Renal protection CT protocol using low-dose and low-concentration iodine contrast medium in at-risk patients of HCC and with chronic kidney disease: a randomized controlled non-inferiority trial

Abstract

Abstract Background Although efforts have been made to reduce the dose of Contrast Medium (CM) to improve patient safety, there are ongoing concerns regarding its potential effects on image quality and diagnostic performance. Moreover, research is lacking to establish a lower limit for safe and effective CM dose reduction. To determine whether the image quality of contrast-enhanced liver computed tomography (CT) using a reduced amount of iodinated CM was similar to that of standard liver CT. Methods We enrolled participants at risk for hepatocellular carcinoma with decreased estimated glomerular filtration rates ( 0.017). Conclusions The reduction in image contrast and overall image quality caused by decreased CM can be restored using either low monoenergetic imaging or DL-based iodine-boosting reconstruction. Trial registration clinicaltrials.gov, NCT04024514, Registered July 18, 2019, prospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT04024514 .