Can high iodine delivery rate help reduce radiation dose in pulmonary CT angiography?

Analysis by JF. Paul

 

In a recent paper published in the Journal of Thoracic Imaging last September, Heusch et al. [ 1] reported an interesting study that evaluated the possibility of reducing radiation dose by using a high iodine delivery rate (IDR) in patients referred for pulmonary CT angiography. The goal of the study was to test the concept of “high IDR – low mAs” protocols in patients suspected of pulmonary embolism in terms of subjective and objective image quality. To achieve this proof-of-concept, the authors compared four protocols that all used a contrast medium with high iodine concentration (85 mL iomeprol; 400 mg/mL iodine) and the same peak tube voltage (100 kVp) but that differed in the injection flow rate and in the tube current-time product:

  • Protocol A: 5 mL/s and 90 mAs
  • Protocol B: 3.5 mL/s and 135 mAs
  • Protocol C: 5 mL/s and 135 mAs
  • Protocol D: 3.5 mL/s and 90 mAs
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