Halved contrast medium dose in lower limb dual-energy computed tomography angiography —a randomized controlled trial

ConclusionsHalf iodine-load SDCT lower limb CTA at 40  keV achieved higher VA than the control. CNR, SNR, noise, and SEQ were higher at 40 keV, while 50 keV showed lower noise.Clinical relevance statementSpectral detector CT with low-energy virtual monoenergetic imaging performed halved iodine contrast medium (CM) lower limb CT-angiography with sustained objective and subjective quality. This facilitates CM reduction, improvement of low CM-dosage examinations, and examination of patients with more severe kidney impairment.Trial registrationRetrospectively registered 5 August 2022 at clinicaltrials.gov NCT05488899.Key Points•Contrast medium dosage may be halved in lower limb dual-energy CT angiography with virtual monoenergetic images at 40  keV, which may reduce contrast medium consumption in the face of a global shortage.•Experimental half-iodine-load dual-energy CT angiography at 40  keV showed higher vascular attenuation, contrast-to-noise ratio, signal-to-noise ratio, and subjective examination quality than standard iodine-load conventional.•Half-iodine dual-energy CT angiography protocols may allow us to reduce the risk of PC-AKI, examine patients with more severe kidney impairment, and provide higher quality examinations or salvage poor examinations when impaired kidney function limits the CM dose.
Source: European Radiology - Category: Radiology Source Type: research