The use of optimised CT protocols regarding radiation exposure is a legal requirement. Since low contrast visibility is intrinsically varying within the CT slice, there is no adequate method for optimisation of dose and image quality. We developed a method to access image quality in a way that represents the situation closer to a real patient. This method is based on a novel difference detail curve (DDC) phantom with low contrast objects representing native tissue contrast and contrast media with different densities and diameters. The position of the contrast objects have been evaluated by a noise level analysis of CT slices of different manufactures. The dose – length – product can be measured within the phantom simultaneously. For all tested manu-factures and CT protocols, the noise analysis revealed a similar spatial variation of the signal -to-noise ratio (SNR). For the DDC method, contrast steps of 6 (4-8) Hounsfield Units (HU) are adequate. For the different CT units, comparable low contrast detectability is associated with remarkably varying dose levels (CTDI range from 8 to 18 mGy for native contrast and 9-16 mGy for contrast media). The novel DDC phantom is sensitive to protocol optimisations and therefore suitable for rating subtle effects caused by protocol optimisation.