NYU Langone Health, Department of Radiology, 660 1st Avenue, New York, NY, 10016, USA.
Department of Radiology, Mayo Clinic, 200 First Street SW, 55905, Rochester, MN, USA.
Abdom Radiol (NY). 2024 Dec;49(12):4600-4609. doi: 10.1007/s00261-024-04503-5. Epub 2024 Jul 25.
Photon counting CT was recently introduced into clinical practice [Rajendran K, Petersilka M, Henning A, Shanblatt ER, Schmidt B, Flohr TG, Ferrero A, Baffour F, Diehn FE, Yu L, Rajiah P, Fletcher JG, Leng S, McCollough CH. First Clinical Photon-counting Detector CT System: Technical Evaluation. Radiology 2022;303(1):130-138. doi: https://doi.org/10.1148/radiol.212579 ]. Photon counting detectors (PCD) afford better spatial resolution, radiation dose efficiency, and iodine contrast-to-noise than EID-CT [Leng S, Bruesewitz M, Tao S, Rajendran K, Halaweish AF, Campeau NG, Fletcher JG, McCollough CH. Photon-counting Detector CT: System Design and Clinical Applications of an Emerging Technology. Radiographics 2019;39(3):729-743. doi: https://doi.org/10.1148/rg.2019180115 ); (Leng S, Rajendran K, Gong H, Zhou W, Halaweish AF, Henning A, Kappler S, Baer M, Fletcher JG, McCollough CH. 150-mum Spatial Resolution Using Photon-Counting Detector Computed Tomography Technology: Technical Performance and First Patient Images. Invest Radiol 2018;53(11):655-662. doi: https://doi.org/10.1097/RLI.0000000000000488 )(Booij R, van der Werf NR, Dijkshoorn ML, van der Lugt A, van Straten M. Assessment of Iodine Contrast-To-Noise Ratio in Virtual Monoenergetic Images Reconstructed from Dual-Source Energy-Integrating CT and Photon-Counting CT Data. Diagnostics (Basel) 2022;12(6). doi: https://doi.org/10.3390/diagnostics12061467 ); (Sawall S, Klein L, Amato C, Wehrse E, Dorn S, Maier J, Heinze S, Schlemmer HP, Ziener CH, Uhrig M, Kachelriess M. Iodine contrast-to-noise ratio improvement at unit dose and contrast media volume reduction in whole-body photon-counting CT. Eur J Radiol 2020;126:108909. doi: https://doi.org/10.1016/j.ejrad.2020.108909 ] while also maintaining multienergy CT (MECT) capabilities[Flohr T, Petersilka M, Henning A, Ulzheimer S, Ferda J, Schmidt B. Photon-counting CT review. Phys Med 2020;79:126-136. doi: https://doi.org/10.1016/j.ejmp.2020.10.030 ]. This article will review the clinical adoption of PCD-CT including protocol development, clinical applications, clinical integration and workflow considerations. Protocol development is institution specific and involves collaborative decision-making among radiologists, physicists, and technologists. Key PCD clinical applications include radiation exposure reduction, intravenous contrast volume reduction, and improved lesion conspicuity. Patients who would most benefit from these improvements may preferentially be scanned with PCD CT. With numerous available reconstructions, radiologists should be strategic in the series sent to PACS for interpretation and routinely sending spectral series to PACS can facilitate integration with clinical workflow. The Society of Abdominal Radiology PCD Emerging Technology Commission endorsed this article.
光子计数 CT 最近已在临床实践中得到应用[Rajendran K、Petersilka M、Henning A、Shanblatt ER、Schmidt B、Flohr TG、Ferrero A、Baffour F、Diehn FE、Yu L、Rajiah P、Fletcher JG、Leng S、McCollough CH。首款临床光子计数探测器 CT 系统：技术评估。放射学 2022;303(1):130-138.doi：https://doi.org/10.1148/radiol.212579]。光子计数探测器（PCD）在空间分辨率、辐射剂量效率和碘对比噪声方面优于能量积分 CT [Leng S、Bruesewitz M、Tao S、Rajendran K、Halaweish AF、Campeau NG、Fletcher JG、McCollough CH。光子计数探测器 CT：新兴技术的系统设计和临床应用。放射学 2019;39(3):729-743.doi：https://doi.org/10.1148/rg.2019180115]；（Leng S、Rajendran K、Gong H、Zhou W、Halaweish AF、Henning A、Kappler S、Baer M、Fletcher JG、McCollough CH。使用光子计数探测器 CT 技术实现 150μm 空间分辨率：技术性能和首例患者图像。介入放射学 2018;53(11):655-662.doi：https://doi.org/10.1097/RLI.0000000000000488]（Booij R、van der Werf NR、Dijkshoorn ML、van der Lugt A、van Straten M。从双源能量积分 CT 和光子计数 CT 数据重建的虚拟单能量图像的碘对比噪声比评估。诊断学（巴塞尔）2022;12(6).doi：https://doi.org/10.3390/diagnostics12061467]；（Sawall S、Klein L、Amato C、Wehrse E、Dorn S、Maier J、Heinze S、Schlemmer HP、Ziener CH、Uhrig M、Kachelriess M。全身体光子计数 CT 中单位剂量碘对比噪声比提高和对比剂用量减少。欧洲放射学杂志 2020;126:108909.doi：https://doi.org/10.1016/j.ejrad.2020.108909]，同时保持多能量 CT（MECT）能力[Flohr T、Petersilka M、Henning A、Ulzheimer S、Ferda J、Schmidt B。光子计数 CT 综述。物理医学 2020;79:126-136.doi：https://doi.org/10.1016/j.ejmp.2020.10.030]。本文将回顾 PCD-CT 的临床应用，包括方案制定、临床应用、临床整合和工作流程考虑。方案制定是机构特有的，涉及放射科医生、物理学家和技术人员之间的协作决策。PCD 的关键临床应用包括降低辐射暴露、减少静脉对比剂用量和提高病变的明显度。可能优先选择这些改进的患者可能会优先使用 PCD CT 进行扫描。有许多可用的重建，放射科医生应该在发送到 PACS 进行解释的系列中具有策略性，并且定期发送光谱系列到 PACS 可以促进与临床工作流程的整合。腹部放射学会 PCD 新兴技术委员会认可了这篇文章。
