Toward molecular imaging using spectral photon-counting computed tomography?

Activatable Probes for Ratiometric Imaging of Endogenous Biomarkers In Vivo

Dynamic variations in the concentration and abnormal distribution of endogenous biomarkers are strongly associated with multiple physiological and pathological states. Therefore, it is crucial to design imaging systems capable of real-time detection of dynamic changes in biomarkers for the accurate diagnosis and effective treatment of diseases. Recently, ratiometric imaging has emerged as a widely used technique for sensing and imaging of biomarkers due to its advantage of circumventing the limitations inherent to conventional intensity-dependent signal readout methods while also providing built-in self-calibration for signal correction. Here, the recent progress of ratiometric probes and their applications in sensing and imaging of biomarkers are outlined. Ratiometric probes are classified according to their imaging mechanisms, and ratiometric photoacoustic imaging, ratiometric optical imaging including photoluminescence imaging and self-luminescence imaging, ratiometric magnetic resonance imaging, and dual-modal ratiometric imaging are discussed. The applications of ratiometric probes in the sensing and imaging of biomarkers such as pH, reactive oxygen species (ROS), reactive nitrogen species (RNS), glutathione (GSH), gas molecules, enzymes, metal ions, and hypoxia are discussed in detail. Additionally, this Review presents an overview of challenges faced in this field along with future research directions.

New Contrast Media for K-Edge Imaging With Photon-Counting Detector CT

ABSTRACT

The recent technological developments in photon-counting detector computed tomography (PCD-CT) and the introduction of the first commercially available clinical PCD-CT unit open up new exciting opportunities for contrast media research. With PCD-CT, the efficacy of available iodine-based contrast media improves, allowing for a reduction of iodine dosage or, on the other hand, an improvement of image quality in low contrast indications. Virtual monoenergetic image reconstructions are routinely available and enable the virtual monoenergetic image energy to be adapted to the diagnostic task.A key property of PCD-CT is the ability of spectral separation in combination with improved material decomposition. Thus, the discrimination of contrast media from intrinsic or pathological tissues and the discrimination of 2 or more contrasting elements that characterize different tissues are attractive fields for contrast media research. For these approaches, K-edge imaging in combination with high atomic number elements such as the lanthanides, tungsten, tantalum, or bismuth plays a central role.The purpose of this article is to present an overview of innovative contrast media concepts that use high atomic number elements. The emphasis is on improving contrast enhancement for cardiovascular plaque imaging, stent visualization, and exploring new approaches using 2 contrasting elements. Along with the published research, new experimental findings with a contrast medium that incorporates tungsten are included.Both the literature review and the new experimental data demonstrate the great potential and feasibility for new contrast media to significantly increase diagnostic performance and to enable new clinical fields and indications in combination with PCD-CT.

Demonstrating a Novel, Hidden Source of Spectral Distortion in X-ray Photon Counting Detectors and Assessing Novel Trigger Schemes Proposed to Avoid It

X-ray photon counting spectral imaging (x-CSI) determines a detected photon's energy by comparing the charge it induces with several thresholds, counting how many times each is crossed (the standard method, STD). This paper is the first to demonstrate that this approach can unexpectedly delete counts from the recorded energy spectrum under some clinically relevant conditions: a process we call negative counting. Four alternative counting schemes are proposed and simulated for a wide range of sensor geometries (pixel pitch 100-600 µm, sensor thickness 1-3 mm), number of thresholds (3, 5, 8, 24 and 130) and medically relevant X-ray fluxes (10⁶-10⁹ photons mm^-2 s^-1). Spectral efficiency and counting efficiency are calculated for each simulation. Performance gains are explained mechanistically and correlated well with the improved suppression of "negative counting". The best performing scheme (Shift Register, SR) entirely eliminates negative counting, remaining close to an ideal scheme at fluxes of up to 10⁸ photons mm^-2 s^-1. At the highest fluxes considered, the deviation from ideal behaviour is reduced by 2/3 in SR compared with STD. The results have significant implications both for generally improving spectral fidelity and as a possible path toward the 10⁹ photons mm^-2 s^-1 goal in photon-counting CT.

Spectral Photon-Counting CT Technology in Chest Imaging

The X-ray imaging field is currently undergoing a period of rapid technological innovation in diagnostic imaging equipment. An important recent development is the advent of new X-ray detectors, i.e., photon-counting detectors (PCD), which have been introduced in recent clinical prototype systems, called PCD computed tomography (PCD-CT) or photon-counting CT (PCCT) or spectral photon-counting CT (SPCCT) systems. PCD allows a pixel up to 200 microns pixels at iso-center, which is much smaller than that can be obtained with conventional energy integrating detectors (EID). PCDs have also a higher dose efficiency than EID mainly because of electronic noise suppression. In addition, the energy-resolving capabilities of these detectors allow generating spectral basis imaging, such as the mono-energetic images or the water/iodine material images as well as the K-edge imaging of a contrast agent based on atoms of high atomic number. In recent years, studies have therefore been conducted to determine the potential of PCD-CT as an alternative to conventional CT for chest imaging.