Evidence map›Paper›PMID 40506637›Full record

ArticleEuropean radiology2025

Contrast media and radiation dose optimization with task-based automatic keV selection: a proof-of-concept study with photon-counting detector CT.

Konstantin Klambauer, Thomas Flohr, Lukas Jakob Moser, Victor Mergen, Matthias Eberhard, Andreas Prokein, Hatem Alkadhi, Gregor Jost, Hubertus Pietsch

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Article in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Konstantin KlambauerDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Thomas FlohrDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Lukas Jakob MoserDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Victor MergenDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Matthias EberhardDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Andreas ProkeinSiemens Healthineers AG, Forchheim, Germany.
Hatem AlkadhiDiagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. hatem.alkadhi@usz.ch.ORCID http://orcid.org/0000-0002-2581-2166
Gregor JostMR and CT Contrast Media Research, Bayer AG, Berlin, Germany.
Hubertus PietschMR and CT Contrast Media Research, Bayer AG, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate whether task-based automatic keV selection of photon-counting detector (PCD)-CT with optimizing radiation and contrast media (CM) dose yields consistent image quality in CT angiography (CTA). MATERIALS AND

methodsPCD-CTA of the aorta was performed in six healthy minipigs across two scan sessions, with virtual monoenergetic images (VMI) reconstructed. In the first session, three protocols were conducted: the reference protocol A1 simulated standard CTA (210 mg iodine/kg CM, image quality (IQ)-level 117, non-contrast task, VMI: 70 keV); protocol A2 reduced radiation while keeping CM dose constant (210 mgI/kg, IQ-level 117, vascular task, VMI: 55 keV); and protocol A3 reduced CM dose while maintaining radiation (164 mgI/kg, IQ-level 117, non-contrast task, VMI: 55 keV). In the second session, protocols A2 and A3 were repeated as B1 and B2 to assess reproducibility, and protocol B3 further reduced the radiation dose with increased CM dose (252 mgI/kg, IQ-level 81, vascular task, VMI: 55 keV). Aortic CNR was measured; subjective assessments included contrast, noise, IQ, and visibility of intrahepatic arteries using a 4-point discrete visual scale.

resultsThe median CTDIvol was 3.8 mGy (A1, A3), 2.4 mGy (A2, B1), 3.9 mGy (B2), and 1.6 mGy (B3), respectively; median CM doses were 23 mL (A1, A2, B1), 18 mL (A3, B2), and 28 mL (B3), respectively. CNR was comparable across protocols (p = 0.906-0.947). Subjective metrics indicated diagnostic image quality (scores ≥ 2) for all protocols, with A1 and A3 having higher noise (p = 0.007-0.008) and lower vascular contrast (p = 0.003-0.008). Subjective image quality (p = 0.226-0.342) and visibility of intrahepatic arteries (p = 0.604-0.873) were similar.

conclusionTask-based automatic keV selection enables optimization of radiation and CM dose in PCD-CTA while maintaining image quality. Protocols can be balanced to either save radiation or CM dose, depending on individual patient needs. KEY POINTS: Question Balancing radiation and contrast media doses in CT angiography is essential, yet the full potential of photon-counting detector (PCD)CT for dose optimization remains underexplored. Findings Task-based automatic keV selection of PCD-CT enabled a 22% contrast reduction at constant radiation or a 58% radiation dose reduction with a compensatory 20% increase in contrast media. Clinical relevance Task-based automatic keV selection of PCD-CT allows individualized dose optimization by balancing radiation exposure and contrast media volume. This approach can improve patient safety by tailoring protocols to either radiation- or contrast media reduction.

Indexed as

Computed Tomography AngiographyContrast MediaRadiation DosageTomography, X-Ray ComputedAnimalsAortaPhantoms, ImagingPhotonsProof of Concept StudyRadiographic Image Interpretation, Computer-AssistedReproducibility of ResultsSwineSwine, MiniatureContrast MediaComputed tomography angiographyContrast mediaPhoton-counting detector CTRadiation doseTask-based automatic keV selection

Identifiers

PMID40506637
PMCPMC12634813

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.