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High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals

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Contrast injection protocols used in oncological CT and opportunities for practice optimisation.

M Gulizia¹, A Viry², C S Dos Reis³

¹Department of Radiology and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne University Hospital, Radiology, 1011 Lausanne, Switzerland.

Radiography (London, England : 1995)

|June 17, 2026

Summary

Oncologic CT contrast protocols show significant variation across Western Switzerland, impacting image quality and patient safety. Standardizing protocols with advanced technologies like spectral imaging is crucial for evidence-based practice.

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Area of Science:

Radiology
Medical Imaging
Oncologic Imaging

Background:

Contrast-enhanced CT is vital for cancer imaging, but lacks standardized injection protocols.
Variability in protocols affects image quality and patient safety.
Mapping current practices is essential to address this heterogeneity.

Purpose of the Study:

To survey and map current contrast injection protocols for oncologic body CT in Western Switzerland.
To identify variations in technical acquisition and injection parameters.
To understand protocol optimization practices and specialist involvement.

Main Methods:

An online survey was distributed to 74 medical imaging institutions.
The survey collected data on demographics, acquisition/injection protocols, and optimization strategies.
Data included details on CT energy levels, reconstruction algorithms, and contrast agent characteristics.

Main Results:

42% of institutions completed the survey, revealing significant protocol heterogeneity.
Most used single-energy CT (74%) and iterative reconstruction (68%).
Contrast volume was typically weight-based (84%), with common iodine concentrations of 350-400 mgI/mL and an average injection rate of 3 mL/s.

Conclusions:

Marked heterogeneity exists in oncologic CT contrast protocols in Western Switzerland.
Optimization potential is high with advanced technologies like spectral imaging and deep learning reconstruction.
There is a need for updated, evidence-based injection protocols aligned with technological advancements.