第一代光子计数计算机断层扫描血管造影术与第三代双能计算机断层扫描血管造影术用于外周动脉疾病成像的比较。

First-generation Photon-counting Computed Tomography Angiography Versus Third-generation Dual-energy Computed Tomography Angiography for Peripheral Artery Disease Imaging.

作者信息

Ghibes Patrick, Partovi Sasan, Wrazidlo Robin, Nikolaou Konstantin, Levitin Abraham, Kirksey Levester, Faby Sebastian, Krumm Patrick, Horger Marius, Hagen Florian

出版信息

Invest Radiol. 2025 Aug 6. doi: 10.1097/RLI.0000000000001230.

DOI:10.1097/RLI.0000000000001230

PMID:40767779

Abstract

OBJECTIVE

To investigate the objective performance and subjective image quality of lower extremity CT angiography (CTA) in peripheral artery disease (PAD) through comparison of the first-generation photon-counting CT (PCCT) technology and the third-generation dual source energy-integrating detector CT (DECT) technology.

MATERIALS AND METHODS

Patients who underwent a CTA either on a PCCT or on a DECT were included in this retrospective analysis. All included patients received a digital subtraction angiography (DSA) as reference standard for stenosis grading. Virtual monoenergetic image data sets were reconstructed at 40, 45, 50, 55, and 60 keV. The noise, the signal-to-noise ratio (SNR), and the contrast-to-noise ratio (CNR) of vascular structures, as well as the subjective image quality using a standardized 5-point Likert Scale, were determined. Finally, the sensitivity, specificity, and accuracy of the stenotic disease detection for either technology (DECT and PCCT) were analyzed.

RESULTS

PCCT angiography was performed in 50 PAD patients (31 males, mean age 76.16 ± 10.26), and DECT angiography was pursued in 50 PAD patients as well (29 males, mean age 74.0 ± 14.26). PCCT reached significantly higher CNR compared with DECT in all assessed arterial territories [eg, 27.84 (IQR: 22.57 to 34.66) vs 17.25 (IQR: 12.12 to 23.71), at the iliac arterial vasculature at 40 keV, P < 0.001]. Image quality and contrast were rated significantly higher for PCCT compared with DECT [eg, mean vessel contrast 5 (IQR: 4 to 5) vs 4 (IQR: 4 to 4)], at the calf arterial vasculature at 40 keV, P <0.001. Overall sensitivity, specificity, and accuracy for PCCT were 96%, 97%, and 97%, respectively, in comparison to 93%, 96%, and 94%, respectively, for DECT image data sets at 55 keV.

CONCLUSION

PCCT offers superior objective performance and better subjective image quality compared with DECT. Hence, PCCT angiography is improving cross-sectional PAD imaging.

摘要

目的

通过比较第一代光子计数CT（PCCT）技术和第三代双源能量积分探测器CT（DECT）技术，研究下肢CT血管造影（CTA）在周围动脉疾病（PAD）中的客观性能和主观图像质量。

材料与方法

本回顾性分析纳入了接受PCCT或DECT检查的CTA患者。所有纳入患者均接受数字减影血管造影（DSA）作为狭窄分级的参考标准。在40、45、50、55和60 keV重建虚拟单能图像数据集。测定血管结构的噪声、信噪比（SNR）和对比噪声比（CNR），以及使用标准化5点李克特量表评估的主观图像质量。最后，分析两种技术（DECT和PCCT）对狭窄性疾病检测的敏感性、特异性和准确性。

结果

50例PAD患者接受了PCCT血管造影（31例男性，平均年龄76.16±10.26岁），50例PAD患者也接受了DECT血管造影（29例男性，平均年龄74.0±14.26岁）。在所有评估的动脉区域，PCCT的CNR均显著高于DECT[例如，在40 keV髂动脉血管处，分别为27.84（IQR：22.57至34.66）和17.25（IQR：12.12至23.71），P<0.001]。与DECT相比，PCCT的图像质量和对比度评分显著更高[例如，在40 keV小腿动脉血管处，平均血管对比度分别为5（IQR：4至5）和4（IQR：4至4）]，P<0.001。PCCT的总体敏感性、特异性和准确性分别为96%、97%和97%，而DECT图像数据集在55 keV时分别为93%、96%和94%。