ABSTRACT
PURPOSE: The purpose of this study was to compare lung image quality obtained with ultra-high resolution (UHR) spectral photon-counting CT (SPCCT) with that of dual-layer CT (DLCT), at standard and low dose levels using an image quality phantom and an anthropomorphic lung phantom. METHODS: An image quality phantom was scanned using a clinical SPCCT prototype and an 8 cm collimation DLCT from the same manufacturer at 10 mGy. Additional acquisitions at 6 mGy were performed with SPCCT only. Images were reconstructed with dedicated high-frequency reconstruction kernels, slice thickness between 0.58 and 0.67 mm, and matrix between 5122 and 10242 mm, using a hybrid iterative algorithm at level 6. Noise power spectrum (NPS), task-based transfer function (TTF) for iodine and air inserts, and detectability index (d') were assessed for ground-glass and solid nodules of 2 mm to simulate highly detailed lung lesions. Subjective analysis of an anthropomorphic lung phantom was performed by two radiologists using a five-point quality score. RESULTS: At 10 mGy, noise magnitude was reduced by 29.1 % with SPCCT images compared to DLCT images for all parameters (27.1 ± 11.0 [standard deviation (SD)] HU vs. 38.2 ± 1.0 [SD] HU, respectively). At 6 mGy with SPCCT images, noise magnitude was reduced by 8.9 % compared to DLCT images at 10 mGy (34.8 ± 14.1 [SD] HU vs. 38.2 ± 1.0 [SD] HU, respectively). At 10 mGy and 6 mGy, average NPS spatial frequency (fav) was greater for SPCCT images (0.75 ± 0.17 [SD] mm-1) compared to DLCT images at 10 mGy (0.55 ± 0.04 [SD] mm-1) while remaining constant from 10 to 6 mGy. At 10 mGy, TTF at 50 % (f50) was greater for SPCCT images (0.92 ± 0.08 [SD] mm-1) compared to DLCT images (0.67 ± 0.06 [SD] mm-1) for both inserts. At 6 mGy, f50 decreased by 1.1 % for SPCCT images, while remaining greater compared to DLCT images at 10 mGy (0.91 ± 0.06 [SD] mm-1 vs. 0.67 ± 0.06 [SD] mm-1, respectively). At both dose levels, d' were greater for SPCCT images compared to DLCT for all clinical tasks. Subjective analysis performed by two radiologists revealed a greater median image quality for SPCCT (5; Q1, 4; Q3, 5) compared to DLCT images (3; Q1, 3; Q3, 3). CONCLUSION: UHR SPCCT outperforms DLCT in terms of image quality for lung imaging. In addition, UHR SPCCT contributes to a 40 % reduction in radiation dose compared to DLCT.
ABSTRACT
OBJECTIVE: Development of spectral photon-counting computed tomography (SPCCT) for ultra-high-resolution coronary CT angiography (CCTA) has the potential to accurately evaluate the coronary arteries of very-high-risk patients. The aim of this study was to compare the diagnostic performances of SPCCT against conventional CT for quantifying coronary stenosis in very-high-risk patients, with invasive coronary angiography (ICA) as the reference method. MATERIALS AND METHODS: In this prospective institutional review board-approved study, very-high-risk patients addressed for ICA following an acute coronary syndrome were consecutively included. CCTA was performed for each patient with both SPCCT and conventional CT before ICA within 3 days. Stenoses were assessed using the minimal diameter over proximal and distal diameters method for CCTA and the quantitative coronary angiography method for ICA. Intraclass correlation coefficients and mean errors were assessed. Sensitivity and specificity were calculated for a >50% diameter stenosis threshold. Reclassification rates for conventional CT and SPCCT were assessed according to CAD-RADS 2.0, using ICA as the gold standard. RESULTS: Twenty-six coronary stenoses were identified in 26 patients (4 women [15%]; age 64 ± 8 years) with 19 (73%) above 50% and 9 (35%) equal or above 70%. The median stenosis value was 64% (interquartile range, 48%-73%). SPCCT showed a lower mean error (6% [5%, 8%]) than conventional CT (12% [9%, 16%]). SPCCT demonstrated greater sensitivity (100%) and specificity (90%) than conventional CT (75% and 50%, respectively). Ten (38%) stenoses were reclassified with SPCCT and one (4%) with conventional CT. CONCLUSIONS: In very-high-risk patients, ultra-high-resolution SPCCT coronary angiography showed greater accuracy, sensitivity, and specificity, and led to more stenosis reclassifications than conventional CT.
ABSTRACT
3D printed biomaterial implants are revolutionizing personalized medicine for tissue repair, especially in orthopedics. In this study, a radiopaque Bi 2 O 3 doped polycaprolactone ( PCL ) composite is developed and implemented to enable the use of diagnostic X-ray technologies, especially photon counting X-ray computed tomography ( PCCT ), for comprehensive in vivo device monitoring. PCL filament with homogeneous Bi 2 O 3 nanoparticle ( NP ) dispersion (0.8 to 11.7 wt%) are first fabricated. Tissue engineered scaffolds ( TES ) are then 3D printed with the composite filament, optimizing printing parameters for small feature size and severely overhung geometries. These composite TES are characterized via micro-computed tomography ( µ CT ), tensile testing, and a cytocompatibility study, with Bi 2 O 3 mass fractions as low as 2 wt% providing excellent radiographic distinguishability, improved tensile properties, and equivalent cytocompatibility of neat PCL. The excellent radiographic distinguishability is validated in situ by imaging 4 and 7 wt% TES in a mouse model with µCT, showing excellent agreement with in vitro measurements. Subsequently, CT image-derived swine menisci are 3D printed with composite filament and re-implanted in their corresponding swine legs ex vivo . Re-imaging the swine legs via clinical CT allows facile identification of device location and alignment. Finally, the emergent technology of PCCT unambiguously distinguishes implanted menisci in situ.
ABSTRACT
X-Ray imaging techniques are among the most widely used modalities in medical imaging and their constant evolution has led to the emergence of new technologies. The new generation of computed tomography (CT) systems - spectral photonic counting CT (SPCCT) and X-ray luminescence optical imaging - are examples of such powerful techniques. With these new technologies the rising demand for new contrast agents has led to extensive research in the field of nanoparticles and the possibility to merge the modalities appears to be highly attractive. In this work, we propose the design of lanthanide-based nanocrystals as a multimodal contrast agent with the two aforementioned technologies, allowing SPCCT and optical imaging at the same time. We present a systematic study on the effect of the Tb3+ doping level and surface modification on the generation of contrast with SPCCT and the luminescence properties of GdF3:Tb3+ nanocrystals (NCs), comparing different surface grafting with organic ligands and coatings with silica to make these NCs bio-compatible. A comparison of the luminescence properties of these NCs with UV revealed that the best results were obtained for the Gd0.9Tb0.1F3 composition. This property was confirmed under X-ray excitation in microCT and with SPCCT. Moreover, we could demonstrate that the intensity of the luminescence and the excited state lifetime are strongly affected by the surface modification. Furthermore, whatever the chemical nature of the ligand, the contrast with SPCCT did not change. Finally, the successful proof of concept of multimodal imaging was performed in vivo with nude mice in the SPCCT taking advantage of the so-called color K-edge imaging method.