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Article

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

1
College of Medicine, Ewha Womans University, Seoul 07804, Republic of Korea
2
Department of Radiology, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
3
Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul 07985, Republic of Korea
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Tomography 2025, 11(6), 66; https://doi.org/10.3390/tomography11060066
Submission received: 9 March 2025 / Revised: 30 May 2025 / Accepted: 3 June 2025 / Published: 4 June 2025

Abstract

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.
Keywords: radiation dosage; radiography; dual-energy scanned projection; iodine; contrast media; tomography radiation dosage; radiography; dual-energy scanned projection; iodine; contrast media; tomography

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MDPI and ACS Style

Kim, J.E.; Lim, Y.; Kim, J.S.; Lee, H.J.; Lee, J.K.; Lee, H.A. Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease. Tomography 2025, 11, 66. https://doi.org/10.3390/tomography11060066

AMA Style

Kim JE, Lim Y, Kim JS, Lee HJ, Lee JK, Lee HA. Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease. Tomography. 2025; 11(6):66. https://doi.org/10.3390/tomography11060066

Chicago/Turabian Style

Kim, Jae En, Yewon Lim, Jin Sil Kim, Hyo Jeong Lee, Jeong Kyong Lee, and Hye Ah Lee. 2025. "Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease" Tomography 11, no. 6: 66. https://doi.org/10.3390/tomography11060066

APA Style

Kim, J. E., Lim, Y., Kim, J. S., Lee, H. J., Lee, J. K., & Lee, H. A. (2025). Image Quality and Lesion Detectability with Low-Monoenergetic Imaging: A Study of Low-Concentration Iodine Contrast in Hepatic Multiphase CT for Chronic Liver Disease. Tomography, 11(6), 66. https://doi.org/10.3390/tomography11060066

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