Back to the Future: Dynamic Contrast-Enhanced Photon-Counting Detector CT for the Detection of Pituitary Adenoma in Cushing Disease.

Historically, MR imaging has been unable to detect a pituitary adenoma in up to one-half of patients with Cushing disease. This issue is problematic because the standard-of-care treatment is surgical resection, and its success is correlated with finding the tumor on imaging. Photon-counting detector CT is a recent advancement that has multiple benefits over conventional energy-integrating detector CT.

Staging of breast cancer in the breast and regional lymph nodes using contrast-enhanced photon-counting detector CT: accuracy and potential impact on patient management.

Objectives: To describe the feasibility and evaluate the performance of multiphasic photon-counting detector (PCD) CT for detecting breast cancer and nodal metastases with correlative dynamic breast MRI and digital mammography as the reference standard.

Methods: Adult females with biopsy-proven breast cancer undergoing staging breast MRI were prospectively recruited to undergo a multiphasic PCD-CT using a 3-phase protocol: a non-contrast ultra-high-resolution (UHR) scan and 2 intravenous contrast-enhanced scans with 50 and 180 s delay. Three breast radiologists compared CT characteristics of the index malignancy, regional lymphadenopathy, and extramammary findings to MRI.

Diagnostic Performance of Decubitus Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas.

Background And Purpose: CSF-venous fistulas are a common cause of spontaneous intracranial hypotension. Lateral decubitus digital subtraction myelography and CT myelography are the diagnostic imaging standards to identify these fistulas. Photon-counting CT myelography has technological advantages that might improve CSF-venous fistula detection, though no large studies have yet assessed its diagnostic performance.

Coronary artery stenosis quantification in patients with dense calcifications using ultra-high-resolution photon-counting-detector computed tomography.

Background: To quantify differences in coronary artery stenosis severity in patients with calcified lesions between conventional energy-integrating detector (EID) CT and ultra-high-resolution (UHR) photon-counting-detector (PCD) CT.

Methods: Patients undergoing clinically indicated coronary CT angiography were prospectively recruited and scanned first on an EID-CT (SOMATOM Force, Siemens Healthineers) and then a PCD-CT (NAEOTOM Alpha, Siemens Healthineers) on the same day. EID-CT was performed with standard mode (192 ​× ​0.

Bilateral lunotriquetral coalition: a dynamic four-dimensional computed tomography technical case report.

Lunotriquetral coalitions are the most common form of carpal coalition wherein the cartilage between the lunate and triquetrum ossification centers failed to undergo apoptosis. This technical case report examines the arthrokinematics of bilateral lunotriquetral coalitions with dissimilar Minnaar types in one participant with one asymptomatic wrist and one wrist with suspected distal radioulnar joint injury. Static and dynamic (four-dimensional) CT images during pronosupination were captured using a photon-counting detector CT scanner.

Potential benefits of photon counting detector computed tomography in pediatric imaging.

Photon counting detector (PCD) CT represents the newest advance in CT technology, with improved radiation dose efficiency, increased spatial resolution, inherent spectral imaging capabilities, and the ability to eliminate electronic noise. Its design fundamentally differs from conventional energy integrating detector CT because photons are directly converted to electrical signal in a single step. Rather than converting X-rays to visible light and having an output signal that is a summation of energies, PCD directly counts each photon and records its individual energy information.

Seeing More with Less: Clinical Benefits of Photon-counting Detector CT.

Photon-counting detector (PCD) CT is an emerging technology that has led to continued innovation and progress in diagnostic imaging after it was approved by the U.S. Food and Drug Administration for clinical use in September 2021.

Diagnostic Performance in Low- and High-Contrast Tasks of an Image-Based Denoising Algorithm Applied to Radiation Dose-Reduced Multiphase Abdominal CT Examinations.

Anatomic redundancy between phases can be used to achieve denoising of multiphase CT examinations. A limitation of iterative reconstruction (IR) techniques is that they generally require use of CT projection data. A frequency-split multi-band-filtration algorithm applies denoising to the multiphase CT images themselves.

The feasibility of low iodine dynamic CT angiography with test bolus for evaluation of lower extremity peripheral artery disease.

Objective: This study aims to determine if low iodine dynamic computed tomography angiography performed after a fixed delay or test bolus acquisition demonstrates high concordance with clinical computed tomography angiography (using a routine amount of iodinated contrast) to display lower extremity peripheral arterial disease.

Methods: After informed consent, low iodine dynamic computed tomography angiography examination (using either a fixed delay or test bolus) using 50 ml of iodine contrast media was performed. A subsequent clinical computed tomography angiography using standard iodine dose (115 or 145 ml) served as the reference standard.

Dynamic computed tomographic assessment of the mitral annulus in patients with and without mitral prolapse.

Objectives: To obtain 3D CT measurements of mitral annulus throughout cardiac cycle using prototype mitral modeling software, assess interobserver agreement, and compare among patients with mitral prolapse (MP) and control group.

Background: Pre-procedural imaging is critical for planning of transcatheter mitral valve (MV) replacement. However, there is limited data regarding reliable CT-based measurements to accurately characterize the dynamic geometry of the mitral annulus in patients with MV disease.

Image quality in abdominal CT using an iodine contrast reduction algorithm employing patient size and weight and low kV CT technique.

Background: Low tube potential-high tube current computed tomography (CT) imaging allows reduction in iodine-based contrast dose and may extend the benefit of routine contrast-enhanced CT exams to patients at risk of nephrotoxicity.

Purpose: To determine the ability of an iodine contrast reduction algorithm to maintain diagnostic image quality for contrast-enhanced abdominal CT.

Material And Methods: CT exams with iodine contrast reduction were prescribed for patients at risk for renal dysfunction.

Individualized Delay for Abdominal Computed Tomography Angiography Bolus-Tracking Based on Sequential Monitoring: Increased Aortic Contrast Permits Decreased Injection Rate and Lower Iodine Dose.

Objective: The aim of this study was to determine if computed tomography (CT) angiography using an individualized transition delay (CTA-ID) would facilitate reductions in injection rate and iodine dose.

Methods: The CTA-ID was performed in 20 patients with routine injection rate and iodine dose; 20 patients with injection rate lowered by 1 mL/s; and 40 patients with injection rate lowered by 1 mL/s with 29% less iodine. Routine CTAs in the same or size-matched patients served as controls.

Breathe New Life Into Your Chest CT Exams: Using Advanced Acquisition and Postprocessing Techniques.

Objective: Chest computed tomography (CT) imaging enables detailed visualization of the pulmonary structures and diseases. This article reviews how continued innovation and improvements in modern CT system hardware and software now facilitate a wider range of image acquisition options and generate unique qualitative and quantitative information that can benefit patients RESULTS: Dual energy imaging utilizes two x-ray energies to highlight differences in tissue properties and increase iodine signal to improve diagnosis or reduce metal artifacts. Ultra-low dose imaging can be performed by using additional x-ray beam filtration, such as a tin filter, combined with iterative reconstruction algorithms to benefit lung cancer screening or pediatric imaging.