Photon Counting CT Angiography of the Head and Neck: Image Quality Assessment of Polyenergetic and Virtual Monoenergetic Reconstructions

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2022 Jun 24

PMID 35741116

Authors

Arwed Elias Michael

Jan Boriesosdick

Denise Schoenbeck

Ingo Lopez-Schmidt

Jan Robert Kroeger

Christoph Moenninghoff

Sebastian Horstmeier

Lenhard Pennig

Jan Borggrefe

Julius Henning Niehoff

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of the present study was the evaluation of the image quality of polyenergetic and monoenergetic reconstructions (PERs and MERs) of CT angiographies (CTAs) of the head and neck acquired with the novel photon counting CT (PCCT) method in clinical routine.

Methods: Thirty-seven patients were enrolled in this retrospective study. Quantitative image parameters of the extracranial, intracranial and cerebral arteries were evaluated for the PER and MER (40-120 keV). Additionally, two radiologists rated the perceived image quality.

Results: The mean CTDI used in the PCCT was 8.31 ± 1.19 mGy. The highest signal within the vessels was detected in the 40 keV MER, whereas the lowest noise was detected in the 115 keV MER. The most favorable contrast-to-noise-ratio (CNR) and signal-to-noise-ratio (SNR) were detected in the PER and low keV MER. In the qualitative image analysis, the PER was superior to the MER in all rated criteria. For MER, 60-65 keV was rated as best image quality.

Conclusion: Overall, PCCT offers excellent image quality for CTAs of the head and neck. At the current state, the PER of the PCCT seems to be the most favorable reconstruction for diagnostic reporting.

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References

Tranvinh E, Heit J, Hacein-Bey L, Provenzale J, Wintermark M . Contemporary Imaging of Cerebral Arteriovenous Malformations. AJR Am J Roentgenol. 2017; 208(6):1320-1330. DOI: 10.2214/AJR.16.17306. View

DAngelo T, Cicero G, Mazziotti S, Ascenti G, Albrecht M, Martin S . Dual energy computed tomography virtual monoenergetic imaging: technique and clinical applications. Br J Radiol. 2019; 92(1098):20180546. PMC: 6592074. DOI: 10.1259/bjr.20180546. View

Yu L, Leng S, McCollough C . Dual-energy CT-based monochromatic imaging. AJR Am J Roentgenol. 2012; 199(5 Suppl):S9-S15. DOI: 10.2214/AJR.12.9121. View

Flohr T, McCollough C, Bruder H, Petersilka M, Gruber K, Suss C . First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol. 2005; 16(2):256-68. DOI: 10.1007/s00330-005-2919-2. View

Niehoff J, Woeltjen M, Saeed S, Michael A, Boriesosdick J, Borggrefe J . 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. 2022; 149:110185. DOI: 10.1016/j.ejrad.2022.110185. View

Asadi H, Dowling R, Yan B, Wong S, Mitchell P . Advances in endovascular treatment of acute ischaemic stroke. Intern Med J. 2014; 45(8):798-805. DOI: 10.1111/imj.12652. View

Leithner D, Mahmoudi S, Wichmann J, Martin S, Lenga L, Albrecht M . Evaluation of virtual monoenergetic imaging algorithms for dual-energy carotid and intracerebral CT angiography: Effects on image quality, artefacts and diagnostic performance for the detection of stenosis. Eur J Radiol. 2018; 99:111-117. DOI: 10.1016/j.ejrad.2017.12.024. View

Euler A, Higashigaito K, Mergen V, Sartoretti T, Zanini B, Schmidt B . 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. 2021; 57(2):115-121. DOI: 10.1097/RLI.0000000000000816. View

Zopfs D, Lennartz S, Pennig L, Glauner A, Abdullayev N, Bremm J . Virtual monoenergetic images and post-processing algorithms effectively reduce CT artifacts from intracranial aneurysm treatment. Sci Rep. 2020; 10(1):6629. PMC: 7170914. DOI: 10.1038/s41598-020-63574-8. View

10.

Michael A, Boriesosdick J, Schoenbeck D, Woeltjen M, Saeed S, Kroeger J . 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 (Basel). 2022; 12(2). PMC: 8871064. DOI: 10.3390/diagnostics12020265. View

11.

TURNIER H, Houdek P, Trefler M . Measurements of the partial volume phenomenon. Comput Tomogr. 1979; 3(3):213-9. DOI: 10.1016/0363-8235(79)90034-6. View

12.

Kreisler B . Photon counting Detectors: Concept, technical Challenges, and clinical outlook. Eur J Radiol. 2022; 149:110229. DOI: 10.1016/j.ejrad.2022.110229. View

13.

Alvarez R, Macovski A . Energy-selective reconstructions in X-ray computerized tomography. Phys Med Biol. 1976; 21(5):733-44. DOI: 10.1088/0031-9155/21/5/002. View

14.

Wang Y, Wang Y, Hu P, Niu Z, Hu H . Comparative study of the image quality of twin beam dual energy and single energy carotid CT angiography. Eur J Radiol. 2022; 148:110160. DOI: 10.1016/j.ejrad.2022.110160. View

15.

Flohr T, Petersilka M, Henning A, Ulzheimer S, Ferda J, Schmidt B . Photon-counting CT review. Phys Med. 2020; 79:126-136. DOI: 10.1016/j.ejmp.2020.10.030. View

16.

Kaup M, Scholtz J, Engler A, Albrecht M, Bauer R, Kerl J . Dual-Energy Computed Tomography Virtual Monoenergetic Imaging of Lung Cancer: Assessment of Optimal Energy Levels. J Comput Assist Tomogr. 2015; 40(1):80-5. DOI: 10.1097/RCT.0000000000000319. View

17.

Powers W . Acute Ischemic Stroke. N Engl J Med. 2020; 383(3):252-260. DOI: 10.1056/NEJMcp1917030. View

18.

Sudarski S, Apfaltrer P, Nance Jr J, Schneider D, Meyer M, Schoenberg S . Optimization of keV-settings in abdominal and lower extremity dual-source dual-energy CT angiography determined with virtual monoenergetic imaging. Eur J Radiol. 2013; 82(10):e574-81. DOI: 10.1016/j.ejrad.2013.04.040. View

19.

Si-Mohamed S, Boccalini S, Lacombe H, Diaw A, Varasteh M, Rodesch P . Coronary CT Angiography with Photon-counting CT: First-In-Human Results. Radiology. 2022; 303(2):303-313. DOI: 10.1148/radiol.211780. View

20.

Wichmann J, Noske E, Kraft J, Burck I, Wagenblast J, Eckardt A . Virtual monoenergetic dual-energy computed tomography: optimization of kiloelectron volt settings in head and neck cancer. Invest Radiol. 2014; 49(11):735-41. DOI: 10.1097/RLI.0000000000000077. View