Khanungwanitkul Khanin, Sliwicka Olga, Schwartz Fides Regina
Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115.
Br J Radiol. 2024 Oct 11. doi: 10.1093/bjr/tqae206.
Photon-counting computed tomography (PCCT) has shown promising advancements in abdominal imaging in clinical use. Though more peer-reviewed primary literature is needed, this commentary explores PCCT's potential applications, focusing on enhancing diagnostic accuracy, optimizing radiation dose management, and improving patient care. PCCT offers improved spatial and contrast resolution, lower image noise, and reduced radiation dose. Increased spatial resolution provides better detail in abdominal imaging, aiding in the detection of small lesions and subtle pathological changes. However, this generates more images per scan, raising concerns about "image overload" in PACS, potentially leading to longer reading times and increased stress for radiologists. PCCT's improved contrast resolution enhances tissue differentiation, reducing the need for intravenous contrast agents. The technology's advanced tissue characterization provides several advantages, such as non-invasive and opportunistic liver disease evaluation and improved differentiation of renal and adrenal masses. PCCT's optimized radiation dose management is crucial for patients requiring frequent scans. Enhanced diagnostic accuracy through spectral information aids in tissue differentiation, improving confidence in diagnoses. Streamlined workflows, particularly in emergency settings, and oncologic imaging, are potential benefits, reducing the need for additional imaging studies. Future integration of PCCT into clinical practice requires collaboration, education, and research to fully harness its potential, ensuring optimized abdominal imaging and improved patient care.
光子计数计算机断层扫描（PCCT）在临床腹部成像中已展现出有前景的进展。尽管需要更多经过同行评审的原始文献，但本评论探讨了PCCT的潜在应用，重点在于提高诊断准确性、优化辐射剂量管理以及改善患者护理。PCCT提供了更高的空间和对比度分辨率、更低的图像噪声以及更低的辐射剂量。更高的空间分辨率在腹部成像中能提供更好的细节，有助于检测小病变和细微的病理变化。然而，每次扫描会生成更多图像，引发了对PACS中“图像过载”的担忧，这可能导致更长的阅片时间以及放射科医生压力增加。PCCT改善的对比度分辨率增强了组织区分能力，减少了对静脉造影剂的需求。该技术先进的组织特征分析具有诸多优势，如对肝脏疾病进行非侵入性和机会性评估以及更好地区分肾和肾上腺肿块。PCCT优化的辐射剂量管理对于需要频繁扫描的患者至关重要。通过光谱信息提高诊断准确性有助于组织区分，增强诊断信心。简化工作流程，特别是在急诊环境和肿瘤成像中，是潜在的益处，可减少对额外成像检查的需求。未来将PCCT整合到临床实践中需要开展合作、教育和研究，以充分发挥其潜力，确保优化腹部成像并改善患者护理。
