Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease

Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease

Background: This study aimed to evaluate whether low-concentration iodine contrast-enhanced multiphase low-monoenergetic computed tomography (LCLM CT; 270 mg I/mL, 40 keV) is non-inferior to standard-dose computed tomography (SDCT; 350 mg I/mL) in image quality and lesion detectability for chronic l...

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Bibliographic Details
Main Authors: Jae En Kim, Yewon Lim, Jin Sil Kim, Hyo Jeong Lee, Jeong Kyong Lee, Hye Ah Lee
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Tomography
Subjects:
radiation dosage
radiography
dual-energy scanned projection
iodine
contrast media
tomography
Online Access:https://www.mdpi.com/2379-139X/11/6/66
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Summary:Background: This study aimed to evaluate whether low-concentration iodine contrast-enhanced multiphase low-monoenergetic computed tomography (LCLM CT; 270 mg I/mL, 40 keV) is non-inferior to standard-dose computed tomography (SDCT; 350 mg I/mL) in image quality and lesion detectability for chronic liver disease patients. Methods: Sixty-seven patients underwent both protocols. Image quality was assessed using a 5-point scale with a non-inferiority margin of −0.5. Quantitative metrics included signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Lesion detectability was evaluated using jackknife free-response receiver operating characteristic (JAFROC) analysis with a −0.1 margin. Results: LCLM CT reduced iodine dose per kilogram by 21.9%. Despite higher image noise, it achieved higher CNR for the aorta and hepatic lesions, as well as superior hepatic artery clarity. Image quality was non-inferior (difference: −0.119; 95% CI: −0.192 to −0.047), and lesion detectability (FOM: 0.744 vs. 0.721; difference: 0.023; 95% CI: −0.170 to 0.218) also showed non-inferiority. Conclusions: LCLM CT maintains diagnostic performance and improves vascular contrast while reducing iodine burden, supporting its clinical utility in longitudinal HCC surveillance.
ISSN:2379-1381
2379-139X

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