Optimizing preoperative CTA protocols for TAVR: enhanced image quality and reduced radiation and contrast doses with dual-source Turbo Flash mode

This study aimed to investigate the feasibility of using the Turbo Flash mode for transcatheter aortic valve replacement (TAVR) computed tomography (CT) with a single contrast agent injection, aiming to reduce contrast agent volume and radiation dose while maintaining image quality. Ninety patients were randomly assigned to either the Turbo Flash group, which received a single contrast agent injection and underwent the Turbo Flash scan without electrocardiogram synchronization, or the conventional group, which received two contrast agent bolus injections and underwent a standard scan. Compared with the conventional group (110 mL contrast agent), the Turbo Flash group showed a 30% reduction in iodine usage (80 mL contrast agent). All examination image qualities met diagnostic requirements. No significant differences were noted between the two groups in terms of subjective and objective aortic root computed tomography angiography (CTA) scores. However, the Turbo Flash group had a significantly higher subjective score for aorta–femoral artery CTA compared with the conventional group (P < 0.001). The Turbo Flash group demonstrated lower radiation doses for aorto-femoral artery scanning (474.73 ± 127.48 mGy cm) compared to the conventional group (661.97 ± 172.91 mGy cm), a 28.3% reduction (P < 0.05). No significant difference in the radiation dose for aortic root scanning was observed between the two groups. Performing pre-TAVR CT with a single segmented contrast agent injection is feasible and effective. These images can meet clinical diagnostic needs while reducing contrast agent volume and radiation dose.