New Virtual Contrast Enhancement Boost Technique Can Reduce the Dose of Intravenous Contrast Medium Used in Angiotomography of the Abdominal Aorta

Purpose: This study aims to evaluate the image quality of computed tomography (CT) angiograms obtained using a virtual contrast augmentation technique, adding an iodine map to the contrast-enhanced images, obtained through a digital subtraction technique, reducing the dose of intravenous iodinated contrast medium compared to the conventional institutional standard technique. Methods: This prospective investigation enrolled patients previously diagnosed with abdominal aortic aneurysms, who underwent two successive computed tomography angiographies (CTAs) of the aorta. One CTA was performed employing the virtual contrast enhancement boost technique with a 40% decrease in the intravenous contrast medium dose, while the other adhered to the conventional protocol without any reduction in contrast medium volume. After imaging, both qualitative and quantitative assessments were conducted to evaluate the opacification level of the aorta and its branching vessels. Results: The study analyzed 28 examinations from 14 subjects (two per participant). Qualitative analysis revealed that image quality was deemed adequate for diagnostic purposes, with nearly all arterial segments in both protocols rated as good or excellent. Although no statistically significant differences were detected, the average attenuation across all arterial segments in the angiograms exhibited a trend towards higher values in the virtual contrast enhancement boost technique, compared to the conventional protocol. Similarly, the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) demonstrated comparable levels between the two methodologies. Conclusion: The application of virtual contrast enhancement in the acquisition of CT angiograms of the aorta maintains comparable image quality, while reducing the dosage of intravenous contrast medium in 40%. This approach suggests a potential for optimizing contrast use in vascular imaging, aligning with goals related to patient safety and radiological efficiency.