{
  "id": "medical/ct-contrast-renal-dose-miscalculation",
  "signature": "AI miscalculates contrast volume for CT scan based on wrong formula, exceeding safe iodine dose for renal impairment",
  "signature_zh": "AI基于错误公式计算CT扫描对比剂体积，超过肾功能不全患者的安全碘剂量",
  "regex": "(?:CT|computed tomography)\\s+(?:contrast|dye)\\s*(?:volume|dose|amount|overdose|miscalculat)",
  "domain": "medical",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "Contrast volume should be calculated using patient weight and estimated GFR (e.g., 1.5 mL/kg for eGFR > 60, max 125 mL), but AI applies a fixed volume (e.g., 100 mL for all adults) or uses body surface area formula, leading to potential contrast-induced nephropathy (CIN) in at-risk patients.",
  "root_cause_type": "generic",
  "root_cause_zh": "对比剂体积应根据患者体重和估算肾小球滤过率计算（例如，eGFR>60时1.5毫升/千克，最大125毫升），但AI使用固定体积（例如所有成人100毫升）或体表面积公式，导致高风险患者可能发生对比剂肾病。",
  "versions": [
    {
      "version": "Siemens Somatom Definition Flash v7.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "GE Revolution CT v3.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Canon Aquilion ONE v6.5",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "This is safe only for normal renal function; for eGFR < 30, even 1.0 mL/kg can exceed safe iodine load (e.g., 350 mgI/kg)",
      "fail_rate": 0.5,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Age alone is not a reliable predictor; some elderly have normal eGFR and need full dose for diagnostic quality; under-dosing causes nondiagnostic scans",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "AI may use outdated formulas (e.g., Cockcroft-Gault instead of CKD-EPI) or ignore acute kidney injury, giving falsely normal eGFR",
      "fail_rate": 0.55,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Use the ACR contrast manual formula: for eGFR > 60, give 1.5 mL/kg up to 125 mL; for eGFR 30-60, give 1.0 mL/kg up to 100 mL; for eGFR < 30, consult radiologist for alternative imaging or pre-hydration protocol",
      "success_rate": 0.85,
      "how": "Use the ACR contrast manual formula: for eGFR > 60, give 1.5 mL/kg up to 125 mL; for eGFR 30-60, give 1.0 mL/kg up to 100 mL; for eGFR < 30, consult radiologist for alternative imaging or pre-hydration protocol",
      "condition": "",
      "sources": []
    },
    {
      "action": "Implement a clinical decision support tool (e.g., Nuance mPower) that checks eGFR, weight, and contrast type before approving the scan order",
      "success_rate": 0.9,
      "how": "Implement a clinical decision support tool (e.g., Nuance mPower) that checks eGFR, weight, and contrast type before approving the scan order",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use iso-osmolar contrast (iodixanol) for all patients with eGFR < 45, which reduces CIN risk, and calculate volume based on 1.0 mL/kg max 100 mL",
      "success_rate": 0.8,
      "how": "Use iso-osmolar contrast (iodixanol) for all patients with eGFR < 45, which reduces CIN risk, and calculate volume based on 1.0 mL/kg max 100 mL",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Use the ACR contrast manual formula: for eGFR > 60, give 1.5 mL/kg up to 125 mL; for eGFR 30-60, give 1.0 mL/kg up to 100 mL; for eGFR < 30, consult radiologist for alternative imaging or pre-hydration protocol",
    "Implement a clinical decision support tool (e.g., Nuance mPower) that checks eGFR, weight, and contrast type before approving the scan order",
    "Use iso-osmolar contrast (iodixanol) for all patients with eGFR < 45, which reduces CIN risk, and calculate volume based on 1.0 mL/kg max 100 mL"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.acr.org/Clinical-Resources/Contrast-Manual",
  "official_doc_section": null,
  "error_code": "CT-CONTRAST-VOL-ERR",
  "verification_tier": "ai_generated",
  "confidence": 0.82,
  "fix_success_rate": 0.85,
  "resolvable": "true",
  "first_seen": "2024-05-10",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}