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. 2025 Jul 2.
doi: 10.1007/s10278-025-01593-5. Online ahead of print.

Photon-Counting Detector CT Allows Abdominal Virtual Monoenergetic Imaging at Lower Kiloelectron Volt Level with Lower Noise Using Lower Radiation Dose: A Prospective Matched Study Compared to Energy-Integrating Detector CT

Huan Zhang #  1 , Yangfan Hu #  2   3 , Lingyun Wang #  1 , Yue Xing  2   3 , Zhihan Xu  4 , Junjie Lu  5 , Jiarui Yang  6 , Bei Ding  7 , Fei Yuan  8 , Jingyu Zhong  9   10
Affiliations

Photon-Counting Detector CT Allows Abdominal Virtual Monoenergetic Imaging at Lower Kiloelectron Volt Level with Lower Noise Using Lower Radiation Dose: A Prospective Matched Study Compared to Energy-Integrating Detector CT

Huan Zhang et al. J Imaging Inform Med. .

Abstract

Our study aimed to assess the image quality of lower kiloelectron volt (keV) level abdominal virtual monoenergetic imaging (VMI) with lower radiation dose on photon-counting detector computed tomography (PCD-CT), in comparison to energy-integrating detector computed tomography (EID-CT). We prospectively included three matched groups, each with 59 participants, to undergo contrast-enhanced abdominal CT scans using EID-CT with full-dose (EID_FD), PCD-CT with full-dose (PCD_FD), and PCD-CT with low-dose (PCD_LD) protocols, respectively. The data of portal-venous phase were reconstructed into VMI at 40, 50, 60, and 70 keV, respectively. The standard deviation of CT values in liver parenchyma was measured as image noise. The signal-to-noise ratio (SNR) of liver parenchyma and contrast-to-noise ratio (CNR) of liver-portal vein were calculated. Three radiologists assessed the image noise, vessel sharpness, and overall quality, and rated the hepatic lesion conspicuity if possible. Our study found that the PCD_LD significantly reduced the radiation dose than EID_FD or PCD_FD (p < 0.001). The noise was significantly decreased by PCD_FD and PCD_LD compared to EID_FD, but SNR values were significantly increased (p ≤ 0.006). The CNR values were significantly increased by PCD_FD and PCD_LD compared to EID_FD in VMI at 40 keV and 50 keV (p ≤ 0.010). The ratings of image noise, vessel sharpness, overall quality, and lesion conspicuity were significantly greater in PCD_FD and PCD_LD compared to EID_FD (p ≤ 0.001). There was no significant difference detected in rating of lesion conspicuity between PCD_FD and PCD_LD (p ≥ 0.259). In conclusion, PCD-CT allows abdominal VMI with lower keV and lower noise using lower radiation dose, to provide better visualization of the hepatic lesions.

Keywords: Image enhancement; Image reconstruction; Multidetector computed tomography; 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 fo Publication: The authors affirm that human research participants provided informed consent for publication of the images of Figs. 5 and 6, and those in the Supplementary Material. Competing interests: Ms. Zhihan Xu is an employee of Siemens Healthineers. 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, Insights into Imaging, American Journal of Roentgenology, 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.

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