Individualized Scan Protocols in Abdominal Computed Tomography: Radiation Versus Contrast Media Dose Optimization

Area of Science:

• Radiology
• Medical Imaging
• Computed Tomography

Background:

• Contrast-enhanced abdominal CT involves linked radiation and contrast media (CM) protocols for optimal image quality.
• Existing research often optimizes radiation or CM parameters separately, neglecting their interdependence.

Purpose of the Study:

• To evaluate the feasibility of optimizing either radiation dose or CM dose independently versus a combined approach in abdominal CT.
• To assess the impact of individualized dose optimization on image quality and lesion detection.

Main Methods:

• Six Göttingen minipigs underwent CT scans using three protocols: standard combined, CM dose-saving, and radiation dose-saving.
• Automated tube voltage selection (ATVS) and automated tube current modulation were employed.
• Objective image quality (attenuation, SNR, CNR) and subjective image quality (Likert scale) were assessed across different phases.

Main Results:

• Radiation dose was reduced by 26% in the radiation dose-saving protocol and CM dose by 16% in the CM dose-saving protocol.
• No significant differences in subjective overall image or contrast quality were observed between protocols.
• The CM dose-saving protocol showed significantly better lesion detection in the portal venous phase compared to the radiation dose-saving protocol.

Conclusions:

• Individualizing either radiation or CM dose in abdominal CT is feasible, yielding comparable objective and subjective image quality.
• Personalized CT protocols can be tailored to individual risk assessments, offering greater flexibility in examination design.
• This approach supports patient-specific risk-benefit considerations in abdominal imaging.