Reducing Radiation and Contrast Exposure in Cardiac CT and Imaging-Guided Cardiovascular Procedures: Validation and Implementation

Radiation exposure from cardiac CT and iodinated contrast exposure during cardiovascular imaging and imaging-guided procedures are increasingly important, cumulative risks in contemporary cardiovascular care. Patients with chronic kidney disease, diabetes, advanced age, or complex coronary anatomy may undergo repeated CT examinations and imaging-intensive procedures, making dose and contrast reduction clinically important. Yet low-dose CT and contrast-sparing imaging strategies remain unevenly adopted: acquisition parameters and iodine loads vary between scanners and centres, and there is limited agreement on how to validate image quality, diagnostic accuracy, procedural safety, and renal outcomes. A focused evidence base is needed to distinguish reproducible dose- and contrast-sparing methods from approaches that are not yet ready for wider use.This Research Topic aims to establish practical, evidence-based approaches to reducing radiation in cardiac CT and contrast exposure in cardiovascular imaging without compromising diagnostic or procedural accuracy. It will bring together technical validation, clinical studies, registry evidence, and implementation research. The focus will be on acquisition and reconstruction protocols, iodine reduction, quality assurance, and validation across scanners and patient groups, alongside the role of advanced cardiac imaging (including intravascular and angiographic imaging techniques) in guiding contrast-sparing decisions during cardiovascular procedures, particularly in patients at risk of contrast-associated acute kidney injury. The collection will prioritise studies that report measurable exposure reduction alongside image quality, procedural success, renal safety, and longer-term clinical outcomes.We welcome submissions addressing, but not limited to, the following areas: low-dose cardiac CT acquisition and reconstruction protocols; reduction of iodine load while preserving diagnostic image quality; standardisation and quality assurance across CT scanners, centres, and patient populations; technical and clinical validation of dose- and contrast-sparing protocols; patient-specific exposure optimisation; the role of intravascular and angiographic imaging (IVUS, OCT, dynamic coronary roadmapping, co-registration) in supporting contrast-sparing procedural guidance; outcomes in patients with chronic kidney disease or high contrast-associated acute kidney injury risk; comparative studies against conventional CT or angiography-guided practice; workflow, training, proctoring, and implementation barriers; and cost, resource-use, and health-system considerations. General CT-guided procedural planning, CT-FFR, structural-heart or electrophysiology applications, and broad imaging papers will be considered only where radiation or contrast reduction is a central evaluated outcome. We encourage Original Research, Clinical Trials, registry and cohort studies, Systematic Reviews and Meta-Analyses, methodology and validation papers, technical notes, and Perspectives. Topic editors: Vinit Baliyan, Dhrubajyoti Bandyopadhyay Source: https://www.frontiersin.org/research-topics/86633/reducing-radiation-and-contrast-exposure-in-cardiac-ct-and-imaging-guided-cardiovascular-procedures-validation-and-implementation