Feasibility of very low iodine dose aortoiliac CT angiography using dual-source photon-counting detector CT

作者：Tim Oechsner, Martin Soschynski, Christopher L. Schlett, Tobias Krauß, Christopher Schupppert, Katharina Müller‐Peltzer, M. Vecsey-Nagy, Dmitrij Kravchenko, Ákos Varga‐Szemes, Tilman Emrich, Raphael Scheu, Jana Taron, Fabian Bamberg, Muhammad Taha Hagar · 发表于：European Journal of Radiology · 年份：2025 · DOI：10.1016/j.ejrad.2025.111919 · 被引用次数：15 · 研究领域：Advanced X-ray and CT Imaging、Radiation Dose and Imaging、Cardiac Imaging and Diagnostics

PURPOSE: To evaluate the feasibility of aortoiliac CT-Angiography (CTA) using dual-source photon-counting detector (PCD)-CT with minimal iodine dose. METHODS: This IRB-approved, single-center prospective study enrolled patients with indications for aortoiliac CTA from December 2022 to March 2023. All scans were performed using a first-generation dual-source PCD-CT. Images were acquired with fast pitch and full spectral capabilities (collimation 144 × 0.4 mm). The contrast protocol included a mixture of sodium chloride and iodinated contrast agent (Iopromide, total iodine dose: 9.5-9.8 g). Virtual monoenergetic images (VMIs) were reconstructed at 40, 50, 60, and 68 keV. Two blinded radiologists evaluated image quality on a 4-point scale. Attenuation was measured across eight regions in the aorta and iliac arteries, and contrast-to-noise ratio (CNR) was calculated. Statistical comparisons were performed using repeated measures ANOVA and Bonferroni post-hoc tests. RESULTS: The final cohort consisted of 39 subjects (mean age: 69.6 ± 9.6 years; 30.8 % female). VMI at 40 keV provided significantly higher attenuation: 478 ± 114 HU, compared to 50 keV (331 ± 74 HU), 60 keV (241 ± 51 HU), and 68 keV (190 ± 48 HU) (p < 0.01). This translated in increased CNR for 40 keV reconstructions (11.8 ± 3.9), followed by 50 keV (9.1 ± 3.0), 60 keV (7.0 ± 2.3), and 68 keV (6.1 ± 1.9) (p < 0.01). Subjective image quality was rated excellent at 40 keV (4 [3,4]), though associated with highest noise ...