Pediatric Applications of Photon-Counting Detector CT

Cao, Joseph; Bache, Steve; Schwartz, Fides R.; Frush, Donald P.

doi:10.2214/ajr.22.28391

Cited by 22 publications

(6 citation statements)

References 62 publications

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“…In pediatric imaging it is hoped that spectral separation of different photon energy groups may allow multiphase images to be obtained with a single imaging technique [81]. For this purpose, in addition to the necessary contrast media, the corresponding post-processing applications are still required.…”

Section: Limitations and Outlookmentioning

confidence: 99%

“…In der pädiatrischen Bildgebung erhofft man sich mit Hilfe der spektralen Auftrennung verschiedener Photonen-Energiegruppen möglicherweise Mehrphasenbilder mit einer einzigen Aufnahmetechnik zu erhalten [81]. Hierzu werden im Moment neben den dafür nötigen Kontrastmitteln erst noch die entsprechenden Nachbearbeitungsapplikationen benötigt.…”

Section: Limitationen/ausblickunclassified

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Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology

Hagen,

Soschynski,

Weis

et al. 2023

Rofo

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Background Photon-counting detector computed tomography (PCD-CT) is a promising new technology with the potential to fundamentally change workflows in the daily routine and provide new quantitative imaging information to improve clinical decision-making and patient management. Method The contents of this review are based on an unrestricted literature search of PubMed and Google Scholar using the search terms “photon-counting CT”, “photon-counting detector”, “spectral CT”, “computed tomography” as well as on the authors’ own experience. Results The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCD-CT allows for the counting of every single photon at the detector level. Based on the identified literature, PCD-CT phantom measurements and initial clinical studies have demonstrated that the new technology allows for improved spatial resolution, reduced image noise, and new possibilities for advanced quantitative image postprocessing. Conclusion For clinical practice, the potential benefits include fewer beam hardening artifacts, a radiation dose reduction, and the use of new or combinations of contrast agents. In particular, critical patient groups such as oncological, cardiovascular, lung, and head & neck as well as pediatric patient collectives benefit from the clinical advantages. Key Points: Citation Format

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Section: Limitations and Outlookmentioning

confidence: 99%

Section: Limitationen/ausblickunclassified

Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology

Hagen,

Soschynski,

Weis

et al. 2023

Rofo

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show abstract

“…Die Kombination aus erhöhter Ortsauflösung und erhöhter Dosissensitivität der PCD-CT bietet auch Vorteile in der pädiatrischen CT-Diagnostik. Die höhere räumliche Auflösung und das bessere Kontrast-Rausch-Verhältnis, verglichen mit EID, verbessern die Sichtbarkeit anatomischer Strukturen bei Kindern mit hoher Dosiseffizienz [ 33 ]. Durch diese höhere Dosiseffizienz wird eine diagnostische Umstellung von Röntgenaufnahmen hin zu Niedrig-Dosis CT ermöglicht [ 34 ].…”

Section: Hintergrundunclassified

CT technology: photon-counting detector computed tomography

Layer¹,

Kravchenko²,

Dell³

et al. 2023

Radiologie

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Hintergrund Die photonenzählende Computertomographie („photon-counting detector computed tomography“, PCD-CT) ist eine Technologie, die viele Einschränkungen der herkömmlichen Detektoren überwindet. Eine direkte Umwandlung der auf den Detektor eintreffenden Photonen in elektrische Signale, verbunden mit einer sensitiveren und präziseren Photonerfassung ermöglicht eine spektrale Auswertung sowie eine potenziell verringerte Strahlenexposition des Patienten. Durch die Kombination von angewandten Energieschwellenwerten und den Verzicht auf Detektorsepten kann elektronisches Rauschen reduziert, die Ortsauflösung erhöht und die Dosiseffizienz gesteigert werden. Bewertung Aktuelle Forschungsarbeiten bestätigen deutlich reduziertes Bildrauschen, reduzierte Strahlendosis, erhöhte Ortsauflösung, verbessertes Jodsignal sowie eine Reduktion von Artefakten. Die spektrale Auswertung potenziert diese Effekte und ermöglicht auch retrospektiv die Errechnung virtuell-monoenergetischer Bilder, virtuell-nativer Bilder oder Jodkarten. Perspektivisch ergibt sich durch die photonenzählende Technologie die Möglichkeit zur Anwendung diverser Kontrastmittel, mit der Aussicht auf einzeitige Mehrphasenbildgebung oder zur Visualisierung bestimmter Stoffwechselprozesse. Bis zum klinischen Einsatz sind hierzu weitere Grundlagenforschung sowie ergänzende Zulassungsprozesse notwendig. Schlussfolgerung Das bisher einzige am Markt verfügbare PCD-CT-Gerät erhielt 2021 die Zulassung. Es bleibt abzuwarten, welche weitere Anwendungen durch Verbesserungen von Hardware und Software möglich werden. Insbesondere für hochauflösende Bildgebung bei detaillierten Fragestellungen und Untersuchungen mit hoher Strahlenbelastung zeigt die Technologie bereits heute eine eindrucksvolle Überlegenheit gegenüber dem vorherigen Technologiestandard.

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“…1 Pediatric populations, especially, stand to benefit from these gains due to their smaller size relative to adult patients and to significant concerns over lifetime cancer risk associated with ionizing radiation exposure. 2 Despite these potential gains, limited protocol optimizations for pediatric patients and trade-offs between image quality and dose made by lowering kV and mAs values contribute to variable image quality in pediatric PCCT. In this work, we address image quality in pediatric cardiac PCCT data.…”

Section: Introductionmentioning

confidence: 99%

Denoising pediatric cardiac photon-counting CT data using volumetric vision transformers and unpaired training data

Clark,

Schwartz,

Cao

et al. 2024

Medical Imaging 2024: Physics of Medical Imaging

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The advent of clinical photon counting x-ray CT (PCCT) has yielded gains in spatial resolution, noise performance, contrast resolution, and radiation dose management in numerous diagnostic applications. Pediatric populations, especially, stand to benefit from these gains due to their smaller size relative to adult patients and to greater concerns over lifetime cancer risk associated with ionizing radiation exposure. No where is this more applicable than in the congenital heart population who are repeatedly imaged during their care. Despite these potential advantages, limited protocol optimizations for pediatric patients, the heterogeneity of metallic implants in pediatric cardiac patients, and trade-offs between image quality and dose made by lowering kV and mAs values contribute to variable image quality in pediatric PCCT. Here, we adapt and demonstrate two deep-learning strategies for denoising pediatric cardiac PCCT data which do not require paired training data and which can be trained using data sets of varying image quality. (1) We train a CycleGAN to map CT images between high and low image quality, as gauged by signal-to-noise ratio measurements. The domain mappings are performed with vision transformers (ViTs) which adeptly preserve high spatial frequencies and enable 50% noise reduction across high and low intensity structures (enhanced vasculature, fat). (2) We adapt prior work using masked autoencoders and 2D natural images to the domain of 3D CT data. Specifically, we propose a ViT network structure and cost function which yields robust interpolation of deleted 3D CT data, similarly reducing image noise by 50% in an assessment of validation data. Comparing CycleGAN and masked autoencoder results, the CycleGAN reduces noise by identifying and attenuating high frequency features associated with noise while the masked autoencoder adeptly removes noise textures but visibly smooths high-contrast structures.

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Pediatric Applications of Photon-Counting Detector CT

Cited by 22 publications

References 62 publications

Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology

Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology

CT technology: photon-counting detector computed tomography

Denoising pediatric cardiac photon-counting CT data using volumetric vision transformers and unpaired training data

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