Rational and Objectives
Comparison of radiation dose and image quality in routine abdominal and pelvic contrast-enhanced
computed tomography (CECT) between a photon-counting detector CT (PCD-CT) and a dual
energy dual source CT (DSCT).
Materials and Methods
70 oncologic patients (mean age 66 ± 12 years, 29 females) were prospectively enrolled
between November 2021 and February 2022. Abdominal CECT were clinically indicated
and performed first on a 2nd-generation DSCT and at follow-up on a 1st-generation dual-source PCD-CT. The same contrast media (Imeron 350, Bracco imaging)
and pump protocol was used for both scans. For both scanners, polychromatic images
were reconstructed with 3mm slice thickness and comparable kernel (I30f[DSCT] and
Br40f[PCD-CT]); for PCD-CT data from all counted events above the lowest energy threshold
at 20 keV (“T3D”) were used. Results were compared in terms of radiation dose metrics
of CT dose index (CTDIvol), dose length product (DLP) and size-specific dose estimation (SSDE), objective and
subjective measurements of image quality were scored by two emergency radiologists
including lesion conspicuity.
Results
Median time interval between the scans was 4 months (IQR: 3–6). CNRvessel and SNRvessel of T3D reconstructions from PCD-CT were significantly higher than those of DSCT (all,
p < 0.05). Qualitative image noise analysis from PCD-CT and DSCT yielded a mean of
4 each. Lesion conspicuity was rated significantly higher in PCD-CT (Q3 strength)
compared to DSCT images. CTDI, DLP and SSDE mean values for PCD-CT and DSCT were 7.98
± 2.56 mGy vs. 14.11 ± 2.92 mGy, 393.13 ± 153.55 mGy*cm vs. 693.61 ± 185.76 mGy*cm
and 9.98 ± 2.41 vs. 14.63 ± 1.63, respectively, translating to a dose reduction of
around 32% (SSDE).
Conclusion
PCD-CT enables oncologic abdominal CT with a significantly reduced dose while keeping
image quality similar to 2nd-generation DSCT.
Key words
Abbreviation:
BMI (Body Mass Index), CNR (Contrast to Noise Ratio), CTDIvol (Computed Tomography Dose Index), DLP (Dose Lengths Product), DSCT (Dual Source Computed Tomography), EID-CT (Energy Integrating Detector Computed Tomography), ICC (Intraclass Correlation Coefficient), PCD-CT (Photon Counting Detector Computed Tomography), ROI (Region Of Interest), SNR (Signal to Noise Ratio), SSDE (Size Specific Dose Estimation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 24, 2022
Accepted:
May 30,
2022
Received in revised form:
May 30,
2022
Received:
April 26,
2022
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
