Several technical innovations in the last decade have significantly impacted CT angiography and the development of new contrast media injection protocols. Optimal intravascular enhancement is the direct result of the adequate timing of contrast media injection, iodine delivery rate (IDR) corresponding to the amount of iodine injected to the patient per second,1 and iodine attenuation secondary to the selected kV.In particular, two major technical advances have had major impact on contrast media injection strategies, (a) low kV acquisitions and (b) dual-energy derived virtual monoenergetic imaging at low keV levels.Our group is currently investigating new contrast media injection protocols for CT angiography, aiming to develop patient-tailored contrast media injection protocols for low kV and low keV imaging. We used an advanced circulation phantom (Bayer-Schering, Wayne, NJ), built to simulate the effect of blood flow on contrast attenuation, to test varying injection protocols at different tube voltages. Our robust results have enabled us to implement these techniques into the injection protocol we are currently using in clinical practice.The aim of this review is to describe and illustrate our research, present our main results, and ultimately advance the conversation regarding optimized CT angiography protocols within the imaging community.