Dual Energy CT Urography With Reduced Iodinated Contrast

Study Overview
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Brief Summary
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The goal of this study is to validate that Dual Energy CT (DECT) urography when performed with a 50% reduction in iodinated contrast dose results in a CT exam with equal or better image quality and equal or better diagnostic capability compared to traditional Single Energy CT (SECT) performed with a standard contrast dose.

Detailed Description
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The investigators hypothesize that DECT urography performed with a 50% iodine dose reduction is equivalent to SECT urography performed with a full iodine dose for: Enhancement of the aorta, renal arteries, and renal veins Enhancement of the renal cortex Enhancement of the renal pelvis, ureters, and bladder Subjective evaluation of image quality Objective evaluation of image quality In addition, the investigators hypothesize that DECT virtual non-contrast images using material suppression from the same low iodine CT exam results in equivalent diagnostic information compared to SECT true non-contrast images obtained in the same patient during the same exam. If the true non-contrast images could be replaced by the virtual non-contrast images without loss of information, there is potential for DECT to both significantly lower radiation dose as well as significantly decreasing iodine dose. The investigators designed this research protocol to prospectively test these hypotheses in a population scanned with a 50% reduced iodine DECT urography protocol compared to a control population scanned with a standard iodine dose clinical SECT urography protocol.

Official Title
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Dual Energy CT Urography Using 50% Reduction in Iodinated Contrast: Feasibility, Image Quality, and Radiation Dose Reduction With Virtual Unenhanced Images.

Conditions
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Aortic Aneurysm

Intervention / Treatment
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* Other: Reduced contrast DECT scan
* Other: Standard contrast SECT scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >50 Outpatient scheduled to have a CT urography at the site Exclusion Criteria: Severe allergy to iodine containing contrast Pregnancy (which is very unlikely for those over 50) Body mass index (BMI) over 35 kg/m2 Inability to provide informed consent Inpatient

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Reduced contrast DECT scan<br>Reduced Contrast Dual Energy CT | Other: Reduced contrast DECT scan<br>* Subjects will undergo a dual energy CT scan with reduced contrast<br>Other: Standard contrast SECT scan<br>* Subjects will undergo standard of care single energy CT scan with a standard dose of contrast. (control)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnostic ability determined by image quality (subjective and objective evaluation of vessel attenuation and depiction, image noise, image quality and information from virtual non-contrast |  | Up to 24 months |