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European Radiology
Published in: European Radiology 12/2022

16-06-2022 | Computed Tomography | Computed Tomography

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

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

Published in: European Radiology | Issue 12/2022

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Abstract

Objective

Evaluation of image characteristics at ultra-low radiation dose levels of a first-generation dual-source photon-counting computed tomography (PCCT) compared to a dual-source dual-energy CT (DECT) scanner.

Methods

A multi-energy CT phantom was imaged with and without an extension ring on both scanners over a range of radiation dose levels (CTDIvol 0.4–15.0 mGy). Scans were performed in different modes of acquisition for PCCT with 120 kVp and DECT with 70/Sn150 kVp and 100/Sn150 kVp. Various tissue inserts were used to characterize the precision and repeatability of Hounsfield units (HUs) on virtual mono-energetic images between 40 and 190 keV. Image noise was additionally investigated at an ultra-low radiation dose to illustrate PCCT’s ability to remove electronic background noise.

Results

Our results demonstrate the high precision of HU measurements for a wide range of inserts and radiation exposure levels with PCCT. We report high performance for both scanners across a wide range of radiation exposure levels, with PCCT outperforming at low exposures compared to DECT. PCCT scans at the lowest radiation exposures illustrate significant reduction in electronic background noise, with a mean percent reduction of 74% (p value ~ 10−8) compared to DECT 70/Sn150 kVp and 60% (p value ~ 10−6) compared to DECT 100/Sn150 kVp.

Conclusions

This paper reports the first experiences with a clinical dual-source PCCT. PCCT provides reliable HUs without disruption from electronic background noise for a wide range of dose values. Diagnostic benefits are not only for quantification at an ultra-low dose but also for imaging of obese patients.

Key Points

  • PCCT scanners provide precise and reliable Hounsfield units at ultra-low dose levels.
  • The influence of electronic background noise can be removed at ultra-low-dose acquisitions with PCCT.
  • Both spectral platforms have high performance along a wide range of radiation exposure levels, with PCCT outperforming at low radiation exposures.
Appendix
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Literature
1.
2.
Muenzel D, Bar-Ness D, Roessl E et al (2017) Spectral photon-counting CT: initial experience with dual–contrast agent K-edge colonography. Radiology 283(3):723–728CrossRefPubMed
3.
Pourmorteza A, Symons R, Sandfort V et al (2016) Abdominal imaging with contrast-enhanced photon-counting CT: first human experience. Radiology 279(1):239–245CrossRefPubMed
4.
Symons R, Reich DS, Bagheri M et al (2018) Photon-counting CT for vascular imaging of the head and neck: first in vivo human results. Invest Radiol 53(3):135CrossRefPubMedPubMedCentral
5.
Cormode DP, Si-Mohamed S, Bar-Ness D et al (2017) Multicolor spectral photon-counting computed tomography: in vivo dual contrast imaging with a high count rate scanner. Sci Rep 7(1):4784CrossRefPubMedPubMedCentral
6.
7.
Si-Mohamed S, Bar-Ness D, Sigovan M et al (2017) Review of an initial experience with an experimental spectral photon-counting computed tomography system. Nucl Instruments Methods Phys Res Sect A Accel Spectrometers, Detect Assoc Equip 873:27–35CrossRef
8.
Gutjahr R, Halaweish AF, Yu Z et al (2016) Human imaging with photon-counting-based CT at clinical dose levels: contrast-to-noise ratio and cadaver studies. Invest Radiol 51(7):421CrossRefPubMedPubMedCentral
9.
Bartlett DJ, Koo CW, Bartholmai BJ et al (2019) High-resolution chest CT imaging of the lungs: impact of 1024 matrix reconstruction and photon-counting-detector CT. Invest Radiol 54(3):129CrossRefPubMedPubMedCentral
10.
Leng S, Zhou W, Yu Z et al (2017) Spectral performance of a whole-body research photon counting detector CT: quantitative accuracy in derived image sets. Phys Med Biol 62(17):7216CrossRefPubMedPubMedCentral
11.
Rajendran K, Voss BA, Zhou W et al (2020) Dose reduction for sinus and temporal bone imaging using photon-counting detector CT with an additional tin filter. Invest Radiol 55(2):91CrossRefPubMedPubMedCentral
12.
van der Werf NR, van Gent M, Booij R et al (2021) Dose reduction in coronary artery calcium scoring using mono-energetic images from reduced tube voltage dual-source photon-counting CT data: a dynamic phantom study. Diagnostics 11(12):2192CrossRefPubMedPubMedCentral
13.
14.
Eberhard M, Mergen V, Higashigaito K et al (2021) Coronary calcium scoring with first generation dual-source photon-counting CT—first evidence from phantom and in-vivo scans. Diagnostics 11(9):1708CrossRefPubMedPubMedCentral
15.
16.
17.
Niehoff JH, Woeltjen MM, Saeed S et al (2022) Assessment of hepatic steatosis based on virtual non-contrast computed tomography: Initial experiences with a photon counting scanner approved for clinical use. Eur J Radiol 149:110185CrossRefPubMed
18.
Jungblut L, Blüthgen C, Polacin M et al First performance evaluation of an artificial intelligence-based computer-aided detection system for pulmonary nodule evaluation in dual-source photon-counting detector CT at different low-dose levels. Invest Radiol 57(2):108–114
19.
Euler A, Higashigaito K, Mergen V et al (2022) High-pitch photon-counting detector computed tomography angiography of the aorta: intraindividual comparison to energy-integrating detector computed tomography at equal radiation dose. Invest Radiol 57(2):115–121CrossRefPubMed
20.
Michael AE, Boriesosdick J, Schoenbeck D et al (2022) Image-quality assessment of polyenergetic and virtual monoenergetic reconstructions of unenhanced CT scans of the head: initial experiences with the first photon-counting CT approved for clinical use. Diagnostics 12(2):265CrossRefPubMedPubMedCentral
21.
Decker JA, Bette S, Lubina N et al (2022) 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 148:110181CrossRefPubMed
22.
23.
van der Werf NR, Booij R, Greuter MJW et al (2022) Reproducibility of coronary artery calcium quantification on dual-source CT and dual-source photon-counting CT: a dynamic phantom study. Int J Card Imaging 11(12):1–7
24.
Willemink MJ, Persson M, Pourmorteza A, Pelc NJ, Fleischmann D (2018) Photon-counting CT: technical principles and clinical prospects. Radiology 289(2):293–312CrossRefPubMed
25.
Sandfort V, Persson M, Pourmorteza A, Noël PB, Fleischmann D, Willemink MJ (2021) Spectral photon-counting CT in cardiovascular imaging. J Cardiovasc Comput Tomogr 15(3):218–225CrossRefPubMed
26.
Leng S, Bruesewitz M, Tao S et al (2019) Photon-counting detector CT: system design and clinical applications of an emerging technology. Radiographics 39(3):729–743CrossRefPubMed
27.
Krauss B, Grant KL, Schmidt BT, Flohr TG (2015) The importance of spectral separation an assessment of dual-energy spectral separation for quantitative ability and dose efficiency. Invest Radiol 50(2):114–118CrossRefPubMed
28.
Sauter AP, Kopp FK, Münzel D et al (2018) Accuracy of iodine quantification in dual-layer spectral CT: influence of iterative reconstruction, patient habitus and tube parameters. Eur J Radiol 102:83–88CrossRefPubMed
29.
30.
Liang JZ, La Riviere PJ, El Fakhri G, Glick SJ, Siewerdsen J (2017) Guest editorial low-dose CT: what has been done, and what challenges remain? IEEE Trans Med Imaging 36(12):2409–2416CrossRef
31.
Yu Z, Leng S, Kappler S et al (2016) Noise performance of low-dose CT: comparison between an energy integrating detector and a photon counting detector using a whole-body research photon counting CT scanner. J Med Imaging 3(4):043503CrossRef
32.
Tao S, Marsh JF, Tao A et al (2020) Multi-energy CT imaging for large patients using dual-source photon-counting detector CT. Phys Med Biol 65(17):17NT01CrossRefPubMedPubMedCentral
33.
Pourmorteza A, Symons R, Henning A, Ulzheimer S, Bluemke DA (2018) Dose efficiency of quarter-millimeter photon-counting computed tomography: first-in-human results. Invest Radiol 53(6):365–372CrossRefPubMed
34.
Symons R, Pourmorteza A, Sandfort V et al (2017) Feasibility of dose-reduced chest CT with photon-counting detectors: initial results in humans. Radiology 285(3):980–989CrossRefPubMed
35.
Si-Mohamed S, Boccalini S, Rodesch PA et al (2021) Feasibility of lung imaging with a large field-of-view spectral photon-counting CT system. Diagn Interv Imaging 102(5):305–312CrossRefPubMed
36.
Si-Mohamed S, Cormode DP, Bar-Ness D et al (2017) Evaluation of spectral photon counting computed tomography K-edge imaging for determination of gold nanoparticle biodistribution in vivo. Nanoscale 9(46):18246–18257CrossRefPubMedPubMedCentral
37.
Hsu JC, Nieves LM, Betzer O et al (2020) Nanoparticle contrast agents for X-ray imaging applications. WIREs Nanomed Nanobiotechnol 12(6):e1642CrossRef
38.
Ren L, Rajendran K, Fletcher JG, McCollough CH, Yu L (2020) Simultaneous dual-contrast imaging of small bowel with iodine and bismuth using photon-counting-detector computed tomography: a feasibility animal study. Invest Radiol 55(10):688–694CrossRefPubMedPubMedCentral
39.
Si-Mohamed S, Thivolet A, Bonnot PE et al (2018) Improved peritoneal cavity and abdominal organ imaging using a biphasic contrast agent protocol and spectral photon counting computed tomography K-edge imaging. Invest Radiol 53(10):629–639CrossRefPubMedPubMedCentral
40.
Muenzel D, Daerr H, Proksa R et al (2017) Simultaneous dual-contrast multi-phase liver imaging using spectral photon-counting computed tomography: a proof-of-concept study. Eur Radiol Exp 1(1):25CrossRefPubMedPubMedCentral
41.
Symons R, Krauss B, Sahbaee P et al (2017) Photon-counting CT for simultaneous imaging of multiple contrast agents in the abdomen: an in vivo study. Med Phys 44(10):5120–5127CrossRefPubMedPubMedCentral
42.
Symons R, Cork TE, Lakshmanan MN et al (2017) Dual-contrast agent photon-counting computed tomography of the heart: initial experience. Int J Card Imaging 33(8):1253–1261CrossRef
43.
Tao S, Rajendran K, McCollough CH, Leng S (2019) Feasibility of multi-contrast imaging on dual-source photon counting detector (PCD) CT: an initial phantom study. Med Phys 46(9):4105–4115CrossRefPubMedPubMedCentral
44.
Dangelmaier J, Bar-Ness D, Daerr H et al (2018) Experimental feasibility of spectral photon-counting computed tomography with two contrast agents for the detection of endoleaks following endovascular aortic repair. Eur Radiol 28(8):3318–3325CrossRefPubMedPubMedCentral
45.
Mei K, Geagan M, Roshkovan L, et al (2021) Three-dimensional printing of patient-specific lung phantoms for CT imaging: emulating lung tissue with accurate attenuation profiles and textures. medRxiv 2021.07.30.21261292
46.
Sellerer T, Noël PB, Patino M et al (2018) Dual-energy CT: a phantom comparison of different platforms for abdominal imaging. Eur Radiol 28(7):2745–2755CrossRefPubMed
Metadata
Title
First-generation clinical dual-source photon-counting CT: ultra-low-dose quantitative spectral imaging
Authors
Leening P. Liu
Nadav Shapira
Andrew A. Chen
Russell T. Shinohara
Pooyan Sahbaee
Mitchell Schnall
Harold I. Litt
Peter B. Noël
Publication date
16-06-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08933-x

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