Iodinated Contrast Media Dose Protocols for Computed Tomography Investigations of the Abdomen: A Systematic Review and Meta-Analysis
Authors: Ohemeng, E., Donkor, A., Anyitey-Kokor, I.C., Otoo, O.K., Akudjedu, T.N., Antwi, W.K., Wiafe, Y.A.
Journal: Journal of Imaging
Publication Date: 01/07/2026
Volume: 12
Issue: 7
eISSN: 2313-433X
DOI: 10.3390/jimaging12070301
Abstract:While several dosing protocols for iodinated contrast media (ICM) exist, a consensus strategy for optimising the physical imaging signal in abdominal CT is lacking. This systematic review and meta-analysis evaluated the performance of individualised dosing protocols, specifically focusing on technical signal optimisation, clinical safety, potential material savings, and environmental sustainability. Electronic databases (Cochrane, Embase, Medline) were searched up to January 2026. Systematic synthesis of 23 studies (11,680 participants) compared protocols based on lean body weight (LBW), total body weight (TBW), fixed volume (FV) and software-assisted dosing. Meta-analyses assessed volume optimisation and hepatic enhancement, with evidence certainty evaluated via the GRADE framework. TBW-based dosing significantly reduced contrast volume by −8.74 mL compared to FV protocols (p = 0.02), while the −4.04 mL reduction in LBW versus TBW groups represented a non-significant trend (p = 0.11); however, a sensitivity analysis revealed a significant effect (−5.41 mL, 95% [CI: −10.43, −0.39]; p = 0.03). Pooled hepatic enhancement showed no statistically significant differences for LBW vs. TBW (−1.36 HU, p = 0.43) or FV vs. TBW (−2.74 HU, p = 0.13). Individualised ICM dosing, particularly LBW-based, may potentially offer a foundational strategy for greener and material savings in clinical radiology by minimising population-level iodine load. Despite modest individual volume reductions, these protocols may potentially facilitate standardised imaging enhancement, though higher-quality randomised trials are required to confirm safety and economic benefits.
Source: Scopus