Photon Counting CT: Technical Principles, Clinical Applications, and Future Prospects

Wu, Yingyi; Zheng, Yi; Chen, Jie; Deng, Liping; Song, Bin

doi:10.1016/j.acra.2023.05.029

Cited by 14 publications

(6 citation statements)

References 126 publications

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“…For thoracic CT imaging, PCCT is an emerging technology, where x-ray photons are directly converted into electrical signals in special detectors. Thus, advantages in image quality can be achieved including a higher spatial resolution, improved iodine signal, artifact reduction, and multienergy imaging accompanied by radiation dose reduction [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Photon-counting CT of degenerative changes and rupture of silicone breast implants: a pilot study

Neubauer,

Gebler,

Wilpert

et al. 2024

Eur Radiol Exp

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Background Accurate assessment of breast implants is important for appropriate clinical management. We evaluated silicone properties and diagnostic accuracy for characterizing silicone implants and detecting degenerative changes including rupture in photon-counting computed tomography (PCCT). Methods Over 16 months, we prospectively included patients with silicone implants and available breast magnetic resonance imaging (MRI) who received thoracic PCCT performed in prone position. Consensus reading of all available imaging studies including MRI served as reference standard. Two readers evaluated all implants in PCCT reconstructions for degenerative changes. In a subgroup of implants, mean density of silicone, adjacent muscle, and fat were measured on PCCT reconstructions. Contrast-to-noise ratios (CNRs) were calculated for implant-to-muscle and implant-to-fat. Results Among 21 subjects, aged 60 ± 13.1 years (mean ± standard deviation) with 29 implants PCCT showed the following: high accuracy for linguine sign, intraimplant fluid (all > 0.99), peri-implant silicone (0.95), keyhole sign (0.90), and folds of the membrane (0.81); high specificity for linguine sign, intraimplant fluid, keyhole sign, folds of the membrane (all > 0.99), and peri-implant silicone (0.98); and high sensitivity for linguine sign and intraimplant fluid (all > 0.99). In a subgroup of 12 implants, the highest CNR for implant-to-muscle was observed on virtual unenhanced reconstructions (20.9) and iodine maps (22.9), for implant-to-fat on iodine maps (27.7) and monoenergetic reconstructions (31.8). Conclusions Our findings demonstrate that silicone breast implants exhibit distinct contrast properties at PCCT, which may provide incremental information for detection of degenerative changes and rupture of implants. Relevance statement Thoracic photon-counting computed tomography is a promising modality for the diagnostic assessment of silicone breast implants. Key points • Thoracic photon-counting computed tomography demonstrates unique contrast properties of silicone breast implants. • Iodine map reconstructions reveal strong contrast-to-noise ratios for implant-to-muscle and implant-to-fat. • Thoracic photon-counting computed tomography shows high diagnostic accuracy in detecting implant degeneration and rupture. Trial registration German Clinical Trials Register number DRKS00028997, date of registration 2022–08-08, retrospectively registered. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%

“…Whole-body photon-counting CT (PCCT) is a new promising CT technology [ 16 ]. So far, to our knowledge, no study regarding the assessment of silicone breast implants exists for thoracic PCCT.…”

Section: Introductionmentioning

confidence: 99%

Photon-counting CT of degenerative changes and rupture of silicone breast implants: a pilot study

Neubauer,

Gebler,

Wilpert

et al. 2024

Eur Radiol Exp

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“…2 These imperfections in PCDs impact detective quantum efficiency, degrade energy resolution, and increase image noise, ultimately compromising the overall image quality. 3 Nevertheless, clinically approved, and experimental prototypes of PCCT scanners are available, indicating successful efforts in tackling these challenges by minimizing their effects.…”

Section: A Introductionmentioning

confidence: 99%

A generic model of semiconductor-based photon-counting detectors for spectral CT

Bhattarai,

Panta,

Clark

et al. 2024

Medical Imaging 2024: Physics of Medical Imaging

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Photon-counting CT (PCCT) is an emerging x-ray spectral imaging technology. There are several PCCT prototypes available for clinical and experimental applications. Despite many published results, objective quantitative evaluation of PCCT systems remains challenging due to varied and unknown influences. In addition, CT acquisition geometry and image processing mechanisms are often proprietary, complicating the correlations between the detector's physical characteristics and the corresponding CT image quality, hindering fair comparisons between different technologies. This study aimed to provide a resource to address these challenges by developing a versatile model that accurately replicates the physics of any semiconductor-based photon-counting detector (PCD) and integrating it into a virtual imaging framework to generate detector-specific CT images. The methodology involved a Monte Carlo simulation to model x-ray photon interactions with PCDs and an analytical Gaussian charge sharing model to model charge-diffusion and -repulsion in the detector. Finally, the energy deposited post-crosstalk by source photons (1-120 keV) in the 3×3-pixelneighborhood was translated into photon counts across two energy thresholds to compute detectorspecific spatio-energetic covariance correlation matrices. This framework was validated against experimental measurements of a clinical CdTe-based PCCT, showcasing its accuracy in reproducing real-world scenarios. Additionally, to demonstrate the model's efficacy, we simulated key PCD materials (Si, CdTe, CZT) and designed standardized scanner components, developing virtual systems (DukeCounter scanners). These systems were used to "scan" a physics phantom (ACR) and anthropomorphic-computational models (XCAT). In low-energy (i.e., 5 keV for Si, 20 keV for CdTe and CZT) threshold images, for 125 mAs acquisitions, (noise magnitudes, HU for bone insert) measured in ACR phantom were (76.0 HU, 889.4 HU), (76.9 HU, 932.9 HU), (81.7 HU, 939.4 HU), and the percent difference in Pi10 (airway-based biomarker) between the ground-truth and CT images of XCAT phantoms were 33.7%±3.6%, 22.6%±15.2%, 33.0%±3.6% for CdTe-, CZT-, Si-based DukeCounter systems, respectively. In this way, we demonstrated the utility of our framework to simulate detector-specific CT images for PCCT systems.

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“…Moreover, PC CT's superior energy resolution reduces scatter and beam-hardening artifacts, which are common challenges in imaging with EIDs. The ability to operate at lower radiation doses without compromising image Tomography 2024, 10 655 quality further underscores the difference, showcasing PC detectors as a transformative technology in the field of diagnostic imaging [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Advanced Imaging of Shunt Valves in Cranial CT Scans with Photon-Counting Scanner

Klempka,

Ackermann,

Brehmer

et al. 2024

Tomography

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This brief report aimed to show the utility of photon-counting technology alongside standard cranial imaging protocols for visualizing shunt valves in a patient’s cranial computed tomography scan. Photon-counting CT scans with cranial protocols were retrospectively surveyed and four types of shunt valves were encountered: proGAV 2.0®, M.blue®, Codman Certas®, and proSA®. These scans were compared with those obtained from non-photon-counting scanners at different time points for the same patients. The analysis of these findings demonstrated the usefulness of photon-counting technology for the clear and precise visualization of shunt valves without any additional radiation or special reconstruction patterns. The enhanced utility of photon-counting is highlighted by providing superior spatial resolution compared to other CT detectors. This technology facilitates a more accurate characterization of shunt valves and may support the detection of subtle abnormalities and a precise assessment of shunt valves.

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Photon Counting CT: Technical Principles, Clinical Applications, and Future Prospects

Cited by 14 publications

References 126 publications

Photon-counting CT of degenerative changes and rupture of silicone breast implants: a pilot study

Photon-counting CT of degenerative changes and rupture of silicone breast implants: a pilot study

A generic model of semiconductor-based photon-counting detectors for spectral CT

Advanced Imaging of Shunt Valves in Cranial CT Scans with Photon-Counting Scanner

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