ArticleFrontiers in medicine2026
Dual-low spectral CT pulmonary angiography: a comparative study of image quality, radiation dose, and iodine intake with evaluation of pulmonary embolism detection.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.
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Corrections and comments
- Erratum issued
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8 authors.
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Abstract
Background: CT pulmonary angiography (CTPA) is widely recognized as the first-line imaging modality for pulmonary embolism (PE) because of its rapid and accurate characteristics. However, the radiation exposure and risk of contrast-induced acute kidney injury associated with conventional CTPA have motivated continuous efforts to develop "dual-low" protocols that achieve both low radiation dose and low iodine contrast dose. Purpose: To evaluate the feasibility of a dual-low CT pulmonary angiography (CTPA) protocol integrating spectral CT, complete dual-flow injection, and low iodine dose (10 mL), and to verify three primary endpoints: (1) reduction of effective radiation dose (ED); (2) reduction of iodine intake; (3) superior subjective image quality (3-point scale) under low-dose conditions. Secondary endpoint: added value of iodine density maps for visualizing perfusion defects. Methods: Prospective randomized controlled trial. 160 suspected pulmonary embolism (PE) patients randomized to experimental group ( Results: Subjective score higher in experimental group (2.69 ± 0.44 vs. 2.33 ± 0.44, Conclusion: The dual-low spectral CTPA protocol achieved 41.2% radiation reduction, 66.7% iodine reduction, and superior subjective image quality. Iodine density maps provide complementary functional information. This protocol is a safe and effective alternative for CTPA.
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