Abdominal Applications of Photon-Counting CT.

Photon-counting computed tomography (PCCT) has shown promising advancements in abdominal imaging in clinical use. Though more peer-reviewed primary literature is needed, this commentary explores PCCT's potential applications, focusing on enhancing diagnostic accuracy, optimizing radiation dose management, and improving patient care. PCCT offers improved spatial and contrast resolution, lower image noise, and reduced radiation dose.

Photon counting CT clinical adoption, integration, and workflow.

Photon counting CT was recently introduced into clinical practice [Rajendran K, Petersilka M, Henning A, Shanblatt ER, Schmidt B, Flohr TG, Ferrero A, Baffour F, Diehn FE, Yu L, Rajiah P, Fletcher JG, Leng S, McCollough CH. First Clinical Photon-counting Detector CT System: Technical Evaluation. Radiology 2022;303(1):130-138.

Technology Characterization Through Diverse Evaluation Methodologies: Application to Thoracic Imaging in Photon-Counting Computed Tomography.

Objective: Different methods can be used to condition imaging systems for clinical use. The purpose of this study was to assess how these methods complement one another in evaluating a system for clinical integration of an emerging technology, photon-counting computed tomography (PCCT), for thoracic imaging.

Methods: Four methods were used to assess a clinical PCCT system (NAEOTOM Alpha; Siemens Healthineers, Forchheim, Germany) across 3 reconstruction kernels (Br40f, Br48f, and Br56f).

Protocol optimization for abdominal imaging using photon-counting CT: a consensus of two academic institutions.

Purpose: Photon-counting detector CT (PCD CT) is a promising technology for abdominal imaging due to its ability to provide high spatial and contrast resolution images with reduced patient radiation exposure. However, there is currently no consensus regarding the optimal imaging protocols for PCD CT. This article aims to present the PCD CT abdominal imaging protocols used by two tertiary care academic centers in the United States.

Myelography Using Energy-Integrating Detector CT Versus Photon-Counting Detector CT for Detection of CSF-Venous Fistulas in Patients With Spontaneous Intracranial Hypotension.

CSF-venous fistulas (CVFs), which are an increasingly recognized cause of spontaneous intracranial hypotension (SIH), are often diminutive in size and exceedingly difficult to detect by conventional imaging. This purpose of this study was to compare energy-integrating detector (EID) CT myelography and photon-counting detector (PCD) CT myelography in terms of image quality and diagnostic performance for detecting CVFs in patients with SIH. This retrospective study included 38 patients (15 men and 23 women; mean age, 55 ± 10 [SD] years) with SIH who underwent both clinically indicated EID CT myelography (slice thickness, 0.

Image quality of photon counting and energy integrating chest CT - Prospective head-to-head comparison on same patients.

Purpose: To prospectively compare the image quality of high-resolution, low-dose photon-counting detector CT (PCD-CT) with standard energy-integrating-detector CT (EID) on the same patients.

Method: IRB-approved, prospective study; patients received same-day non-contrast CT on EID and PCD-CT (NAEOTOM Alpha, blinded) with clinical protocols. Four blinded radiologists evaluated subsegmental bronchial wall definition, noise, and overall image quality in randomized order (0 = worst; 100 = best).

First experience of evaluation of the impact of high-matrix size reconstruction in image quality in arterial CT runoff studies of the lower extremities.

Objectives: To determine whether image reconstruction with a higher matrix size improves image quality for lower extremity CTA studies.

Methods: Raw data from 50 consecutive lower extremity CTA studies acquired on two MDCT scanners (SOMATOM Flash, Force) in patients evaluated for peripheral arterial disease (PAD) were retrospectively collected and reconstructed with standard (512 × 512) and higher resolution (768 × 768, 1024 × 1024) matrix sizes. Five blinded readers reviewed representative transverse images in randomized order (150 total).

High Spatial-Resolution Skull Base Imaging With Photon-Counting Computed Tomography and Energy-Integrating Computed Tomography: A Comparative Phantom Study.

Photon-counting computed tomography (PCCT) offers better high-resolution and noise performance than energy integrating detector (EID) CT. In this work, we compared both technologies for imaging of the temporal bone and skull base. A clinical PCCT system and 3 clinical EID CT scanners were used to image the American College of Radiology image quality phantom using a clinical imaging protocol with matched CTDI vol (CT dose index-volume) of 25 mGy.

Relationship Between Pretreatment Body Composition and Clinical Outcomes in Patients With Metastatic Renal Cell Carcinoma Receiving First-Line Ipilimumab Plus Nivolumab.

Introduction: Biomarkers are needed to identify patients with metastatic renal cell carcinoma (mRCC) most likely to benefit from immune checkpoint inhibitors. We examined associations between radiographically assessed body composition (BC) variables and body mass index (BMI) with clinical outcomes for patients with mRCC receiving first-line ipilimumab + nivolumab (ipi/nivo).

Patients And Methods: We retrospectively reviewed all patients with mRCC treated with first-line ipi/nivo at one institution before June 1, 2021 with an analyzable baseline computed tomography (CT) scan.

Evaluation of the impact of a novel denoising algorithm on image quality in dual-energy abdominal CT of obese patients.

Objectives: Evaluate a novel algorithm for noise reduction in obese patients using dual-source dual-energy (DE) CT imaging.

Methods: Seventy-nine patients with contrast-enhanced abdominal imaging (54 women; age: 58 ± 14 years; BMI: 39 ± 5 kg/m, range: 35-62 kg/m) from seven DECT (SOMATOM Flash or Force) were retrospectively included (01/2019-12/2020). Image domain data were reconstructed with the standard clinical algorithm (ADMIRE/SAFIRE 2), and denoised with a comparison (ME-NLM) and a test algorithm (rank-sparse kernel regression).

Liver fat quantification in photon counting CT in head to head comparison with clinical MRI - First experience.

Purpose: To compare liver fat quantification between MRI and photon-counting CT (PCCT).

Method: A cylindrical phantom with inserts containing six concentrations of oil (0, 10, 20, 30, 50 and 100%) and oil-iodine mixtures (0, 10, 20, 30 and 50% fat +3 mg/mL iodine) was imaged with a PCCT (NAEOTOM Alpha) and a 1.5 T MRI system (MR 450w, IDEAL-IQ sequence), using clinical parameters.

Exploiting the Potential of Photon-Counting CT in Abdominal Imaging.

Photon-counting computed tomography (PCCT) imaging uses a new detector technology to provide added information beyond what can already be obtained with current CT and MR technologies. This review provides an overview of PCCT of the abdomen and focuses specifically on applications that benefit the most from this new imaging technique. We describe the requirements for a successful abdominal PCCT acquisition and the challenges for clinical translation.

Coronary Artery Calcium Evaluation Using New Generation Photon-counting Computed Tomography Yields Lower Radiation Dose Compared With Standard Computed Tomography.

Prospective head-to-head comparison of coronary calcium scores between standard computed tomography (CT) and photon-counting CT show no significant differences, while photon-counting CT administers substantially lower radiation dose.

Prospective Multireader Evaluation of Photon-counting CT for Multiple Myeloma Screening.

Purpose To determine whether photon-counting CT (PCCT) acquisition of whole-body CT images provides similar quantitative image quality and reader satisfaction for multiple myeloma screening at lower radiation doses than does standard energy-integrating detector (EID) CT. Materials and Methods Patients with monoclonal gammopathy of undetermined significance prospectively underwent clinical noncontrast whole-body CT with EID and same-day PCCT (August-December 2021). Five axial scan locations were evaluated by seven radiologists, with 11% (eight of 70) of images including osteolytic lesions.

Is it possible to use low-dose deep learning reconstruction for the detection of liver metastases on CT routinely?

Objectives: To compare the image quality and hepatic metastasis detection of low-dose deep learning image reconstruction (DLIR) with full-dose filtered back projection (FBP)/iterative reconstruction (IR).

Methods: A contrast-detail phantom consisting of low-contrast objects was scanned at five CT dose index levels (10, 6, 3, 2, and 1 mGy). A total of 154 participants with 305 hepatic lesions who underwent abdominal CT were enrolled in a prospective non-inferiority trial with a three-arm design based on phantom results.

Pediatric Applications of Photon-Counting Detector CT.

Photon-counting detector (PCD) CT represents the most recent generational advance in CT technology. PCD CT has the potential to reduce image noise, improve spatial resolution and contrast resolution, and provide multispectral capability, all of which may be achieved with an overall decrease in the radiation dose. These effects may be used to reduce the iodinated contrast media dose and potentially obtain multiphase images through a single-acquisition technique.

CT Radiomic Features of Superior Mesenteric Artery Involvement in Pancreatic Ductal Adenocarcinoma: A Pilot Study.

Background Current imaging methods for prediction of complete margin resection (R0) in patients with pancreatic ductal adenocarcinoma (PDAC) are not reliable. Purpose To investigate whether tumor-related and perivascular CT radiomic features improve preoperative assessment of arterial involvement in patients with surgically proven PDAC. Materials and Methods This retrospective study included consecutive patients with PDAC who underwent surgery after preoperative CT between 2012 and 2019.

Electronic Health Record Closed-Loop Communication Program for Unexpected Nonemergent Findings.

Background Reliance on examination reporting of unexpected imaging findings does not ensure receipt of findings or appropriate follow-up. A closed-loop communication system should include provider and patient notifications and be auditable through the electronic health record (EHR). Purpose To report the initial design of and results from using an EHR-integrated unexpected findings navigator (UFN) program that ensures closed-loop communication of unexpected nonemergent findings.

Collaborative Writing Projects: Set Yourself up for Success.

This article will review critical components for the successful completion of a multi-institution, multiauthor collaborative paper. Best practices for the creation and publication of a collaborative paper will be addressed.

Effect of deep learning image reconstruction in the prediction of resectability of pancreatic cancer: Diagnostic performance and reader confidence.

Objective: To assess the diagnostic performance and reader confidence in determining the resectability of pancreatic cancer at computed tomography (CT) using a new deep learning image reconstruction (DLIR) algorithm.

Methods: A retrospective review was conduct of on forty-seven patients with pathologically confirmed pancreatic cancers who underwent baseline multiphasic contrast-enhanced CT scan. Image data sets were reconstructed using filtered back projection (FBP), hybrid model-based adaptive statistical iterative reconstruction (ASiR-V) 60 %, and DLIR "TrueFidelity" at low(L), medium(M), and high strength levels(H).