Hartung Viktor, Gruschwitz Philipp, Huflage Henner, Augustin Anne Marie, Kleefeldt Florian, Peter Dominik, Lichthardt Sven, Ergün Süleyman, Bley Thorsten Alexander, Grunz Jan-Peter, Petritsch Bernhard
From the Department of Diagnostic and Interventional Radiology, University Hospital of Würzburg, Würzburg, Germany (V.H., P.G., H.H., A.M.A., T.A.B., J.-P.G., B.M.W.P.); Institute of Anatomy and Cell Biology, Julius-Maximilians University Würzburg, Würzburg, Germany (F.K., S.E.); and Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, Center of Operative Medicine, University Hospital of Würzburg, Würzburg, Germany (D.P., S.L.).
Invest Radiol. 2024 Apr 1;59(4):320-327. doi: 10.1097/RLI.0000000000001019. Epub 2023 Oct 7.
This study aims to compare the performance of first-generation dual-source photon-counting detector computed tomography (PCD-CT) to third-generation dual-source energy-integrating detector (EID-CT) regarding stent imaging in the femoral arterial runoff.
Continuous extracorporeal perfusion was established in 1 human cadaver using an inguinal and infragenicular access and peristaltic pump. Seven peripheral stents were implanted into both superior femoral arteries by means of percutaneous angioplasty. Radiation dose-equivalent CT angiographies (high-/medium-/low-dose: 10/5/3 mGy) with constant tube voltage of 120 kVp, matching iterative reconstruction algorithm levels, and convolution kernels were used both with PCD-CT and EID-CT. In-stent lumen visibility, luminal and in-stent attenuation as well as contrast-to-noise ratio (CNR) were assessed via region of interest and diameter measurements. Results were compared using analyses of variance and regression analyses.
Maximum in-stent lumen visibility achieved with PCD-CT was 94.48% ± 2.62%. The PCD-CT protocol with the lowest lumen visibility (BV40: 78.93% ± 4.67%) performed equal to the EID-CT protocol with the best lumen visibility (BV59: 79.49% ± 2.64%, P > 0.999). Photon-counting detector CT yielded superior CNR compared with EID-CT regardless of kernel and dose level ( P < 0.001). Maximum CNR was 48.8 ± 17.4 in PCD-CT versus 31.28 ± 5.7 in EID-CT (both BV40, high-dose). The theoretical dose reduction potential of PCD-CT over EID-CT was established at 88% (BV40), 83% (BV48/49), and 73% (BV59/60), respectively. In-stent attenuation was not significantly different from luminal attenuation outside stents in any protocol.
With superior lumen visibility and CNR, PCD-CT allowed for noticeable dose reduction over EID-CT while maintaining image quality in a continuously perfused human cadaveric model.
本研究旨在比较第一代双源光子计数探测器计算机断层扫描（PCD-CT）与第三代双源能量积分探测器（EID-CT）在股动脉血流中支架成像方面的性能。
使用腹股沟和膝下通路及蠕动泵在1具人体尸体上建立连续体外灌注。通过经皮血管成形术将7个外周支架植入双侧股浅动脉。PCD-CT和EID-CT均采用管电压恒定为120 kVp、匹配的迭代重建算法水平和卷积核的辐射剂量等效CT血管造影（高/中/低剂量：10/5/3 mGy）。通过感兴趣区和直径测量评估支架内管腔可视性、管腔和支架内衰减以及对比噪声比（CNR）。使用方差分析和回归分析比较结果。
PCD-CT实现的最大支架内管腔可视性为94.48%±2.62%。管腔可视性最低的PCD-CT方案（BV40：78.93%±4.67%）与管腔可视性最佳的EID-CT方案（BV59：79.49%±2.64%，P>0.999）表现相当。无论内核和剂量水平如何，光子计数探测器CT产生的CNR均优于EID-CT（P<0.001）。PCD-CT的最大CNR为48.8±17.4，而EID-CT为31.28±5.7（均为BV40，高剂量）。PCD-CT相对于EID-CT的理论剂量降低潜力分别为88%（BV40）、83%（BV48/49）和73%（BV59/60）。在任何方案中，支架内衰减与支架外管腔衰减均无显著差异。
PCD-CT具有出色的管腔可视性和CNR，在连续灌注的人体尸体模型中，与EID-CT相比，在保持图像质量的同时可显著降低剂量。
