Clinical impact of low tube voltage computed tomography during hepatic arteriography with low iodine to detect hepatocellular carcinoma before transarterial chemoembolization

This study aimed to evaluate the clinical impact of low tube voltage computed tomography (CT) during hepatic arteriography (CTHA) using low iodine contrast to detect hepatocellular carcinoma (HCC). CTHA images were obtained using a dual-spin technique (80 kVp and 135 kVp) with 30 ml of low-dose iodine contrast (75 mgI/ml). Three radiologists reviewed 135 kVp and 80 kVp CTHA images to diagnose HCC, recording their confidence scores and evaluations of sharpness, noise, artifact, and overall image quality. Lesion-to-liver contrast ratios and objective noise were measured by a non-reader radiologist. We included 23 patients (body mass index, 23.6 ± 2.6 kg/m2) with 89 HCCs. The mean radiation dose index volume was 21.3 mGy at 135 kVp and 9.4 mGy at 80 kVp (P