of
contrast injection becomes more exacting than it was in the
single-slice era. The period when the intravenous contrast bolus is
where it is needed is short; injection rates, contrast volumes, and
contrast concentration must be adjusted to optimize the target
This supplement to
presents the views of a group of true experts in the field of MDCT
imaging and contrast utilization who were brought together as a
panel to address the use of high-concentration contrast in MDCT.
Drs. Dennis Foley and Paul Silverman reviewed general concepts of
MDCT technology with a focus on CT angiography. Dr. Rendon Nelson
discussed MDCT of hepatic imaging, Dr. Lawrence Tanenbaum
considered neurologic imaging, Dr. William Stanford reviewed
progress in cardiac applications, and Dr. Sergio Ginaldi presented
a summary of contrast safety.
Following these presentations, all of the participants discussed
their views of and experiences with contrast-enhanced CT scanning,
particularly the use of high-concentration contrast for MDCT
applications. As moderator of this discussion, I sought to foster
as open (no-holds-barred) a discussion as possible to find out
where consensus and differences of opinion lay and to discover the
real day-to-day experiences of the panelists rather than just their
formal "for-the-record" positions. I hope that the reader will find
that the formal presentations and the follow-up freewheeling
discussion offer valuable, useful information on how to perform
optimal MDCT imaging studies for a variety of applications.