Evaluation of Coronary Plaques and Stents with Conventional and Photon-counting CT: Benefits of High-Resolution Photon-counting CT

Rajagopal, Jayasai R.; Farhadi, Faraz; Richards, Taylor; Nikpanah, Moozhan; Sahbaee, Pooyan; Shanbhag, Sujata M.; Bandettini, W. Patricia; Saboury, Babak; Malayeri, Ashkan A.; Pritchard, William F.; Jones, Elizabeth; Samei, Ehsan; Chen, Marcus Y

doi:10.1148/ryct.2021210102

Cited by 39 publications

(28 citation statements)

References 22 publications

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“…At matched protocol settings and identical image reconstruction parameters, the in-stent lumen delineation of coronary artery stents was better on PCD CT- than conventional EID CT scans [ 31 ]. A comparison of specialized high-resolution PCD CT, EID CT, and standard PCD CT showed that despite an increase in the noise, the visualization of coronary plaques was improved and stent artifacts were decreased on PCD CT scans [ 32 , 33 ].…”

Section: Clinical Potential Of Photon-counting Detector Ctmentioning

confidence: 99%

An introduction to photon-counting detector CT (PCD CT) for radiologists

et al. 2022

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The basic performance of photon-counting detector computed tomography (PCD CT) is superior to conventional CT (energy-integrating detector CT: EID CT) because its spatial- and contrast resolution of soft tissues is higher, and artifacts are reduced. Because the X-ray photon energy separation is better with PCD CT than conventional EID-based dual-energy CT, it has the potential to improve virtual monochromatic- and virtual non-contrast images, material decomposition including quantification of the iodine distribution, and K-edge imaging. Therefore, its clinical applicability may be increased. Although the image quality of PCD CT scans is superior to that of EID CT currently, further improvement may be possible. The introduction of iterative image reconstruction and reconstruction with deep convolutional neural networks will be useful.

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Section: Clinical Potential Of Photon-counting Detector Ctmentioning

confidence: 99%

An introduction to photon-counting detector CT (PCD CT) for radiologists

et al. 2022

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“…Previous phantom studies using a high-resolution mode with a prototype PCD-CT system yielded superior coronary plaque and in-stent visualization as compared with EID-CT. [14][15][16] High-resolution CCTA acquired with another prototype PCD-CT also outperformed EID-CT in patients with regard to overall image quality and diagnostic quality of coronary calcifications, stents, and noncalcified plaques. 17,18 The purpose of this study was to evaluate the feasibility and quality of ultra-high-resolution CCTA with dual-source PCD-CT in patients with a high coronary calcium load, including an analysis of the optimal reconstruction kernel and matrix size.…”

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confidence: 99%

Ultra-High-Resolution Coronary CT Angiography With Photon-Counting Detector CT

et al. 2022

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Objectives: The aim of this study was to evaluate the feasibility and quality of ultra-high-resolution coronary computed tomography angiography (CCTA) with dual-source photon-counting detector CT (PCD-CT) in patients with a high coronary calcium load, including an analysis of the optimal reconstruction kernel and matrix size. Materials and Methods: In this institutional review board-approved study, 20 patients (6 women; mean age, 79 ± 10 years; mean body mass index, 25.6 ± 4.3 kg/m 2 ) undergoing PCD-CCTA in the ultra-high-resolution mode were included. Ultra-high-resolution CCTA was acquired in an electrocardiography-gated dual-source spiral mode at a tube voltage of 120 kV and collimation of 120 Â 0.2 mm. The field of view (FOV) and matrix sizes were adjusted to the resolution properties of the individual reconstruction kernels using a FOV of 200 Â 200 mm 2 or 150 Â 150 mm 2 and a matrix size of 512 Â 512 pixels or 1024 Â 1024 pixels, respectively. Images were reconstructed using vascular kernels of 8 sharpness levels (Bv40, Bv44, Bv56, Bv60, Bv64, Bv72, Bv80, and Bv89), using quantum iterative reconstruction (QIR) at a strength level of 4, and a slice thickness of 0.2 mm. Images with the Bv40 kernel, QIR at a strength level of 4, and a slice thickness of 0.6 mm served as the reference. Image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), vessel sharpness, and blooming artifacts were quantified. For subjective image quality, 2 blinded readers evaluated image noise and delineation of coronary artery plaques and the adjacent vessel lumen using a 5-point discrete visual scale. A phantom scan served to characterize image noise texture by calculating the noise power spectrum for every reconstruction kernel. Results: Maximum spatial frequency (f peak ) gradually shifted to higher values for reconstructions with the Bv40 to Bv64 kernel (0.15 to 0.56 mm −1 ), but not for reconstructions with the Bv72 to Bv89 kernel. Ultra-high-resolution CCTA was feasible in all patients (median calcium score, 479). In patients, reconstructions with the Bv40 kernel and a slice thickness of 0.6 mm showed largest blooming artifacts (55.2% ± 9.8%) and lowest vessel sharpness (477.1 ± 73.6 ΔHU/mm) while achieving highest SNR (27.4 ± 5.6) and CNR (32.9 ± 6.6) and lowest noise (17.1 ± 2.2 HU). Considering reconstructions with a slice thickness of 0.2 mm, image noise, SNR, CNR, vessel sharpness, and blooming artifacts significantly differed across kernels (all P's < 0.001). With higher kernel sharpness, SNR and CNR continuously decreased, whereas image noise and vessel sharpness increased, with highest sharpness for the Bv89 kernel (2383.4 ± 787.1 ΔHU/mm). Blooming artifacts continuously decreased for reconstructions with the Bv40 (slice thickness, 0.2 mm; 52.8% ± 9.2%) to the Bv72 kernel (39.7% ± 9.1%). Subjective noise was perceived by both readers in agreement with the objective measurements. Considering delineation of coronary artery plaques and the adjacent vessel lumen, reconstructions with the Bv64 and Bv72 kernel (...

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“…The latter study even demonstrated 40% less noise for PCD-CT UHR-based temporal bone imaging as compared to comb-filter UHR EID-CT imaging at matching radiation doses and reconstruction settings. 33 A variety of further studies have been published on HR and UHR PCD-CT imaging highlighting its value for lung assessment, 15,25,27,[34][35][36][37][38][39] cardiac imaging 20,24,[40][41][42][43][44] and musculoskeletal applications. 19,33,[45][46][47][48] UHR imaging is of particular interest for these anatomical areas because the clear depiction of fine details may effectively enhance diagnostic accuracy.…”

Section: Translating the Benefits Of Pcd-ct Into Clinical Routine Imp...mentioning

confidence: 99%

“…39 In regard to coronary artery imaging, plaque visualization and stent imaging can be improved. 24,40 Two recent studies assessing the UHR scan mode of clinical PCD-CT in patients referred for coronary CT angiography have shown that coronary arteries can be visualized in excellent quality with improved visualization of non-calcified plaque components and with reduced blooming of calcified plaques. 43,44 For bone imaging, fine bone details and previously occult hairline fractures may become apparent.…”

Section: Translating the Benefits Of Pcd-ct Into Clinical Routine Imp...mentioning

confidence: 99%

Photon-counting detector CT: early clinical experience review

Sartoretti

Wildberger

Flohr

et al. 2023

BJR

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Since its development in the 1970’s, X-ray computed tomography (CT) has emerged as a landmark diagnostic imaging modality of modern medicine. Technological advances have been crucial to the success of CT imaging, as they have increasingly enabled improvements in image quality and diagnostic value at increasing radiation dose efficiency. With recent advances in engineering and physics, a novel technology has emerged with the potential to surpass several shortcomings and limitations of current CT systems. Photon-counting detector (PCD)-CT might substantially improve and expand the applicability of CT imaging by offering intrinsic spectral capabilities, increased spatial resolution, reduced electronic noise and improved image contrast. In this review we sought to summarize the first clinical experience of PCD-CT. We focused on most recent prototype and first clinically approved PCD-CT systems thereby reviewing initial publications and presenting corresponding clinical cases.

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Evaluation of Coronary Plaques and Stents with Conventional and Photon-counting CT: Benefits of High-Resolution Photon-counting CT

Cited by 39 publications

References 22 publications

An introduction to photon-counting detector CT (PCD CT) for radiologists

An introduction to photon-counting detector CT (PCD CT) for radiologists

Ultra-High-Resolution Coronary CT Angiography With Photon-Counting Detector CT

Photon-counting detector CT: early clinical experience review

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