Spectral Photon-Counting CT Technology in Chest Imaging

Si‐Mohamed, Salim; Miailhes, Jade; Rodesch, Pierre‐Antoine; Boccalini, Sara; Lacombe, Hugo; Leitman, Valérie; Cottin, Vincent; Boussel, Loîc; Douek, Philippe

doi:10.3390/jcm10245757

Cited by 57 publications

(35 citation statements)

References 71 publications

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“…Regarding thoracic imaging, the reduction in noise could significantly improve the evaluation of patients with interstitial and alveolar lung disease, in whom even small attenuation changes can be associated with the progression of disease 5. Alternatively, PCD-CT has the potential to reduce radiation dose while maintaining image quality, which is especially interesting if using HRCT as a screening tool for lung cancer 1…”

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confidence: 99%

Dose Reduction and Image Quality in Photon-counting Detector High-resolution Computed Tomography of the Chest

Graafen¹,

Emrich

Halfmann

et al. 2022

Journal of Thoracic Imaging

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Purpose: Photon-counting detector computed tomography (PCD-CT) has the potential to significantly improve CT imaging in many ways including, but not limited to, low-dose high-resolution CT (HRCT) of the lung. The aim of this study was to perform an intrapatient comparison of the radiation dose and image quality of PCD-CT compared with conventional energy-integrating detector CT (EID-CT). Methods: A total of 32 consecutive patients with available PCD-CT and EID-CT HRCT scans were included in the final analysis. The CT dose index (CTDIvol) was extracted from patient dose reports. Qualitative image analysis comprised the lung parenchyma and mediastinal structures and was assessed by 3 readers using a 5-point Likert scale. Quantitative image analysis included assessment of noise and signal-to-noise ratio in the lung parenchyma, trachea, aorta, muscle, and background. Results: The mean CTDIvol was 2.0 times higher in the conventional EID-CT scans (1.8±0.5 mGy) compared with PCD-CT (0.9±0.5 mGy, P<0.001). The overall image quality was rated significantly better by all 3 raters (P<0.001) in the PCD-CT relative to the EID-CT. Quantitative analysis showed no significant differences in noise and signal-to-noise ratio in the lung parenchyma between PCD-CT and EID-CT. Conclusion: Compared with conventional EID-CT scans, PCD-CT demonstrated similar or better objective and subjective image quality at significantly reduced dose levels in an intrapatient comparison. These results and their effect on clinical decision-making should be further investigated in prospective studies.

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confidence: 99%

Dose Reduction and Image Quality in Photon-counting Detector High-resolution Computed Tomography of the Chest

Graafen¹,

Emrich

Halfmann

et al. 2022

Journal of Thoracic Imaging

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“…Current publications spotlight many benefits of the PCD-CT in comparison with previous generations of CT; they provide a higher contrast-to-noise ratio, lower radiation dose and the possibility to reconstruct VMI energies [ 12 , 13 , 15 , 16 , 17 , 19 , 25 , 26 , 27 , 28 ]. Our study assessed the impact of different VMI energies in the diagnosis of PE with PCD-CT.…”

Section: Discussionmentioning

confidence: 99%

Impact of Photon Counting Detector CT Derived Virtual Monoenergetic Images on the Diagnosis of Pulmonary Embolism

et al. 2022

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Purpose: To assess the impact of virtual-monoenergetic-image (VMI) energies on the diagnosis of pulmonary embolism (PE) in photon-counting-detector computed-tomography (PCD-CT). Methods: Eighty patients (median age 60.4 years) with suspected PE were retrospectively included. Scans were performed on PCD-CT in the multi-energy mode at 120 kV. VMIs from 40–70 keV in 10 keV intervals were reconstructed. CT-attenuation was measured in the pulmonary trunk and the main branches of the pulmonary artery. Signal-to-noise (SNR) ratio was calculated. Two radiologists evaluated subjective-image-quality (noise, vessel-attenuation and sharpness; five-point-Likert-scale, non-diagnostic–excellent), the presence of hardening artefacts and presence/visibility of PE. Results: Signal was highest at the lowest evaluated VMI (40 keV; 1053.50 HU); image noise was lowest at the highest VMI (70 keV; 15.60 HU). Highest SNR was achieved at the lowest VMI (p < 0.05). Inter-reader-agreement for subjective analysis was fair to excellent (k = 0.373–1.000; p < 0.001). Scores for vessel-attenuation and sharpness were highest at 40 keV (both:5, range 4/3–5; k = 1.000); scores for image-noise were highest at 70 keV (4, range 3–5). The highest number of hardening artifacts were reported at 40 keV (n = 22; 28%). PE-visualization was rated best at 50 keV (4.7; range 4–5) and decreased with increasing VMI-energy (r = −0.558; p < 0.001). Conclusions: While SNR was best at 40 keV, subjective PE visibility was rated highest at 50 keV, potentially owing to the lower image noise and hardening artefacts.

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“…23 In a recent phantom study on lung nodules, PCD CT yielded higher subjective and objective image quality compared to a regular CT scanner at the same low radiation dose. 24 First clinical examples in chest CT, as reviewed by Si-Mohamed, 25 show excellent spatial resolution of small parenchymal structures, and improved detection of low density structures like subsolid nodules. The first patient studies on the advantages of clinical PCD CT scanners in chest imaging are eagerly awaited.…”

Section: Photon-counting Detector Ct Scannermentioning

confidence: 99%

Innovations in thoracic imaging: CT, radiomics, AI and x‐ray velocimetry

Vliegenthart

Fouras²,

Jacobs

et al. 2022

Respirology

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In recent years, pulmonary imaging has seen enormous progress, with the introduction, validation and implementation of new hardware and software. There is a general trend from mere visual evaluation of radiological images to quantification of abnormalities and biomarkers, and assessment of ‘non visual’ markers that contribute to establishing diagnosis or prognosis. Important catalysts to these developments in thoracic imaging include new indications (like computed tomography [CT] lung cancer screening) and the COVID‐19 pandemic. This review focuses on developments in CT, radiomics, artificial intelligence (AI) and x‐ray velocimetry for imaging of the lungs. Recent developments in CT include the potential for ultra‐low‐dose CT imaging for lung nodules, and the advent of a new generation of CT systems based on photon‐counting detector technology. Radiomics has demonstrated potential towards predictive and prognostic tasks particularly in lung cancer, previously not achievable by visual inspection by radiologists, exploiting high dimensional patterns (mostly texture related) on medical imaging data. Deep learning technology has revolutionized the field of AI and as a result, performance of AI algorithms is approaching human performance for an increasing number of specific tasks. X‐ray velocimetry integrates x‐ray (fluoroscopic) imaging with unique image processing to produce quantitative four dimensional measurement of lung tissue motion, and accurate calculations of lung ventilation.

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Spectral Photon-Counting CT Technology in Chest Imaging

Cited by 57 publications

References 71 publications

Dose Reduction and Image Quality in Photon-counting Detector High-resolution Computed Tomography of the Chest

Dose Reduction and Image Quality in Photon-counting Detector High-resolution Computed Tomography of the Chest

Impact of Photon Counting Detector CT Derived Virtual Monoenergetic Images on the Diagnosis of Pulmonary Embolism

Innovations in thoracic imaging: CT, radiomics, AI and x‐ray velocimetry

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