Image quality improvement in head and neck CT angiography: Individualized post-trigger delay versus fixed delay

Purpose To compare the contrast media opacification of head and neck CT angiography (CTA) between conventional fixed trigger delay and individualized post-trigger delay (PTD). Methods In this prospective study (April–October 2022), 196 consecutive participants were randomly divided into two groups to perform head and neck CTA in bolus tracking with either an individualized PTD (Group A) or a fixed 4-second PTD (Group B). All CT and contrast media protocol parameters were consistent between the two groups. One reader evaluated objective image quality, while two readers rated subjective image quality. Objective image quality was compared between groups via two-sample t-test, while the subjective ratings were compared with chi-square analysis. Results Participants' clinical information including sex, age, weight, body weight index (BMI), and heart rate were not statistically different between two groups (all p > 0.05). Individualized PTD ranging from 3.5-7.9 seconds (average 5.6 seconds), which is shorter than fixed delays (p < 0.05). Both readers rated better subjective image quality for the Group A (p < 0.05). The mean vessel enhancement was significantly higher in Group A in all vessels (all p < 0.05). Conclusions Compared to the fixed post-trigger delay in bolus tracking technique, individualized post-trigger delay could achieve reliable scan timing, optimize vessel opacification and obtain better image quality for head and neck CT angiography.