CT Angiography in the Lower Extremity Peripheral Artery Disease Feasibility of an Ultra-Low Volume Contrast Media Protocol

Barbora Horehledova*, Casper Mihl, Gianluca Milanese, Rutger Brans, Nienke G. Eijsvoogel, Babs M. F. Hendriks, Joachim E. Wildberger, Marco Das

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Web of Science)


PurposeThe ALARA principle is not only relevant for effective dose (ED) reduction, but also applicable for contrast media (CM) management. Therefore, the aim was to evaluate the feasibility of an ultra-low CM protocol in the assessment of peripheral artery disease (PAD). Materials and methodsFifty PAD patients were scanned on third-generation dual-source computed tomography, from diaphragm to the forefoot, as follows: tube voltage: 70kV, reference effective tube current: 90mAs, collimation: 192x2x0.6mm, with individualized acquisition timing. The protocol ED (mSv) was quantified with dedicated software. CM protocol consisted of 15ml test bolus and 30ml main bolus (300mgI/ml) injected at 5ml/s, followed by a 40ml saline chaser at the same flow rate. Aorto-popliteal bolus transit time was used to calculate the overall acquisition time and delay. Objective (hounsfield unitsHU; contrast-to-noise ratioCNR) and subjective image quality (four-point Likert score) were assessed at different anatomical regions from the aorta down to the forefoot.ResultsMean attenuation values were exceeding 250HU from aorta down to the anterior tibial artery with CNR

Original languageEnglish
Pages (from-to)1751-1764
Number of pages14
JournalCardiovascular and Interventional Radiology
Issue number11
Publication statusPublished - Nov 2018


  • Peripheral vascular diseases
  • Peripheral arterial disease
  • Diagnostic imaging
  • Multidetector computed tomography
  • Angiography
  • Radiographic image enhancement
  • Contrast media
  • Humans
  • Middle Aged
  • Image Interpretation, Computer-Assisted
  • Male
  • Feasibility Studies
  • Aged, 80 and over
  • Female
  • Contrast Media/administration & dosage
  • Computed Tomography Angiography/methods
  • Peripheral Arterial Disease/diagnostic imaging
  • Lower Extremity/blood supply
  • Aged
  • Software

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