{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T17:39:45Z","timestamp":1767202785859,"version":"3.48.0"},"reference-count":18,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T00:00:00Z","timestamp":1766620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"TAEJOON Pharmaceutical Co., Ltd.","award":["CTC42M014"],"award-info":[{"award-number":["CTC42M014"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: To evaluate the effect of low-concentration contrast media (LCCMs) on 100 kVp conventional chest CT by comparing the proportions of acceptable-quality scans obtained using various CM concentrations with those obtained using the standard protocol. Materials and Methods: This prospective, multicenter, randomized controlled trial enrolled adult patients with BMI &lt; 30 who underwent enhanced chest CT between December 2023 and September 2024. Participants were randomly assigned to four groups: one control group (120 kVp, 320 mgI\/mL) and three test groups using 100 kVp and standard CM (320 mgI\/mL) or LCCMs (270 or 240 mgI\/mL). Non-inferiority was tested based on the proportion of acceptable-quality scans independently assessed by two readers. Adverse reactions, including injection site pain and localized and systemic heat sensations, were recorded. Results: A total of 371 participants (mean age: 66.0, IQR: 58\u201373 years) were randomized. 100 kVp chest CT with LCCM groups showed non-inferior image quality to the standard protocol (270 mgI\/mL: reader 1\u201498.33% confidence interval [CI]: \u22124.95, 9.37 and reader 2\u201398.33% CI: \u22127.11, 7.21; 240 mgI\/mL: reader 1\u201398.33% CI: \u22126.44, 8.71 and reader 2\u201398.33% CI: \u221211.47, 5.11; all p &lt; 0.001). Reader 2 reported a lower proportion of acceptable scans in the 320 mgI\/mL low-voltage group (p = 0.11), whereas Reader 1 did not find significant inferiority (p = 0.003). Injection site pain, localized heat, and systemic heat were less frequent in LCCM groups, while systemic heat was only statistically significant (p = 0.003). Conclusions: Low-tube-voltage (100 kVp) chest CECT using LCCMs yields non-inferior image quality compared with the standard protocol while using conventional concentration contrast media under 100 kVp resulted in decreased proportion of diagnostically acceptable scans.<\/jats:p>","DOI":"10.3390\/diagnostics16010082","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T03:06:02Z","timestamp":1766718362000},"page":"82","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimization of the Contrast Concentration for Low-Tube-Voltage Chest CT: A Randomized Controlled Trial with Low-Concentration Contrast Media"],"prefix":"10.3390","volume":"16","author":[{"given":"Jiho","family":"Park","sequence":"first","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo Mi","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Radiology, Bucheon St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon 14627, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-0729","authenticated-orcid":false,"given":"Yun-Hyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-ro, Gwangju 61469, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gong Yong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, 20 Geongi-ro, Jeonju 54907, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1741-9604","authenticated-orcid":false,"given":"Yeon Joo","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan 50612, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1791-7942","authenticated-orcid":false,"given":"Jin Mo","family":"Goo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Seoul 03080, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-8116","authenticated-orcid":false,"given":"Suyon","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9262-1001","authenticated-orcid":false,"given":"Kyongmin Sarah","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8264-9388","authenticated-orcid":false,"given":"Jung Im","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Radiology, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e221257","DOI":"10.1148\/radiol.221257","article-title":"Deep learning image reconstruction for CT: Technical principles and clinical prospects","volume":"306","author":"Koetzier","year":"2023","journal-title":"Radiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1146\/annurev-bioeng-121813-113601","article-title":"Advances in computed tomography imaging technology","volume":"16","author":"Ginat","year":"2014","journal-title":"Annu. 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