Duke University Health System, Department of Radiology, 2301 Erwin Road Box 3808, Durham, NC 27110, United States.
Eur J Radiol. 2023 Sep;166:111014. doi: 10.1016/j.ejrad.2023.111014. Epub 2023 Jul 26.
To prospectively compare the image quality of high-resolution, low-dose photon-counting detector CT (PCD-CT) with standard energy-integrating-detector CT (EID) on the same patients.
IRB-approved, prospective study; patients received same-day non-contrast CT on EID and PCD-CT (NAEOTOM Alpha, blinded) with clinical protocols. Four blinded radiologists evaluated subsegmental bronchial wall definition, noise, and overall image quality in randomized order (0 = worst; 100 = best). Cases were quantitatively compared using the average Global-Noise-Index (GNI), Noise-Power-Spectrum average frequency (f), NPS frequency-peak (f), Task-Transfer-Function-10%-frequency (f) an adjusted detectability index (d'), and applied output radiation doses (CTDI).
Sixty patients were prospectively imaged (27 men, mean age 67 ± 10 years, mean BMI 27.9 ± 6.5, 15.9-49.4 kg/m). Subsegmental wall definition was rated significantly better for PCD-CT than EID (mean 71 [56-87] vs 60 [45-76]; P < 0.001), noise was rated higher for PCD-CT (48 [26-69] vs 34 [13-56]; P < 0.001). Overall image quality was rated significantly higher for PCD-CT than EID (66 [48-85] vs 61 [42-79], P = 0.008). Automated image quality measures showed similar differences for PCD-CT vs EID (mean GNI 70 ± 19 HU vs 26 ± 8 HU, f 0.35 ± 0.02 vs 0.25 ± 0.02 mm, f 0.07 ± 0.01 vs 0.09 ± 0.03 mm, f 0.7 ± 0.08 vs 0.6 ± 0.1 mm, all p-values < 0.001). PCD-CT showed a 10% average d' increase (-49% min, 233% max). PCD-CT studies were acquired at significantly lower radiation doses than EID (mean CTDI 4.5 ± 2.1 vs 7.7 ± 3.2 mGy, P < 0.01).
Though PCD-CT had higher measured and perceived noise, it offered equivalent or better diagnostic quality compared to EID at lower radiation doses, due to its improved resolution.
前瞻性比较高分辨率、低剂量光子计数探测器 CT（PCD-CT）与标准能量积分探测器 CT（EID）在同一患者中的图像质量。
IRB 批准的前瞻性研究；患者在同日内接受 EID 和 PCD-CT（NAEOTOM Alpha，盲法）的非对比 CT 检查，采用临床方案。四位盲法放射科医生以随机顺序（0=最差；100=最佳）评估亚段支气管壁定义、噪声和整体图像质量。使用平均全局噪声指数（GNI）、噪声功率谱平均频率（f）、NPS 频率峰值（f）、10%任务传递函数频率（f）和调整后的可检测性指数（d'）以及应用的输出辐射剂量（CTDI）对病例进行定量比较。
前瞻性成像 60 例患者（27 例男性，平均年龄 67±10 岁，平均 BMI 27.9±6.5，15.9-49.4kg/m）。与 EID 相比，PCD-CT 对亚段壁的定义明显更好（平均 71[56-87]与 60[45-76]；P<0.001），PCD-CT 的噪声评分更高（48[26-69]与 34[13-56]；P<0.001）。与 EID 相比，PCD-CT 的整体图像质量评分明显更高（66[48-85]与 61[42-79]；P=0.008）。PCD-CT 与 EID 相比，自动图像质量测量也显示出相似的差异（平均 GNI 70±19 HU 与 26±8 HU，f 0.35±0.02 与 0.25±0.02mm，f 0.07±0.01 与 0.09±0.03mm，f 0.7±0.08 与 0.6±0.1mm，所有 P 值均<0.001）。PCD-CT 显示平均 d'增加 10%（-49%最小，233%最大）。与 EID 相比，PCD-CT 检查的辐射剂量明显更低（平均 CTDI 4.5±2.1 与 7.7±3.2mGy，P<0.01）。
尽管 PCD-CT 的测量和感知噪声较高，但由于其分辨率提高，与 EID 相比，在更低的辐射剂量下提供了等效或更好的诊断质量。
