Photon-Counting Computed Tomography for Microstructural Imaging of Bone and Joints

Overview

Journal Curr Osteoporos Rep

Publisher Current Science

Specialties Endocrinology
Orthopedics

Date 2024 Jun 4

PMID 38833188

Authors

Jilmen Quintiens

G Harry van Lenthe

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Recently, photon-counting computed tomography (PCCT) has been introduced in clinical research and diagnostics. This review describes the technological advances and provides an overview of recent applications with a focus on imaging of bone.

Recent Findings: PCCT is a full-body scanner with short scanning times that provides better spatial and spectral resolution than conventional energy-integrating-detector CT (EID-CT), along with an up to 50% reduced radiation dose. It can be used to quantify bone mineral density, to perform bone microstructural analyses and to assess cartilage quality with adequate precision and accuracy. Using a virtual monoenergetic image reconstruction, metal artefacts can be greatly reduced when imaging bone-implant interfaces. Current PCCT systems do not allow spectral imaging in ultra-high-resolution (UHR) mode. Given its improved resolution, reduced noise and spectral imaging capabilities PCCT has diagnostic capacities in both qualitative and quantitative imaging that outperform those of conventional CT. Clinical use in monitoring bone health has already been demonstrated. The full potential of PCCT systems will be unlocked when UHR spectral imaging becomes available.

References

Cann C, Genant H, KOLB F, Ettinger B . Quantitative computed tomography for prediction of vertebral fracture risk. Bone. 1985; 6(1):1-7. DOI: 10.1016/8756-3282(85)90399-0. View

Link T, Lang T . Axial QCT: clinical applications and new developments. J Clin Densitom. 2014; 17(4):438-48. DOI: 10.1016/j.jocd.2014.04.119. View

Elliott J, Dover S . X-ray microtomography. J Microsc. 1982; 126(Pt 2):211-3. DOI: 10.1111/j.1365-2818.1982.tb00376.x. View

Nakashima D, Ishii K, Nishiwaki Y, Kawana H, Jinzaki M, Matsumoto M . Quantitative CT-based bone strength parameters for the prediction of novel spinal implant stability using resonance frequency analysis: a cadaveric study involving experimental micro-CT and clinical multislice CT. Eur Radiol Exp. 2019; 3(1):1. PMC: 6342748. DOI: 10.1186/s41747-018-0080-3. View

Mys K, Stockmans F, Vereecke E, van Lenthe G . Quantification of bone microstructure in the wrist using cone-beam computed tomography. Bone. 2018; 114:206-214. DOI: 10.1016/j.bone.2018.06.006. View

Mys K, Varga P, Gueorguiev B, Hemmatian H, Stockmans F, van Lenthe G . Correlation Between Cone-Beam Computed Tomography and High-Resolution Peripheral Computed Tomography for Assessment of Wrist Bone Microstructure. J Bone Miner Res. 2019; 34(5):867-874. DOI: 10.1002/jbmr.3673. View

van den Bergh J, Szulc P, Cheung A, Bouxsein M, Engelke K, Chapurlat R . The clinical application of high-resolution peripheral computed tomography (HR-pQCT) in adults: state of the art and future directions. Osteoporos Int. 2021; 32(8):1465-1485. PMC: 8376700. DOI: 10.1007/s00198-021-05999-z. View

Tatsugami F, Higaki T, Nakamura Y, Honda Y, Awai K . Dual-energy CT: minimal essentials for radiologists. Jpn J Radiol. 2022; 40(6):547-559. PMC: 9162973. DOI: 10.1007/s11604-021-01233-2. View

Gruenewald L, Koch V, Martin S, Yel I, Eichler K, Gruber-Rouh T . Diagnostic accuracy of quantitative dual-energy CT-based volumetric bone mineral density assessment for the prediction of osteoporosis-associated fractures. Eur Radiol. 2021; 32(5):3076-3084. PMC: 9038932. DOI: 10.1007/s00330-021-08323-9. View

10.

Wichmann J, Booz C, Wesarg S, Kafchitsas K, Bauer R, Kerl J . Dual-energy CT-based phantomless in vivo three-dimensional bone mineral density assessment of the lumbar spine. Radiology. 2014; 271(3):778-84. DOI: 10.1148/radiol.13131952. View

11.

Wong A, Wong M, Kutschera P, Lau K . Dual-energy CT in musculoskeletal trauma. Clin Radiol. 2020; 76(1):38-49. DOI: 10.1016/j.crad.2020.08.006. View

12.

Shikhaliev P, Xu T, Molloi S . Photon counting computed tomography: concept and initial results. Med Phys. 2005; 32(2):427-36. DOI: 10.1118/1.1854779. View

13.

Willemink M, Persson M, Pourmorteza A, Pelc N, Fleischmann D . Photon-counting CT: Technical Principles and Clinical Prospects. Radiology. 2018; 289(2):293-312. DOI: 10.1148/radiol.2018172656. View

14.

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

15.

Bhattarai M, Bache S, Abadi E, Samei E . Exploration of the pulse pileup effects in a clinical CdTe-based photon-counting computed tomography. Med Phys. 2023; 50(11):6693-6703. PMC: 10840699. DOI: 10.1002/mp.16671. View

16.

Tanguay J, Cunningham I . Cascaded systems analysis of charge sharing in cadmium telluride photon-counting x-ray detectors. Med Phys. 2018; 45(5):1926-1941. DOI: 10.1002/mp.12853. View

17.

Booij R, Kammerling N, Oei E, Persson A, Tesselaar E . Assessment of visibility of bone structures in the wrist using normal and half of the radiation dose with photon-counting detector CT. Eur J Radiol. 2022; 159:110662. DOI: 10.1016/j.ejrad.2022.110662. View

18.

Conrads N, Grunz J, Huflage H, Luetkens K, Feldle P, Pennig L . Ultrahigh-resolution computed tomography of the cervical spine without dose penalty employing a cadmium-telluride photon-counting detector. Eur J Radiol. 2023; 160:110718. DOI: 10.1016/j.ejrad.2023.110718. View

19.

Rau A, Straehle J, Stein T, Diallo T, Rau S, Faby S . Photon-Counting Computed Tomography (PC-CT) of the spine: impact on diagnostic confidence and radiation dose. Eur Radiol. 2023; 33(8):5578-5586. PMC: 10326119. DOI: 10.1007/s00330-023-09511-5. View

20.

Baffour F, Rajendran K, Glazebrook K, Thorne J, Larson N, Leng S . Ultra-high-resolution imaging of the shoulder and pelvis using photon-counting-detector CT: a feasibility study in patients. Eur Radiol. 2022; 32(10):7079-7086. PMC: 9474720. DOI: 10.1007/s00330-022-08925-x. View