Dataset Information

Feasibility of Dose-reduced Chest CT with Photon-counting Detectors: Initial Results in Humans.

ABSTRACT: Purpose To investigate whether photon-counting detector (PCD) technology can improve dose-reduced chest computed tomography (CT) image quality compared with that attained with conventional energy-integrating detector (EID) technology in vivo. Materials and Methods This was a HIPAA-compliant institutional review board-approved study, with informed consent from patients. Dose-reduced spiral unenhanced lung EID and PCD CT examinations were performed in 30 asymptomatic volunteers in accordance with manufacturer-recommended guidelines for CT lung cancer screening (120-kVp tube voltage, 20-mAs reference tube current-time product for both detectors). Quantitative analysis of images included measurement of mean attenuation, noise power spectrum (NPS), and lung nodule contrast-to-noise ratio (CNR). Images were qualitatively analyzed by three radiologists blinded to detector type. Reproducibility was assessed with the intraclass correlation coefficient (ICC). McNemar, paired t, and Wilcoxon signed-rank tests were used to compare image quality. Results Thirty study subjects were evaluated (mean age, 55.0 years ± 8.7 [standard deviation]; 14 men). Of these patients, 10 had a normal body mass index (BMI) (BMI range, 18.5-24.9 kg/m2; group 1), 10 were overweight (BMI range, 25.0-29.9 kg/m2; group 2), and 10 were obese (BMI ?30.0 kg/m2, group 3). PCD diagnostic quality was higher than EID diagnostic quality (P = .016, P = .016, and P = .013 for readers 1, 2, and 3, respectively), with significantly better NPS and image quality scores for lung, soft tissue, and bone and with fewer beam-hardening artifacts (all P < .001). Image noise was significantly lower for PCD images in all BMI groups (P < .001 for groups 1 and 3, P < .01 for group 2), with higher CNR for lung nodule detection (12.1 ± 1.7 vs 10.0 ± 1.8, P < .001). Inter- and intrareader reproducibility were good (all ICC > 0.800). Conclusion Initial human experience with dose-reduced PCD chest CT demonstrated lower image noise compared with conventional EID CT, with better diagnostic quality and lung nodule CNR. © RSNA, 2017 Online supplemental material is available for this article.

SUBMITTER: Symons R

PROVIDER: S-EPMC5708286 | biostudies-other | 2017 Dec

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Feasibility of Dose-reduced Chest CT with Photon-counting Detectors: Initial Results in Humans.

Symons Rolf R Pourmorteza Amir A Sandfort Veit V Ahlman Mark A MA Cropper Tracy T Mallek Marissa M Kappler Steffen S Ulzheimer Stefan S Mahesh Mahadevappa M Jones Elizabeth C EC Malayeri Ashkan A AA Folio Les R LR Bluemke David A DA

Radiology 20170728 3

Purpose To investigate whether photon-counting detector (PCD) technology can improve dose-reduced chest computed tomography (CT) image quality compared with that attained with conventional energy-integrating detector (EID) technology in vivo. Materials and Methods This was a HIPAA-compliant institutional review board-approved study, with informed consent from patients. Dose-reduced spiral unenhanced lung EID and PCD CT examinations were performed in 30 asymptomatic volunteers in accordance with ...[more]

PMID: 28753389

Similar Datasets

Project description:PurposeThe implementation of photon-counting detectors is widely expected to be the next breakthrough in X-ray computed tomography (CT) instrumentation. A small number of prototype scanners equipped with direct-conversion detectors based on room-temperature semiconductors, such as CdTe and CdZnTe (CZT), are currently installed at medical centers. Here, we investigate the feasibility of using silicon photomultiplier (SiPM)-based scintillation detectors in photon-counting computed tomography (PCCT) scanners, as a potential alternative to CdTe and CZT detectors.MethodsWe introduce a model that allows us to compute the expected energy resolution as well as the expected pulse shape and associated rate capability of SiPM-based PCCT detectors. The model takes into account SiPM saturation and optical crosstalk, because these phenomena may substantially affect the performance of SiPM-based PCCT detectors with sub-mm pixels. We present model validation experiments using a single-pixel detector consisting of a 0.9 × 0.9 × 1.0 mm3 LuAP:Ce scintillation crystal coupled to a 1 × 1 mm2 SiPM. We subsequently use the validated model to compute the expected performance of the fast scintillators LYSO:Ce, LuAP:Ce, and LaBr3 :Ce, coupled to currently available SiPMs, as well as to a more advanced SiPM prototype with improved dynamic range, for sub-mm pixel sizes.ResultsThe model was found to be in good agreement with the validation experiments, both with respect to energy resolution and pulse shape. It shows how saturation progressively degrades the energy resolution of detectors equipped with currently available SiPMs as the pixel size decreases. Moreover, the expected pulse duration is relatively long (~200 ns) with these SiPMs. However, when LuAP:Ce and LaBr3 :Ce are coupled to the more advanced SiPM prototype, the pulse duration improves to less than 60 ns, which is in the same order of magnitude as pulses from CdTe and CZT detectors. It follows that sufficient rate capability can be achieved with pixel sizes of 400 μm or smaller. Moreover, LaBr3 :Ce detectors can provide an energy resolution of 11.5%-13.5% at 60 keV, comparable to CdTe and CZT detectors.ConclusionsThis work provides first evidence that it may be feasible to develop SiPM-based scintillation detectors for PCCT that can compete with CdTe and CZT detectors in terms of energy resolution and rate capability.

Project description:The objective of the study was to demonstrate that, in x-ray computed tomography (CT), more than two types of materials can be effectively separated with the use of an energy resolved photon-counting detector and classification methodology. Specifically, this applies to the case when contrast agents that contain K-absorption edges in the energy range of interest are present in the object. This separation is enabled via the use of recently developed energy resolved photon-counting detectors with multiple thresholds, which allow simultaneous measurements of the x-ray attenuation at multiple energies.To demonstrate this capability, we performed simulations and physical experiments using a six-threshold energy resolved photon-counting detector. We imaged mouse-sized cylindrical phantoms filled with several soft-tissue-like and bone-like materials and with iodine-based and gadolinium-based contrast agents. The linear attenuation coefficients were reconstructed for each material in each energy window and were visualized as scatter plots between pairs of energy windows. For comparison, a dual-kVp CT was also simulated using the same phantom materials. In this case, the linear attenuation coefficients at the lower kVp were plotted against those at the higher kVp.In both the simulations and the physical experiments, the contrast agents were easily separable from other soft-tissue-like and bone-like materials, thanks to the availability of the attenuation coefficient measurements at more than two energies provided by the energy resolved photon-counting detector. In the simulations, the amount of separation was observed to be proportional to the concentration of the contrast agents; however, this was not observed in the physical experiments due to limitations of the real detector system. We used the angle between pairs of attenuation coefficient vectors in either the 5-D space (for non-contrast-agent materials using energy resolved photon-counting acquisition) or a 2-D space (for contrast agents using energy resolved photon-counting acquisition and all materials using dual-kVp acquisition) as a measure of the degree of separation. Compared to dual-kVp techniques, an energy resolved detector provided a larger separation and the ability to separate different target materials using measurements acquired in different energy window pairs with a single x-ray exposure.We concluded that x-ray CT with an energy resolved photon-counting detector with more than two energy windows allows the separation of more than two types of materials, e.g., soft-tissue-like, bone-like, and one or more materials with K-edges in the energy range of interest. Separating material types using energy resolved photon-counting detectors has a number of advantages over dual-kVp CT in terms of the degree of separation and the number of materials that can be separated simultaneously.

Project description:ObjectiveEvaluation of image characteristics at ultra-low radiation dose levels of a first-generation dual-source photon-counting computed tomography (PCCT) compared to a dual-source dual-energy CT (DECT) scanner.MethodsA multi-energy CT phantom was imaged with and without an extension ring on both scanners over a range of radiation dose levels (CTDIvol 0.4-15.0 mGy). Scans were performed in different modes of acquisition for PCCT with 120 kVp and DECT with 70/Sn150 kVp and 100/Sn150 kVp. Various tissue inserts were used to characterize the precision and repeatability of Hounsfield units (HUs) on virtual mono-energetic images between 40 and 190 keV. Image noise was additionally investigated at an ultra-low radiation dose to illustrate PCCT's ability to remove electronic background noise.ResultsOur results demonstrate the high precision of HU measurements for a wide range of inserts and radiation exposure levels with PCCT. We report high performance for both scanners across a wide range of radiation exposure levels, with PCCT outperforming at low exposures compared to DECT. PCCT scans at the lowest radiation exposures illustrate significant reduction in electronic background noise, with a mean percent reduction of 74% (p value ~ 10-8) compared to DECT 70/Sn150 kVp and 60% (p value ~ 10-6) compared to DECT 100/Sn150 kVp.ConclusionsThis paper reports the first experiences with a clinical dual-source PCCT. PCCT provides reliable HUs without disruption from electronic background noise for a wide range of dose values. Diagnostic benefits are not only for quantification at an ultra-low dose but also for imaging of obese patients.Key pointsPCCT scanners provide precise and reliable Hounsfield units at ultra-low dose levels. The influence of electronic background noise can be removed at ultra-low-dose acquisitions with PCCT. Both spectral platforms have high performance along a wide range of radiation exposure levels, with PCCT outperforming at low radiation exposures.

Project description:The maturation of photon-counting detector (PCD) technology promises to enhance routine CT imaging applications with high-fidelity spectral information. In this paper, we demonstrate the power of this synergy and our complementary reconstruction techniques, performing 4D, cardiac PCD-CT data acquisition and reconstruction in a mouse model of atherosclerosis, including calcified plaque. Specifically, in vivo cardiac micro-CT scans were performed in four ApoE knockout mice, following their development of calcified plaques. The scans were performed with a prototype PCD (DECTRIS, Ltd.) with 4 energy thresholds. Projections were sampled every 10 ms with a 10 ms exposure, allowing the reconstruction of 10 cardiac phases at each of 4 energies (40 total 3D volumes per mouse scan). Reconstruction was performed iteratively using the split Bregman method with constraints on spectral rank and spatio-temporal gradient sparsity. The reconstructed images represent the first in vivo, 4D PCD-CT data in a mouse model of atherosclerosis. Robust regularization during iterative reconstruction yields high-fidelity results: an 8-fold reduction in noise standard deviation for the highest energy threshold (relative to unregularized algebraic reconstruction), while absolute spectral bias measurements remain below 13 Hounsfield units across all energy thresholds and scans. Qualitatively, image domain material decomposition results show clear separation of iodinated contrast and soft tissue from calcified plaque in the in vivo data. Quantitatively, spatial, spectral, and temporal fidelity are verified through a water phantom scan and a realistic MOBY phantom simulation experiment: spatial resolution is robustly preserved by iterative reconstruction (10% MTF: 2.8-3.0 lp/mm), left-ventricle, cardiac functional metrics can be measured from iodine map segmentations with ~1% error, and small calcifications (615 μm) can be detected during slow moving phases of the cardiac cycle. Given these preliminary results, we believe that PCD technology will enhance dynamic CT imaging applications with high-fidelity spectral and material information.

Dataset Information

Feasibility of Dose-reduced Chest CT with Photon-counting Detectors: Initial Results in Humans.

Publications

Feasibility of Dose-reduced Chest CT with Photon-counting Detectors: Initial Results in Humans.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets