Feasibility study of portable multi-energy computed tomography with photon-counting detector for preclinical and clinical applications

Lee, Chang-Lae; Hong, Ki‐Ha; Kim, Namwoo; Han, Kyunghun; Kim, Dongkyu; Jung, Haijo; Lee, Sang‐Min; Park, Jun-Young; Lee, Kyoung‐Yong; Lee, Jee Eun; Choi, Yuna; Cho, Minkook

doi:10.1038/s41598-021-02210-5

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…В настоящее время в мире для нейровизуализационной диагностики инсульта на уровне приемного отделения широко применяются две основные методики: КТ и МРТ. Достоинствами КТ является быстрота проведения процедуры (до 15 мин), возможность проведения ее пациентам с металлическими конструкциями и кардиостимуляторами, а также находящимся на ИВЛ, невы-2022;16 (14):32-37 сокая стоимость манипуляции, низкие требования к установке оборудования, высокая точность при проведении дифференциальной диагностики между ишемическим и геморрагическим инсультом [6,7]. Несмотря на преимущества КТ, у этой методики есть свои недостатки, поскольку она не всегда показывает четкий очаг ишемии [8][9][10].…”

Section: Discussionunclassified

What affects the neurovisualisational detection of ischemic stroke?

et al. 2022

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Introduction. The incidence of stroke is 2.5–3 cases per 1 000 population per year, mortality – 1 case per 1 000 population per year. According to various data, up to 20% of computed tomography (CT) scans performed on the first day do not reveal signs of an ischemic focus.Aim of the study. To assess the detectability of acute ischemia foci using CT, depending on the location of the foci, the timing of neuroimaging, the severity of stroke, and other indicators.Material and methods. We analyzed 100 cases of acute cerebrovascular accident (ACV) by ischemic type. The timing of the CT scan, glucose level, coagulogram parameters, NIHSS scores at admission, focus localization, the presence of atherosclerosis of the arteries of the head, and atrial fibrillation were taken into account. Patients were divided into two groups depending on the fact of detection of the focus during the primary tomographic examination. Repeated neuroimaging (magnetic resonance imaging) was performed in 54 patients.Results. In the “CT-negative” group, stem strokes predominated (p = 0.01), patients were younger (р = 0.038), and there were significantly more women than men (р = 0.00006). An increase in glucose over 8 mmol/l, on the contrary, was more often detected in the “CT-positive” group (14 cases in “CT-positive” against 5 cases in “CT-negative” group, p = 0.022). NIHSS scores ≥ 5 were found in 24 patients (47%) in the “CT-positive” group and in 13 patients (26.5%) in the “CT-negative” group (p = 0.034).Conclusions. Cases of stroke that are not detected on CT scan upon admission to the hospital are more common among women, with stem localization, are associated with low NIHSS scores. High glucose levels at admission is associated with the detection of ischemic foci during the initial CT examination.

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Section: Discussionunclassified

What affects the neurovisualisational detection of ischemic stroke?

et al. 2022

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“…2021 wurde der erste Computertomograph mit PCD der Firma Siemens Healthcare GmbH (Erlangen, Deutschland) für den klinischen Einsatz in den USA und Europa zugelassen [ 2 ]. In den nächsten Jahren sollen PCD-Systeme weiterer Gerätehersteller folgen [ 3 , 4 ].…”

Section: Hintergrundunclassified

CT technology: photon-counting detector computed tomography

Layer¹,

Kravchenko²,

Dell³

et al. 2023

Radiologie

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Hintergrund Die photonenzählende Computertomographie („photon-counting detector computed tomography“, PCD-CT) ist eine Technologie, die viele Einschränkungen der herkömmlichen Detektoren überwindet. Eine direkte Umwandlung der auf den Detektor eintreffenden Photonen in elektrische Signale, verbunden mit einer sensitiveren und präziseren Photonerfassung ermöglicht eine spektrale Auswertung sowie eine potenziell verringerte Strahlenexposition des Patienten. Durch die Kombination von angewandten Energieschwellenwerten und den Verzicht auf Detektorsepten kann elektronisches Rauschen reduziert, die Ortsauflösung erhöht und die Dosiseffizienz gesteigert werden. Bewertung Aktuelle Forschungsarbeiten bestätigen deutlich reduziertes Bildrauschen, reduzierte Strahlendosis, erhöhte Ortsauflösung, verbessertes Jodsignal sowie eine Reduktion von Artefakten. Die spektrale Auswertung potenziert diese Effekte und ermöglicht auch retrospektiv die Errechnung virtuell-monoenergetischer Bilder, virtuell-nativer Bilder oder Jodkarten. Perspektivisch ergibt sich durch die photonenzählende Technologie die Möglichkeit zur Anwendung diverser Kontrastmittel, mit der Aussicht auf einzeitige Mehrphasenbildgebung oder zur Visualisierung bestimmter Stoffwechselprozesse. Bis zum klinischen Einsatz sind hierzu weitere Grundlagenforschung sowie ergänzende Zulassungsprozesse notwendig. Schlussfolgerung Das bisher einzige am Markt verfügbare PCD-CT-Gerät erhielt 2021 die Zulassung. Es bleibt abzuwarten, welche weitere Anwendungen durch Verbesserungen von Hardware und Software möglich werden. Insbesondere für hochauflösende Bildgebung bei detaillierten Fragestellungen und Untersuchungen mit hoher Strahlenbelastung zeigt die Technologie bereits heute eine eindrucksvolle Überlegenheit gegenüber dem vorherigen Technologiestandard.

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The first mobile photon-counting detector CT: the human images and technical performance study

Park

Kim

et al. 2023

Phys. Med. Biol.

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Objective: The purpose of this study is to assess its human images and its unique capabilities such as the “on demand” higher spatial resolution and multi-spectral imaging of photon-counting-detector (PCD)-CT. Approach: In this study, the FDA 510(k) cleared mobile PCD-CT (OmniTom Elite) was used. To this end, we imaged internationally certified CT phantoms and a human cadaver head to evaluate the feasibility of high resolution and multi-energy imaging. We also demonstrate the performance of PCD-CT via first-in-human imaging by scanning three human volunteers. Main results: At the 5 mm slice thickness, routinely used in diagnostic head CT, the first human PCD-CT images were diagnostically equivalent to the EID-CT scanner. The high resolution (HR) acquisition mode of PCD-CT achieved a resolution of 11 line-pairs (lp)/cm as compared to 7 lp/cm using the same kernel (posterior fossa-kernel) in the standard acquisition mode of EID-CT. For the quantitative multi-energy CT performance, the measured CT numbers in virtual mono-energetic images (VMI) of iodine inserts in the Gammex Multi-Energy CT phantom (model 1492, Sun Nuclear Corporation, USA) matched the manufacturer reference values with mean percent error of 3.25%. Multi-energy decomposition with PCD-CT demonstrated the separation and quantification of iodine, calcium, and water.Significance: PCD-CT can achieve multi-resolution acquisition modes without physically changing the CT detector. It can provide superior spatial resolution compared with the standard acquisition mode the conventional mobile EID-CT. Quantitative spectral capability of PCD-CT can provide accurate, simultaneous multi-energy images for material decomposition and VMI generation using a single exposure.

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Feasibility study of portable multi-energy computed tomography with photon-counting detector for preclinical and clinical applications

Cited by 4 publications

References 31 publications

What affects the neurovisualisational detection of ischemic stroke?

What affects the neurovisualisational detection of ischemic stroke?

CT technology: photon-counting detector computed tomography

The first mobile photon-counting detector CT: the human images and technical performance study

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