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Comparative Study
. 2025 Jun;38(3):1891-1903.
doi: 10.1007/s10278-024-01232-5. Epub 2024 Oct 25.

Ultra-High-Resolution Photon-Counting Detector CT Benefits Visualization of Abdominal Arteries: A Comparison to Standard-Reconstruction

Huan Zhang  1 , Yue Xing  2 , Lingyun Wang  1 , Yangfan Hu  2 , Zhihan Xu  3 , Haoda Chen  4 , Junjie Lu  5 , Jiarui Yang  6 , Bei Ding  7 , Weiguo Hu  8   9 , Jingyu Zhong  10
Affiliations
Comparative Study

Ultra-High-Resolution Photon-Counting Detector CT Benefits Visualization of Abdominal Arteries: A Comparison to Standard-Reconstruction

Huan Zhang et al. J Imaging Inform Med. 2025 Jun.

Abstract

This study aimed to investigate the potential benefit of ultra-high-resolution (UHR) photon-counting detector CT (PCD-CT) angiography in visualization of abdominal arteries in comparison to standard-reconstruction (SR) images of virtual monoenergetic images (VMI) at low kiloelectron volt (keV). We prospectively included 47 and 47 participants to undergo contrast-enhanced abdominal CT scans within UHR mode on a PCD-CT system using full-dose (FD) and low-dose (LD) protocols, respectively. The data were reconstructed into six series of images: FD_UHR_Br48, FD_UHR_Bv56, FD_UHR_Bv60, FD_SR_Bv40, LD_UHR_Bv48, and LD_SR_Bv40. The UHR reconstructions were performed with three kernels (Bv48, Bv56, and Bv60) within 0.2 mm. The SR were virtual monoenergetic imaging reconstruction with Bv40 kernel at 40-keV within 1 mm. Each series of axial images were reconstructed into coronal and volume-rendered images. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of seven arteries were measured. Three radiologists assessed the image quality, and visibility of nine arteries on all the images. SNR and CNR values of SR images were significantly higher than those of UHR images (P < 0.001). The SR images have higher ratings in image noise (P < 0.001), but the FD_UHR_Bv56 and FD_UHR_Bv60 images has higher rating in vessel sharpness (P < 0.001). The overall quality was not significantly different among FD_VMI_40keV, LD_VMI_40keV, FD_UHR_Bv48, and LD_UHR_Bv48 images (P > 0.05) but higher than those of FD_UHR_Bv56 and FD_UHR_Bv60 images (P < 0.001). There is no significant difference of nine abdominal arteries among six series of images of axial, coronal and volume-rendered images (P > 0.05). To conclude, 1-mm SR image of VMI at 40-keV is superior to 0.2-mm UHR regardless of which kernel is used to visualize abdominal arteries, while 0.2-mm UHR image using a relatively smooth kernel may allow similar image quality and artery visibility when thinner slice image is warranted.

Keywords: Computed tomography angiography; Contrast media; Image enhancement; Image reconstruction; Radiation dosage.

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Conflict of interest statement

Declarations. Ethics Approval: This study was performed in line with the principles of the Declaration of Helsinki. Institutional Review Board approval was obtained from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (No. 2015–76). Consent to Participate: Written informed consent from all participants were received. Consent for Publication: The authors affirm that human research participants provided informed consent for publication of the images of Fig 5 and Fig6 andthose in the Supplementary Material. Competing Interests: Ms. Zhihan Xu is an employee of Siemens Healthineers, which is the manufacturer of the CT system used in this study. However, she neither had access nor control on the data acquisition and analysis. Dr. Jingyu Zhong acknowledges his position as a member of the Scientific Editorial Board of European Radiology and BMC Medical Imaging. All other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Overlapping Cohort: The abstract of this study entitled “Does ultra-high-resolution photon-counting detector CT benefit visualization of abdominal arteries? A comparison to standard-reconstruction” (C-22800) has been accepted as a digital poster, EPOS Radiologist (scientific), on European Congress of Radiology 2024 ( https://doi.org/ https://doi.org/10.26044/ecr2024/C-22800 ). The presenting author of this abstract is Dr. Jingyu Zhong.

Figures

Fig. 1
Fig. 1
Workflow of the current study
Fig. 2
Fig. 2
Objective image quality. A SNR values of seven arteries. B CNR values of seven arteries
Fig. 3
Fig. 3
Subjective image quality. The ratings of image noise, vessel sharpness, and overall quality for A axial, B coronal, and C volume-rendered images, respectively, among six series of images
Fig. 4
Fig. 4
Artery visibility. The artery visibility for A axial, B coronal, and C volume-rendered images, respectively, among six series of images
Fig. 5
Fig. 5
Representative example of two participants who both underwent full-dose scan. A A 71-year man with a BMI of 19.7 kg/m2 underwent abdominal CTA using a FD protocol with CTDIvol, DLP, SSDE, and effective dose of 6.23 mGy, 212.0 mGy·cm, 9.06 mGy, and 3.18 mSv, respectively. The data were reconstructed into FD_UHR_Bv48, FD_UHR_Bv56, FD_UHR_Bv60, FD_SR_Bv40 images, respectively. The UHR images have higher image noise, but better vessel sharpness. The overall quality of FD_UHR_Bv48, and FD_SR_Bv40 images are comparable. The FD_UHR_Bv56 and FD_UHR_Bv60 images presented better vessel sharpness than but were damaged by higher image noise. B–D Another 57-year woman with a BMI of 20.8 kg/m.2 underwent abdominal CTA using a FD protocol with CTDIvol, DLP, SSDE, and effective dose of 4.06 mGy, 111.0 mGy·cm, 6.25 mGy, and 1.67 mSv, respectively. The data were reconstructed into FD_UHR_Bv48, and FD_SR_Bv40 images, respectively. B The left gastric artery is only visible in axial FD_UHR_Bv48 images (solid arrow), and the soft tissue between the abdominal aorta and celiac trunk were better depicted (open arrow). C There were more visible vascular segments of left renal artery in coronal FD_UHR_Bv48 images than FD_SR_Bv40 images (solid arrow). D The left renal artery can be better visualized to the more distal vascular segments in volume-rendered FD_UHR_Bv48 images than FD_SR_Bv40 images (solid arrow). The volume-rendered FD_UHR_Bv48 images allowed more visible vascular segments of superior mesenteric artery (open arrow)
Fig. 6
Fig. 6
Representative example of two participants who underwent full-dose and low-dose scan. A 61-year man with a BMI of 29.8 kg/m2 underwent abdominal CTA using a FD protocol with CTDIvol, DLP, SSDE, and effective dose of 8.75 mGy, 245.0 mGy·cm, 10.50 mGy, and 3.68 mSv, respectively (the first and the third column). Another 62-year man with a BMI of 23.2 kg/m2 underwent abdominal CTA using a LD protocol with CTDIvol, DLP, SSDE, and effective dose of 3.60 mGy, 106.0 mGy·cm, 5.05 mGy, and 1.59 mSv, respectively (the second and the fourth column). The data were reconstructed into FD_UHR_Bv48, LD_UHR_Bv48, FD_SR_Bv40, LD_SR_Bv40 images, respectively. A The overall quality of FD and LD images were comparable. B–D The artery visibility of FD and LD images were comparable regardless of axial, coronal and volume-rendered images. The UHR images allowed more vascular segments and thinner image slice but with higher image noise. The SR images showed better contrast but lower vessel sharpness and thicker image slice
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