Lion Stammen, Eva J I Hoeijmakers, Thomas G Flohr, Hester A Gietema, Janneke Vandewall, Joachim E Wildberger, Cécile R L P N Jeukens, Bibi Martens
{"title":"降低造影剂剂量对肺栓塞CTPA在PCD-CT中的应用：个体化时代EID-CT与PCD-CT的对比研究","authors":"Lion Stammen, Eva J I Hoeijmakers, Thomas G Flohr, Hester A Gietema, Janneke Vandewall, Joachim E Wildberger, Cécile R L P N Jeukens, Bibi Martens","doi":"10.1007/s00330-025-12054-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate diagnostic image quality (IQ) for pulmonary embolism detection in photon-counting detector CT (PCD-CT) with significantly reduced contrast media (CM) dose vs conventional energy-integrating detector CT (EID-CT), using optimized and individualized CM protocols.</p><p><strong>Materials and methods: </strong>Consecutive CT pulmonary angiography (CTPA) scans performed on the EID-CT (Jan 2024-Mar 2024) with an individualized kilovoltage (kV) and total body weight (TBW) adapted CM protocol, and on the PCD-CT (Aug 2023-Feb 2024) with a TBW adapted CM protocol matching the 70 kV EID-CT protocol, were retrospectively collected. EID-CT scans were performed at 70-120 kV, based on patients' size, while PCD-CT scans were performed at 120 kV with 55 keV virtual monoenergetic images. Objective IQ assessment included mean attenuation (in Hounsfield Units), signal-to-noise ratio, and contrast-to-noise ratio (CNR). Two board-certified radiologists assessed diagnostic IQ subjectively using a five-point Likert scale.</p><p><strong>Results: </strong>In 140 EID-CT and 118 PCD-CT scans, PCD-CT reduced total iodine load by 26.7% and CT dose index volume by 24.4%. Objective IQ parameters showed no significant differences, except for a decrease in CNR in the proximal pulmonary arteries in PCD-CT scans (p = 0.02). Subjective IQ was rated as moderate/good by observers 1 and 2 in 94.9% and 97.9% of the EID-CT scans, respectively, and 96.5% and 100% of the PCD-CT scans, respectively.</p><p><strong>Conclusion: </strong>PCD-CT with a TBW-adapted CM protocol can achieve substantial reductions in both CM and radiation dose compared to EID-CT with individualized kV and TBW adapted CM protocols, while maintaining diagnostic IQ in CTPA scans.</p><p><strong>Key points: </strong>Question The feasibility of CM reduction in PCD-CT vs EID-CT with highly individualized CM protocols, while maintaining diagnostic IQ. Findings PCD-CT reduces total iodine load by 26.7% and CT dose index volume by 24.4% compared to EID-CT, with comparable objective and subjective diagnostic IQ. Clinical relevance This approach enables CM reduction, potentially lowering patient risk and providing environmental and financial benefits. Additionally, PCD-CT allows for CM and radiation dose reduction while maintaining comparable IQ.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reducing contrast media dosage for pulmonary embolism CTPA in PCD-CT: a comparative study of EID-CT and PCD-CT in the era of individualized protocolling.\",\"authors\":\"Lion Stammen, Eva J I Hoeijmakers, Thomas G Flohr, Hester A Gietema, Janneke Vandewall, Joachim E Wildberger, Cécile R L P N Jeukens, Bibi Martens\",\"doi\":\"10.1007/s00330-025-12054-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate diagnostic image quality (IQ) for pulmonary embolism detection in photon-counting detector CT (PCD-CT) with significantly reduced contrast media (CM) dose vs conventional energy-integrating detector CT (EID-CT), using optimized and individualized CM protocols.</p><p><strong>Materials and methods: </strong>Consecutive CT pulmonary angiography (CTPA) scans performed on the EID-CT (Jan 2024-Mar 2024) with an individualized kilovoltage (kV) and total body weight (TBW) adapted CM protocol, and on the PCD-CT (Aug 2023-Feb 2024) with a TBW adapted CM protocol matching the 70 kV EID-CT protocol, were retrospectively collected. EID-CT scans were performed at 70-120 kV, based on patients' size, while PCD-CT scans were performed at 120 kV with 55 keV virtual monoenergetic images. Objective IQ assessment included mean attenuation (in Hounsfield Units), signal-to-noise ratio, and contrast-to-noise ratio (CNR). Two board-certified radiologists assessed diagnostic IQ subjectively using a five-point Likert scale.</p><p><strong>Results: </strong>In 140 EID-CT and 118 PCD-CT scans, PCD-CT reduced total iodine load by 26.7% and CT dose index volume by 24.4%. Objective IQ parameters showed no significant differences, except for a decrease in CNR in the proximal pulmonary arteries in PCD-CT scans (p = 0.02). Subjective IQ was rated as moderate/good by observers 1 and 2 in 94.9% and 97.9% of the EID-CT scans, respectively, and 96.5% and 100% of the PCD-CT scans, respectively.</p><p><strong>Conclusion: </strong>PCD-CT with a TBW-adapted CM protocol can achieve substantial reductions in both CM and radiation dose compared to EID-CT with individualized kV and TBW adapted CM protocols, while maintaining diagnostic IQ in CTPA scans.</p><p><strong>Key points: </strong>Question The feasibility of CM reduction in PCD-CT vs EID-CT with highly individualized CM protocols, while maintaining diagnostic IQ. Findings PCD-CT reduces total iodine load by 26.7% and CT dose index volume by 24.4% compared to EID-CT, with comparable objective and subjective diagnostic IQ. Clinical relevance This approach enables CM reduction, potentially lowering patient risk and providing environmental and financial benefits. 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Reducing contrast media dosage for pulmonary embolism CTPA in PCD-CT: a comparative study of EID-CT and PCD-CT in the era of individualized protocolling.
Objectives: To evaluate diagnostic image quality (IQ) for pulmonary embolism detection in photon-counting detector CT (PCD-CT) with significantly reduced contrast media (CM) dose vs conventional energy-integrating detector CT (EID-CT), using optimized and individualized CM protocols.
Materials and methods: Consecutive CT pulmonary angiography (CTPA) scans performed on the EID-CT (Jan 2024-Mar 2024) with an individualized kilovoltage (kV) and total body weight (TBW) adapted CM protocol, and on the PCD-CT (Aug 2023-Feb 2024) with a TBW adapted CM protocol matching the 70 kV EID-CT protocol, were retrospectively collected. EID-CT scans were performed at 70-120 kV, based on patients' size, while PCD-CT scans were performed at 120 kV with 55 keV virtual monoenergetic images. Objective IQ assessment included mean attenuation (in Hounsfield Units), signal-to-noise ratio, and contrast-to-noise ratio (CNR). Two board-certified radiologists assessed diagnostic IQ subjectively using a five-point Likert scale.
Results: In 140 EID-CT and 118 PCD-CT scans, PCD-CT reduced total iodine load by 26.7% and CT dose index volume by 24.4%. Objective IQ parameters showed no significant differences, except for a decrease in CNR in the proximal pulmonary arteries in PCD-CT scans (p = 0.02). Subjective IQ was rated as moderate/good by observers 1 and 2 in 94.9% and 97.9% of the EID-CT scans, respectively, and 96.5% and 100% of the PCD-CT scans, respectively.
Conclusion: PCD-CT with a TBW-adapted CM protocol can achieve substantial reductions in both CM and radiation dose compared to EID-CT with individualized kV and TBW adapted CM protocols, while maintaining diagnostic IQ in CTPA scans.
Key points: Question The feasibility of CM reduction in PCD-CT vs EID-CT with highly individualized CM protocols, while maintaining diagnostic IQ. Findings PCD-CT reduces total iodine load by 26.7% and CT dose index volume by 24.4% compared to EID-CT, with comparable objective and subjective diagnostic IQ. Clinical relevance This approach enables CM reduction, potentially lowering patient risk and providing environmental and financial benefits. Additionally, PCD-CT allows for CM and radiation dose reduction while maintaining comparable IQ.
期刊介绍：
European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field.
This is the Journal of the European Society of Radiology, and the official journal of a number of societies.
From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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