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Mourad C, Gallego Manzano L, Viry A, Booij R, Oei EHG, Becce F, Omoumi P. Chances and challenges of photon-counting CT in musculoskeletal imaging. Skeletal Radiol 2024; 53:1889-1902. [PMID: 38441616 PMCID: PMC11303444 DOI: 10.1007/s00256-024-04622-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 08/09/2024]
Abstract
In musculoskeletal imaging, CT is used in a wide range of indications, either alone or in a synergistic approach with MRI. While MRI is the preferred modality for the assessment of soft tissues and bone marrow, CT excels in the imaging of high-contrast structures, such as mineralized tissue. Additionally, the introduction of dual-energy CT in clinical practice two decades ago opened the door for spectral imaging applications. Recently, the advent of photon-counting detectors (PCDs) has further advanced the potential of CT, at least in theory. Compared to conventional energy-integrating detectors (EIDs), PCDs provide superior spatial resolution, reduced noise, and intrinsic spectral imaging capabilities. This review briefly describes the technical advantages of PCDs. For each technical feature, the corresponding applications in musculoskeletal imaging will be discussed, including high-spatial resolution imaging for the assessment of bone and crystal deposits, low-dose applications such as whole-body CT, as well as spectral imaging applications including the characterization of crystal deposits and imaging of metal hardware. Finally, we will highlight the potential of PCD-CT in emerging applications, underscoring the need for further preclinical and clinical validation to unleash its full clinical potential.
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Affiliation(s)
- Charbel Mourad
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Department of Diagnostic Imaging and Interventional Therapeutics, Hôpital Libanais Geitaoui-CHU, Beyrouth, Lebanon
| | - Lucia Gallego Manzano
- Institute of Radiation Physics (IRA), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Anaïs Viry
- Institute of Radiation Physics (IRA), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ronald Booij
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Fabio Becce
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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2
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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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3
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Zhao FL, Gou YL, Lan YS. Experimental study on the effects of different exposure conditions and contrast agent concentrations on spectral computed tomography virtual non-contrast images. Quant Imaging Med Surg 2024; 14:986-994. [PMID: 38223038 PMCID: PMC10784069 DOI: 10.21037/qims-23-1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/13/2023] [Indexed: 01/16/2024]
Abstract
Background The early diagnosis of thrombosis and fat embolism is important for subsequent treatment regimens. Spectral computed tomography (CT) virtual non-contrast (VNC) scanning can not only accurately diagnose thrombosis and medium fat embolism but can also reduce the radiation dose and scanning time. However, there is a relative paucity of studies on what contrast concentration and exposure conditions are best for the quality of VNC images. To address this issue, this study aimed to investigate the effects of different exposure conditions and contrast concentrations on the quality of VNC images of low-density substances in spectral CT. Methods Four solution groups [i.e., groups A (15 mgI/mL), B (10 mgI/mL), C (5 mgI/mL), and D (the control group)] were matched with normal saline and contrast agent groups. Four groups of solution, duck blood clots, and fat were injected into four sections of the pig large intestine, respectively. CT scans with different exposure amounts were performed under the condition of 120 KV. Comparing the true non-contrast (TNC) image based on solution D group with the VNC images of the other three solution groups. The differences in the CT values, standard deviation (SD) values, and contrast noise ratio (CNR) values of the duck blood and fat under different iodine concentrations and exposures were compared. The image quality was evaluated using a three-point method and the Kappa consistency test was performed. The consistency of the tissue CT values in the TNC and VNC images was analyzed by drawing Bland-Altman scatter plots. Results The CT values of the duck blood in the VNC20mAs and VNCC groups were lower than those in the TNC groups (P<0.05). Under different exposures and contrast agent concentrations, the CT value of the fat in the VNC group was higher than that in the TNC group (P<0.05). The SD values of the duck blood and fat in three groups (i.e., groups A, B, and C) were lower than those in the TNC group (P<0.05). The CNR value of the duck blood in the VNC20mAs group was lower than that in the TNC group (Z=-2.10, P=0.04), and the CNR values of the duck blood and fat in the VNC group were higher than those in the TNC groups in the remaining different exposure and concentration groups (P<0.05). The CT values of the lesions in the two groups were consistent, and there were no statistically significant differences between the subjective scores of the TNC and VNC images (z=-1.34, P=0.18); the subjective evaluations of the two physicians had good consistency (K=0.80). Conclusions Under the conditions of higher contrast agent concentrations and proper exposure conditions, the VNC images were better able to restore the CT values of the blood clots, reduce the SD values of the blood clots and fat. In addition, and improve the CNR values of the blood clots and fat. In addition, the quality of the two images was similar.
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Affiliation(s)
- Fu-Lin Zhao
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yu-Lin Gou
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yong-Shu Lan
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Schadow JE, Maxey D, Smith TO, Finnilä MAJ, Manske SL, Segal NA, Wong AKO, Davey RA, Turmezei T, Stok KS. Systematic review of computed tomography parameters used for the assessment of subchondral bone in osteoarthritis. Bone 2024; 178:116948. [PMID: 37926204 DOI: 10.1016/j.bone.2023.116948] [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] [Received: 08/15/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To systematically review the published parameters for the assessment of subchondral bone in human osteoarthritis (OA) using computed tomography (CT) and gain an overview of current practices and standards. DESIGN A literature search of Medline, Embase and Cochrane Library databases was performed with search strategies tailored to each database (search from 2010 to January 2023). The search results were screened independently by two reviewers against pre-determined inclusion and exclusion criteria. Studies were deemed eligible if conducted in vivo/ex vivo in human adults (>18 years) using any type of CT to assess subchondral bone in OA. Extracted data from eligible studies were compiled in a qualitative summary and formal narrative synthesis. RESULTS This analysis included 202 studies. Four groups of CT modalities were identified to have been used for subchondral bone assessment in OA across nine anatomical locations. Subchondral bone parameters measuring similar features of OA were combined in six categories: (i) microstructure, (ii) bone adaptation, (iii) gross morphology (iv) mineralisation, (v) joint space, and (vi) mechanical properties. CONCLUSIONS Clinically meaningful parameter categories were identified as well as categories with the potential to become relevant in the clinical field. Furthermore, we stress the importance of quantification of parameters to improve their sensitivity and reliability for the evaluation of OA disease progression and the need for standardised measurement methods to improve their clinical value.
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Affiliation(s)
- Jemima E Schadow
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
| | - David Maxey
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
| | - Toby O Smith
- Warwick Medical School, University of Warwick, United Kingdom.
| | - Mikko A J Finnilä
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Sarah L Manske
- Department of Radiology, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Neil A Segal
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, United States.
| | - Andy Kin On Wong
- Joint Department of Medical Imaging, University Health Network, Toronto, Canada; Schroeder's Arthritis Institute, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
| | - Rachel A Davey
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
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Hagen F, Soschynski M, Weis M, Hagar MT, Krumm P, Ayx I, Taron J, Krauss T, Hein M, Ruile P, von Zur Muehlen C, Schlett CL, Neubauer J, Tsiflikas I, Russe MF, Arnold P, Faby S, Froelich MF, Weiß J, Stein T, Overhoff D, Bongers M, Nikolaou K, Schönberg SO, Bamberg F, Horger M. Photon-counting computed tomography - clinical application in oncological, cardiovascular, and pediatric radiology. ROFO-FORTSCHR RONTG 2024; 196:25-35. [PMID: 37793417 DOI: 10.1055/a-2119-5802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Photon-counting detector computed tomography (PCD-CT) is a promising new technology with the potential to fundamentally change workflows in the daily routine and provide new quantitative imaging information to improve clinical decision-making and patient management. METHOD The contents of this review are based on an unrestricted literature search of PubMed and Google Scholar using the search terms "photon-counting CT", "photon-counting detector", "spectral CT", "computed tomography" as well as on the authors' own experience. RESULTS The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCD-CT allows for the counting of every single photon at the detector level. Based on the identified literature, PCD-CT phantom measurements and initial clinical studies have demonstrated that the new technology allows for improved spatial resolution, reduced image noise, and new possibilities for advanced quantitative image postprocessing. CONCLUSION For clinical practice, the potential benefits include fewer beam hardening artifacts, a radiation dose reduction, and the use of new or combinations of contrast agents. In particular, critical patient groups such as oncological, cardiovascular, lung, and head & neck as well as pediatric patient collectives benefit from the clinical advantages. KEY POINTS · Photon-counting computed tomography (PCD-CT) is being used for the first time in routine clinical practice, enabling a significant dose reduction in critical patient populations such as oncology, cardiology, and pediatrics.. · Compared to conventional CT, PCD-CT enables a reduction in electronic image noise.. · Due to the spectral data sets, PCD-CT enables fully comprehensive post-processing applications.. CITATION FORMAT · Hagen F, Soschynski M, Weis M et al. Photon-counting computed tomography - clinical application in oncological, cardiovascular, and pediatric radiology. Fortschr Röntgenstr 2024; 196: 25 - 34.
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Affiliation(s)
- Florian Hagen
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Martin Soschynski
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Meike Weis
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Muhammad Taha Hagar
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Patrick Krumm
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Isabelle Ayx
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jana Taron
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tobias Krauss
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Manuel Hein
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Philipp Ruile
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Constantin von Zur Muehlen
- Department of Cardiology & Angiology, University Heart Center Freiburg - Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jakob Neubauer
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ilias Tsiflikas
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Maximilian Frederik Russe
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Arnold
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian Faby
- Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
| | - Matthias F Froelich
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jakob Weiß
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Stein
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Daniel Overhoff
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Malte Bongers
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Stefan O Schönberg
- Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marius Horger
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
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Fukuda T, Yonenaga T, Miyasaka T, Kimura T, Jinzaki M, Ojiri H. CT in osteoarthritis: its clinical role and recent advances. Skeletal Radiol 2023; 52:2199-2210. [PMID: 36287235 DOI: 10.1007/s00256-022-04217-z] [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] [Received: 08/31/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 02/02/2023]
Abstract
Computed tomography (CT) is a widely available imaging method and considered as one of the most reliable techniques in bone assessment. Although CT has limited tissue contrast and needs radiation exposure, it has several advantages like fast scanning time and high spatial resolution. In this regard, CT has unique roles in osteoarthritis (OA) and its variable utilities have been reported. Hence, this review highlights the clinical role of CT in OA of representative joints. In addition, CT showed the several technical advancements recently, for example, acquiring the CT image with standing, obtaining the dual-energy data, and novel photon-counting detector development. Therefore, the recent studies and potential utility of these new CT systems in OA are also discussed.
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Affiliation(s)
- Takeshi Fukuda
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan.
| | - Takenori Yonenaga
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Teruyuki Miyasaka
- Department of Orthopedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Tadashi Kimura
- Department of Orthopedic Surgery, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, Japan
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7
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Wu Y, Ye Z, Chen J, Deng L, Song B. Photon Counting CT: Technical Principles, Clinical Applications, and Future Prospects. Acad Radiol 2023; 30:2362-2382. [PMID: 37369618 DOI: 10.1016/j.acra.2023.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/27/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023]
Abstract
Photon-counting computed tomography (PCCT) is a new technique that utilizes photon-counting detectors to convert individual X-ray photons directly into an electrical signal, which can achieve higher spatial resolution, improved iodine signal, radiation dose reduction, artifact reduction, and multienergy imaging. This review introduces the technical principles of PCCT, and summarizes its first-in-human experience and current applications in clinical settings, and discusses the future prospects of PCCT.
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Affiliation(s)
- Yingyi Wu
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China (Y.Y.W., Z.Y., J.C., L.P.D., B.S.)
| | - Zheng Ye
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China (Y.Y.W., Z.Y., J.C., L.P.D., B.S.)
| | - Jie Chen
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China (Y.Y.W., Z.Y., J.C., L.P.D., B.S.)
| | - Liping Deng
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China (Y.Y.W., Z.Y., J.C., L.P.D., B.S.)
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, China (Y.Y.W., Z.Y., J.C., L.P.D., B.S.); Department of Radiology, Sanya People' s Hospital, Sanya, Hainan, China (B.S.).
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8
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Douek PC, Boccalini S, Oei EHG, Cormode DP, Pourmorteza A, Boussel L, Si-Mohamed SA, Budde RPJ. Clinical Applications of Photon-counting CT: A Review of Pioneer Studies and a Glimpse into the Future. Radiology 2023; 309:e222432. [PMID: 37787672 PMCID: PMC10623209 DOI: 10.1148/radiol.222432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 10/04/2023]
Abstract
CT systems equipped with photon-counting detectors (PCDs), referred to as photon-counting CT (PCCT), are beginning to change imaging in several subspecialties, such as cardiac, vascular, thoracic, and musculoskeletal radiology. Evidence has been building in the literature underpinning the many advantages of PCCT for different clinical applications. These benefits derive from the distinct features of PCDs, which are made of semiconductor materials capable of converting photons directly into electric signal. PCCT advancements include, among the most important, improved spatial resolution, noise reduction, and spectral properties. PCCT spatial resolution on the order of 0.25 mm allows for the improved visualization of small structures (eg, small vessels, arterial walls, distal bronchi, and bone trabeculations) and their pathologies, as well as the identification of previously undetectable anomalies. In addition, blooming artifacts from calcifications, stents, and other dense structures are reduced. The benefits of the spectral capabilities of PCCT are broad and include reducing radiation and contrast material dose for patients. In addition, multiple types of information can be extracted from a single data set (ie, multiparametric imaging), including quantitative data often regarded as surrogates of functional information (eg, lung perfusion). PCCT also allows for a novel type of CT imaging, K-edge imaging. This technique, combined with new contrast materials specifically designed for this modality, opens the door to new applications for imaging in the future.
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Affiliation(s)
| | | | - Edwin H. G. Oei
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
| | - David P. Cormode
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
| | - Amir Pourmorteza
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
| | - Loic Boussel
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
| | - Salim A. Si-Mohamed
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
| | - Ricardo P. J. Budde
- From the University of Lyon, INSA-Lyon, Claude Bernard Lyon 1
University, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France (P.C.D., L.B.,
S.A.S.M.); Department of Cardiovascular and Thoracic Radiology, Louis Pradel
Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500 Bron, France
(P.C.D., S.B., L.B., S.A.S.M.); Claude Bernard Lyon 1 University, Villeurbanne,
France (S.B.); Department of Radiology and Nuclear Medicine, Erasmus Medical
Center, Rotterdam, the Netherlands (E.H.G.O., R.P.J.B.); Department of
Radiology, University of Pennsylvania, Philadelphia, Pa (D.P.C.); Department of
Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.P.); Department
of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Ga (A.P.);
and Winship Cancer Institute, Atlanta, Ga (A.P.)
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9
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Greffier J, Si-Mohamed SA, Lacombe H, Labour J, Djabli D, Boccalini S, Varasteh M, Villien M, Yagil Y, Erhard K, Boussel L, Beregi JP, Douek PC. Virtual monochromatic images for coronary artery imaging with a spectral photon-counting CT in comparison to dual-layer CT systems: a phantom and a preliminary human study. Eur Radiol 2023; 33:5476-5488. [PMID: 36920517 PMCID: PMC10326132 DOI: 10.1007/s00330-023-09529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/09/2023] [Accepted: 02/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To evaluate the quality of virtual monochromatic images (VMIs) from spectral photon-counting CT (SPCCT) and two energy-integrating detector dual-energy CT (EID-DECT) scanners from the same manufacturer, for the coronary lumen. METHODS A 21-cm section of the Mercury v4.0 phantom was scanned using a cardiac CT protocol. VMIs from 40 to 90 keV were reconstructed using high-resolution (HR) parameters for EID-DECT and SPCCT (CB and HRB kernels at 0.67 mm slice thickness, respectively). Ultra-high-resolution (UHR) parameters were used in addition to SPCCT (detailed-2 kernel, 0.43 mm slice thickness). Noise-power-spectrum (NPS), task-based transfer function (TTF), and detectability index (d') were computed for 2-mm-diameter lumen detection. In consensus, two radiologists analyzed the quality of the images from 8 patients who underwent coronary CTA on both CT systems. RESULTS For all keV images, fpeak, f50, and d' were higher with SPCCT. The fpeak and f50 were higher with UHR-SPCCT with greater noise and lower d' compared to those of the HR-SPCCT images. Noise magnitude was constant for all energy levels (keV) with both systems, and lower with HR images, and d' decreased as keV decreased. Subjective analysis showed greater lumen sharpness and overall quality for HR and UHR-SPCCT images using all keV, with a greater difference at low keV compared to HR-EID-DECT images. CONCLUSION HR and UHR-SPCCT images gave greater detectability of the coronary lumen for 40 to 90 keV VMIs compared to two EID-DECT systems, with benefits of higher lumen sharpness and overall quality. KEY POINTS • Compared with 2 dual-energy CT systems, spectral photon-counting CT (SPCCT) improved spatial resolution, noise texture, noise magnitude, and detectability of the coronary lumen. • Use of ultra-high-resolution parameters with SPCCT improved spatial resolution and noise texture and provided high detectability of the coronary lumen, despite an increase in noise magnitude. • In eight patients, radiologists found greater overall image quality with SPCCT for all virtual monochromatic images with a greater difference at low keV, compared with dual-energy CT systems.
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Affiliation(s)
- Joel Greffier
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, Nîmes, France
| | - Salim A Si-Mohamed
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France.
- Department of Cardiothoracic Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.
| | - Hugo Lacombe
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
| | - Joey Labour
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
| | - Djamel Djabli
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, Nîmes, France
| | - Sara Boccalini
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
- Department of Cardiothoracic Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
| | - Mohammad Varasteh
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
| | | | | | | | - Loic Boussel
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
- Department of Cardiothoracic Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
- Department of Radiology, Croix Rousse Hospital, Hospices Civils de Lyon, 103 Gd Rue de la Croix-Rousse, 69004, Lyon, France
| | - Jean-Paul Beregi
- IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, Nîmes, France
| | - Philippe C Douek
- University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, F-69621, 7 Avenue Jean Capelle O, 69100, Villeurbanne, France
- Department of Cardiothoracic Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
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10
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Demehri S, Kasaeian A, Roemer FW, Guermazi A. Osteoarthritis year in review 2022: imaging. Osteoarthritis Cartilage 2023; 31:1003-1011. [PMID: 36924919 DOI: 10.1016/j.joca.2023.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/17/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE This narrative review summarizes original research focusing on imaging in osteoarthritis (OA) published between April 1st 2021 and March 31st 2022. We only considered English publications that were in vivo human studies. METHODS The PubMed, Medline, Embase, Scopus, and ISI Web of Science databases were searched for "Osteoarthritis/OA" studies based on the search terms: "Radiography", "Ultrasound/US", "Computed Tomography/CT", "DXA", "Magnetic Resonance Imaging/MRI", "Artificial Intelligence/AI", and "Deep Learning". This review highlights the anatomical focus of research on the structures within the tibiofemoral, patellofemoral, hip, and hand joints. There is also a noted focus on artificial intelligence applications in OA imaging. RESULTS Over the last decade, the increasing trend of using open-access large databases has reached a plateau (from 17 to 37). Compositional MRI has had the most prominent use in OA imaging and its biomarkers have been used in the detection of preclinical OA and prediction of OA outcomes. Most noteworthy, there has been an accelerated rate of publications on the implications of artificial intelligence, used in developing prediction models and performing trabecular texture analysis, in OA imaging (from 17 to 154). CONCLUSIONS While imaging has maintained its key role in OA research, publication trends have shown an emphasis on the integration of AI. During the past year, MRI has maintained the highest prevalence in usage while US and CT remain as readily available modalities. Finally, there has been a notable uptake in the development and validation of AI techniques used to perform texture analysis and predict OA progression.
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Affiliation(s)
- S Demehri
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - A Kasaeian
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - F W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - A Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
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11
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Garcelon C, Abascal J, Olivier C, Uk S, Si-Mohamed S, Ea HK, Douek P, Peyrin F, Chappard C. Quantification of cartilage and subchondral bone cysts on knee specimens based on a spectral photon-counting computed tomography. Sci Rep 2023; 13:11080. [PMID: 37422514 PMCID: PMC10329701 DOI: 10.1038/s41598-023-38238-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/05/2023] [Indexed: 07/10/2023] Open
Abstract
Spectral photon-counting computed tomography (SPCCT) is a new technique with the capability to provide mono-energetic (monoE) images with high signal to noise ratio. We demonstrate the feasibility of SPCCT to characterize at the same time cartilage and subchondral bone cysts (SBCs) without contrast agent in osteoarthritis (OA). To achieve this goal, 10 human knee specimens (6 normal and 4 with OA) were imaged with a clinical prototype SPCCT. The monoE images at 60 keV with isotropic voxels of 250 × 250 × 250 µm3 were compared with monoE synchrotron radiation CT (SR micro-CT) images at 55 keV with isotropic voxels of 45 × 45 × 45 µm3 used as benchmark for cartilage segmentation. In the two OA knees with SBCs, the volume and density of SBCs were evaluated in SPCCT images. In 25 compartments (lateral tibial (LT), medial tibial, (MT), lateral femoral (LF), medial femoral and patella), the mean bias between SPCCT and SR micro-CT analyses were 101 ± 272 mm3 for cartilage volume and 0.33 mm ± 0.18 for mean cartilage thickness. Between normal and OA knees, mean cartilage thicknesses were found statistically different (0.005 < p < 0.04) for LT, MT and LF compartments. The 2 OA knees displayed different SBCs profiles in terms of volume, density, and distribution according to size and location. SPCCT with fast acquisitions is able to characterize cartilage morphology and SBCs. SPCCT can be used potentially as a new tool in clinical studies in OA.
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Affiliation(s)
- Célestin Garcelon
- Paris Cité University, CNRS, INSERM, B3OA UMR 7052 U1273, Paris, France
| | - Juan Abascal
- University of Lyon, INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
| | - Cecile Olivier
- University of Lyon, INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
| | - Stéphanie Uk
- Paris Cité University, CNRS, INSERM, B3OA UMR 7052 U1273, Paris, France
| | - Salim Si-Mohamed
- University of Lyon, INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
| | - Hang-Korng Ea
- Rheumatology Department, University Paris Cité, Paris, France
| | - Philippe Douek
- University of Lyon, INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
| | - Francoise Peyrin
- University of Lyon, INSA-Lyon, CNRS, INSERM, CREATIS UMR 5220, U1206, Lyon, France
| | - Christine Chappard
- Paris Cité University, CNRS, INSERM, B3OA UMR 7052 U1273, Paris, France.
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12
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Si-Mohamed SA, Boccalini S, Villien M, Yagil Y, Erhard K, Boussel L, Douek PC. First Experience With a Whole-Body Spectral Photon-Counting CT Clinical Prototype. Invest Radiol 2023; 58:459-471. [PMID: 36822663 PMCID: PMC10259214 DOI: 10.1097/rli.0000000000000965] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
ABSTRACT Spectral photon-counting computed tomography (SPCCT) technology holds great promise for becoming the next generation of computed tomography (CT) systems. Its technical characteristics have many advantages over conventional CT imaging. For example, SPCCT provides better spatial resolution, greater dose efficiency for ultra-low-dose and low-dose protocols, and tissue contrast superior to that of conventional CT. In addition, SPCCT takes advantage of several known approaches in the field of spectral CT imaging, such as virtual monochromatic imaging and material decomposition imaging. In addition, SPCCT takes advantage of a new approach in this field, known as K-edge imaging, which allows specific and quantitative imaging of a heavy atom-based contrast agent. Hence, the high potential of SPCCT systems supports their ongoing investigation in clinical research settings. In this review, we propose an overview of our clinical research experience of a whole-body SPCCT clinical prototype, to give an insight into the potential benefits for clinical human imaging on image quality, diagnostic confidence, and new approaches in spectral CT imaging.
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Affiliation(s)
- Salim A. Si-Mohamed
- From the University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Sara Boccalini
- From the University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | | | | | | | - Loic Boussel
- From the University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Philippe C. Douek
- From the University Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, Villeurbanne, France
- Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
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13
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Li X, Roemer FW, Cicuttini F, MacKay JW, Turmezei T, Link TM. Early knee OA definition-what do we know at this stage? An imaging perspective. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158204. [PMID: 36937824 PMCID: PMC10017942 DOI: 10.1177/1759720x231158204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
While criteria for early-stage knee osteoarthritis (OA) in a primary care setting have been proposed, the role of imaging has been limited to radiography using the standard Kellgren-Lawrence classification. Standardized imaging and interpretation are critical with radiographs, yet studies have also shown that even early stages of radiographic OA already demonstrate advanced damage to knee joint tissues such as cartilage, menisci, and bone marrow. Morphological magnetic resonance imaging (MRI) shows degenerative damage earlier than radiographs and definitions for OA using MRI have been published though no accepted definition of early OA based on MRI is currently available. The clinical significance of structural abnormalities has also not been well defined, and the differentiation between normal aging and structural OA development remains a challenge. Compositional MRI of cartilage provides information on biochemical, degenerative changes within the cartilage matrix before cartilage defects occur and when cartilage damage is potentially reversible. Studies have shown that cartilage composition can predict cartilage loss and radiographic OA. However, while this technology is most promising for characterizing early OA it has currently limited clinical application. Better standardization of compositional MRI is required, which is currently work in progress. Finally, there has been renewed interest in computed tomography (CT) for assessing early knee OA as new techniques such as weight bearing and spectral CT are available, which may provide information on joint loading, cartilage, and bone and potentially have a role in better characterizing early OA. In conclusion, while imaging may have a limited role in diagnosing early OA in a primary care setting, there are advanced imaging technologies available, which detect early degeneration and may thus significantly alter management as new therapeutic modalities evolve.
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Affiliation(s)
- Xiaojuan Li
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Frank W. Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Flavia Cicuttini
- Musculoskeletal Unit, Monash University and Rheumatology, Alfred Hospital, Melbourne, VIC, Australia
| | - Jamie W. MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK
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14
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Giovannetti G, Guerrini A, Minozzi S, Panetta D, Salvadori PA. Computer tomography and magnetic resonance for multimodal imaging of fossils and mummies. Magn Reson Imaging 2022; 94:7-17. [PMID: 36084902 DOI: 10.1016/j.mri.2022.08.019] [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: 06/07/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/24/2022]
Abstract
The study of fossils and mummies has largely benefited from the use of modern noninvasive and nondestructive imaging technologies and represents a fast developing area. In this review, we describe the emerging role of imaging based on Magnetic Resonance (MR) and Computer Tomography (CT) employed for the study of ancient remains and mummies. For each methodology, the state of the art in paleoradiology applications is described, by emphasizing new technologies developed in the field of both CT, such as micro- and nano-CT, dual-energy and multi-energy CT, and MR, with the description of novel dedicated sequences, radiofrequency coils and gradients. The complementarity of CT and MR in paleoradiology is also discussed, by pointing out what MR provides in addition to CT, with an overview on the state of the art of emerging strategies in the use of CT/MR combination for the study of a sample following a multimodal integrated approach.
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Affiliation(s)
- Giulio Giovannetti
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy.
| | - Andrea Guerrini
- Gruppo Archeologico e Paleontologico Livornese, Museo di Storia Naturale del Mediterraneo, via Roma, 234, 57127 Leghorn, Italy
| | - Simona Minozzi
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 57, 56100 Pisa, Italy
| | - Daniele Panetta
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy
| | - Piero A Salvadori
- Institute of Clinical Physiology, National Council of Research, via G. Moruzzi 1, 56124 Pisa, Italy
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15
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Bette S, Decker JA, Braun FM, Becker J, Haerting M, Haeckel T, Gebhard M, Risch F, Woźnicki P, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI. Diagnostics (Basel) 2022; 12:diagnostics12051231. [PMID: 35626387 PMCID: PMC9140684 DOI: 10.3390/diagnostics12051231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
In dual-energy CT datasets, the conspicuity of liver metastases can be enhanced by virtual monoenergetic imaging (VMI) reconstructions at low keV levels. Our study investigated whether this effect can be reproduced in photon-counting detector CT (PCD-CT) datasets. We analyzed 100 patients with liver metastases who had undergone contrast-enhanced CT of the abdomen on a PCD-CT (n = 50) or energy-integrating detector CT (EID-CT, single-energy mode, n = 50). PCD-VMI-reconstructions were performed at various keV levels. Identical regions of interest were positioned in metastases, normal liver, and other defined locations assessing image noise, tumor-to-liver ratio (TLR), and contrast-to-noise ratio (CNR). Patients were compared inter-individually. Subgroup analyses were performed according to BMI. On the PCD-CT, noise and CNR peaked at the low end of the keV spectrum. In comparison with the EID-CT, PCD-VMI-reconstructions exhibited lower image noise (at 70 keV) but higher CNR (for ≤70 keV), despite similar CTDIs. Comparing high- and low-BMI patients, CTDI-upregulation was more modest for the PCD-CT but still resulted in similar noise levels and preserved CNR, unlike the EID-CT. In conclusion, PCD-CT VMIs in oncologic patients demonstrated reduced image noise–compared to a standard EID-CT–and improved conspicuity of hypovascularized liver metastases at low keV values. Patients with higher BMIs especially benefited from constant image noise and preservation of lesion conspicuity, despite a more moderate upregulation of CTDI.
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Affiliation(s)
- Stefanie Bette
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Josua A. Decker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franziska M. Braun
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Judith Becker
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Mark Haerting
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas Haeckel
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Michael Gebhard
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Franka Risch
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Piotr Woźnicki
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Christian Scheurig-Muenkler
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
| | - Thomas J. Kroencke
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Correspondence: ; Tel.: +49-821-400-2441
| | - Florian Schwarz
- Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany; (S.B.); (J.A.D.); (F.M.B.); (J.B.); (M.H.); (T.H.); (M.G.); (F.R.); (P.W.); (C.S.-M.); (F.S.)
- Medical Faculty, Ludwig Maximilian University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
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