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Rajendran K, Bruesewitz M, Swicklik J, Ferrero A, Thorne J, Yu L, McCollough C, Leng S. Task-based automatic keV selection: leveraging routine virtual monoenergetic imaging for dose reduction on clinical photon-counting detector CT . Phys Med Biol 2024; 69:10.1088/1361-6560/ad41b3. [PMID: 38648795 PMCID: PMC11108732 DOI: 10.1088/1361-6560/ad41b3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/22/2024] [Indexed: 04/25/2024]
Abstract
Objective. Photon-counting detector (PCD) CT enables routine virtual-monoenergetic image (VMI) reconstruction. We evaluated the performance of an automatic VMI energy level (keV) selection tool on a clinical PCD-CT system in comparison to an automatic tube potential (kV) selection tool from an energy-integrating-detector (EID) CT system from the same manufacturer.Approach.Four torso-shaped phantoms (20-50 cm width) containing iodine (2, 5, and 10 mg cc-1) and calcium (100 mg cc-1) were scanned on PCD-CT and EID-CT. Dose optimization techniques, task-based VMI energy level and tube-potential selection on PCD-CT (CARE keV) and task-based tube potential selection on EID-CT (CARE kV), were enabled. CT numbers, image noise, and dose-normalized contrast-to-noise ratio (CNRd) were compared.Main results. PCD-CT produced task-specific VMIs at 70, 65, 60, and 55 keV for non-contrast, bone, soft tissue with contrast, and vascular settings, respectively. A 120 kV tube potential was automatically selected on PCD-CT for all scans. In comparison, EID-CT used x-ray tube potentials from 80 to 150 kV based on imaging task and phantom size. PCD-CT achieved consistent dose reduction at 9%, 21% and 39% for bone, soft tissue with contrast, and vascular tasks relative to the non-contrast task, independent of phantom size. On EID-CT, dose reduction factor for contrast tasks relative to the non-contrast task ranged from a 65% decrease (vascular task, 70 kV, 20 cm phantom) to a 21% increase (soft tissue with contrast task, 150 kV, 50 cm phantom) due to size-specific tube potential adaptation. PCD-CT CNRdwas equivalent to or higher than those of EID-CT for all tasks and phantom sizes, except for the vascular task with 20 cm phantom, where 70 kV EID-CT CNRdoutperformed 55 keV PCD-CT images.Significance. PCD-CT produced more consistent CT numbers compared to EID-CT due to standardized VMI output, which greatly benefits standardization efforts and facilitates radiation dose reduction.
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Affiliation(s)
| | | | | | - Andrea Ferrero
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jamison Thorne
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Lifeng Yu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Shuai Leng
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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2
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Madhavan AA, Bathla G, Benson JC, Diehn FE, Nagelschneider AA, Lehman VT. High yield clinical applications for photon counting CT in neurovascular imaging. Br J Radiol 2024; 97:894-901. [PMID: 38460543 DOI: 10.1093/bjr/tqae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/05/2024] [Accepted: 03/07/2024] [Indexed: 03/11/2024] Open
Abstract
Photon-counting CT (PCCT) uses a novel X-ray detection mechanism that confers many advantages over that used in traditional energy integrating CT. As PCCT becomes more available, it is important to thoroughly understand its benefits and highest yield areas for improvements in diagnosis of various diseases. Based on our early experience, we have identified several areas of neurovascular imaging in which PCCT shows promise. Here, we describe the benefits in diagnosing arterial and venous diseases in the head, neck, and spine. Specifically, we focus on applications in head and neck CT angiography (CTA), spinal CT angiography, and CT myelography for detection of CSF-venous fistulas. Each of these applications highlights the technological advantages of PCCT in neurovascular imaging. Further understanding of these applications will not only benefit institutions incorporating PCCT into their practices but will also help guide future directions for implementation of PCCT for diagnosing other pathologies in neuroimaging.
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Affiliation(s)
- Ajay A Madhavan
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Girish Bathla
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - John C Benson
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Felix E Diehn
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Alex A Nagelschneider
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Vance T Lehman
- Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
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3
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Horst KK, Cao JY, McCollough CH, El-Ali A, Frush DP, Siegel MJ, Ramirez-Giraldo JC, O'Donnell T, Bach S, Yu L. Multi-institutional Protocol Guidance for Pediatric Photon-counting CT. Radiology 2024; 311:e231741. [PMID: 38771176 DOI: 10.1148/radiol.231741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Performing CT in children comes with unique challenges such as greater degrees of patient motion, smaller and densely packed anatomy, and potential risks of radiation exposure. The technical advancements of photon-counting detector (PCD) CT enable decreased radiation dose and noise, as well as increased spatial and contrast resolution across all ages, compared with conventional energy-integrating detector CT. It is therefore valuable to review the relevant technical aspects and principles specific to protocol development on the new PCD CT platform to realize the potential benefits for this population. The purpose of this article, based on multi-institutional clinical and research experience from pediatric radiologists and medical physicists, is to provide protocol guidance for use of PCD CT in the imaging of pediatric patients.
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Affiliation(s)
- Kelly K Horst
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Joseph Y Cao
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Cynthia H McCollough
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Alex El-Ali
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Donald P Frush
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Marilyn J Siegel
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Juan Carlos Ramirez-Giraldo
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Tom O'Donnell
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Steve Bach
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
| | - Lifeng Yu
- From the Department of Radiology, Division of Pediatric Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 (K.K.H., C.H.M., L.Y.); Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham, NC (J.Y.C., D.P.F., S.B.); Department of Radiology, Division of Pediatric Radiology, NYU Grossman School of Medicine, New York, NY (A.E.A.); Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (M.J.S.); and Siemens Medical Solutions USA, Malvern, Pa (J.C.R.G., T.O.)
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Zhou W, Huo D, Browne LP, Zhou X, Weinman J. Universal 120-kV Dual-Source Ultra-High Pitch Protocol on the Photon-Counting CT System for Pediatric Abdomen of All Sizes: A Phantom Investigation Comparing With Energy-Integrating CT. Invest Radiol 2024:00004424-990000000-00208. [PMID: 38595181 DOI: 10.1097/rli.0000000000001080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The purpose of this study is to determine if a universal 120-kV ultra-high pitch and virtual monoenergetic images (VMIs) protocol on the photon-counting computed tomography (PCCT) system can provide sufficient image quality for pediatric abdominal imaging, regardless of size, compared with protocols using a size-dependent kV and dual-source flash mode on the energy-integrating CT (EICT) system. MATERIALS AND METHODS One solid water insert and 3 iodine (2, 5, 10 mg I/mL) inserts were attached or inserted into phantoms of variable sizes, simulating the abdomens of a newborn, 5-year-old, 10-year-old, and adult-sized pediatric patients. Each phantom setting was scanned on an EICT using clinical size-specific kV dual-source protocols with a pitch of 3.0. The scans were performed with fixed scanning parameters, and the CTDIvol values of full dose were 0.30, 0.71, 1.05, and 7.40 mGy for newborn to adult size, respectively. In addition, half dose scans were acquired on EICT. Each phantom was then scanned on a PCCT (Siemens Alpha) using a universal 120-kV protocol with the same full dose and half dose as determined above on the EICT scanner. All other parameters matched to EICT settings. Virtual monoenergetic images were generated from PCCT scans between 40 and 80 keV with a 5-keV interval. Image quality metrics were compared between PCCT VMIs and EICT, including image noise (measured as standard deviation of solid water), contrast-to-noise ratio (CNR) (measured at iodine inserts with solid water as background), and noise power spectrum (measured in uniform phantom regions). RESULTS Noise at a PCCT VMI of 70 keV (7.0 ± 0.6 HU for newborn, 14.7 ± 1.6 HU for adult) is comparable (P > 0.05, t test) or significantly lower (P < 0.05, t test) compared with EICT (7.8 ± 0.8 HU for newborn, 15.3 ± 1.5 HU for adult). Iodine CNR from PCCT VMI at 50 keV (50.8 ± 8.4 for newborn, 27.3 ± 2.8 for adult) is comparable (P > 0.05, t test) or significantly higher (P < 0.05, t test) to the corresponding EICT measurements (57.5 ± 6.7 for newborn, 13.8 ± 1.7 for adult). The noise power spectrum curve shape of PCCT VMI is similar to EICT, despite PCCT VMI exhibiting higher noise at low keV levels. CONCLUSIONS The universal PCCT 120 kV with ultra-high pitch and postprocessed VMIs demonstrated equivalent or improved performance in noise (70 keV) and iodine CNR (50 keV) for pediatric abdominal CT, compared with size-specific kV images on the EICT.
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Affiliation(s)
- Wei Zhou
- From the Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO (W.Z., D.H., L.P.B., J.W.); Department of Radiology, Children's Hospital Colorado, Aurora, CO (L.P.B., J.W.); and Bioinformatics and Computational Biology, University of Minnesota, St Paul, MN (X.Z.)
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5
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Decker JA, Becker J, Härting M, Jehs B, Risch F, Canalini L, Wollny C, Scheurig-Muenkler C, Kroencke T, Schwarz F, Bette S. Optimal conspicuity of pancreatic ductal adenocarcinoma in virtual monochromatic imaging reconstructions on a photon-counting detector CT: comparison to conventional MDCT. Abdom Radiol (NY) 2024; 49:103-116. [PMID: 37796327 PMCID: PMC10789688 DOI: 10.1007/s00261-023-04042-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023]
Abstract
PURPOSE To analyze the conspicuity of pancreatic ductal adenocarcinoma (PDAC) in virtual monoenergetic images (VMI) on a novel photon-counting detector CT (PCD-CT) in comparison to energy-integrating CT (EID-CT). METHODS Inclusion criteria comprised initial diagnosis of PDAC (reference standard: histopathological analysis) and standardized contrast-enhanced CT imaging either on an EID-CT or a PCD-CT. Patients were excluded due to different histopathological diagnosis or missing tumor delineation on CT. On the PCD-CT, 40-190 keV VMI reconstructions were generated. Image noise, tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) were analyzed by ROI-based measurements in arterial and portal venous contrast phase. Two board-certified radiologist evaluated image quality and tumor delineation at both, EID-CT and PCD-CT (40 and 70 keV). RESULTS Thirty-eight patients (mean age 70.4 years ± 10.3 [range 45-91], 27 males; PCD-CT: n=19, EID-CT: n=19) were retrospectively included. On the PCD-CT, tumor conspicuity (reflected by low TPR and high CNR) was significantly improved at low-energy VMI series (≤ 70 keV compared to > 70 keV), both in arterial and in portal venous contrast phase (P < 0.001), reaching the maximum at 40 keV. Comparison between PCD-CT and EID-CT showed significantly higher CNR on the PCD-CT in portal venous contrast phase at < 70 keV (P < 0.016). On the PCD-CT, tumor conspicuity was improved in portal venous contrast phase compared to arterial contrast phase especially at the lower end of the VMI spectrum (≤ 70 keV). Qualitative analysis revealed that tumor delineation is improved in 40 keV reconstructions compared to 70 keV reconstructions on a PCD-CT. CONCLUSION PCD-CT VMI reconstructions (≤ 70 keV) showed significantly improved conspicuity of PDAC in quantitative and qualitative analysis in both, arterial and portal venous contrast phase, compared to EID-CT, which may be important for early detection of tumor tissue in clinical routine. Tumor delineation was superior in portal venous contrast phase compared to arterial contrast phase.
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Affiliation(s)
- Josua A Decker
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Judith Becker
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Mark Härting
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Bertram Jehs
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Franka Risch
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Luca Canalini
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Claudia Wollny
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Christian Scheurig-Muenkler
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
| | - Thomas Kroencke
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
- Centre for Advanced Analytics and Predictive Sciences (CAAPS), University of Augsburg, Universitätsstr. 2, 86159, Augsburg, Germany.
| | - Florian Schwarz
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
- Medical Faculty, Ludwig Maximilian University Munich, Bavariaring 19, 80336, Munich, Germany
- Institute for Radiology, DONAUISAR Hospital Deggendorf-Dingolfing-Landau, Perlasberger Str. 41, 94469, Deggendorf, Germany
| | - Stefanie Bette
- Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany
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Chamberlin JH, Baruah D, Smith C, McGuire A, Maisuria D, Kabakus IM. Cardiac Computed Tomography Protocols in Structural Heart Disease: A State-of-the-Art Review. Semin Roentgenol 2024; 59:7-19. [PMID: 38388099 DOI: 10.1053/j.ro.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Jordan H Chamberlin
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
| | - Dhiraj Baruah
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC.
| | - Carter Smith
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
| | - Aaron McGuire
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
| | - Dhruw Maisuria
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
| | - Ismail M Kabakus
- Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC
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7
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Hennes JL, Huflage H, Grunz JP, Hartung V, Augustin AM, Patzer TS, Pannenbecker P, Petritsch B, Bley TA, Gruschwitz P. An Intra-Individual Comparison of Low-keV Photon-Counting CT versus Energy-Integrating-Detector CT Angiography of the Aorta. Diagnostics (Basel) 2023; 13:3645. [PMID: 38132229 PMCID: PMC10742757 DOI: 10.3390/diagnostics13243645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
This retrospective study aims to provide an intra-individual comparison of aortic CT angiographies (CTAs) using first-generation photon-counting-detector CT (PCD-CT) and third-generation energy-integrating-detector CT (EID-CT). High-pitch CTAs were performed with both scanners and equal contrast-agent protocols. EID-CT employed automatic tube voltage selection (90/100 kVp) with reference tube current of 434/350 mAs, whereas multi-energy PCD-CT scans were generated with fixed tube voltage (120 kVp), image quality level of 64, and reconstructed as 55 keV monoenergetic images. For image quality assessment, contrast-to-noise ratios (CNRs) were calculated, and subjective evaluation (overall quality, luminal contrast, vessel sharpness, blooming, and beam hardening) was performed independently by three radiologists. Fifty-seven patients (12 women, 45 men) were included with a median interval between examinations of 12.7 months (interquartile range 11.1 months). Using manufacturer-recommended scan protocols resulted in a substantially lower radiation dose in PCD-CT (size-specific dose estimate: 4.88 ± 0.48 versus 6.28 ± 0.50 mGy, p < 0.001), while CNR was approximately 50% higher (41.11 ± 8.68 versus 27.05 ± 6.73, p < 0.001). Overall image quality and luminal contrast were deemed superior in PCD-CT (p < 0.001). Notably, EID-CT allowed for comparable vessel sharpness (p = 0.439) and less pronounced blooming and beam hardening (p < 0.001). Inter-rater agreement was good to excellent (0.58-0.87). Concluding, aortic PCD-CTAs facilitate increased image quality with significantly lower radiation dose compared to EID-CTAs.
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Affiliation(s)
- Jan-Lucca Hennes
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, 97080 Würzburg, Germany; (H.H.); (A.M.A.); (P.G.)
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8
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Horst KK, Yu L, McCollough CH, Esquivel A, Thorne JE, Rajiah PS, Baffour F, Hull NC, Weber NM, Thacker PG, Thomas KB, Binkovitz LA, Guerin JB, Fletcher JG. Potential benefits of photon counting detector computed tomography in pediatric imaging. Br J Radiol 2023; 96:20230189. [PMID: 37750939 PMCID: PMC10646626 DOI: 10.1259/bjr.20230189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023] Open
Abstract
Photon counting detector (PCD) CT represents the newest advance in CT technology, with improved radiation dose efficiency, increased spatial resolution, inherent spectral imaging capabilities, and the ability to eliminate electronic noise. Its design fundamentally differs from conventional energy integrating detector CT because photons are directly converted to electrical signal in a single step. Rather than converting X-rays to visible light and having an output signal that is a summation of energies, PCD directly counts each photon and records its individual energy information. The current commercially available PCD-CT utilizes a dual-source CT geometry, which allows 66 ms cardiac temporal resolution and high-pitch (up to 3.2) scanning. This can greatly benefit pediatric patients by facilitating high quality fast scanning to allow sedation-free imaging. The energy-resolving nature of the utilized PCDs allows "always-on" dual-energy imaging capabilities, such as the creation of virtual monoenergetic, virtual non-contrast, virtual non-calcium, and other material-specific images. These features may be combined with high-resolution imaging, made possible by the decreased size of individual detector elements and the absence of interelement septa. This work reviews the foundational concepts associated with PCD-CT and presents examples to highlight the benefits of PCD-CT in the pediatric population.
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Affiliation(s)
- Kelly K. Horst
- Pediatric Radiology Division, Department of Radiology, Mayo Clinic, Rochester, United States
| | - Lifeng Yu
- Department of Radiology, Mayo Clinic, Rochester, United States
| | | | - Andrea Esquivel
- Department of Radiology, Mayo Clinic, Rochester, United States
| | | | | | - Francis Baffour
- Department of Radiology, Mayo Clinic, Rochester, United States
| | - Nathan C. Hull
- Pediatric Radiology Division, Department of Radiology, Mayo Clinic, Rochester, United States
| | | | - Paul G. Thacker
- Pediatric Radiology Division, Department of Radiology, Mayo Clinic, Rochester, United States
| | - Kristen B. Thomas
- Pediatric Radiology Division, Department of Radiology, Mayo Clinic, Rochester, United States
| | - Larry A. Binkovitz
- Pediatric Radiology Division, Department of Radiology, Mayo Clinic, Rochester, United States
| | - Julie B. Guerin
- Department of Radiology, Mayo Clinic, Rochester, United States
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Popp D, Sinzinger AX, Decker JA, Braun F, Bette S, Risch F, Haerting M, Garthe T, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Spectral metal artifact reduction after posterior spinal fixation in photon-counting detector CT datasets. Eur J Radiol 2023; 165:110946. [PMID: 37399668 DOI: 10.1016/j.ejrad.2023.110946] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/12/2023] [Accepted: 06/19/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE To investigate the usefulness of virtual monoenergetic image (VMI) reconstructions derived from scans on a novel photon-counting detector CT (PCD-CT) for artifact reduction in patients after posterior spinal fixation. METHODS This retrospective cohort study included 23 patients status post posterior spinal fixation. Subjects were scanned on a novel PCD-CT (NAEOTOM Alpha, Siemens Healthineers, Erlangen, Germany) as part of routine clinical care. 14 sets of VMI reconstructions were derived in 10 keV increments for the interval 60-190 keV. The mean and the standard deviation (SD) of CT-values in 12 defined locations around a pair of pedicle screws on one vertebral level and the SD of homogenous fat were measured and used to calculate an artifact index (AIx). RESULTS Averaged over all regions, the lowest AIx was observed at VMI levels of 110 keV (32.5 (27.8-37.9)) which was significantly different from those of VMIs ≤ 90 keV (p < 0.001) or ≥160 keV (p < 0.015), respectively. Overall AIx values increased in both lower- and higher-keV levels. Regarding individual locations, either a monotonous AIx-decrease for increasing keV values or an AIx-minimum in intermediate-keV levels (100-140 keV) was found. In locations adjacent to larger metal parts, the increase of AIx values at the high-end of the keV spectrum was mainly explained by a reappearance of streak artifacts. CONCLUSION Our findings suggest that 110 keV is the optimal VMI setting for overall artifact suppression. In specific anatomical regions, however, slight adjustments towards higher-keV levels may provide better results.
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Affiliation(s)
- Daniel Popp
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Andrea X Sinzinger
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Josua A Decker
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Franziska Braun
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Stefanie Bette
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Franka Risch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Mark Haerting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Tarik Garthe
- Department of Trauma, Orthopedics, Plastic and Hand Surgery, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Christian Scheurig-Muenkler
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Thomas J Kroencke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany.
| | - Florian Schwarz
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; Institute for Radiology, DONAUISAR Hospital Deggendorf-Dingolfing-Landau, Perlasberger Str. 41, 94469 Deggendorf, Germany; Medical Faculty, Ludwig Maximilian University Munich, Bavariaring 19, 80336 Munich, Germany.
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