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Rajagopal JR, Schwartz FR, McCabe C, Farhadi F, Zarei M, Ria F, Abadi E, Segars P, Ramirez-Giraldo JC, Jones EC, Henry T, Marin D, Samei E. Technology Characterization Through Diverse Evaluation Methodologies: Application to Thoracic Imaging in Photon-Counting Computed Tomography. J Comput Assist Tomogr 2024:00004728-990000000-00312. [PMID: 38626754 DOI: 10.1097/rct.0000000000001608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
OBJECTIVE Different methods can be used to condition imaging systems for clinical use. The purpose of this study was to assess how these methods complement one another in evaluating a system for clinical integration of an emerging technology, photon-counting computed tomography (PCCT), for thoracic imaging. METHODS Four methods were used to assess a clinical PCCT system (NAEOTOM Alpha; Siemens Healthineers, Forchheim, Germany) across 3 reconstruction kernels (Br40f, Br48f, and Br56f). First, a phantom evaluation was performed using a computed tomography quality control phantom to characterize noise magnitude, spatial resolution, and detectability. Second, clinical images acquired using conventional and PCCT systems were used for a multi-institutional reader study where readers from 2 institutions were asked to rank their preference of images. Third, the clinical images were assessed in terms of in vivo image quality characterization of global noise index and detectability. Fourth, a virtual imaging trial was conducted using a validated simulation platform (DukeSim) that models PCCT and a virtual patient model (XCAT) with embedded lung lesions imaged under differing conditions of respiratory phase and positional displacement. Using known ground truth of the patient model, images were evaluated for quantitative biomarkers of lung intensity histograms and lesion morphology metrics. RESULTS For the physical phantom study, the Br56f kernel was shown to have the highest resolution despite having the highest noise and lowest detectability. Readers across both institutions preferred the Br56f kernel (71% first rank) with a high interclass correlation (0.990). In vivo assessments found superior detectability for PCCT compared with conventional computed tomography but higher noise and reduced detectability with increased kernel sharpness. For the virtual imaging trial, Br40f was shown to have the best performance for histogram measures, whereas Br56f was shown to have the most precise and accurate morphology metrics. CONCLUSION The 4 evaluation methods each have their strengths and limitations and bring complementary insight to the evaluation of PCCT. Although no method offers a complete answer, concordant findings between methods offer affirmatory confidence in a decision, whereas discordant ones offer insight for added perspective. Aggregating our findings, we concluded the Br56f kernel best for high-resolution tasks and Br40f for contrast-dependent tasks.
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Affiliation(s)
| | - Fides R Schwartz
- Duke University Health System, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Cindy McCabe
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
| | | | - Mojtaba Zarei
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Francesco Ria
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Ehsan Abadi
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Paul Segars
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
| | | | - Elizabeth C Jones
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD
| | - Travis Henry
- Duke University Health System, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Daniele Marin
- Duke University Health System, Department of Radiology, Duke University Medical Center, Durham, NC
| | - Ehsan Samei
- From the Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC
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Bhattarai M, Bache S, Abadi E, Samei E. A systematic task-based image quality assessment of photon-counting and energy integrating CT as a function of reconstruction kernel and phantom size. Med Phys 2024; 51:1047-1060. [PMID: 37469179 PMCID: PMC10796834 DOI: 10.1002/mp.16619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/25/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Image quality of photon-counting and energy integrating CT scanners changes with object size, dose to the object, and kernel selection. PURPOSE To comprehensively compare task-generic image quality of photon-counting CT (PCCT) and energy integrating CT (EICT) systems as a function of phantom size, dose, and reconstruction kernel. METHODS A size-variant phantom (Mercury Phantom 3.0) was used to characterize the image quality of PCCT and EICT systems as a function of object size. The phantom contained five cylinders attached by slanted tapered sections. Each cylinder contained two sections: one uniform for noise, and the other with inserts for spatial resolution and contrast measurements. The phantom was scanned on Siemens' SOMATOM Force and NAEOTOM Alpha at 1.18 and 7.51 mGy without tube current modulation. CTDIvol was matched across two systems by setting the required tube currents, else, all other acquisition settings were fixed. CT sinograms were reconstructed using FBP and iterative (ADMIRE2 - Force; QIR2 - Alpha) algorithms with Body regular (Br) kernels. Noise Power Spectrum (NPS), Task Transfer Function (TTF), contrast-to-noise ratio (CNR), and detectability index (d') for a task of identifying 2-mm disk were evaluated based on AAPM TG-233 metrology using imQuest, an open-source software package. Averaged noise frequency (fav ) and 50% cut-off frequency for TTF (f50 ) were used as scalar metrics to quantify noise texture and spatial resolution, respectively. The difference between image quality metrics' measurements was calculated as IQPCCT - IQEICT . RESULTS From Br40 (soft) to Br64 (sharp), f50 for air insert increased from 0.35 mm-1 ± 0.04 (standard deviation) to 0.76 mm-1 ± 0.17, 0.34 mm-1 ± 0.04 to 0.77 mm-1 ± 0.17, 0.37 mm-1 ± 0.02 to 0.95 mm-1 ± 0.17 for PCCT-T3D-QIR2, PCCT-70keV-QIR2, and EICT-ADMIRE2, respectively, when averaged over all sizes and dose levels. Similarly, from Br40 to Br64, noise magnitude increased from 10.86 HU ± 7.12 to 38.61 HU ± 18.84, 10.94 HU ± 7.08 to 38.82 HU ± 18.70, 13.74 HU ± 11.02 to 52.11 HU ± 26.22 for PCCT-T3D-QIR2, PCCT-70keV-QIR2, and EICT-ADMIRE2, respectively. The difference in fav was consistent across all sizes and dose levels. PCCT-70keV-VMI showed better consistency in contrast measurements for iodine and bone inserts than PCCT-T3D and EICT; however, PCCT-T3D had higher contrast for both inserts. From Br40 to Br64, considering all sizes and dose levels, CNR for iodine insert decreased from 52.30 ± 46.44 to 12.18 ± 10.07, 40.42 ± 33.42 to 9.48 ± 7.16, 39.94 ± 37.60 to 7.84 ± 6.67 for PCCT-T3D-QIR2, PCCT-70keV-QIR2, and EICT-ADMIRE2, respectively. CONCLUSIONS Both PCCT image types, T3D and 70-keV-VMI exhibited similar or better noise, contrast, CNR than EICT when comparing kernels with similar names. For 512 × 512 matrix, PCCT's sharp kernels had lower resolution than EICT's sharp kernels. For all image quality metrics, except extreme low, every dose condition had a similar set of IQ-matching kernels. It suggests that considering patient size and dose level to determine IQ-matching kernel pairs across PCCT and EICT systems may not be imperative while translating protocols, except when the signal to the detector is extremely low.
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Affiliation(s)
- Mridul Bhattarai
- Medical Physics Graduate Program, Duke University, Durham, North Carolina, 27705, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, 27705, USA
- Department of Radiology – School of Medicine, Duke University, Durham, North Carolina, 27705, USA
| | - Steve Bache
- Clinical Imaging Physics Group – Duke University Health System, Durham, North Carolina, 27705, USA
| | - Ehsan Abadi
- Medical Physics Graduate Program, Duke University, Durham, North Carolina, 27705, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, 27705, USA
- Department of Radiology – School of Medicine, Duke University, Durham, North Carolina, 27705, USA
| | - Ehsan Samei
- Medical Physics Graduate Program, Duke University, Durham, North Carolina, 27705, USA
- Center for Virtual Imaging Trials (CVIT), Duke University, Durham, North Carolina, 27705, USA
- Department of Radiology – School of Medicine, Duke University, Durham, North Carolina, 27705, USA
- Clinical Imaging Physics Group – Duke University Health System, Durham, North Carolina, 27705, USA
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Rajagopal JR, Farhadi F, Nikpanah M, Sahbaee P, Saboury B, Pritchard WF, Jones EC, Chen MY, Samei E. Impact of the confluence of cardiac motion and high spatial resolution on performance of ECG-gated imaging with an investigational photon-counting CT system: A phantom study. Phys Med 2023; 114:102683. [PMID: 37738807 PMCID: PMC10798551 DOI: 10.1016/j.ejmp.2023.102683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/06/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
PURPOSE Photon-counting CT (PCCT) has higher spatial resolution that conventional EID CT which improves imaging of stationary coronary plaques and stents.. In this work, we evaluated the relationship between higher spatial resolution and motion acquisition on an investigational PCCT system. METHODS An investigational photon-counting CT scanner (Siemens CounT) with ECG gating was used to image a coronary tree phantom with models of healthy, stenotic, and stented arteries using a motion simulator. Images were acquired with matched clinical parameters at rest and 60 beats per minute. An additional set of high dose stationary images were averaged to generate a motion-free, reduced noise reference. Scans were completed at standard (0.5 mm2) and high-resolution (0.25 mm2). Motion images were reconstructed at multiple phases. Regions of interest were drawn around vessels and segmented. Percentage difference from the reference standard was evaluated for vessel diameter and circularity. Mutual information between the reference and stationary and motion datasets was used as a measure of volumetric similarity. RESULTS The stenotic vessel showed the most variation from the reference when compared to healthy or stented vessels. Compared to standard resolution, high-resolution images had lower bias for diameter (-0.012 ± 0.19% vs -0.052 ± 0.14%) and lower variability for circularity (-0.13 ± 0.138% vs -0.12 ± 0.144%). Both differences were found to be statistically significant. High-resolution images had a slightly lower mutual information (1.28) than standard resolution (1.31). CONCLUSION The higher spatial resolution enabled by photon-counting CT can be harnessed for cardiac imaging as the benefits of high spatial resolution acquisitions remain relevant in the presence of motion.
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Affiliation(s)
- Jayasai R Rajagopal
- Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Department of Radiology, Duke University Medical Center, Durham, NC, 27705, USA; Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Faraz Farhadi
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Moozhan Nikpanah
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Babak Saboury
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - William F Pritchard
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Elizabeth C Jones
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
| | - Marcus Y Chen
- Cardiovascular Branch, National Institute of Heart, Lung, and Blood, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA
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Schwartz FR, Ria F, McCabe C, Zarei M, Rajagopal J, Molvin L, Marin D, O'Sullivan-Murphy B, Kalisz KR, Tailor TD, Washington L, Henry T, Samei E. Image quality of photon counting and energy integrating chest CT - Prospective head-to-head comparison on same patients. Eur J Radiol 2023; 166:111014. [PMID: 37542816 DOI: 10.1016/j.ejrad.2023.111014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/11/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To prospectively compare the image quality of high-resolution, low-dose photon-counting detector CT (PCD-CT) with standard energy-integrating-detector CT (EID) on the same patients. METHOD IRB-approved, prospective study; patients received same-day non-contrast CT on EID and PCD-CT (NAEOTOM Alpha, blinded) with clinical protocols. Four blinded radiologists evaluated subsegmental bronchial wall definition, noise, and overall image quality in randomized order (0 = worst; 100 = best). Cases were quantitatively compared using the average Global-Noise-Index (GNI), Noise-Power-Spectrum average frequency (fav), NPS frequency-peak (fpeak), Task-Transfer-Function-10%-frequency (f10) an adjusted detectability index (d'adj), and applied output radiation doses (CTDIvol). RESULTS Sixty patients were prospectively imaged (27 men, mean age 67 ± 10 years, mean BMI 27.9 ± 6.5, 15.9-49.4 kg/m2). Subsegmental wall definition was rated significantly better for PCD-CT than EID (mean 71 [56-87] vs 60 [45-76]; P < 0.001), noise was rated higher for PCD-CT (48 [26-69] vs 34 [13-56]; P < 0.001). Overall image quality was rated significantly higher for PCD-CT than EID (66 [48-85] vs 61 [42-79], P = 0.008). Automated image quality measures showed similar differences for PCD-CT vs EID (mean GNI 70 ± 19 HU vs 26 ± 8 HU, fav 0.35 ± 0.02 vs 0.25 ± 0.02 mm-1, fpeak 0.07 ± 0.01 vs 0.09 ± 0.03 mm-1, f10 0.7 ± 0.08 vs 0.6 ± 0.1 mm-1, all p-values < 0.001). PCD-CT showed a 10% average d'adj increase (-49% min, 233% max). PCD-CT studies were acquired at significantly lower radiation doses than EID (mean CTDIvol 4.5 ± 2.1 vs 7.7 ± 3.2 mGy, P < 0.01). CONCLUSION Though PCD-CT had higher measured and perceived noise, it offered equivalent or better diagnostic quality compared to EID at lower radiation doses, due to its improved resolution.
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Affiliation(s)
- Fides R Schwartz
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Francesco Ria
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Cindy McCabe
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Mojtaba Zarei
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Jayasai Rajagopal
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Lior Molvin
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Daniele Marin
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Bryan O'Sullivan-Murphy
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Kevin R Kalisz
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Tina D Tailor
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Lacey Washington
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Travis Henry
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
| | - Ehsan Samei
- Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
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Bache ST, Samei E. A methodology for incorporating a photon-counting CT system into routine clinical use. J Appl Clin Med Phys 2023; 24:e14069. [PMID: 37389963 PMCID: PMC10402682 DOI: 10.1002/acm2.14069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/24/2023] [Accepted: 05/22/2023] [Indexed: 07/02/2023] Open
Abstract
Photon-counting computed tomography (PCCT) systems are increasingly available in the U.S. following Food and Drug Administration (FDA) approval of the first clinical PCCT system in Fall 2021. Consequently, there will be a need to incorporate PCCTs into existing fleets of traditional CT systems. The commissioning process of a PCCT was devised by evaluating the degree of agreement between the performance of the PCCT and that of established clinical CT systems. A PCCT system (Siemens NAEOTOM Alpha) was evaluated using the American College of Radiology(ACR) CT phantom (Gammex 464). The phantom was scanned on the system and on a 3rd Generation EID CT system (Siemens Force) at three clinical dose levels. Images were reconstructed across the range of available reconstruction kernels and Iterative Reconstruction (IR) strengths. Two image quality metrics-spatial resolution and noise texture-were calculated using AAPM TG233 software (imQuest), as well as a dose metric to achieve target image noise magnitude of 10 HU. For each pair of EID-PCCT kernel/IR strengths, the difference in metrics were calculated, weighted, and multiplied over all metrics to determine the concordance between systems. IR performance was characterized by comparing relative noise texture and reference dose as a function of IR strength for each system. In general, as kernel "sharpness" increased for each system, spatial resolution, noise spatial frequency, and reference dose increased. For a given kernel, EID reconstruction showed higher spatial resolution compared to PCCT in standard resolution mode. PCCT implementation of IR better preserved noise texture across all strengths compared to the EID, demonstrated by respective 20 and 7% shifts in noise texture from IR "Off" to IR "Max." Overall, the closest match for a given EID reconstruction kernel/IR strength was identified as a PCCT kernel with "sharpness" increased by 1 step and IR strength increased by 1-2 steps. Substantial dose reduction potential of up to 70% was found when targeting a constant noise magnitude.
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Affiliation(s)
- Steven T. Bache
- Department of Radiology Clinical Imaging Physics GroupDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging LaboratoriesDuke University Medical CenterDurhamNorth CarolinaUSA
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Rajagopal JR, Schwartz FR, Solomon JB, Enterline DS, Samei E. High Spatial-Resolution Skull Base Imaging With Photon-Counting Computed Tomography and Energy-Integrating Computed Tomography: A Comparative Phantom Study. J Comput Assist Tomogr 2023; 47:613-620. [PMID: 37380149 PMCID: PMC10356746 DOI: 10.1097/rct.0000000000001464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
ABSTRACT Photon-counting computed tomography (PCCT) offers better high-resolution and noise performance than energy integrating detector (EID) CT. In this work, we compared both technologies for imaging of the temporal bone and skull base. A clinical PCCT system and 3 clinical EID CT scanners were used to image the American College of Radiology image quality phantom using a clinical imaging protocol with matched CTDI vol (CT dose index-volume) of 25 mGy. Images were used to characterize the image quality of each system across a series of high-resolution reconstruction options. Noise was calculated from the noise power spectrum, whereas resolution was quantified with a bone insert by calculating a task transfer function. Images of an anthropomorphic skull phantom and 2 patient cases were examined for visualization of small anatomical structures. Across measured conditions, PCCT had a comparable or smaller average noise magnitude (120 Hounsfield units [HU]) to the EID systems (144-326 HU). Photon-counting CT also had comparable resolution (task transfer function f25 : 1.60 mm -1 ) to the EID systems (1.34-1.77 mm -1 ). Imaging results supported quantitative findings as PCCT more clearly showed the 12-lp/cm bars from the fourth section of the American College of Radiology phantom and better represented the vestibular aqueduct and oval and round windows when compared with the EID scanners. A clinical PCCT system was able to image the temporal bone and skull base with improved spatial resolution and lower noise than clinical EID CT systems at matched dose.
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Affiliation(s)
- Jayasai R. Rajagopal
- Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Department of Radiology, Duke University Medical Center, Durham, NC 27705
- Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD 20892
| | - Fides R. Schwartz
- Duke University Health System, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Justin B. Solomon
- Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - David S. Enterline
- Duke University Health System, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Ehsan Samei
- Carl E. Ravin Advanced Imaging Laboratories, Medical Physics Graduate Program, Department of Radiology, Duke University Medical Center, Durham, NC 27705
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Decker JA, Bette S, Lubina N, Rippel K, Braun F, Risch F, Woznicki P, Wollny C, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Low-dose CT of the abdomen: Initial experience on a novel Photon-Counting Detector CT and comparison with Energy-Integrating Detector CT. Eur J Radiol 2022; 148:110181. [DOI: 10.1016/j.ejrad.2022.110181] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/03/2022] [Accepted: 01/26/2022] [Indexed: 11/03/2022]
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