{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T13:32:37Z","timestamp":1781962357075,"version":"3.54.5"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>To compare vascular attenuation (VA) with three strategies for administering a low contrast medium (CM) dose in dual-layer spectral detector CT pulmonary angiography (CTPA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients were prospectively randomised into control- or one of two experimental groups. Control group patients received CM (350 mgI\/mL) diluted 1:1 with saline. Experimental group B received CM (350 mgI\/mL) with low flow. Experimental group C received CM with low concentration (140 mgI\/mL). Virtual monoenergetic images at 40 and 55 kiloelectron Volt (keV) were reconstructed. Objective examination quality (OEQ) i.e., VA, noise, and signal-to-noise ratio, was measured and subjective examination quality (SEQ) was rated at three anatomical levels: in the pulmonary trunk (PT), the interlobar arteries and the posterior basal segmental arteries. Primary outcome: VA in PT at 40\u2009keV. Secondary outcomes: OEQ and SEQ across all anatomic levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 328 patients were randomised. 112 vs 115 and 101 were analysed in the control (A) vs experimental groups (B and C), respectively. There were no differences in VA in PT between the groups: A vs B (<jats:italic>p<\/jats:italic>\u2009=\u20090.96), B vs C (<jats:italic>p<\/jats:italic>\u2009=\u20090.14), and A vs C (<jats:italic>p<\/jats:italic>\u2009=\u20090.18). Group C showed higher VA across all anatomical levels. There were no differences in SEQ.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>There was no difference in the attenuation in the PT between the dilution-, low flow-, and low concentration groups. However, the low concentration group showed higher attenuation in the pulmonary arteries when all anatomical levels were assessed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Question<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>Contrast medium reduction may be accomplished with dilution, low flow, or low concentration. However, the effect of the different strategies on vascular attenuation is unknown<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Findings\u00a0<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>There was no difference in pulmonary trunk attenuation between the three strategies on spectral detector CT pulmonary angiography<\/jats:italic>.<\/jats:p>\n            <jats:p>\n              <jats:bold>\n                <jats:italic>Clinical relevance<\/jats:italic>\n              <\/jats:bold>\n              <jats:italic>\u00a0Low contrast medium dose spectral detector CT pulmonary angiography may be implemented with the administration strategy of the unit\u2019s own choice<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00330-025-11420-8","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T15:34:39Z","timestamp":1739979279000},"page":"4649-4660","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A randomised controlled trial comparing three clinical administration strategies in spectral detector CT pulmonary angiography with low contrast medium dose"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8591-8029","authenticated-orcid":false,"given":"Cathrine Helgestad","family":"Kristiansen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton Bengt","family":"Nyquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audun","family":"Sanderud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao","family":"Boavida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonn Terje","family":"Geitung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thien Trung","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M\u00e6hre","family":"Lauritzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"11420_CR1","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","volume":"41","author":"SV Konstantinides","year":"2020","unstructured":"Konstantinides SV, Meyer G, Becattini C et al (2020) 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 41:543\u2013603","journal-title":"Eur Heart J"},{"key":"11420_CR2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s13244-022-01175-x","volume":"13","author":"HM Dekker","year":"2022","unstructured":"Dekker HM, Stroomberg GJ, Prokop M (2022) Tackling the increasing contamination of the water supply by iodinated contrast media. Insights Imaging 13:30","journal-title":"Insights Imaging"},{"key":"11420_CR3","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-20254-y","volume":"8","author":"M Meyer","year":"2018","unstructured":"Meyer M, Haubenreisser H, Schabel C et al (2018) CT pulmonary angiography in patients with acute or chronic renal insufficiency: evaluation of a low dose contrast material protocol. Sci Rep 8:1995","journal-title":"Sci Rep"},{"key":"11420_CR4","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1097\/RCT.0b013e31828f5020","volume":"37","author":"J Dong","year":"2013","unstructured":"Dong J, Wang X, Jiang X et al (2013) Low-contrast agent dose dual-energy CT monochromatic imaging in pulmonary angiography versus routine CT. J Comput Assist Tomogr 37:618\u2013625","journal-title":"J Comput Assist Tomogr"},{"key":"11420_CR5","doi-asserted-by":"publisher","first-page":"e0167214","DOI":"10.1371\/journal.pone.0167214","volume":"11","author":"A Meier","year":"2016","unstructured":"Meier A, Higashigaito K, Martini K et al (2016) Dual energy CT pulmonary angiography with 6g iodine\u2014a propensity score-matched study. PLoS One 11:e0167214","journal-title":"PLoS One"},{"key":"11420_CR6","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1148\/radiol.11110648","volume":"262","author":"R Yuan","year":"2012","unstructured":"Yuan R, Shuman WP, Earls JP et al (2012) Reduced iodine load at CT pulmonary angiography with dual-energy monochromatic imaging: comparison with standard CT pulmonary angiography-a prospective randomized trial. Radiology 262:290\u2013297","journal-title":"Radiology"},{"key":"11420_CR7","doi-asserted-by":"publisher","first-page":"6033","DOI":"10.1007\/s00330-023-09575-3","volume":"33","author":"CH Kristiansen","year":"2023","unstructured":"Kristiansen CH, Thomas O, Tran TT et al (2023) Halved contrast medium dose in lower limb dual-energy computed tomography angiography-a randomized controlled trial. Eur Radiol 33:6033\u20136044","journal-title":"Eur Radiol"},{"key":"11420_CR8","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1148\/radiol.2021204446","volume":"301","author":"TH Su","year":"2021","unstructured":"Su TH, Hsieh CH, Chan YL et al (2021) Intravenous CT contrast media and acute kidney injury: a multicenter emergency department-based study. Radiology 301:571\u2013581","journal-title":"Radiology"},{"key":"11420_CR9","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1148\/radiol.221183","volume":"304","author":"TM Grist","year":"2022","unstructured":"Grist TM, Canon CL, Fishman EK, Kohi MP, Mossa-Basha M (2022) Short-, mid-, and long-term strategies to manage the shortage of iohexol. Radiology 304:289\u2013293","journal-title":"Radiology"},{"key":"11420_CR10","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20190995","volume":"93","author":"H Alobeidi","year":"2020","unstructured":"Alobeidi H, Alshamari M, Widell J, Eriksson T, Lid\u00e9n M (2020) Minimizing contrast media dose in CT pulmonary angiography with high-pitch technique. Br J Radiol 93:20190995","journal-title":"Br J Radiol"},{"key":"11420_CR11","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1148\/radiol.2019190829","volume":"293","author":"HJ Park","year":"2019","unstructured":"Park HJ, Son JH, Kim TB et al (2019) Relationship between lower dose and injection speed of iodinated contrast material for CT and acute hypersensitivity reactions: an observational study. Radiology 293:565\u2013572","journal-title":"Radiology"},{"key":"11420_CR12","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1016\/j.ejrad.2019.03.008","volume":"116","author":"AL Faucon","year":"2019","unstructured":"Faucon AL, Bobrie G, Cl\u00e9ment O (2019) Nephrotoxicity of iodinated contrast media: from pathophysiology to prevention strategies. Eur J Radiol 116:231\u2013241","journal-title":"Eur J Radiol"},{"key":"11420_CR13","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1016\/j.ejrad.2013.11.005","volume":"83","author":"P Apfaltrer","year":"2014","unstructured":"Apfaltrer P, Sudarski S, Schneider D et al (2014) Value of monoenergetic low-kV dual energy CT datasets for improved image quality of CT pulmonary angiography. Eur J Radiol 83:322\u2013328","journal-title":"Eur J Radiol"},{"key":"11420_CR14","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1148\/radiol.2018180594","volume":"289","author":"EK Weidman","year":"2018","unstructured":"Weidman EK, Plodkowski AJ, Halpenny DF et al (2018) Dual-energy CT angiography for detection of pulmonary emboli: incremental benefit of iodine maps. Radiology 289:546\u2013553","journal-title":"Radiology"},{"key":"11420_CR15","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1055\/s-0043-103089","volume":"189","author":"B Petritsch","year":"2017","unstructured":"Petritsch B, Kosmala A, Gassenmaier T et al (2017) Diagnosis of pulmonary artery embolism: comparison of single-source CT and 3rd generation dual-source CT using a dual-energy protocol regarding image quality and radiation dose. Rofo 189:527\u2013536","journal-title":"Rofo"},{"key":"11420_CR16","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1148\/radiol.2019182297","volume":"293","author":"MH Albrecht","year":"2019","unstructured":"Albrecht MH, Vogl TJ, Martin SS et al (2019) Review of clinical applications for virtual monoenergetic dual-energy CT. Radiology 293:260\u2013271","journal-title":"Radiology"},{"key":"11420_CR17","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.ejrad.2017.01.016","volume":"88","author":"M Ohana","year":"2017","unstructured":"Ohana M, Labani A, Severac F et al (2017) Single source dual energy CT: what is the optimal monochromatic energy level for the analysis of the lung parenchyma? Eur J Radiol 88:163\u2013170","journal-title":"Eur J Radiol"},{"key":"11420_CR18","doi-asserted-by":"publisher","first-page":"41","DOI":"10.25259\/JCIS_51_2022","volume":"12","author":"K Kaproth-Joslin","year":"2022","unstructured":"Kaproth-Joslin K, Hobbs S, Rajiah P, Chaturvedi A, Chaturvedi A (2022) Optimizing low contrast volume thoracic CT angiography: from the basics to the advanced. J Clin Imaging Sci 12:41","journal-title":"J Clin Imaging Sci"},{"key":"11420_CR19","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.crad.2010.05.011","volume":"66","author":"MR Radon","year":"2011","unstructured":"Radon MR, Kaduthodil MJ, Jagdish J et al (2011) Potentials and limitations of low-concentration contrast medium (150 mg iodine\/mL) in CT pulmonary angiography. Clin Radiol 66:43\u201349","journal-title":"Clin Radiol"},{"key":"11420_CR20","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/00005382-200401000-00001","volume":"19","author":"MV Gosselin","year":"2004","unstructured":"Gosselin MV, Rassner UA, Thieszen SL, Phillips J, Oki A (2004) Contrast dynamics during CT pulmonary angiogram: analysis of an inspiration associated artifact. J Thorac Imaging 19:1\u20137","journal-title":"J Thorac Imaging"},{"key":"11420_CR21","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.2214\/AJR.06.1104","volume":"188","author":"C Wittram","year":"2007","unstructured":"Wittram C (2007) How I do it: CT pulmonary angiography. AJR Am J Roentgenol 188:1255\u20131261","journal-title":"AJR Am J Roentgenol"},{"key":"11420_CR22","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1148\/radiol.10100047","volume":"257","author":"PD Deak","year":"2010","unstructured":"Deak PD, Smal Y, Kalender WA (2010) Multisection CT protocols: sex- and age-specific conversion factors used to determine effective dose from dose-length product. Radiology 257:158\u2013166","journal-title":"Radiology"},{"key":"11420_CR23","first-page":"65","volume":"6","author":"S Holm","year":"1979","unstructured":"Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Stat 6:65\u201370","journal-title":"Scand J Stat"},{"key":"11420_CR24","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","volume":"33","author":"JR Landis","year":"1977","unstructured":"Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159\u2013174","journal-title":"Biometrics"},{"key":"11420_CR25","unstructured":"R Core Team (2023) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna"},{"key":"11420_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v082.i13","volume":"82","author":"A Kuznetsova","year":"2017","unstructured":"Kuznetsova A, Brockhoff PB, Christensen RHB (2017) lmerTest package: tests in linear mixed effects models. J Stat Softw 82:1\u201326","journal-title":"J Stat Softw"},{"key":"11420_CR27","unstructured":"Christensen RHB (2022) Ordinal\u2014regression models for ordinal data. R package version 2022.11-16"},{"key":"11420_CR28","doi-asserted-by":"publisher","first-page":"2826","DOI":"10.1007\/s00330-008-1080-0","volume":"18","author":"G M\u00fchlenbruch","year":"2008","unstructured":"M\u00fchlenbruch G, Behrendt FF, Eddahabi MA et al (2008) Which iodine concentration in chest CT?\u2014A prospective study in 300 patients. Eur Radiol 18:2826\u20132832","journal-title":"Eur Radiol"},{"key":"11420_CR29","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-35918-y","volume":"8","author":"T Van Cauteren","year":"2018","unstructured":"Van Cauteren T, Van Gompel G, Nieboer KH et al (2018) Improved enhancement in CT angiography with reduced contrast media iodine concentrations at constant iodine dose. Sci Rep 8:17493","journal-title":"Sci Rep"},{"key":"11420_CR30","doi-asserted-by":"publisher","first-page":"225","DOI":"10.21037\/cdt.2017.12.01","volume":"8","author":"AJE Moore","year":"2018","unstructured":"Moore AJE, Wachsmann J, Chamarthy MR, Panjikaran L, Tanabe Y, Rajiah P (2018) Imaging of acute pulmonary embolism: an update. Cardiovasc Diagn Ther 8:225\u2013243","journal-title":"Cardiovasc Diagn Ther"},{"key":"11420_CR31","doi-asserted-by":"publisher","DOI":"10.1148\/ryai.210162","volume":"4","author":"LD Hahn","year":"2022","unstructured":"Hahn LD, Hall K, Alebdi T, Kligerman SJ, Hsiao A (2022) Automated deep learning analysis for quality improvement of CT pulmonary angiography. Radiol Artif Intell 4:e210162","journal-title":"Radiol Artif Intell"},{"key":"11420_CR32","doi-asserted-by":"publisher","first-page":"20150850","DOI":"10.1259\/bjr.20150850","volume":"89","author":"BM Hendriks","year":"2016","unstructured":"Hendriks BM, Kok M, Mihl C, Bekkers SC, Wildberger JE, Das M (2016) Individually tailored contrast enhancement in CT pulmonary angiography. Br J Radiol 89:20150850","journal-title":"Br J Radiol"},{"key":"11420_CR33","doi-asserted-by":"publisher","first-page":"399","DOI":"10.2967\/jnumed.120.242776","volume":"62","author":"MS Lazarus","year":"2021","unstructured":"Lazarus MS, Kim Y, Mathai B et al (2021) Diagnostic performance of pulmonary embolism imaging in patients with history of asthma. J Nucl Med 62:399\u2013404","journal-title":"J Nucl Med"},{"key":"11420_CR34","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s10140-016-1425-y","volume":"23","author":"DD Bates","year":"2016","unstructured":"Bates DD, Tkacz JN, LeBedis CA, Holalkere N (2016) Suboptimal CT pulmonary angiography in the emergency department: a retrospective analysis of outcomes in a large academic medical center. Emerg Radiol 23:603\u2013607","journal-title":"Emerg Radiol"},{"key":"11420_CR35","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1016\/j.jhsa.2024.01.006","volume":"49","author":"BM Derksen","year":"2024","unstructured":"Derksen BM, Bruinsma W, Goslings JC, Schep NWL (2024) The Kappa Paradox explained. J Hand Surg Am 49:482\u2013485","journal-title":"J Hand Surg Am"},{"key":"11420_CR36","doi-asserted-by":"publisher","first-page":"549","DOI":"10.5606\/tgkdc.dergisi.2022.21976","volume":"30","author":"P \u00c7eltik\u00e7i","year":"2022","unstructured":"\u00c7eltik\u00e7i P, Hekimo\u011flu K, Kahraman G, Murat Haberal K, K\u0131l\u0131\u00e7 D (2022) Dual-energy computed tomography pulmonary angiography with ultra-low dose contrast administration: comparison of image quality with standard computed tomography pulmonary angiography. Turk Gogus Kalp Damar Cerrahisi Derg 30:549\u2013556","journal-title":"Turk Gogus Kalp Damar Cerrahisi Derg"},{"key":"11420_CR37","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.clinimag.2020.10.006","volume":"69","author":"SR Digumarthy","year":"2021","unstructured":"Digumarthy SR, Singh R, Rastogi S et al (2021) Low contrast volume dual-energy CT of the chest: quantitative and qualitative assessment. Clin Imaging 69:305\u2013310","journal-title":"Clin Imaging"},{"key":"11420_CR38","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1016\/j.jmir.2020.06.002","volume":"51","author":"PJ Ratnakanthan","year":"2020","unstructured":"Ratnakanthan PJ, Kavnoudias H, Paul E, Clements WJ (2020) Weight-adjusted contrast administration in the computed tomography evaluation of pulmonary embolism. J Med Imaging Radiat Sci 51:451\u2013461","journal-title":"J Med Imaging Radiat Sci"},{"key":"11420_CR39","unstructured":"GEHealthCare (2024) Prescribing information Omnipaque GE HealthCare. Available via https:\/\/www.legemiddelsok.no\/_layouts\/15\/Preparatomtaler\/Spc\/0000-06733.pdf. Accessed 15 Oct 2024"},{"key":"11420_CR40","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1097\/RLI.0b013e31829979e8","volume":"48","author":"C Mihl","year":"2013","unstructured":"Mihl C, Wildberger JE, Jurencak T et al (2013) Intravascular enhancement with identical iodine delivery rate using different iodine contrast media in a circulation phantom. Invest Radiol 48:813\u2013818","journal-title":"Invest Radiol"},{"key":"11420_CR41","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1148\/radiol.10090908","volume":"256","author":"KT Bae","year":"2010","unstructured":"Bae KT (2010) Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology 256:32\u201361","journal-title":"Radiology"},{"key":"11420_CR42","volume":"2019","author":"H Tomita","year":"2019","unstructured":"Tomita H, Shibata K (2019) Verification of the dose reduction effect via diluted injection in dual-energy computed tomography using a human blood flow phantom. Radiol Res Pract 2019:3512126","journal-title":"Radiol Res Pract"},{"key":"11420_CR43","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.rcl.2009.08.012","volume":"48","author":"KT Bae","year":"2010","unstructured":"Bae KT (2010) Optimization of contrast enhancement in thoracic MDCT. Radiol Clin North Am 48:9\u201329","journal-title":"Radiol Clin North Am"},{"key":"11420_CR44","doi-asserted-by":"publisher","first-page":"57","DOI":"10.4103\/2156-7514.100999","volume":"2","author":"J Gossner","year":"2012","unstructured":"Gossner J (2012) Feasibility of computed tomography pulmonary angiography with low flow rates. J Clin Imaging Sci 2:57","journal-title":"J Clin Imaging Sci"},{"key":"11420_CR45","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1016\/j.ejrad.2015.06.031","volume":"84","author":"C Mihl","year":"2015","unstructured":"Mihl C, Kok M, Wildberger JE et al (2015) Coronary CT angiography using low concentrated contrast media injected with high flow rates: feasible in clinical practice. Eur J Radiol 84:2155\u20132160","journal-title":"Eur J Radiol"},{"key":"11420_CR46","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s11604-022-01367-x","volume":"41","author":"Y Nakamura","year":"2023","unstructured":"Nakamura Y, Higaki T, Kondo S, Kawashita I, Takahashi I, Awai K (2023) An introduction to photon-counting detector CT (PCD CT) for radiologists. Jpn J Radiol 41:266\u2013282","journal-title":"Jpn J Radiol"},{"key":"11420_CR47","doi-asserted-by":"publisher","first-page":"7830","DOI":"10.1007\/s00330-023-09777-9","volume":"33","author":"P Pannenbecker","year":"2023","unstructured":"Pannenbecker P, Huflage H, Grunz JP et al (2023) Photon-counting CT for diagnosis of acute pulmonary embolism: potential for contrast medium and radiation dose reduction. Eur Radiol 33:7830\u20137839","journal-title":"Eur Radiol"},{"key":"11420_CR48","doi-asserted-by":"crossref","unstructured":"Saeed S, Niehoff JH, Boriesosdick J et al (2023) Minimizing contrast media dose in CT pulmonary angiography with clinical photon counting using high pitch technique. Acad Radiol 31:686\u2013692","DOI":"10.1016\/j.acra.2023.05.018"},{"key":"11420_CR49","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1590\/S1806-37562016000000105","volume":"42","author":"EV Ferreira","year":"2016","unstructured":"Ferreira EV, Gazzana MB, Sarmento MB et al (2016) Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism. J Bras Pneumol 42:35\u201341","journal-title":"J Bras Pneumol"},{"key":"11420_CR50","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/470358","volume":"2014","author":"E Ozakin","year":"2014","unstructured":"Ozakin E, Kaya FB, Acar N, Cevik AA (2014) An analysis of patients that underwent computed tomography pulmonary angiography with the prediagnosis of pulmonary embolism in the emergency department. ScientificWorldJournal 2014:470358","journal-title":"ScientificWorldJournal"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-025-11420-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00330-025-11420-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-025-11420-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T17:02:47Z","timestamp":1751562167000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00330-025-11420-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":50,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["11420"],"URL":"https:\/\/doi.org\/10.1007\/s00330-025-11420-8","relation":{},"ISSN":["1432-1084"],"issn-type":[{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,19]]},"assertion":[{"value":"24 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 December 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Peter M. Lauritzen.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"Cathrine H. Kristiansen is working part-time on hours for Philips Healthcare. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors, Owen Thomas, has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all patients in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"No study subjects or cohorts have been previously reported.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}