All chest CT scans were obtained using a multi-detector CT scanner (Somatom Definition AS+, Siemens Healthineers, Erlangen, Germany), and the scanning protocol included both non-enhanced (37 patients) and contrast-enhanced (14 patients) scans. The scanning parameters were as follows: detector collimation, 128 × 0.6 mm; beam pitch, 1.2; gantry speed, 0.5 s/rotation; tube voltage, 100–120 kVp; tube current with automatic exposure control, non-enhanced scan (reference 50 mAs, ranging between 32 and 82 mAs) and contrast-enhanced scan (reference 134 mAs, ranging between 120 and 250 mAs); slice thickness, 3.0 mm; reconstruction interval, 3.0 mm; and a sharp reconstruction kernel. Contrast medium (Iomeprol, Iomeron 350®; BRACCO, Milan, Italy) was administered using a mechanical injector (Stellant, Medrad®, Bayer, Leverkusan, Germany). All CT scans were obtained with the patient in a supine position at full inspiration.
Iomeron 350
Manufactured by Bracco
Sourced in Italy, Germany, France
Iomeron 350 is an iodinated contrast agent used for diagnostic imaging procedures. It is a water-soluble, non-ionic compound that can be administered intravenously or intra-arterially. Iomeron 350 provides contrast enhancement to improve visualization of internal structures during imaging examinations.
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Lab products found in correlation
Somatom definition flash, by Siemens (5 mentions)
Xenetix 350, by Guerbet (4 mentions)
Brilliance ict, by Philips (4 mentions)
Somatom sensation 64, by Siemens (3 mentions)
Somatom definition as, by Siemens (2 mentions)
Somatom force, by Siemens (2 mentions)
Revolution hd, by GE Healthcare (2 mentions)
Ge optima ct660, by GE Healthcare (2 mentions)
Discovery hd 750, by GE Healthcare (2 mentions)
Brilliance 64, by Philips (2 mentions)
Bz x analyzer, by Keyence (1 mentions)
Omnipaque, by GE Healthcare (1 mentions)
Somatom sensation, by Siemens (1 mentions)
Revolution ct, by GE Healthcare (1 mentions)
Smartprep, by GE Healthcare (1 mentions)
Intellispace portal, by Philips (1 mentions)
Ultravist 370, by Bayer (1 mentions)
Iqon spectral ct, by Philips (1 mentions)
Somatom definition edge, by Siemens (1 mentions)
Extended brilliance workspace version 4.5, by Philips (1 mentions)
32 protocols using iomeron 350
1
Chest CT Imaging Protocol for COVID-19
2
PET/CT Imaging Protocol for 18F-FDG
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10.57 ± 1.79 MBq 18F-FDG was diluted in 100 μl in sterile saline (n = 103) and injected through the lateral vein catheter using an automated infusion pump (0.2 ml/min). A 60-minute list mode PET acquisition was started simultaneously with the start of the 18F-FDG injection. After PET acquisition, two CT scans were acquired at 80 kVp, 2 × 2 binning, 512 projections, and 1.3 × magnification. The first was performed without contrast agent, and the second with 125 µl Iomeron350 (Bracco Imaging Scandinavia AB, Sweden) injected through the lateral vein catheter using an automated infusion pump over a 60 s period. The second CT scan started 2 min post-contrast agent injection.
The acquired list mode PET data were histogrammed into 24 × 5 s, 9 × 20 s, and 11 × 5 min, in total 44 time frames, and reconstructed using 3-dimensional maximum likelihood expectation maximization (MLEM) algorithm with 50 iterations. PET images were corrected for varying detector element efficiency, radioactive decay, random coincidences, dead time losses, attenuation, and scatter, before a dose calibration factor was applied, to convert the output images into the unit of MBq/cm3. CT raw data were reconstructed using filtered back projection algorithm.
The acquired list mode PET data were histogrammed into 24 × 5 s, 9 × 20 s, and 11 × 5 min, in total 44 time frames, and reconstructed using 3-dimensional maximum likelihood expectation maximization (MLEM) algorithm with 50 iterations. PET images were corrected for varying detector element efficiency, radioactive decay, random coincidences, dead time losses, attenuation, and scatter, before a dose calibration factor was applied, to convert the output images into the unit of MBq/cm3. CT raw data were reconstructed using filtered back projection algorithm.
3
Aortic Dynamics and Valve Pathology
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The aortographies were measured at a projection resembling the one used in the transcatheter aortic valve implantation – all three sinuses were visible at the same level (LAO ≈ 10, caudal ≈ –10). The examinations were performed by injecting 40 ml of the Iomeron 350 contrast agent (Bracco Imaging S.p.A., Bioindustry Park, Via Ribes 5, 10010 Colleretto Giacosa, Italy) directly into the aortic root. The radiation dose for the aortography ranged from 5 to 10 mGy. The diameters were measured at the level of the aortic root, sinotubular junction (STJ) and tubular ascending aorta. A systolic-diastolic longitudinal translocation of the aorta (systolic aortic stretching – SAS) caused by the contraction of the heart during systole was measured at the level of the ventriculo-aortic junction (Figure 1 ). This was correlated with the maximum dimension of the aortic root and ascending aorta, the patient age, the body surface area (BSA) and the left ventricular ejection fraction (EF). Moreover, the systolic aortic stretching was compared between patients with and without an aortic valve pathology.
4
Dynamic CT Perfusion Phantom Imaging
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Dynamic CT perfusion scans were performed at a third-generation dual source CT scanner (SOMATOM Force, Siemens Healthineers, Forchheim, Germany). The FOV was determined based on frontal and lateral scout images and covered the anthropomorphic thorax phantom with myocardial perfusion phantom insert. Dynamic scans were started nine seconds prior to contrast bolus injection into the flow circuit. 60 mL of 350 mg/mL iomeprol solution (Iomeron350, Bracco, Milan, Italy) was injected at an injection rate of 6.0 mL/s. Contrast injection was followed by a 32 mL saline flush, also at 6.0 mL/s. Based on preliminary phantom measurements we slightly altered the standard contrast protocol (40% dilution with saline) to obtain patient realistic AIFs (i.e., a peak intensity of around 800 HU). Dynamic CT perfusion scans of 30 s were performed in shuttle mode during end-systole (mimicked by a simulated 60 bpm ECG trigger pulse), providing one full heart coverage scan with a z-range of 102 mm per 2 s. Other acquisition parameters included a tube voltage of 70 kVp, a tube current time product of 280 mAs, and a gantry rotation time of 0.6 s. Dynamic CT perfusion data were reconstructed with 3.0 mm slice thickness and 1.5 mm increment. Traditional filtered back projection was used with a B23f kernel.
5
Characterizing Particle Shapes in Contrast Agent
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First, 2 mg of IPM/CS was mixed into non-ionic contrast agent (Iomeron350®; Bracco UK) as the solvent. Images were immediately taken under electron microscopy (40×) and observed.
Two radiologists performed these evaluations, visually categorizing shapes as round, elliptical, or polygonal (Fig.2 ). The shape was defined as polygonal if angles ≤90° were seen for ≥3 vertices. All other particles were classified as either round or elliptical; particles for which the ratio of the short diameter to the long diameter was <0.75 were taken as elliptical; and particles for which the ratio of the short diameter to the long diameter was ≥0.75 were taken as round. For these visual judgments, particles showing suspected polymerization with other particles were excluded.![]()
Two radiologists performed these evaluations, visually categorizing shapes as round, elliptical, or polygonal (Fig.
Particle shape is classified as round (
6
Measuring Particle Size with Contrast Agent
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In measuring particle size, a non-ionic contrast agent (Iomeron350®; Bracco UK, Milano, Italy) was used same as when using IPM/CS as embolic agent which were observed under electron microscopy (20×) immediately after mixing in 2 mg of IPM/CS.
The entire field of view was observed first, then visual fields with little polymerization among particles were selectively imaged. Particles within a total of five visual fields were examined. The long diameters of particles were measured using the microcell counter of the BZ-X Analyzer analysis application (Keyence Corporation) (Fig.1 ). When polymerization among particles was suspected from visual judgments those particles were excluded.![]()
The entire field of view was observed first, then visual fields with little polymerization among particles were selectively imaged. Particles within a total of five visual fields were examined. The long diameters of particles were measured using the microcell counter of the BZ-X Analyzer analysis application (Keyence Corporation) (Fig.
7
Triple-Phase CT Imaging Protocol for Comprehensive Evaluation
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All CT examinations were performed with a single-source 64-section MDCT unit (Somatom Sensation, Siemens Healthineers). CT examinations were all performed with a triple phase protocol with and without oral contrast material. An unenhanced phase was used before and after administration of oral contrast material. Low-dose unenhanced CT images were obtained with a section thickness of 1.25 mm, with an extended coverage of chest, to depict any preexisting hyperattenuating material
10 (link)
. Unenhanced CT was repeated using a standard radiation dose through the same coverage area with diluted non-ionic water-soluble oral contrast (Iohexol, Omnipaque; GE Healthcare; 240 mg of iodine/mL). A third phase was obtained during the venous phase to study parenchymal and pleural enhancement. Imaging parameters were as follows: nominal section thickness, 0.625 mm; beam pitch, 1.2; reconstruction interval, 1 mm; tube voltage, 120-kV (100 kV for the first unenhanced phase); and tube current, 120–170 mA. Patients received 90 to 110 mL of contrast agent at a concentration of 350 mg/mL of iodine (Iomeprol, Iomeron 350; Bracco, or Xenetix 350; Guerbet), administered intravenously with an automated injector (OptiVantage, Mallinckrodt-Tyco/Healthcare) at a rate of 2.5 to 3.5 mL/s. We used an antecubital vein as the access route and an 18 G venous catheter.
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All CT examinations were performed with a single-source 64-section MDCT unit (Somatom Sensation, Siemens Healthineers). CT examinations were all performed with a triple phase protocol with and without oral contrast material. An unenhanced phase was used before and after administration of oral contrast material. Low-dose unenhanced CT images were obtained with a section thickness of 1.25 mm, with an extended coverage of chest, to depict any preexisting hyperattenuating material
10 (link)
. Unenhanced CT was repeated using a standard radiation dose through the same coverage area with diluted non-ionic water-soluble oral contrast (Iohexol, Omnipaque; GE Healthcare; 240 mg of iodine/mL). A third phase was obtained during the venous phase to study parenchymal and pleural enhancement. Imaging parameters were as follows: nominal section thickness, 0.625 mm; beam pitch, 1.2; reconstruction interval, 1 mm; tube voltage, 120-kV (100 kV for the first unenhanced phase); and tube current, 120–170 mA. Patients received 90 to 110 mL of contrast agent at a concentration of 350 mg/mL of iodine (Iomeprol, Iomeron 350; Bracco, or Xenetix 350; Guerbet), administered intravenously with an automated injector (OptiVantage, Mallinckrodt-Tyco/Healthcare) at a rate of 2.5 to 3.5 mL/s. We used an antecubital vein as the access route and an 18 G venous catheter.
8
Contrast-Enhanced CT Protocol for Imaging
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CT examinations were performed with a single source helical CT equipment (Revolution HD®, General-Electric Healthcare, Wauwatosa, WI, USA; Somatom Sensation® 64, Siemens Healthineers; or Somatom Definition® Flash, Siemens Healthineers, Erlangen, Germany). Acquisition parameters were as follows: field-of-view, 279–350 mm; beam collimation, 38.4–40 mm (64 × 0.6–0.625 mm collimator setting); slice thickness, 1–1.25 mm; peak tube potential, 110–120 kVp; gantry revolution time, 0.5 s; and beam pitch, 0.984–1.2.
Iodinated contrast material (iomeprol, Iomeron 350®, Bracco Imaging; or iobitridol, Xenetix 350®, Guerbet, Aulnay-sous-Bois, France) was injected intravenously with an automated power injector (rate, 2.5–4 mL/s; total volume, 95–125 mL). After unenhanced acquisition, arterial phase (35–45 s after initiating contrast material administration) and portal venous phase (delay, 65–80 s) acquisitions were obtained.
Iodinated contrast material (iomeprol, Iomeron 350®, Bracco Imaging; or iobitridol, Xenetix 350®, Guerbet, Aulnay-sous-Bois, France) was injected intravenously with an automated power injector (rate, 2.5–4 mL/s; total volume, 95–125 mL). After unenhanced acquisition, arterial phase (35–45 s after initiating contrast material administration) and portal venous phase (delay, 65–80 s) acquisitions were obtained.
9
CT Angiography Protocol for Cardiovascular Imaging
10
64-row 128-slice CT Imaging Protocol
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All studies were performed with a 64-row 128-slice CT system (GE Optima CT 660, GE Healthcare, USA) using the following parameters: collimation 39.38 × 0.625 mm, spiral pitch 0.516:1, anode voltage 120 kV, anode amperage 40–500 mA, rotation time 0.6 seconds, slice thickness 0.625 mm. Patients received intravenous non-ionic contrast agent (Iomeron 350, Bracco Imaging Deutschland GmbH, Konstanz, Germany) at volume adjusted to their body weight, 50 mL on average, followed by a 30 mL NaCl flush. Iomeron 350 was given to the basilic vein at a rate of 4–4.5 mL/second with the aid of an automatic syringe (OptiVantage DH, Mallincrodt, St Louis, MO, USA). The scanning started 15–20 seconds after administration of the contrast agent, after reaching attenuation of 100 HU above the baseline attenuation and lasted for 6 seconds. The images were recorded as digital imaging and communications in medicine (DICOM) files on a HP Z800 workstation.
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