Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina (25 Courtenay Dr, Charleston, SC, 29425, USA).
Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina (25 Courtenay Dr, Charleston, SC, 29425, USA); Department of Diagnostic and Interventional Radiology, University Medical Center Mainz (1 Langenbeckstraße, 55131 Mainz, Germany); German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany (1 Langenbeckstraße, 55131 Mainz, Germany).
Eur J Radiol. 2023 Sep;166:111008. doi: 10.1016/j.ejrad.2023.111008. Epub 2023 Jul 24.
To intra-individually compare the objective and subjective image quality of coronary computed tomography angiography (CCTA) between photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT).
Consecutive patients undergoing clinically indicated CCTA on an EID-CT system were prospectively enrolled for a research CCTA performed on a PCD-CT system within 30 days. Polychromatic images were reconstructed for both EID- and PCD-CT, while virtual monoenergetic images (VMI) were generated at 40, 45, 50, 55, 60 and 70 keV for PCD-CT. Two blinded readers calculated contrast-to-noise ratio (CNR) for each major coronary artery and rated image noise, vessel attenuation, vessel sharpness, and overall quality on a 1-5 Likert scale. Patients were then stratified by body mass index (BMI) [high (>30 kg/m) vs low (<30 kg/m)] for subgroup analysis.
A total of 20 patients (67.5 ± 9.0 years, 75% male) were included in the study. Compared with EID-CT, coronary artery CNR values from PCD-CT monoenergetic and polychromatic reconstructions were all significantly higher than CNR values from EID-CT, with incrementally greater differences in obese subjects (all p < 0.008). Subjective image noise and sharpness were also significantly higher for all VMI reconstructions compared to EID-CT (all p < 0.008). All subjective scores were significantly higher for 55, 60, and 70 keV PCD-CT than EID-CT values (all p < 0.05).
The improved objective and subjective image quality of PCD-CT compared to EID-CT may provide better visualization of the coronary arteries for a wide array of patients, especially those with a high BMI.
个体内比较光子计数探测器 CT（PCD-CT）和能量积分探测器 CT（EID-CT）冠状动脉 CT 血管造影（CCTA）的客观和主观图像质量。
连续纳入在 EID-CT 系统上进行临床指征 CCTA 的患者，前瞻性地在 30 天内在 PCD-CT 系统上进行研究 CCTA。对 EID-和 PCD-CT 进行多光谱图像重建，而对 PCD-CT 生成 40、45、50、55、60 和 70 keV 的虚拟单能量图像（VMI）。两名盲法读者计算了每支主要冠状动脉的对比噪声比（CNR），并对图像噪声、血管衰减、血管锐利度和整体质量进行了 1-5 级 Likert 评分。然后根据体重指数（BMI）[高（>30 kg/m）与低（<30 kg/m）]对患者进行分层，进行亚组分析。
本研究共纳入 20 例患者（67.5±9.0 岁，75%为男性）。与 EID-CT 相比，PCD-CT 单能量和多光谱重建的冠状动脉 CNR 值均明显高于 EID-CT 的 CNR 值，肥胖患者的差异逐渐增大（均 p<0.008）。与 EID-CT 相比，所有 VMI 重建的图像噪声和锐利度也明显更高（均 p<0.008）。与 EID-CT 值相比，55、60 和 70 keV PCD-CT 的所有主观评分均明显更高（均 p<0.05）。
与 EID-CT 相比，PCD-CT 的客观和主观图像质量的改善可能为广泛的患者，尤其是 BMI 较高的患者，提供更好的冠状动脉可视化效果。
