Image quality of lung perfusion with photon-counting-detector CT: comparison with dual-source, dual-energy CT.

Autor: Remy-Jardin M; Department of Thoracic Imaging, University Hospital Center of Lille, LILLE, France. dr.remy.jardin@gmail.com.; ULR 2694 METRICS Evaluation des technologies de santé et des pratiques médicales, LILLE, France. dr.remy.jardin@gmail.com.; IMALLIANCE-Haut-de-France, Valenciennes, France. dr.remy.jardin@gmail.com., Guiffault L; Department of Thoracic Imaging, University Hospital Center of Lille, LILLE, France., Oufriche I; Department of Thoracic Imaging, University Hospital Center of Lille, LILLE, France., Duhamel A; ULR 2694 METRICS Evaluation des technologies de santé et des pratiques médicales, LILLE, France.; Department of Biostatistics, University of Lille, CHU Lille, LILLE, France., Flohr T; Department of Computed Tomography Research & Development, Siemens Healthineers AG, Forchheim, Germany., Schmidt B; Department of Computed Tomography Research & Development, Siemens Healthineers AG, Forchheim, Germany., Remy J; Department of Thoracic Imaging, University Hospital Center of Lille, LILLE, France.; Department of Radiology, Valenciennes Regional Hospital, Valenciennes, France.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2024 Dec; Vol. 34 (12), pp. 7831-7844. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1007/s00330-024-10888-0
Abstrakt: Purpose: To evaluate the quality of lung perfusion imaging obtained with photon-counting-detector CT (PCD-CT) in comparison with dual-source, dual-energy CT (DECT).
Methods: Seventy-one consecutive patients scanned with PCD-CT were compared to a paired population scanned with dual-energy on a 3rd-generation DS-CT scanner using (a) for DS-CT (Group 1): collimation: 64 × 0.6 × 2 mm; pitch: 0.55; (b) for PCD-CT (Group 2): collimation: 144 × 0.4 mm; pitch: 1.5; single-source acquisition. The injection protocol was similar in both groups with the reconstruction of perfusion images by subtraction of high- and low-energy virtual monoenergetic images.
Results: Compared to Group 1, Group 2 examinations showed: (a) a shorter duration of data acquisition (0.93 ± 0.1 s vs 3.98 ± 0.35 s; p < 0.0001); (b) a significantly lower dose-length-product (172.6 ± 55.14 vs 339.4 ± 75.64 mGy·cm; p < 0.0001); and (c) a higher level of objective noise (p < 0.0001) on mediastinal images. On perfusion images: (a) the mean level of attenuation did not differ (p = 0.05) with less subjective image noise in Group 2 (p = 0.049); (b) the distribution of scores of fissure visualization differed between the 2 groups (p < 0.0001) with a higher proportion of fissures sharply delineated in Group 2 (n = 60; 84.5% vs n = 26; 26.6%); (c) the rating of cardiac motion artifacts differed between the 2 groups (p < 0.0001) with a predominance of examinations rated with mild artifacts in Group 2 (n = 69; 97.2%) while the most Group 1 examinations showed moderate artifacts (n = 52; 73.2%).
Conclusion: PCD-CT acquisitions provided similar morphologic image quality and superior perfusion imaging at lower radiation doses.
Clinical Relevance Statement: The improvement in the overall quality of perfusion images at lower radiation doses opens the door for wider applications of lung perfusion imaging in clinical practice.
Key Points: The speed of data acquisition with PCD-CT accounts for mild motion artifacts. Sharply delineated fissures are depicted on PCD-CT perfusion images. High-quality perfusion imaging was obtained with a 52% dose reduction.
Competing Interests: Compliance with ethical standards Guarantor The scientific guarantor of this publication is Pr Martine Remy-Jardin. Conflict of Interest Three authors of this manuscript declare relationships with the following companies: Jacques Remy: Consultant for Siemens Healthineers. Thomas Flohr: Siemens Healthineers employee. Bernhard Schmidt: Siemens Healthineers employee. Statistics and biometry Pr Alain Duhamel, former Head of the Department of Biostatistics and currently Professor Emeritus, did all statistical analyses. He is the co-author of this article. Informed consent Written informed consent was waived by the Institutional Review Board. Ethical approval Institutional Review Board approval was obtained. The study was validated under the number HP 23/08. Study subjects or cohorts overlap None of the study subjects have been previously reported. Methodology RetrospectiveObservational studyPerformed at one institution
(© 2024. The Author(s), under exclusive licence to European Society of Radiology.)
Databáze: MEDLINE
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