Photon-Counting CT of the Brain: In Vivo Human Results and Image-Quality Assessment

Pourmorteza, Amir; Symons, Rolf; Reich, Daniel S.; Bagheri, Mohammadhadi; Cork, Tyler E.; Kappler, S.; Ulzheimer, Stefan; Bluemke, David A.

doi:10.3174/ajnr.a5402

Cited by 78 publications

(68 citation statements)

References 30 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These findings [14,39,65] confirm the predicted CNR improvements with photon-counting detectors because of the better weighting of low-energy X-rays. CNR is significantly improved in contrast-enhanced CT scans (iodinated contrast agent versus soft tissue), and to a lesser degree in non-contrast brain CT scans (grey versus white brain matter).…”

Section: Pre-clinical Evaluation Of Photon-counting Ctsupporting

confidence: 74%

“…These improvements in iodine CNR can potentially be translated into reduced radiation dose, or reduced amount of contrast agent. Improvement of soft-tissue contrasts by photon-counting CT was demonstrated by Pourmorteza et al [39] in a brain CT study with 21 human volunteers. Photon-counting CT images received much higher reader scores for the differentiation of grey and white brain matter than conventional CT images.…”

Section: Pre-clinical Evaluation Of Photon-counting Ctmentioning

confidence: 85%

“…The photon-counting CT images show higher grey-white brain matter contrast. With permission from [39] improve the quality of CAC scoring at low radiation dose. In a combined phantom, ex vivo and in vivo study, the authors evaluated the potential of photon-counting CT for standard and reduced-dose CAC scoring.…”

Section: Pre-clinical Evaluation Of Photon-counting Ctmentioning

confidence: 99%

See 2 more Smart Citations

Basic principles and clinical potential of photon-counting detector CT

et al. 2020

View full text Add to dashboard Cite

Photon-counting detectors are a new technology for future computed tomography (CT) systems, with the potential to overcome major limitations of conventional CT detectors. They provide energy-resolved CT data at very high spatial resolution without electronic noise. This review article gives an overview of the basic principles of photon-counting detector CT, of potential benefits and limitations, and of the clinical experience gained so far in pre-clinical installations.

show abstract

Section: Pre-clinical Evaluation Of Photon-counting Ctsupporting

confidence: 74%

Section: Pre-clinical Evaluation Of Photon-counting Ctmentioning

confidence: 85%

Section: Pre-clinical Evaluation Of Photon-counting Ctmentioning

confidence: 99%

See 1 more Smart Citation

Basic principles and clinical potential of photon-counting detector CT

et al. 2020

View full text Add to dashboard Cite

show abstract

“…They found increased iodine contrast with similar image noise compared with EID, resulting in a radiation dose reduction of up to 32%. Recent in vivo human experiments confirmed a dose reduction of up to 34% in photon-counting CT scans of the chest and brain (21,26).…”

Section: Current Statusmentioning

confidence: 91%

“…The benefits associated with the ability of a PCD to assign more weight to low-energy photons have been assessed in two clinical studies. Pourmorteza et al (21) reported up to 30% improvement in gray matter-white matter CNR in noncontrast PCD human brain scans, and Symons et al (22) have shown that PCD head and neck CT angiograms had 9% lower image noise compared with EID at a similar dose. A summary of the factors determining the performance of an ideal PCD is shown in Table 1.…”

Section: Essentialsmentioning

confidence: 99%

Photon-counting CT: Technical Principles and Clinical Prospects

et al. 2018

Self Cite

View full text Add to dashboard Cite

Photon-counting CT is an emerging technology with the potential to dramatically change clinical CT. Photon-counting CT uses new energy-resolving x-ray detectors, with mechanisms that differ substantially from those of conventional energy-integrating detectors. Photon-counting CT detectors count the number of incoming photons and measure photon energy. This technique results in higher contrast-to-noise ratio, improved spatial resolution, and optimized spectral imaging. Photon-counting CT can reduce radiation exposure, reconstruct images at a higher resolution, correct beam-hardening artifacts, optimize the use of contrast agents, and create opportunities for quantitative imaging relative to current CT technology. In this review, the authors will explain the technical principles of photon-counting CT in nonmathematical terms for radiologists and clinicians. Following a general overview of the current status of photon-counting CT, they will explain potential clinical applications of this technology.

show abstract

A dynamic simulation framework for CT perfusion in stroke assessment built from first principles

et al. 2021

View full text Add to dashboard Cite

Physicians utilize cerebral perfusion maps (e.g., cerebral blood flow, cerebral blood volume, transit time) to prescribe the plan of care for stroke patients. Variability in scanning techniques and post-processing software can result in differences between these perfusion maps. To determine which techniques are acceptable for clinical care, it is important to validate the accuracy and reproducibility of the perfusion maps. Validation using clinical data is challenging due to the lack of a gold standard to assess cerebral perfusion and the impracticality of scanning patients multiple times with different scanning techniques. In contrast, simulated data from a realistic digital phantom of the cerebral perfusion in acute stroke patients would enable studies to optimize and validate the scanning and post-processing techniques. Methods: We describe a complete framework to simulate CT perfusion studies for stroke assessment. We begin by expanding the XCAT brain phantom to enable spatially varying contrast agent dynamics and incorporate a realistic model of the dynamics in the cerebral vasculature derived from first principles. A dynamic CT simulator utilizes the time-concentration curves to define the contrast agent concentration in the object at each time point and generates CT perfusion images compatible with commercially available post-processing software. We also generate ground truth perfusion maps to which the maps generated by post-processing software can be compared. Results: We demonstrate a dynamic CT perfusion study of a simulated patient with an ischemic stroke and the resulting perfusion maps generated by post-processing software. We include a visual comparison between the computer-generated perfusion maps and the ground truth perfusion maps. The framework is highly tunable; users can modify the perfusion properties (e.g., occlusion location, CBF, CBV, and MTT), scanner specifications (e.g., focal spot size and detector configuration), scanning protocol (e.g., kVp and mAs), and reconstruction parameters (e.g., slice thickness and reconstruction filter). Conclusions: This framework provides realistic test data with the underlying ground truth that enables a robust assessment of CT perfusion techniques and post-processing methods for stroke assessment.

show abstract

Photon-Counting CT of the Brain: In Vivo Human Results and Image-Quality Assessment

Abstract: BACKGROUND AND PURPOSE: Photon-counting detectors offer the potential for improved image quality for brain CT but have not yet been evaluated in vivo. The purpose of this study was to compare photon-counting detector CT with conventional energy-integrating detector CT for human brains.

Cited by 78 publications

References 30 publications

Basic principles and clinical potential of photon-counting detector CT

Basic principles and clinical potential of photon-counting detector CT

Photon-counting CT: Technical Principles and Clinical Prospects

A dynamic simulation framework for CT perfusion in stroke assessment built from first principles

Contact Info

Product

Resources

About