(2026) Stammen | Contrast media reduction for CTPA using PCCT vs EID-CT

Daniel Stromer

PCCT reduced iodine load by 26.7% and CTDIvol by 24.4% compared to highly individualized EID-CT protocols, confirming real-world dose efficiency even against optimized reference standards. Diagnostic image quality (IQ) remained equivalent, with no significant differences in attenuation or SNR and only a minor, clinically irrelevant CNR reduction proximally.

A TBW-adapted CM protocol with fixed 120 kV and 55 keV VMI is sufficient on PCCT, simplifying workflow while enabling contrast and radiation dose savings.

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Figure 3

Representative CT pulmonary artery scans from both a PCD-CT and an EID-CT. Images A and B were rated by both observers as moderate, and C and D were rated as good by both observers. Images E and F are examples of PE findings for both scanners.

Protocol

Detail	Protocol
Scanner	NAEOTOM Alpha
Scan area	Pulmonary arteries (CTPA)
Scan mode	QuantumPlus
Tube voltage [kV]	120
IQ level	70 (CARE keV)
Dose modulation	CARE Dose4D, CARE keV
CTDIvol [mGy]	3.4 +/- 1.1
DLP [mGy*cm]	n.r.
Effective dose [mSv]	n.r.
Rotation time [s]	0.25
Pitch	2.4
Slice collimation [mm]	144 × 0.4
Slice width [mm]	1.0
Reconstruction increment [mm]	0.8
Reconstruction kernel	Bv40
Iterative reconstruction	QIR (strength 3)
keV level [keV]	55 (VMI)
Contrast agent	Ultravist 300 / 370
Contrast volume	TBW-adapted (≈10.2 +/- 1.4 g iodine total load)
Flow rate	n.r. (fixed injection duration around 8 s)
Saline chaser	40 mL
Acquisition phase	Pulmonary arterial (test bolus + peak + 7 s)

Stammen L, Hoeijmakers EJI, Flohr TG, et al. Reducing contrast media dosage for pulmonary embolism CTPA in PCCT. Eur Radiol. 2026;36:3206–3215. doi:10.1007/s00330-025-12054-6