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Improved visualization of the wrist at lower radiation dose with photon-counting-detector CT

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Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To compare the image quality of ultra-high-resolution wrist CTs acquired on photon-counting detector CT versus conventional energy-integrating-detector CT systems.

Materials and methods

Participants were scanned on a photon-counting-detector CT system after clinical energy-integrating detector CTs. Energy-integrating-detector CT scan parameters: comb filter-based ultra-high-resolution mode, 120 kV, 250 mAs, Ur70 or Ur73 kernel, 0.4- or 0.6-mm section thickness. Photon-counting-detector CT scan parameters: non-comb-based ultra-high-resolution mode, 120 kV, 120 mAs, Br84 kernel, 0.4-mm section thickness. Two musculoskeletal radiologists blinded to CT system, scored specific osseous structures using a 5-point Likert scale (1 to 5). The Wilcoxon rank-sum test was used for statistical analysis of reader scores. Paired t-test was used to compare volume CT dose index, bone CT number, and image noise between CT systems. P-value < 0.05 was considered statistically significant.

Results

Twelve wrists (mean participant age 55.3 ± 17.8, 6 females, 6 males) were included. The mean volume CT dose index was lower for photon-counting detector CT (9.6 ± 0.1 mGy versus 19.0 ± 6.7 mGy, p < .001). Photon-counting-detector CT images had higher Likert scores for visualization of osseous structures (median score = 4, p < 0.001). The mean bone CT number was higher in photon-counting-detector CT images (1946 ± 77 HU versus 1727 ± 49 HU, p < 0.001). Conversely, there was no difference in the mean image noise of the two CT systems (63 ± 6 HU versus 61 ± 6 HU, p = 0.13).

Conclusion

Ultra-high-resolution imaging with photon-counting-detector CT depicted wrist structures more clearly than conventional energy-integrating-detector CT despite a 49% radiation dose reduction.

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Funding

Research support for this work was provided, in part, to Mayo Clinic from Siemens Healthcare GmbH. The device described is a research scanner and is not commercially available.

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Author notes

  1. Kishore Rajendran and Francis Baffour contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55902, USA

    Kishore Rajendran, Francis Baffour, Garret Powell, Katrina Glazebrook, Jamison Thorne, Shuai Leng, Cynthia McCollough & Joel Fletcher

  2. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA

    Nicholas Larson

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  1. Kishore Rajendran
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Corresponding author

Correspondence to Francis Baffour.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

Drs. McCollough and Fletcher receive industry funding to their institution from Siemens Healthcare GmbH. Drs. McCollough, Fletcher, and Leng have intellectual property rights (owned by the Mayo Clinic) licensed to Siemens Healthineers. For the remaining authors, no conflicts were declared.

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Rajendran, K., Baffour, F., Powell, G. et al. Improved visualization of the wrist at lower radiation dose with photon-counting-detector CT. Skeletal Radiol 52, 23–29 (2023). https://doi.org/10.1007/s00256-022-04117-2

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  • DOI: https://doi.org/10.1007/s00256-022-04117-2

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