ArticleQuantitative imaging in medicine and surgery2026
Test-bolus peak attenuation for predicting aortic enhancement in coronary computed tomography angiography: an exploratory subgroup analysis.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Adequate intravascular enhancement is essential for accurate coronary computed tomography angiography (CCTA) evaluation; however, conventional empirical contrast protocols often result in significant variability in enhancement because they do not account for individual physiological differences. Test-bolus techniques represent a potential approach for individualized contrast delivery; however, their precise quantitative relationship with final vascular enhancement requires further clarification. This study aimed to investigate the quantitative association between test-bolus peak attenuation and final aortic enhancement (FAE) in CCTA and to describe subgroup variations based on body mass index (BMI) and cardiac output (CO). Methods: This single-center retrospective study included 50 patients who underwent CCTA. Test-bolus peak attenuation and FAE were systematically recorded. To evaluate the quantitative association between test-bolus peak attenuation and FAE, univariate linear regression analysis was performed, followed by subgroup analyses stratified by BMI (normal, overweight, or obese) and CO (normal or high). Results: Test-bolus peak attenuation was a significant positive predictor of FAE (β=0.924, P<0.001), accounting for 26.1% of the overall variance in FAE. Exploratory subgroup analyses revealed descriptive differences in the strength of this predictive trend across BMI categories. Notably, a stronger predictive trend was observed in obese patients (R Conclusions: Test-bolus peak attenuation demonstrated significant potential as a quantitative predictor of aortic enhancement in CCTA, suggesting that test-bolus peak attenuation may be useful in exploring individualized contrast protocols. The descriptive trends observed in the obese subgroup are strictly hypothesis-generating. Exploratory findings suggest that the predictive trend might vary according to BMI and CO. Larger studies are needed to confirm these descriptive observations.
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