Standardizing technical parameters and terms for abdominopelvic photon-counting CT: laying the groundwork for innovation and evidence sharing.

Publisher: Springer Country of Publication: United States NLM ID: 101674571 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2366-0058 (Electronic) NLM ISO Abbreviation: Abdom Radiol (NY) Subsets: MEDLINE

Original Publication: [New York] : Springer, [2016]-

Tomography, X-Ray Computed*/methods ; Radiography, Abdominal*/methods ; Photons*; Humans ; Terminology as Topic ; Radiation Dosage ; Pelvis/diagnostic imaging

Photon-counting detector CT (PCD-CT) is a new technology that has multiple diagnostic benefits including increased spatial resolution, iodine signal, and radiation dose efficiency, as well as multi-energy imaging capability, but which also has unique challenges in abdominal imaging. The purpose of this work is to summarize key features, technical parameters, and terms, which are common amongst current abdominopelvic PCD-CT systems and to propose standardized terminology (where none exists). In addition, user-selectable protocol parameters are highlighted to facilitate both scientific evaluation and early clinical adoption. Unique features of PCD-CT systems include photon-counting detectors themselves, energy thresholds and bins, and tube potential considerations for preserved spectral separation. Key parameters for describing different PCD-CT systems are reviewed and explained. While PCD-CT can generate multi-energy images like dual-energy CT, there are new types of images such as threshold images, energy bin images, and special spectral images. The standardized terms and concepts herein build upon prior interdisciplinary consensus and have been endorsed by the newly created Society of Abdominal Radiology Photon-counting CT Emerging Technology Commission.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Rajendran K, Petersilka M, Henning A et al (2022) First Clinical Photon-counting Detector CT System: Technical Evaluation. Radiology 303:130-138. (PMID: 34904876)
Leng S, Bruesewitz M, Tao S et al (2019) Photon-counting Detector CT: System Design and Clinical Applications of an Emerging Technology. Radiographics 39:729-743. (PMID: 31059394)
Baffour FI, Glazebrook KN, Ferrero A et al (2023) Photon-Counting Detector CT for Musculoskeletal Imaging: A Clinical Perspective. AJR Am J Roentgenol 220:551-560. (PMID: 36259593)
Danielsson M, Persson M, Sjolin M (2021) Photon-counting x-ray detectors for CT. Phys Med Biol 66:03TR01. (PMID: 33113525)
Flohr T, Petersilka M, Henning A, Ulzheimer S, Ferda J, Schmidt B (2020) Photon-counting CT review. Phys Med 79:126-136. (PMID: 33249223)
Flohr T, Schmidt B (2023) Technical Basics and Clinical Benefits of Photon-Counting CT. Invest Radiol 58:441-450. (PMID: 3718530210259209)
Greffier J, Villani N, Defez D, Dabli D, Si-Mohamed S (2023) Spectral CT imaging: Technical principles of dual-energy CT and multi-energy photon-counting CT. Diagn Interv Imaging 104:167-177. (PMID: 36414506)
Mergen V, Sartoretti T, Baer-Beck M et al (2022) Ultra-High-Resolution Coronary CT Angiography With Photon-Counting Detector CT: Feasibility and Image Characterization. Invest Radiol 57:780-788. (PMID: 3564001910184822)
Nehra AK, Rajendran K, Baffour FI et al (2023) Seeing More with Less: Clinical Benefits of Photon-counting Detector CT. Radiographics 43:e220158. (PMID: 37022956)
Schwartz FR, Samei E, Marin D (2023) Exploiting the Potential of Photon-Counting CT in Abdominal Imaging. Invest Radiol 58:488-498. (PMID: 36728045)
Si-Mohamed SA, Boccalini S, Villien M et al (2023) First Experience With a Whole-Body Spectral Photon-Counting CT Clinical Prototype. Invest Radiol 58:459-471. (PMID: 3682266310259214)
Willemink MJ, Persson M, Pourmorteza A, Pelc NJ, Fleischmann D (2018) Photon-counting CT: Technical Principles and Clinical Prospects. Radiology 289:293-312. (PMID: 30179101)
Oostveen LJ, Boedeker KL, Brink M, Prokop M, de Lange F, Sechopoulos I (2020) Physical evaluation of an ultra-high-resolution CT scanner. European radiology 30:2552-2560. (PMID: 320407267160079)
Latina J, Shabani M, Kapoor K et al (2021) Ultra-High-Resolution Coronary CT Angiography for Assessment of Patients with Severe Coronary Artery Calcification: Initial Experience. Radiol Cardiothorac Imaging 3:e210053. (PMID: 344980078415143)
Koons EK, Rajiah PS, Thorne JE et al (2024) Coronary artery stenosis quantification in patients with dense calcifications using ultra-high-resolution photon-counting-detector computed tomography. J Cardiovasc Comput Tomogr 18:56-61. (PMID: 37945454)
Baffour FI, Huber NR, Ferrero A et al (2023) Photon-counting Detector CT with Deep Learning Noise Reduction to Detect Multiple Myeloma. Radiology 306:229-236. (PMID: 36066364)
Baffour FI, Rajendran K, Glazebrook KN et al (2022) Ultra-high-resolution imaging of the shoulder and pelvis using photon-counting-detector CT: a feasibility study in patients. Eur Radiol 32:7079-7086. (PMID: 35689699)
Benson JC, Rajendran K, Lane JI et al (2022) A New Frontier in Temporal Bone Imaging: Photon-Counting Detector CT Demonstrates Superior Visualization of Critical Anatomic Structures at Reduced Radiation Dose. AJNR Am J Neuroradiol 43:579-584. (PMID: 353320198993187)
Douek PC, Boccalini S, Oei EHG et al (2023) Clinical Applications of Photon-counting CT: A Review of Pioneer Studies and a Glimpse into the Future. Radiology 309:e222432. (PMID: 37787672)
Inoue A, Johnson TF, White D et al (2022) Estimating the Clinical Impact of Photon-Counting-Detector CT in Diagnosing Usual Interstitial Pneumonia. Invest Radiol 57:734-741. (PMID: 35703439)
Fletcher JG, Inoue A, Bratt A et al (2024) Photoncounting CT in Thoracic Imaging: Early Clinical Evidence and Incorporation Into Clinical Practice. Radiology 310(3):e231986. https://doi.org/10.1148/radiol.231986. (PMID: 38501953)
Si-Mohamed SA, Boccalini S, Lacombe H et al (2022) Coronary CT Angiography with Photon-counting CT: First-In-Human Results. Radiology 303:303-313. (PMID: 35166583)
Rajiah P, Dunning CAS, Rajendran K et al (2023) High-pitch multi-energy coronary CT angiography in dual-source photon-counting detector CT scanner at low iodinated contrast dose. Invest Radiol. (PMID: 36822655)
Taguchi K, Iwanczyk JS (2013) Vision 20/20: Single photon counting x-ray detectors in medical imaging. Med Phys 40:100901. (PMID: 240898893786515)
Huber NR, Ferrero A, Rajendran K et al (2022) Dedicated convolutional neural network for noise reduction in ultra-high-resolution photon-counting detector computed tomography. Phys Med Biol 67. (PMID: 359445569444982)
Leng S, Yu Z, Halaweish A et al (2016) Dose-efficient ultrahigh-resolution scan mode using a photon counting detector computed tomography system. J Med Imaging (Bellingham) 3:043504. (PMID: 28042589)
Mergen V, Racine D, Jungblut L et al (2022) Virtual Noncontrast Abdominal Imaging with Photon-counting Detector CT. Radiology 305:107-115. (PMID: 35670712)
Wrazidlo R, Walder L, Estler A et al (2023) Radiation Dose Reduction in Contrast-Enhanced Abdominal CT: Comparison of Photon-Counting Detector CT with 2nd Generation Dual-Source Dual-Energy CT in an oncologic cohort. Acad Radiol 30:855-862. (PMID: 35760710)
Zhou W, Michalak GJ, Weaver JM et al (2020) A Universal Protocol for Abdominal CT Examinations Performed on a Photon-Counting Detector CT System: A Feasibility Study. Invest Radiol 55:226-232. (PMID: 320496917241672)
Hagar MT, Soschynski M, Saffar R et al (2023) Accuracy of Ultrahigh-Resolution Photon-counting CT for Detecting Coronary Artery Disease in a High-Risk Population. Radiology 307:e223305. (PMID: 37338354)
Madhavan AA, Cutsforth-Gregory JK, Brinjikji W et al (2023) Diagnostic Performance of Decubitus Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas. AJNR Am J Neuroradiol 44:1445-1450. (PMID: 37945523)
Madhavan AA, Yu L, Brinjikji W et al (2023) Utility of Photon-Counting Detector CT Myelography for the Detection of CSF-Venous Fistulas. AJNR Am J Neuroradiol 44:740-744. (PMID: 3720211610249691)
Yalon M, Inoue A, Thorne JE et al (2024) Infrapopliteal Segments on Lower Extremity CTA: Prospective Intraindividual Comparison of Energy-Integrating Detector CT and Photon-Counting Detector CT. AJR Am J Roentgenol 222:e2329778. (PMID: 37991334)
Si-Mohamed S, Boccalini S, Rodesch PA et al (2021) Feasibility of lung imaging with a large field-of-view spectral photon-counting CT system. Diagn Interv Imaging 102:305-312. (PMID: 33610503)
RadLex. RSNA. Available via https://radlex.org/ . Accessed July 28th, 2023.
American Association for Physicists in Medicine (2022) AAPM CT Lexicon version 2.0.
DICOM Standards Committee WG (2018) Supplement 188: Multi-energy CT Images.
Koweek L, Achenbach S, Berman DS et al (2023) Standardized medical terminology for cardiac computed tomography 2023 update: An Expert Consensus Document of the Society of Cardiovascular Computed Tomography (SCCT), American Association of Physicists in Medicine (AAPM), American College of Radiology (ACR), North American Society for Cardiovascular Imaging (NASCI) and Radiological Society of North America (RSNA) with endorsement by the Asian Society of Cardiovascular Imaging (ASCI), the European Association of Cardiovascular Imaging (EACI), and the European Society of Cardiovascular Radiology (ESCR). J Cardiovasc Comput Tomogr 17:345-354. (PMID: 37495455)
Leng S, Rajendran K, Gong H et al (2018) 150-mum Spatial Resolution Using Photon-Counting Detector Computed Tomography Technology: Technical Performance and First Patient Images. Invest Radiol 53:655-662. (PMID: 298474126173631)
Ballabriga R, Alozy J, Bandi FN et al (2021) Photon Counting Detectors for X-Ray Imaging With Emphasis on CT. Ieee Transactions on Radiation and Plasma Medical Sciences 5:422-440.
Nakamura Y, Higaki T, Kondo S, Kawashita I, Takahashi I, Awai K (2023) An introduction to photon-counting detector CT (PCD CT) for radiologists. Jpn J Radiol 41:266-282. (PMID: 36255601)
Salyapongse AM, Rose SD, Pickhardt PJ et al (2023) CT Number Accuracy and Association With Object Size: A Phantom Study Comparing Energy-Integrating Detector CT and Deep Silicon Photon-Counting Detector CT. AJR Am J Roentgenol 221:539-547. (PMID: 37255042)
Zhan X, Zhang R, Niu X et al (2023) Comprehensive evaluations of a prototype full field-of-view photon counting CT system through phantom studies. Phys Med Biol 68:175007.
Jiang H, Hoffman D, Vartuli J (2005) CT detector array having non-pixelated scintillator array. In: U.S. Patent and Trademark Office, (ed). General Electric Co, GE Medical Systems Global Technology Co LLC.
Baek J, Pineda AR, Pelc NJ (2013) To bin or not to bin? The effect of CT system limiting resolution on noise and detectability. Phys Med Biol 58:1433-1446. (PMID: 23399724)
Kachelriess M, Kalender WA (2005) Presampling, algorithm factors, and noise: considerations for CT in particular and for medical imaging in general. Med Phys 32:1321-1334. (PMID: 15984684)
Klein L, Dorn S, Amato C et al (2020) Effects of Detector Sampling on Noise Reduction in Clinical Photon-Counting Whole-Body Computed Tomography. Invest Radiol 55:111-119. (PMID: 31770298)
Barber W, Nygard E, Iwanczyk J et al (2009) Characterization of a novel photon counting detector for clinical CT: count rate, energy resolution, and noise performance. Proc SPIE Int Soc Opt Eng 7258. (PMID: 212978973033223)
Grönberg F, Yin Z, Maltz J, Pelc NJ, Persson M (2022) The effects of intra-detector Compton scatter on zero-frequency DQE for photon-counting CT using edge-on-irradiated silicon detectors. arXiv preprint arXiv:2206.04164.
Yu Z, Leng S, Jorgensen SM et al (2016) Evaluation of conventional imaging performance in a research whole-body CT system with a photon-counting detector array. Phys Med Biol 61:1572-1595. (PMID: 268358394782185)
Tsang DS, Merchant TE, Merchant SE, Smith H, Yagil Y, Hua CH (2017) Quantifying potential reduction in contrast dose with monoenergetic images synthesized from dual-layer detector spectral CT. Br J Radiol 90:20170290. (PMID: 287491765853359)
Yoon JH, Chang W, Lee ES, Lee SM, Lee JM (2020) Double Low-Dose Dual-Energy Liver CT in Patients at High-Risk of HCC: A Prospective, Randomized, Single-Center Study. Invest Radiol 55:340-348. (PMID: 31917765)
van Hamersvelt RW, Eijsvoogel NG, Mihl C et al (2018) Contrast agent concentration optimization in CTA using low tube voltage and dual-energy CT in multiple vendors: a phantom study. Int J Cardiovasc Imaging 34:1265-1275. (PMID: 29516228)
Rajendran K, Voss BA, Zhou W et al (2020) Dose Reduction for Sinus and Temporal Bone Imaging Using Photon-Counting Detector CT With an Additional Tin Filter. Invest Radiol 55:91-100. (PMID: 317702978522262)
Cormode DP, Roessl E, Thran A et al (2010) Atherosclerotic plaque composition: analysis with multicolor CT and targeted gold nanoparticles. Radiology 256:774-782. (PMID: 206681182923725)
Symons R, Cork TE, Lakshmanan MN et al (2017) Dual-contrast agent photon-counting computed tomography of the heart: initial experience. Int J Cardiovasc Imaging 33:1253-1261. (PMID: 28289990)
Flohr TG, Leng S, Yu L et al (2009) Dual-source spiral CT with pitch up to 3.2 and 75 ms temporal resolution: image reconstruction and assessment of image quality. Med Phys 36:5641-5653. (PMID: 20095277)
Ahmed Z, Campeau D, Gong H et al (2023) High-pitch, high temporal resolution, multi-energy cardiac imaging on a dual-source photon-counting-detector CT. Med Phys 50:1428-1435. (PMID: 36427356)
Almeida IP, Schyns LE, Ollers MC et al (2017) Dual-energy CT quantitative imaging: a comparison study between twin-beam and dual-source CT scanners. Med Phys 44:171-179. (PMID: 28070917)
Hua CH, Shapira N, Merchant TE, Klahr P, Yagil Y (2018) Accuracy of electron density, effective atomic number, and iodine concentration determination with a dual-layer dual-energy computed tomography system. Med Phys 45:2486-2497. (PMID: 29624708)
Mayneord W (1937) The significance of the Röntgen. Unio Internationalis Contra Cancrum 2:271-282.
De Cecco CN, Boll DT, Bolus DN et al (2017) White Paper of the Society of Computed Body Tomography and Magnetic Resonance on Dual-Energy CT, Part 4: Abdominal and Pelvic Applications. J Comput Assist Tomogr 41:8-14. (PMID: 27824670)
Euler A, Laqua FC, Cester D et al (2021) Virtual Monoenergetic Images of Dual-Energy CT-Impact on Repeatability, Reproducibility, and Classification in Radiomics. Cancers (Basel) 13. (PMID: 34572937)
Leng S, Zhou W, Yu Z et al (2017) Spectral performance of a whole-body research photon counting detector CT: quantitative accuracy in derived image sets. Phys Med Biol 62:7216-7232. (PMID: 287266695565680)
McCollough CH, Rajendran K, Leng S (2023) Standardization and Quantitative Imaging With Photon-Counting Detector CT. Invest Radiol 58:451-458. (PMID: 3672845210272018)
Michalak G, Grimes J, Fletcher J et al (2016) Technical Note: Improved CT number stability across patient size using dual-energy CT virtual monoenergetic imaging. Med Phys 43:513. (PMID: 26745944)
Yang Y, Qin L, Lin H et al (2024) Consistency of Monoenergetic Attenuation Measurements for a Clinical Dual-Source Photon-Counting Detector CT System Across Scanning Paradigms: A Phantom Study. AJR Am J Roentgenol. https://doi.org/10.2214/AJR.23.30631. (PMID: 38691415)

Keywords: Abdomen; Computed tomography; Humans; Photons; Radiation dosage; Standardization; X-ray

Date Created: 20240520 Date Completed: 20240820 Latest Revision: 20240820

20240821

10.1007/s00261-024-04342-4

38769199