First-generation clinical dual-source photon-counting CT: ultra-low-dose quantitative spectral imaging

Liu, Leening P.; Shapira, Nadav; Chen, Andrew A.; Shinohara, Russell T.; Sahbaee, Pooyan; Schnall, Mitchell D.; Litt, Harold; Noël, Peter B.

doi:10.1007/s00330-022-08933-x

Cited by 44 publications

(39 citation statements)

References 44 publications

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“…They can reduce the electronic circuit noise, beam hardening, and metal artifacts; increase iodine CNR, spectral separation, and spatial resolution; and generate greater quality VMIs. Additionally, dose efficiency is improved [ 1 , 45 , 72 , 73 , 74 ]. Labeling nanoparticles with elements that may be detected by K-edge imaging allows for molecular CT imaging, and the injection of multiple contrast agents (such as iodine and gadolinium) allow multiple-phase images at the same time, reducing the number of acquisitions and radiation doses, although further research is needed before human scanning approval [ 7 , 45 , 75 ].…”

Section: Resultsmentioning

confidence: 99%

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

2023

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Dual-energy computed tomography (DECT) uses different energy spectrum X-ray beams for differentiating materials with similar attenuation at a certain energy. Compared with single-energy CT, it provides images with better diagnostic performance and a potential reduction of contrast agent and radiation doses. There are different commercially available DECT technologies, with machines that may display two X-ray sources and two detectors, a single source capable of fast switching between two energy levels, a specialized detector capable of acquiring high- and low-energy data sets, and a filter splitting the beam into high- and low-energy beams at the output. Sequential acquisition at different tube voltages is an alternative approach. This narrative review describes the DECT technique using a Q&A format and visual representations. Physical concepts, parameters influencing image quality, postprocessing methods, applicability in daily routine workflow, and radiation considerations are discussed. Differences between scanners are described, regarding design, image quality variabilities, and their advantages and limitations. Additionally, current clinical applications are listed, and future perspectives for spectral CT imaging are addressed. Acknowledging the strengths and weaknesses of different DECT scanners is important, as these could be adapted to each patient, clinical scenario, and financial capability. This technology is undoubtedly valuable and will certainly keep improving.

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Section: Resultsmentioning

confidence: 99%

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

2023

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“…The use of photon counting detector multienergy CT imaging is associated with reduced electronic noise, higher iodine signal-to-noise-ratio, and improved spatial resolution, which all contribute to minimizing the radiation exposure needed. PCD-CT technology continues to be a topic of great research interest, and recently an FDA-approved system has become available and offers larger field of view and higher resolution than its predecessor 56 , 57 . In addition, the possible role of artificial intelligence and other algorithmic methods to reduce radiation exposure is currently a topic of widespread interest 58 …”

Section: Discussionmentioning

confidence: 99%

Measurement of enhanced vasa vasorum density in a porcine carotid model using photon counting detector CT

et al. 2023

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Purpose: The onset of atherosclerosis is preceded by changes in blood perfusion within the arterial wall due to localized proliferation of the vasa vasorum. The purpose of this study was to quantify these changes in spatial density of the vasa vasorum using a research whole-body photon-counting detector CT (PCD-CT) scanner and a porcine model.Approach: Vasa vasorum angiogenesis was stimulated in the left carotid artery wall of anesthetized pigs (n ¼ 5) while the right carotid served as a control. After a 6-week recovery period, the animals were scanned on the PCD-CT prior to and after injection of iodinated contrast. Annular regions of interest were used to measure wall enhancement in the injured and control arteries. The exact Wilcoxon-signed rank test was used to determine whether a significant difference in contrast enhancement existed between the injured and control arterial walls. Results:The greatest arterial wall enhancement was observed following contrast recirculation. The wall enhancement measurements made over these time points revealed that the enhancement was greater in the injured artery for 13/16 scanned arterial regions. Using an exact Wilcoxonsigned rank test, a significantly increased enhancement ratio was found in injured arteries compared with control arteries (p ¼ 0.013). Vasa vasorum angiogenesis was confirmed in micro-CT scans of excised arteries.Conclusions: Whole-body PCD-CT scanners can be used to detect and quantify the increased perfusion occurring within the porcine carotid arterial wall resulting from an increased density of vasa vasorum.

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“…While many have compared the imaging performance of different DECT technologies in larger phantoms (36,37), results might differ for pediatric-sized phantoms. Moreover, the recent clinical implementation of the first commercial photo-counting CT (38)(39)(40) may open new possibilities for spectral imaging that can benefit pediatric patients; however, future studies are needed to investigate and compare the pediatric imaging performance.…”

Section: B Cmentioning

confidence: 99%

Phantom-based quantification of the spectral accuracy in dual-layer spectral CT for pediatric imaging at 100 kVp

Meyer¹,

Liu²,

Litt³

et al. 2023

Quant Imaging Med Surg

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Background: To determine the spectral accuracy in detector-based dual-energy CT (DECT) at 100 kVp and wide (8 cm) collimation width for dose levels and object sizes relevant to pediatric imaging.Methods: A spectral CT phantom containing tissue-equivalent materials and iodine inserts of varying concentrations was scanned on the latest generation detector-based DECT system. Two 3D-printed extension rings were used to mimic varying pediatric patient sizes. Scans were performed at 100 and 120 kVp, 4 and 8 cm collimation widths, and progressively reduced radiation dose levels, down to 0.9 mGy CTDI vol . Virtual mono-energetic, iodine density, effective atomic number, and electron density results were quantified and compared to their expected values for all acquisition settings and phantom sizes.Results: DECT scans at 100 kVp provided highly accurate spectral results; however, a size dependence was observed for iodine quantification. For the medium phantom configuration (15 cm diameter), measurement errors in iodine density, effective atomic number, and electron density (ED) were below 0.3 mg/mL, 0.2 and 1.8 %ED water , respectively. The average accuracy was slightly different from scans at 120 kVp; however, not statistically significant for all configurations. Collimation width had no substantial impact. Spectral results were accurate and reliable for radiation exposures down to 0.9 mGy CTDI vol .Conclusions: Detector-based DECT at 100 kVp can provide on-demand or retrospective spectral information with high accuracy even at extremely low doses, thereby making it an attractive solution for pediatric imaging.

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First-generation clinical dual-source photon-counting CT: ultra-low-dose quantitative spectral imaging

Cited by 44 publications

References 44 publications

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

Pros and Cons of Dual-Energy CT Systems: “One Does Not Fit All”

Measurement of enhanced vasa vasorum density in a porcine carotid model using photon counting detector CT

Phantom-based quantification of the spectral accuracy in dual-layer spectral CT for pediatric imaging at 100 kVp

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