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Benson JC, Campeau NG, Diehn FE, Lane JI, Leng S, Moonis G. Photon-Counting CT in the Head and Neck: Current Applications and Future Prospects. AJNR Am J Neuroradiol 2024; 45:1000-1005. [PMID: 38964861 DOI: 10.3174/ajnr.a8265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/12/2024] [Indexed: 07/06/2024]
Abstract
Photon-counting detectors (PCDs) represent a major milestone in the evolution of CT imaging. CT scanners using PCD systems have already been shown to generate images with substantially greater spatial resolution, superior iodine contrast-to-noise ratio, and reduced artifact compared with conventional energy-integrating detector-based systems. These benefits can be achieved with considerably decreased radiation dose. Recent studies have focused on the advantages of PCD-CT scanners in numerous anatomic regions, particularly the coronary and cerebral vasculature, pulmonary structures, and musculoskeletal imaging. However, PCD-CT imaging is also anticipated to be a major advantage for head and neck imaging. In this paper, we review current clinical applications of PCD-CT in head and neck imaging, with a focus on the temporal bone, facial bones, and paranasal sinuses; minor arterial vasculature; and the spectral capabilities of PCD systems.
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Affiliation(s)
- John C Benson
- From the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
| | - Norbert G Campeau
- From the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
| | - Felix E Diehn
- From the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
| | - John I Lane
- From the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
| | - Shuai Leng
- Department of Radiology (S.L.), Mayo Clinic, Rochester, MN USA
| | - Gul Moonis
- Department of Radiology (G.M.), Columbia University Irving Medical Center, New York, New York
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Quintiens J, van Lenthe GH. Photon-Counting Computed Tomography for Microstructural Imaging of Bone and Joints. Curr Osteoporos Rep 2024; 22:387-395. [PMID: 38833188 DOI: 10.1007/s11914-024-00876-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE OF REVIEW Recently, photon-counting computed tomography (PCCT) has been introduced in clinical research and diagnostics. This review describes the technological advances and provides an overview of recent applications with a focus on imaging of bone. RECENT FINDINGS PCCT is a full-body scanner with short scanning times that provides better spatial and spectral resolution than conventional energy-integrating-detector CT (EID-CT), along with an up to 50% reduced radiation dose. It can be used to quantify bone mineral density, to perform bone microstructural analyses and to assess cartilage quality with adequate precision and accuracy. Using a virtual monoenergetic image reconstruction, metal artefacts can be greatly reduced when imaging bone-implant interfaces. Current PCCT systems do not allow spectral imaging in ultra-high-resolution (UHR) mode. Given its improved resolution, reduced noise and spectral imaging capabilities PCCT has diagnostic capacities in both qualitative and quantitative imaging that outperform those of conventional CT. Clinical use in monitoring bone health has already been demonstrated. The full potential of PCCT systems will be unlocked when UHR spectral imaging becomes available.
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Affiliation(s)
- Jilmen Quintiens
- Department of Mechanical Engineering, KU Leuven, Leuven, Belgium
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Lee JS, Kim J, Bapuraj JR, Srinivasan A. Comparison of Image Quality and Radiation Dose in Pediatric Temporal Bone CT Using Photon-Counting Detector CT and Energy-Integrating Detector CT. AJNR Am J Neuroradiol 2024:ajnr.A8276. [PMID: 38589057 DOI: 10.3174/ajnr.a8276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND AND PURPOSE Currently, there is a lack of research directly comparing photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT) in pediatric temporal bone CT imaging. The purpose of this study was to compare the image quality and radiation dose of temporal bone CT scans in pediatric patients acquired with PCD-CT and EID-CT. MATERIALS AND METHODS The retrospective study included a total of 110 pediatric temporal bone CT scans (PCD-CT, n = 52; EID-CT, n = 58). Two independent readers evaluated the spatial resolution of 4 anatomic structures (tympanic membrane, incudostapedial joint, stapedial crura, and cochlear modiolus) and overall image quality by using a 4-point scale. Interreader agreement was assessed. Dose-length product for each CT was compared, and subgroup analyses were performed based on age (younger than 3 years, 3-5 years, 6-11 years, and 12 years and above). RESULTS PCD-CT demonstrated statistically significantly higher scores than EID-CT for all items (tympanic membrane, 2.9 versus 2.4; incudostapedial joint, 3.6 versus 2.6; stapedial crura, 3.2 versus 2.4; cochlear modiolus, 3.4 versus 2.8; overall image quality, 3.6 versus 2.8; P < .05). Interreader agreement ranged from good to excellent (interclass correlation coefficients, 0.6-0.81). PCD-CT exhibited a 43% dose reduction compared with EID-CT, with a particularly substantial reduction of over 70% in the subgroups of children younger than 6 years. CONCLUSIONS PCD temporal bone CT achieves significantly superior imaging quality at a lower radiation dose compared with EID-CT.
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Affiliation(s)
- Jeong Sub Lee
- From the Department of Radiology (J.S.L.), Jeju National University Hospital, Jeju National University College of Medicine, Jeju-si, Jeju-do, Republic of Korea
| | - John Kim
- Department of Radiology (J.K., J.R.B., A.S.), University of Michigan, Ann Arbor, Michigan.
| | - Jayapalli R Bapuraj
- Department of Radiology (J.K., J.R.B., A.S.), University of Michigan, Ann Arbor, Michigan
| | - Ashok Srinivasan
- Department of Radiology (J.K., J.R.B., A.S.), University of Michigan, Ann Arbor, Michigan
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Bette S, Risch F, Becker J, Popp D, Decker JA, Kaufmann D, Friedrich L, Scheurig-Münkler C, Schwarz F, Kröncke TJ. Photon-counting detector CT - first experiences in the field of musculoskeletal radiology. ROFO-FORTSCHR RONTG 2024. [PMID: 38788741 DOI: 10.1055/a-2312-6914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
The introduction of photon-counting detector CT (PCD-CT) marks a remarkable leap in innovation in CT imaging. The new detector technology allows X-rays to be converted directly into an electrical signal without an intermediate step via a scintillation layer and allows the energy of individual photons to be measured. Initial data show high spatial resolution, complete elimination of electronic noise, and steady availability of spectral image data sets. In particular, the new technology shows promise with respect to the imaging of osseous structures. Recently, PCD-CT was implemented in the clinical routine. The aim of this review was to summarize recent studies and to show our first experiences with photon-counting detector technology in the field of musculoskeletal radiology.We performed a literature search using Medline and included a total of 90 articles and reviews that covered recent experimental and clinical experiences with the new technology.In this review, we focus on (1) spatial resolution and delineation of fine anatomic structures, (2) reduction of radiation dose, (3) electronic noise, (4) techniques for metal artifact reduction, and (5) possibilities of spectral imaging. This article provides insight into our first experiences with photon-counting detector technology and shows results and images from experimental and clinical studies. · This review summarizes recent experimental and clinical studies in the field of photon-counting detector CT and musculoskeletal radiology.. · The potential of photon-counting detector technology in the field of musculoskeletal radiology includes improved spatial resolution, reduction in radiation dose, metal artifact reduction, and spectral imaging.. · PCD-CT enables imaging at lower radiation doses while maintaining or even enhancing spatial resolution, crucial for reducing patient exposure, especially in repeated or prolonged imaging scenarios.. · It offers promising results in reducing metal artifacts commonly encountered in orthopedic or dental implants, enhancing the interpretability of adjacent structures in postoperative and follow-up imaging.. · With its ability to routinely acquire spectral data, PCD-CT scans allow for material classification, such as detecting urate crystals in suspected gout or visualizing bone marrow edema, potentially reducing reliance on MRI in certain cases.. Bette S, Risch F, Becker J et al. Photon-counting detector CT - first experiences in the field of musculoskeletal radiology. Fortschr Röntgenstr 2024; DOI 10.1055/a-2312-6914.
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Affiliation(s)
- Stefanie Bette
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Franka Risch
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Judith Becker
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Daniel Popp
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Josua A Decker
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - David Kaufmann
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Lena Friedrich
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Christian Scheurig-Münkler
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Florian Schwarz
- Institute of Conventional and Interventional Radiology, Donauisar Hospital Deggendorf, Deggendorf, Germany
| | - Thomas J Kröncke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
- Centre for Advanced Analytics and Predictive Sciences (CAAPS), University of Augsburg, Augsburg, Germany
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Toia GV, Mileto A, Borhani AA, Chen GH, Ren L, Uyeda JW, Marin D. Approaches, advantages, and challenges to photon counting detector and multi-energy CT. Abdom Radiol (NY) 2024:10.1007/s00261-024-04357-x. [PMID: 38744702 DOI: 10.1007/s00261-024-04357-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/21/2024] [Accepted: 04/21/2024] [Indexed: 05/16/2024]
Abstract
Photon counting detector CT (PCD-CT) is the newest major development in CT technology and has been commercially available since 2021. It offers major technological advantages over current standard-of-care energy integrating detector CT (EID-CT) including improved spatial resolution, improved iodine contrast to noise ratio, multi-energy imaging, and reduced noise. This article serves as a foundational basis to the technical approaches and concepts of PCD-CT technology with primary emphasis on detector technology in direct comparison to EID-CT. The article also addresses current technological challenges to PCD-CT with particular attention to cross talk and its causes (e.g., Compton scattering, fluorescence, charge sharing, K-escape) as well as pile-up.
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Affiliation(s)
- Giuseppe V Toia
- Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA.
| | - Achille Mileto
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Amir A Borhani
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Guang-Hong Chen
- Departments of Radiology and Medical Physics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI, 53792, USA
| | - Liqiang Ren
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Jennifer W Uyeda
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniele Marin
- Department of Radiology, Duke University Health System, Durham, NC, USA
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Waumans J, Desloovere C, Devos J. Tophaceous Gout of the Middle Ear. J Belg Soc Radiol 2024; 108:11. [PMID: 38371367 PMCID: PMC10870940 DOI: 10.5334/jbsr.3421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/05/2024] [Indexed: 02/20/2024] Open
Abstract
Tophaceous gout can rarely present in the middle ear as a mass-like lesion, causing conductive hearing loss. Noncontrast high-resolution computed tomography (HRCT) of the temporal bone plays a significant role in the diagnosis. Awareness of this condition among radiologists is important since it presents a distinctive appearance on HRCT. We present a case of tophaceous gout of the middle ear diagnosed with photon-counting computed tomography (PCCT). Teaching point: The presence of a partially calcified mass with a semolina-like appearance within the middle ear is highly suggestive of tophaceous gout, even in the presence of normal serum uric acid levels.
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Affiliation(s)
- Joren Waumans
- Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium,
| | - Christian Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium,
| | - Johannes Devos
- Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven, 3000, Belgium,
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Xu N, Ding H, Tang R, Li X, Zhang Z, Lv H, Dai C, Qiu X, Huang Y, Han X, Wang GP, Liu Y, Gong S, Yang Z, Wang Z, Zhao P. Comparative study of the sensitivity of ultra-high-resolution CT and high-resolution CT in the diagnosis of isolated fenestral otosclerosis. Insights Imaging 2023; 14:211. [PMID: 38015307 PMCID: PMC10684447 DOI: 10.1186/s13244-023-01562-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE To compare the diagnostic sensitivity of ultra-high-resolution computed tomography (U-HRCT) and HRCT in isolated fenestral otosclerosis (IFO). METHODS A retrospective analysis was conducted on 85 patients (85 ears) diagnosed with IFO between October 2020 and November 2022. U-HRCT (0.1 mm thickness) was performed for 20 ears, HRCT (0.67 mm thickness) for 45 ears, and both for 20 ears. The images were evaluated by general radiologists and neuroradiologists who were blinded to the diagnosis and surgical information. The diagnostic sensitivity of U-HRCT and HRCT for detecting IFO was compared between the two groups. RESULTS Excellent inter-observer agreement existed between the two neuroradiologists (Cohen's κ coefficient 0.806, 95% CI 0.692-0.920), with good agreement between the general radiologists (Cohen's κ coefficient 0.680, 95% CI 0.417-0.943). U-HRCT had a sensitivity of 100% (40/40 ears) for neuroradiologists and 87.5% (35/40 ears) for general radiologists, significantly higher than HRCT (89.2% [58/65 ears] for neuroradiologists; 41.5% [27/65 ears] for general radiologists) (p = 0.042, p' < 0.000). General radiologists' sensitivity with HRCT was significantly lower compared to neuroradiologists (p < 0.000), but no significant difference was observed when general radiologists switched to U-HRCT (p = 0.152). Among the 20 ears that underwent both examinations, U-HRCT detected lesions smaller than 1 mm in 5 ears, whereas HRCT's sensitivity for neuroradiologists was 40% (2/5 ears), significantly lower than for lesions larger than 1 mm (93.3%, 14/15 ears, p = 0.032). CONCLUSION U-HRCT exhibits higher sensitivity than HRCT in diagnosing IFO, suggesting its potential as a screening tool for suspected otosclerosis patients. CRITICAL RELEVANCE STATEMENT Ultra-high-resolution computed tomography has the potential to become a screening tool in patients with suspected otosclerosis and to bridge the diagnostic accuracy gap between general radiologists and neuroradiologists. KEY POINTS • U-HRCT exhibits higher sensitivity than HRCT in the diagnosis of IFO. • U-HRCT has a significant advantage in the detection of less than 1 mm IFO. • U-HRCT has the potential to be used for screening of patients with suspected otosclerosis.
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Affiliation(s)
- Ning Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Ruowei Tang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Zhengyu Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Chihang Dai
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Xiaoyu Qiu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Yan Huang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Xu Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Guo-Peng Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Yuhe Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Shusheng Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China.
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China.
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