Abstract
Photon-counting detector computed tomography (PCD-CT) is an emerging technology and represents the next milestone in CT developments. Compared to conventional energy-integrating detectors in which an indirect conversion technology is used to detect incident photons, PCD technology uses semiconductors that directly convert X-ray photons to an electrical signal. This generated signal includes the energy information of every individually detected photon enabling intrinsic spectral imaging in every CT scan.
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References
Alkadhi H, Euler A (2020) The future of computed tomography: personalized, functional, and precise. Investig Radiol 55(9):545–555. https://doi.org/10.1097/RLI.0000000000000668
Aoki M, Hirose K, Sato M, Akimoto H, Kawaguchi H, Hatayama Y, Fujioka I, Tanaka M, Ono S, Takai Y (2016) Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy. J Radiat Res 57(4):381–386. https://doi.org/10.1093/jrr/rrv100
Bartlett DJ, Koo CW, Bartholmai BJ, Rajendran K, Weaver JM, Halaweish AF, Leng S, McCollough CH, Fletcher JG (2019) High-resolution chest computed tomography imaging of the lungs: impact of 1024 matrix reconstruction and photon-counting detector computed tomography. Investig Radiol 54(3):129–137. https://doi.org/10.1097/RLI.0000000000000524
Chae EJ, Song JW, Krauss B, Song KS, Lee CW, Lee HJ, Seo JB (2010) Dual-energy computed tomography characterization of solitary pulmonary nodules. J Thorac Imaging 25(4):301–310. https://doi.org/10.1097/RTI.0b013e3181e16232
Dangelmaier J, Bar-Ness D, Daerr H, Muenzel D, Si-Mohamed S, Ehn S, Fingerle AA, Kimm MA, Kopp FK, Boussel L, Roessl E, Pfeiffer F, Rummeny EJ, Proksa R, Douek P, Noël PB (2018) Experimental feasibility of spectral photon-counting computed tomography with two contrast agents for the detection of endoleaks following endovascular aortic repair. Eur Radiol 28(8):3318–3325. https://doi.org/10.1007/s00330-017-5252-7
Darras KE, Clark SJ, Kang H, Mohammed MF, Barrett S, Chang SD, Harris AC, Nicolaou S, McLaughlin PD (2019) Virtual monoenergetic reconstruction of contrast-enhanced CT scans of the abdomen and pelvis at 40 keV improves the detection of peritoneal metastatic deposits. Abdom Radiol (NY) 44(2):422–428. https://doi.org/10.1007/s00261-018-1733-7
Do T, Sawall S, Heinze S, Reiner T, Ziener C, Stiller W, Schlemmer H, Kachelrieß M, Kauczor H, Skornitzke S (2020) A semi-automated quantitative comparison of metal artifact reduction in photon-counting computed tomography by energy-selective thresholding. Sci Rep 10(1):1–10. https://doi.org/10.1038/s41598-020-77904-3
Elbanna KY, Mansoori B, Mileto A, Rogalla P, Guimarães SL (2020) Dual-energy CT in diffuse liver disease: is there a role? Abdom Radiol (NY) 45(11):3413–3424. https://doi.org/10.1007/s00261-020-02702-4
Euler A, Higashigaito K, Mergen V, Sartoretti T, Zanini B, Schmidt B, Flohr TG, Ulzheimer S, Eberhard M, Alkadhi H (2021) High-pitch photon-counting detector computed tomography angiography of the aorta: Intraindividual comparison to energy-integrating detector computed tomography at equal radiation dose. Investig Radiol. https://doi.org/10.1097/rli.0000000000000816
Farhadi F, Rajagopal JR, Nikpanah M, Sahbaee P, Malayeri AA, Pritchard WF, Samei E, Jones EC, Chen MY (2021) Review of technical advancements and clinical applications of photon-counting computed tomography in imaging of the thorax. J Thorac Imaging 36(2):84–94. https://doi.org/10.1097/RTI.0000000000000569
Ferda J, Vendiš T, Flohr T, Schmidt B, Henning A, Ulzheimer S, Pecen L, Ferdová E, Baxa J, Mírka H (2021) Computed tomography with a full FOV photon-counting detector in a clinical setting, the first experience. Eur J Radiol 137:109614. https://doi.org/10.1016/j.ejrad.2021.109614
Flohr T, Petersilka M, Henning A, Ulzheimer S, Ferda J, Schmidt B (2020a) Photon-counting CT review. Phys Med 79:126–136. https://doi.org/10.1016/j.ejmp.2020.10.030
Flohr T, Ulzheimer S, Petersilka M, Schmidt B (2020b) Basic principles and clinical potential of photon-counting detector CT. Chin J Acad Radiol 3(1):19–34. https://doi.org/10.1007/s42058-020-00029-z
Gutjahr R, Halaweish AF, Yu Z, Leng S, Yu L, Li Z, Jorgensen SM, Ritman EL, Kappler S, McCollough CH (2016a) Human imaging with photon-counting-based CT at clinical dose levels: contrast-to-noise ratio and cadaver studies. Investig Radiol 51(7):421. https://doi.org/10.1097/RLI.0000000000000251
Gutjahr R, Halaweish AF, Yu Z, Leng S, Yu L, Li Z, Jorgensen SM, Ritman EL, Kappler S, McCollough CH (2016b) Human imaging with photon counting-based computed tomography at clinical dose levels: contrast-to-noise ratio and cadaver studies. Investig Radiol 51(7):421–429. https://doi.org/10.1097/rli.0000000000000251
Habashy D, **a R, Ridley W, Chan L, Ridley L (2016) Impact of dual energy characterization of urinary calculus on management. J Med Imaging Radiat Oncol 60(5):624–631. https://doi.org/10.1111/1754-9485.12497
Higashigaito K, Euler A, Eberhard M, Flohr TG, Schmidt B, Alkadhi H (2021) Contrast-enhanced abdominal CT with clinical photon-counting detector CT: assessment of image quality and comparison with energy-integrating detector CT. Acad Radiol. https://doi.org/10.1016/j.acra.2021.06.018
Jiang C, Yang P, Lei J, Li J, Yan K, Li F, Yan R, **a L (2017) The application of iodine quantitative information obtained by dual-source dual-energy computed tomography on Chemoradiotherapy effect monitoring for cervical cancer: a preliminary study. J Comput Assist Tomogr 41(5):737–745. https://doi.org/10.1097/rct.0000000000000603
Jungblut L, Blüthgen C, Polacin M, Messerli M, Schmidt B, Euler A, Alkadhi H, Frauenfelder T, Martini K (2021) First performance evaluation of an artificial intelligence–based computer-aided detection system for pulmonary nodule evaluation in dual-source photon-counting detector CT at different low-dose levels. Investig Radiol. https://doi.org/10.1097/rli.0000000000000814
Leng S, Bruesewitz M, Tao S, Rajendran K, Halaweish AF, Campeau NG, Fletcher JG, McCollough CH (2019) Photon-counting detector CT: system design and clinical applications of an emerging technology. Radiographics 39(3):729–743. https://doi.org/10.1148/rg.2019180115
Leng S, Diehn FE, Lane JI, Koeller KK, Witte RJ, Carter RE, McCollough CH (2015) Temporal bone CT: improved image quality and potential for decreased radiation dose using an ultra-high-resolution scan mode with an iterative reconstruction algorithm. Am J Neuroradiol 36(9):1599–1603. https://doi.org/10.3174/ajnr.A4338
Leng S, Rajendran K, Gong H, Zhou W, Halaweish AF, Henning A, Kappler S, Baer M, Fletcher JG, McCollough CH (2018) 150-μm spatial resolution using photon-counting detector computed tomography technology: technical performance and first patient images. Investig Radiol 53(11):655–662. https://doi.org/10.1097/RLI.0000000000000488
Leng S, Yu Z, Halaweish A, Kappler S, Hahn K, Henning A, Li Z, Lane J, Levin DL, Jorgensen S (2016) Dose-efficient ultrahigh-resolution scan mode using a photon counting detector computed tomography system. J Med Imag 3(4):043504. https://doi.org/10.1117/1.JMI.3.4.043504
Mannil M, Hickethier T, von Spiczak J, Baer M, Henning A, Hertel M, Schmidt B, Flohr T, Maintz D, Alkadhi H (2018) Photon-counting CT: high-resolution imaging of coronary stents. Investig Radiol 53(3):143–149. https://doi.org/10.1097/rli.0000000000000420
Marcus RP, Fletcher JG, Ferrero A, Leng S, Halaweish AF, Gutjahr R, Vrtiska TJ, Wells ML, Enders FT, McCollough CH (2018) Detection and characterization of renal stones by using photon-counting-based CT. Radiology 289(2):436–442. https://doi.org/10.1148/radiol.2018180126
Marri UK, Das P, Shalimar M, Kalaivani DNS, Madhusudhan KS (2021) Noninvasive staging of liver fibrosis using 5-minute delayed dual-energy CT: comparison with US Elastography and correlation with histologic findings. Radiology 298(3):600–608. https://doi.org/10.1148/radiol.2021202232
Martini K, Higashigaito K, Barth BK, Baumueller S, Alkadhi H, Frauenfelder T (2015) Ultralow-dose CT with tin filtration for detection of solid and sub solid pulmonary nodules: a phantom study. Br J Radiol 88(1056):20150389. https://doi.org/10.1259/bjr.20150389
Masy M, Giordano J, Petyt G, Hossein-Foucher C, Duhamel A, Kyheng M, De Groote P, Fertin M, Lamblin N, Bervar JF, Remy J, Remy-Jardin M (2018) Dual-energy CT (DECT) lung perfusion in pulmonary hypertension: concordance rate with V/Q scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH). Eur Radiol 28(12):5100–5110. https://doi.org/10.1007/s00330-018-5467-2
Meier A, Higashigaito K, Martini K, Wurnig M, Seifert B, Keller DI, Frauenfelder T, Alkadhi H (2016) Dual energy CT pulmonary angiography with 6g iodine-a propensity score-matched study. PLoS One 11(12):e0167214. https://doi.org/10.1371/journal.pone.0167214
Mergen V, Sartoretti T, Klotz E, Schmidt B, Jungblut L, Higashigaito K, Manka R, Euler A, Kasel M, Eberhard M, Alkadhi H (2022) Extracellular volume quantification with cardiac late enhancement scanning using dual-source photon-counting detector CT. Invest Radiol. https://doi.org/10.1097/RLI.0000000000000851. Epub ahead of print. PMID: 35066531
Nagayama Y, Inoue T, Oda S, Tanoue S, Nakaura T, Ikeda O, Yamashita Y (2020) Adrenal adenomas versus metastases: diagnostic performance of dual-energy spectral CT virtual noncontrast imaging and iodine maps. Radiology 296(2):324–332. https://doi.org/10.1148/radiol.2020192227
Nowak T, Eberhard M, Schmidt B, Frey D, Distler O, Saltybaeva N, Alkadhi H, Euler A (2021) Bone mineral density quantification from localizer radiographs: accuracy and precision of energy-integrating detector CT and photon-counting detector CT. Radiology 298(1):147–152. https://doi.org/10.1148/radiol.2020202767
Parakh A, Patino M, Muenzel D, Kambadakone A, Sahani DV (2018) Role of rapid kV-switching dual-energy CT in assessment of post-surgical local recurrence of pancreatic adenocarcinoma. Abdom Radiol (NY) 43(2):497–504. https://doi.org/10.1007/s00261-017-1390-2
Pourmorteza A, Symons R, Henning A, Ulzheimer S, Bluemke DA (2018) Dose efficiency of quarter-millimeter photon-counting computed tomography: first-in-human results. Investig Radiol 53(6):365–372. https://doi.org/10.1097/RLI.0000000000000463
Rajendran K, Voss BA, Zhou W, Tao S, DeLone DR, Lane JI, Weaver JM, Carlson ML, Fletcher JG, McCollough CH, Leng S (2020) Dose reduction for sinus and temporal bone imaging using photon-counting detector CT with an additional tin filter. Investig Radiol 55(2):91–100. https://doi.org/10.1097/rli.0000000000000614
Rajiah P, Sundaram M, Subhas N (2019) Dual-energy CT in musculoskeletal imaging: what is the role beyond gout? AJR Am J Roentgenol 213(3):493–505. https://doi.org/10.2214/ajr.19.21095
Ren L, Rajendran K, Fletcher JG, McCollough CH, Yu L (2020) Simultaneous dual-contrast imaging of small bowel with iodine and bismuth using photon-counting-detector computed tomography: a feasibility animal study. Investig Radiol 55(10):688–694. https://doi.org/10.1097/rli.0000000000000687
Riederer I, Si-Mohamed S, Ehn S, Bar-Ness D, Noël PB, Fingerle AA, Pfeiffer F, Rummeny EJ, Douek P, Pfeiffer D (2019) Differentiation between blood and iodine in a bovine brain—initial experience with spectral photon-counting computed tomography (SPCCT). PLoS One 14(2):e0212679. https://doi.org/10.1371/journal.pone.0212679
Sartoretti T, Eberhard M, Nowak T, Gutjahr R, Jost G, Pietsch H, Schmidt B, Flohr T, Alkadhi H, Euler A (2021) Photon-counting multienergy computed tomography with spectrally optimized contrast Media for Plaque Removal and Stenosis Assessment. Investig Radiol. https://doi.org/10.1097/rli.0000000000000773
Sartoretti T, Eberhard M, Rüschoff JH, Pietsch H, Jost G, Nowak T, Schmidt B, Flohr T, Euler A, Alkadhi H (2020) Photon-counting CT with tungsten as contrast medium: experimental evidence of vessel lumen and plaque visualization. Atherosclerosis 310:11–16. https://doi.org/10.1016/j.atherosclerosis.2020.07.023
Sartoretti T, Mergen V, Higashigaito K, Eberhard M, Alkadhi H, Euler A (2022a) Virtual noncontrast imaging of the liver using photon-counting detector computed tomography: a systematic phantom and patient study. Invest Radiol. https://doi.org/10.1097/RLI.0000000000000860. Epub ahead of print. PMID: 35136003
Sartoretti T, Landsmann A, Nakhostin D, Eberhard M, Röeren C, Mergen V, Higashigaito K, Raupach R, Alkadhi H, Euler A (2022b) Quantum iterative reconstruction for abdominal photon-counting detector ct improves image quality. Radiology. https://doi.org/10.1148/radiol.211931. Epub ahead of print. PMID: 35103540
Schmidt TG (2009) Optimal “image-based” weighting for energy-resolved CT. Med Phys 36(7):3018–3027. https://doi.org/10.1118/1.3148535
Shuman WP, Green DE, Busey JM, Mitsumori LM, Choi E, Koprowicz KM, Kanal KM (2014) Dual-energy liver CT: effect of monochromatic imaging on lesion detection, conspicuity, and contrast-to-noise ratio of hypervascular lesions on late arterial phase. AJR Am J Roentgenol 203(3):601–606. https://doi.org/10.2214/ajr.13.11337
Si-Mohamed S, Tatard-Leitman V, Laugerette A, Sigovan M, Pfeiffer D, Rummeny EJ, Coulon P, Yagil Y, Douek P, Boussel L (2019) Spectral photon-counting computed tomography (SPCCT): in-vivo single-acquisition multi-phase liver imaging with a dual contrast agent protocol. Sci Rep 9(1):1–8. https://doi.org/10.1038/s41598-019-44821-z
Si-Mohamed SA, Sigovan M, Hsu JC, Tatard-Leitman V, Chalabreysse L, Naha PC, Garrivier T, Dessouky R, Carnaru M, Boussel L, Cormode DP, Douek PC (2021) In vivo molecular K-edge imaging of atherosclerotic plaque using photon-counting CT. Radiology:203968. https://doi.org/10.1148/radiol.2021203968
von Spiczak J, Mannil M, Peters B, Hickethier T, Baer M, Henning A, Schmidt B, Flohr T, Manka R, Maintz D, Alkadhi H (2018) Photon counting computed tomography with dedicated sharp convolution kernels: tap** the potential of a new Technology for Stent Imaging. Investig Radiol 53(8):486–494. https://doi.org/10.1097/rli.0000000000000485
Stamp LK, Anderson NG, Becce F, Rajeswari M, Polson M, Guyen O, Viry A, Choi C, Kirkbride TE, Raja AY (2019) Clinical utility of multi-energy spectral photon-counting computed tomography in crystal arthritis. Arthritis Rheumatol 71(7):1158–1162. https://doi.org/10.1002/art.40848
Symons R, Krauss B, Sahbaee P, Cork TE, Lakshmanan MN, Bluemke DA, Pourmorteza A (2017a) Photon-counting CT for simultaneous imaging of multiple contrast agents in the abdomen: an in vivo study. Med Phys 44(10):5120–5127. https://doi.org/10.1002/mp.12301
Symons R, Pourmorteza A, Sandfort V, Ahlman MA, Cropper T, Mallek M, Kappler S, Ulzheimer S, Mahesh M, Jones EC, Malayeri AA, Folio LR, Bluemke DA (2017b) Feasibility of dose-reduced chest CT with photon-counting detectors: initial results in humans. Radiology 285(3):980–989. https://doi.org/10.1148/radiol.2017162587
Symons R, Reich DS, Bagheri M, Cork TE, Krauss B, Ulzheimer S, Kappler S, Bluemke DA, Pourmorteza A (2018) Photon-counting computed tomography for vascular imaging of the head and neck: first in vivo human results. Investig Radiol 53(3):135–142. https://doi.org/10.1097/rli.0000000000000418
Symons R, Sandfort V, Mallek M, Ulzheimer S, Pourmorteza A (2019) Coronary artery calcium scoring with photon-counting CT: first in vivo human experience. Int J Cardiovasc Imaging 35(4):733–739. https://doi.org/10.1007/s10554-018-1499-6
Taguchi K, Iwanczyk JS (2013) Vision 20/20: single photon counting x-ray detectors in medical imaging. Med Phys 40(10):100901. https://doi.org/10.1118/1.4820371
Tao S, Rajendran K, McCollough CH, Leng S (2019) Feasibility of multi-contrast imaging on dual-source photon counting detector (PCD) CT: an initial phantom study. Med Phys 46(9):4105–4115. https://doi.org/10.1002/mp.13668
Uyeda JW, Richardson IJ, Sodickson AD (2017) Making the invisible visible: improving conspicuity of noncalcified gallstones using dual-energy CT. Abdom Radiol (NY) 42(12):2933–2939. https://doi.org/10.1007/s00261-017-1229-x
Willemink MJ, Persson M, Pourmorteza A, Pelc NJ, Fleischmann D (2018) Photon-counting CT: technical principles and clinical prospects. Radiology 289(2):293–312. https://doi.org/10.1148/radiol.2018172656
Yu Z, Leng S, Kappler S, Hahn K, Li Z, Halaweish AF, Henning A, McCollough CH (2016) Noise performance of low-dose CT: comparison between an energy integrating detector and a photon counting detector using a whole-body research photon counting CT scanner. J Med Imag 3(4):043503. https://doi.org/10.1117/1.JMI.3.4.043503
Zheng X, Liu Y, Li M, Wang Q, Song B (2016) Dual-energy computed tomography for characterizing urinary calcified calculi and uric acid calculi: a meta-analysis. Eur J Radiol 85(10):1843–1848. https://doi.org/10.1016/j.ejrad.2016.08.013
Zhou W, Bartlett DJ, Diehn FE, Glazebrook KN, Kotsenas AL, Carter RE, Fletcher JG, McCollough CH, Leng S (2019) Reduction of metal artifacts and improvement in dose efficiency using photon-counting detector computed tomography and tin filtration. Investig Radiol 54(4):204–211. https://doi.org/10.1097/rli.0000000000000535
Zhou W, Lane JI, Carlson ML, Bruesewitz MR, Witte RJ, Koeller KK, Eckel LJ, Carter RE, McCollough CH, Leng S (2018) Comparison of a photon-counting-detector CT with an energy-integrating-detector CT for temporal bone imaging: a cadaveric study. AJNR Am J Neuroradiol 39(9):1733–1738. https://doi.org/10.3174/ajnr.A5768
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Mergen, V., Euler, A., Higashigaito, K., Eberhard, M., Alkadhi, H. (2022). Photon-Counting CT: Initial Clinical Experience. In: Alkadhi, H., Euler, A., Maintz, D., Sahani, D. (eds) Spectral Imaging. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/978-3-030-96285-2_25
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