An investigation into the variability of radiographers assessing body composition prior to CT contrast media administration

Introduction: To evaluate and report the variability of radiographers in determining a patient's body type and using this to determine contrast media (CM) volumes for chest computed tomography (CT). Methods: This prospective study recruited 50 patients undergoing chest CT examinations. Three radiographers independently used two methods to determine patient body type and consequently CM volume. In Method 1, subjective evaluation of body type together with patient weight determined CM volume. In Method 2, patient weight along with additional criteria applied by the radiographer determined CM volume. Both the determination of body type and CM volumes were compared in terms of agreement and variability between radiographers, and between methods. Results: Fleiss’ kappa was lower (0.583) for Method 1 when compared to Method 2 (0.926) indicating stronger agreement in the radiographer determination of body type for Method 2. Median (IQR) CM volume was 95.0 mL (85.0–110.0) for Method 1, compared to 92.5 mL (85.0–100.0) for method 2 (P < 0.001). Conclusion: Method 2 provided greater agreement in determination of body type, and reduction of CM volumes compared to Method 1. Implications for practice: Determining body type as part of a CT CM strategy can be subjective and enhanced methods are required to ensure that the most appropriate CM volumes are reliably used.