{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:36:23Z","timestamp":1791513383670,"version":"4.3.4"},"reference-count":72,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Our study aims to provide an overview of existing evidence regarding the image quality of dual-energy CT (DECT) employing reduced contrast media (CM) volumes, in comparison to single-energy CT (SECT) with standard CM loads. The advantages, indications, and possible applications of DECT were investigated from the perspective of providing better patient care, minimizing CM volume and managing CM shortage. Methods: In this systematic review (PRISMA methodology), PubMed and WOS were searched from January 2010 to January 2023 by two independent reviewers. The scan and CM characteristics, radiation dose, and results of quantitative (contrast to noise ratio, CNR, and signal to noise ratio, SNR) and qualitative assessment of image quality were collected. Sixty non-duplicated records eligible for full-text screening were examined. Results: Finally, 22 articles (1818 patients) were included. The average CM reduction with DECT ranged between 43.4 \u00b1 11%. Despite the wide variability in CT scan protocols, no differences were found in radiation doses between DECT and SECT. Conclusions: DECT scanners allow the employment of lower CM volumes with equal or better image quality evaluated by quantitative and qualitative analyses and similar dose radiation compared to SECT. Using image reconstructions at low monochromatic energy levels, DECT increases iodine conspicuity and attenuation contributing to CM containment measures.<\/jats:p>","DOI":"10.3390\/jcm13216345","type":"journal-article","created":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T12:04:22Z","timestamp":1729685062000},"page":"6345","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Dual-Energy CT as a Well-Established CT Modality to Reduce Contrast Media Amount: A Systematic Review from the Computed Tomography Subspecialty Section of the Italian Society of Radiology"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7875-3342","authenticated-orcid":false,"given":"Susanna","family":"Guerrini","sequence":"first","affiliation":[{"name":"Unit of Diagnostic Imaging, Department of Medical Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy"},{"name":"Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-3316","authenticated-orcid":false,"given":"Matteo","family":"Zanoni","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0541-2122","authenticated-orcid":false,"given":"Cristian","family":"Sica","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5797-1129","authenticated-orcid":false,"given":"Giulio","family":"Bagnacci","sequence":"additional","affiliation":[{"name":"Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy"},{"name":"Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, University of Siena, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7009-2367","authenticated-orcid":false,"given":"Nicoletta","family":"Mancianti","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Transplantation, Azienda Ospedaliero-Universitaria Senese, 53100 Siena, 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Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy"},{"name":"Department of Clinical, Special and Dental Sciences, University Politecnica Delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7401-1971","authenticated-orcid":false,"given":"Michaela","family":"Cellina","sequence":"additional","affiliation":[{"name":"Italian Society of Medical and Interventional Radiology (SIRM), Italian College of Computed Tomography, Italian Society of Medical and Interventional Radiology, 20122 Milano, Italy"},{"name":"Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Principessa Clotilde 3, 20121 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-3305","authenticated-orcid":false,"given":"Giulia 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