Image quality of photon counting and energy integrating chest CT – Prospective head-to-head comparison on same patients

Fides R. Schwartz, Francesco Ria, Cindy McCabe, Mojtaba Zarei, Jayasai Rajagopal, Lior Molvin, Daniele Marin, Bryan O'Sullivan-Murphy, Kevin R. Kalisz, Tina D. Tailor, Lacey Washington, Travis Henry, Ehsan Samei

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Purpose: To prospectively compare the image quality of high-resolution, low-dose photon-counting detector CT (PCD-CT) with standard energy-integrating-detector CT (EID) on the same patients. Method: IRB-approved, prospective study; patients received same-day non-contrast CT on EID and PCD-CT (NAEOTOM Alpha, blinded) with clinical protocols. Four blinded radiologists evaluated subsegmental bronchial wall definition, noise, and overall image quality in randomized order (0 = worst; 100 = best). Cases were quantitatively compared using the average Global-Noise-Index (GNI), Noise-Power-Spectrum average frequency (fav), NPS frequency-peak (fpeak), Task-Transfer-Function-10%-frequency (f10) an adjusted detectability index (d’adj), and applied output radiation doses (CTDIvol). Results: Sixty patients were prospectively imaged (27 men, mean age 67 ± 10 years, mean BMI 27.9 ± 6.5, 15.9–49.4 kg/m2). Subsegmental wall definition was rated significantly better for PCD-CT than EID (mean 71 [56–87] vs 60 [45–76]; P < 0.001), noise was rated higher for PCD-CT (48 [26–69] vs 34 [13–56]; P < 0.001). Overall image quality was rated significantly higher for PCD-CT than EID (66 [48–85] vs 61 [42–79], P = 0.008). Automated image quality measures showed similar differences for PCD-CT vs EID (mean GNI 70 ± 19 HU vs 26 ± 8 HU, fav 0.35 ± 0.02 vs 0.25 ± 0.02 mm−1, fpeak 0.07 ± 0.01 vs 0.09 ± 0.03 mm−1, f10 0.7 ± 0.08 vs 0.6 ± 0.1 mm−1, all p-values < 0.001). PCD-CT showed a 10% average d’adj increase (-49% min, 233% max). PCD-CT studies were acquired at significantly lower radiation doses than EID (mean CTDIvol 4.5 ± 2.1 vs 7.7 ± 3.2 mGy, P < 0.01). Conclusion: Though PCD-CT had higher measured and perceived noise, it offered equivalent or better diagnostic quality compared to EID at lower radiation doses, due to its improved resolution.

Original languageEnglish
Article number111014
JournalEuropean Journal of Radiology
Volume166
DOIs
StatePublished - Sep 2023
Externally publishedYes

Keywords

  • Bronchi
  • Lung
  • Multidetector computed tomography
  • Thorax
  • Tomography
  • X-Ray computed

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