A review of computed tomography pulmonary angiogram protocols with low contrast medium volume in delivering diagnostic image quality

Administration of iodinated contrast medium (CM) is essential when performing a computed tomography pulmonary angiogram (CTPA) to visualise the pulmonary arteries and to diagnose or rule out the possibility of a pulmonary nephrotoxicity and allergic reactions, necessitate the reduction of administered CM volume while maintaining image quality in CTPA. This review summarises literature from two electronic databases on the application of reduced CM volume CTPA protocols and the comparison of their image quality with routine CTPA protocols. When medical imaging professionals utilise the capabilities of modern computed tomography scanners, consider patient characteristics to apply patient-specific protocols, and leverage sophisticated image reconstruction techniques, they can reduce the volume of administered CM, while still achieving adequate visualisation of the pulmonary arteries in CTPA. In conclusion, reducing the volume of administered contrast medium in CTPA is feasible, with several techniques and protocols demonstrating efficacy in daily clinical practice.