Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, the Netherlands.
Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 50, 6200 MD Maastricht, the Netherlands.
Eur J Radiol. 2024 Oct;179:111680. doi: 10.1016/j.ejrad.2024.111680. Epub 2024 Aug 10.
This study aims to demonstrate reduced iodine contrast media (CM) in routine abdominal CT scans in portal venous phase (PVP) using a photon-counting detector CT (PCD-CT) compared to total body weight (TBW) and kV-adapted CM injection protocols on a state-of-the-art energy-integrating detector CT (EID-CT) while maintaining sufficient image quality (IQ).
Consecutive contrast-enhanced abdominal PVP CT scans from an EID-CT (Nov 2022-March 2024) and a PCD-CT (Sep 2023-Dec 2023) were compared. CM parameters (total iodine load (TIL), iodine delivery rate (IDR) and dosing factor (DF)) were reported. An individualized acquisition and CM injection protocol based on TBW and kV was applied for the EID-CT and a TBW adapted CM injection protocol was used for the PCD-CT. Objective IQ was evaluated with mean attenuation (Hounsfield Units, HU), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)). Subjective IQ was assessed via a 5-point Likert scale by 2 expert readers based on diagnostic confidence.
Based on 91 EID-CT scans and 102 PCD-CT scans a TIL reduction of 20.1 % was observed for PCD-CT. PCD-CT demonstrated significantly higher SNR (9.9 ± 1.7 vs. 9.1 ± 1.8, p < 0.001) and CNR (5.1 ± 1.7 vs. 4.3 ± 1.3, p < 0.001) compared to EID-CT. Subjective IQ assessment showed that all scans had sufficient diagnostic IQ.
PCD-CT allows for CM reduction while providing higher SNR and CNR compared to EID-CT, using clinical individualized scan and CM injection protocols.
本研究旨在展示与全身重量（TBW）和千伏自适应对比剂注射方案相比，在最先进的能量积分探测器 CT（EID-CT）上使用光子计数探测器 CT（PCD-CT）进行常规腹部 CT 门静脉期（PVP）时，碘对比剂（CM）用量减少，同时保持足够的图像质量（IQ）。
比较了 2022 年 11 月至 2024 年 3 月期间 EID-CT 和 2023 年 9 月至 2023 年 12 月期间 PCD-CT 的连续对比增强腹部 PVP CT 扫描。报告了 CM 参数（总碘负荷（TIL）、碘输送率（IDR）和剂量因子（DF））。EID-CT 采用基于 TBW 和 kV 的个体化采集和 CM 注射方案，PCD-CT 采用 TBW 自适应 CM 注射方案。通过平均衰减（亨氏单位，HU）、信噪比（SNR）和对比噪声比（CNR）评估客观 IQ。两位专家读者根据诊断信心对主观 IQ 进行了 5 分制评估。
基于 91 例 EID-CT 扫描和 102 例 PCD-CT 扫描，PCD-CT 显示 TIL 减少 20.1%。PCD-CT 显示出显著更高的 SNR（9.9±1.7 与 9.1±1.8，p<0.001）和 CNR（5.1±1.7 与 4.3±1.3，p<0.001）与 EID-CT 相比。主观 IQ 评估显示所有扫描均具有足够的诊断 IQ。
与 EID-CT 相比，PCD-CT 允许减少 CM 用量，同时提供更高的 SNR 和 CNR，使用临床个体化扫描和 CM 注射方案。
