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Optimal Abdominal CT Image Quality in Non-Lean Patients: Customization of CM Injection Protocols and Low-Energy
Francesco Macri1, Elina Khasanova1, Bonnie T Niu2
1Department of Radiology, Geneva University Hospitals, University of Geneva, 1211 Geneva, Switzerland.
Customized contrast media injection protocols significantly reduce contrast volume and injection rate in abdominopelvic CT scans. This approach enhances image quality for both single-energy CT (SECT) and dual-energy CT (DECT) compared to standard fixed protocols.
Area of Science:
- Radiology
- Medical Imaging
- Computed Tomography
Background:
- Standard abdominopelvic CT scans often use fixed contrast media (CM) volumes.
- Optimizing CM administration is crucial for balancing image quality and patient dose.
Purpose of the Study:
- To compare the image quality of abdominopelvic single-energy CT (SECT) and dual-energy CT (DECT) using customized CM injection protocols versus standard fixed protocols.
Main Methods:
- Retrospective analysis of 91 patients (SECT-100 kVp) and 83 patients (DECT-65 keV) with customized injection protocols.
- Comparison with prior abdominopelvic SECT-120 kVp scans using fixed CM injection.
- Customized protocols based on patient weight, contrast concentration, and injection rate formula.
Main Results:
- Customized injection significantly reduced CM volume (9-12 mL) and injection rate (0.2-0.4 mL/s) compared to SECT-120 kVp (p ≤ 0.001).
- Improved attenuation, noise, signal-to-noise, and contrast-to-noise ratios were observed for SECT-100 kVp and DECT-65 keV.
- Qualitative image quality scores were high (≥4) in 98.8% of customized injection cases.
Conclusions:
- Customized CM injection protocols offer a substantial reduction in iodine dose.
- These protocols yield superior image quality in abdominopelvic SECT-100 kVp and DECT-65 keV examinations.
- Weight-based customized protocols represent an effective strategy for optimizing CM administration in CT imaging.
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