ArticleEuropean radiology2026
Reducing contrast media dosage for pulmonary embolism CTPA in PCD-CT: a comparative study of EID-CT and PCD-CT in the era of individualized protocolling.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Patient-Specific Timing for Pulmonary CT Angiography: Human Validation of a Physiologically Derived Post-Trigger Delay Model.Diagnostics (Basel, Switzerland) · 2026Article
- Understanding Photon-Counting CT: Physics, Detector Technology, and Image Reconstructions.Sensors (Basel, Switzerland) · 2026Review
- Increasing pulmonary artery visibility and diagnostic confidence with ultra-high resolution photon-counting detector CT pulmonary angiography.European radiology · 2026Article
- Photon counting detector CT contrast agent-reduced transcatheter aortic valve reconstruction planning: a comparative study.European radiology · 2026Article
- Photon-counting detector CT for CT pulmonary angiography: a systematic review and meta-analysis.European radiology · 2026Article
- Insights into programmed cell death from multiple imaging modalities.Journal of translational medicine · 2026Review
- Lesion conspicuity assessment of prone 40-keV virtual monoenergetic imaging in arterial-phase photon-counting CT for breast cancer: a retrospective comparison with DCE-MRI.Japanese journal of radiology · 2026Article
- A personalized iodine delivery rate-based injection protocol in coronary angiography on photon-counting CT.European radiology · 2026Article
- Comparison of deep learning reconstruction and iterative reconstruction algorithms for virtual monoenergetic image quality in overweight and obese patients with triple-low scan protocol dual-energy carotid computed tomography angiography.Quantitative imaging in medicine and surgery · 2026Article
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8 authors.
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Abstract
objectivesTo evaluate diagnostic image quality (IQ) for pulmonary embolism detection in photon-counting detector CT (PCD-CT) with significantly reduced contrast media (CM) dose vs conventional energy-integrating detector CT (EID-CT), using optimized and individualized CM protocols. MATERIALS AND
methodsConsecutive CT pulmonary angiography (CTPA) scans performed on the EID-CT (Jan 2024-Mar 2024) with an individualized kilovoltage (kV) and total body weight (TBW) adapted CM protocol, and on the PCD-CT (Aug 2023-Feb 2024) with a TBW adapted CM protocol matching the 70 kV EID-CT protocol, were retrospectively collected. EID-CT scans were performed at 70-120 kV, based on patients' size, while PCD-CT scans were performed at 120 kV with 55 keV virtual monoenergetic images. Objective IQ assessment included mean attenuation (in Hounsfield Units), signal-to-noise ratio, and contrast-to-noise ratio (CNR). Two board-certified radiologists assessed diagnostic IQ subjectively using a five-point Likert scale.
resultsIn 140 EID-CT and 118 PCD-CT scans, PCD-CT reduced total iodine load by 26.7% and CT dose index volume by 24.4%. Objective IQ parameters showed no significant differences, except for a decrease in CNR in the proximal pulmonary arteries in PCD-CT scans (p = 0.02). Subjective IQ was rated as moderate/good by observers 1 and 2 in 94.9% and 97.9% of the EID-CT scans, respectively, and 96.5% and 100% of the PCD-CT scans, respectively.
conclusionPCD-CT with a TBW-adapted CM protocol can achieve substantial reductions in both CM and radiation dose compared to EID-CT with individualized kV and TBW adapted CM protocols, while maintaining diagnostic IQ in CTPA scans. KEY POINTS: Question The feasibility of CM reduction in PCD-CT vs EID-CT with highly individualized CM protocols, while maintaining diagnostic IQ. Findings PCD-CT reduces total iodine load by 26.7% and CT dose index volume by 24.4% compared to EID-CT, with comparable objective and subjective diagnostic IQ. Clinical relevance This approach enables CM reduction, potentially lowering patient risk and providing environmental and financial benefits. Additionally, PCD-CT allows for CM and radiation dose reduction while maintaining comparable IQ.
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