Low-concentration contrast abdominopelvic CT - A comparison with high-concentration contrast CT image quality

Sep 29, 2026

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A prospective noninferiority study compared abdominopelvic computed tomography (APCT) image quality using low- versus high-concentration iodinated contrast agents in cancer patients. Low concentration used 1.5 mL/kg iohexol 270, while a matched control group received 1.1–1.2 mL/kg iohexol 350 with dual tube voltages (80 kVp and 80/Sn150 kVp). Subjective and objective quality of focal lesions were analyzed by blinded radiologists. Overall image quality showed no significant differences; margin sharpness and conspicuity were also similar, supporting comparable diagnostic performance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Abstract

Objective

Methods

Results

Conclusions

Introduction

Clinical importance of contrast-enhanced CT

Contrast dose and concentration considerations

Rationale for low-concentration protocols

OPEN ACCESS Citation: Yoon S, Park J-H, Sym SJ, Yang DH, Lee JS, Park SH (2026) Low-concentration contrast abdominopelvic CT: A comparison with high-concentration contrast CT image quality. PLoS One 21(1): e0338726. [https://doi](https://doi). org/10.1371/journal.pone.0338726 Editor: Haipeng Liu, Coventry University, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND Received: June 8, 2025 Accepted: November 26, 2025 Published: January 5, 2026 Copyright: © 2026 Yoon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: All relevant data are within the paper and its Supporting Information files. Funding: This study was supported by a grant from TAEJOON Pharmaceutical Co. , Ltd. There RESEARCH ARTICLE Low-concentration contrast abdominopelvic CT: A comparison with high-concentration contrast CT image quality Sungjin Yoon1,2‡, Joo-Hwan Park3‡, Sun Jin Sym3, Dong Hyuk Yang1, Ji Sung Lee4, So Hyun Park1,5* 1 Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea, 2 Department of Radiology, Incheon Sejong hospital, Incheon, Republic of Korea, 3 Division of Medical Oncology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea, 4 Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea, 5 Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea ‡ These authors contributed equally to this work and share first authorship on this work. * [nnoleeter@naver.com](nnoleeter@naver.com) Abstract Objective This study aimed to compare abdominopelvic computed tomography (APCT) image quality using low and high concentrations of a contrast agent in patients with cancer via a noninferiority design. Methods This study prospectively included 99 patients with malignancies who underwent dual-source APCT following injection of 1.5 mL/kg of iohexol 270 (low-concentration group) . The control group included patients who were retrospectively matched 1:1 based on weight, body mass index, and sex. These patients (high-concentration group) received 1.1 or 1.2 mL/kg of iohexol 350, reconstructed at two tube voltages (80 kVp and 80/Sn150 kVp) . The noninferiority margins were set at −0.21 for overall image quality. Two radiologists blindly and independently analyzed the subjective and objective image quality of matching focal lesions. Results A total of 198 patients with 102 focal lesions (44 liver lesions, 58 renal lesions) were assessed. The total iodine amount was slightly higher in the low-concentration group than in the high-concentration group without significant differences (24580 .0 ± 3745.6 vs. 24190.2 ± 3954.3 mg I/mL; p = 0.051) . Overall image quality did not differ significantly between the groups (2 .6 ± 0.5 vs. 2.6 ± 0.5 on 80 kVp; p = 0.484; 3.4 ± 0.5 PLOS One | [https://doi.org/10.1371/journal.pone.0338726](https://doi.org/10.1371/journal.pone.0338726) January 5, 2026 1 / 15 was no additional external funding received for this study. Competing interests: The authors have declared that no competing interests exist. vs. 3.4 ± 0.6 on 80/Sn 150 kVp, p = 0.891) . Margin sharpness and conspicuity also showed no significant differences between the low-and high-concentration groups at 80 kVp (p = 0.890, 0. 103) and 80/Sn 150 kVp images (p = 0.278, 0.369) . Liver attenuation was slightly higher in the low-concentration than in the high-concentration group (80 kVp, 127.3 ± 16.8 vs. 122.4 ± 13 .0, p = 0.013; 80 kVp/Sn 150 kVp, 108.2 ± 13.3 vs. 104.5 ± 10 .9, p = 0.025) . No major or minor adverse reacti

FAQs

What was the primary objective of the study?

To compare abdominopelvic CT image quality using low- and high-concentration contrast agents in cancer patients under a noninferiority design.

How were patients assigned to the low- and high-concentration groups?

Ninety-nine patients underwent dual-source APCT with low-concentration iohexol 270, and the high-concentration group was retrospectively matched 1:1 by weight, body mass index, and sex.

What were the main findings regarding image quality?

Overall image quality did not differ significantly between low- and high-concentration groups, and margin sharpness and conspicuity were also not significantly different.

Sep 29, 2026

Uploaded by Elsa