Scholarlink

Objectives <p>To evaluate whether task-based automatic keV selection of photon-counting detector (PCD)-CT with optimizing radiation and contrast media (CM) dose yields consistent image quality in CT angiography (CTA).</p> Materials and methods <p>PCD-CTA of the aorta was performed in six healthy minipigs across two scan sessions, with virtual monoenergetic images (VMI) reconstructed. In the first session, three protocols were conducted: the reference protocol A1 simulated standard CTA (210 mg iodine/kg CM, image quality (IQ)-level 117, non-contrast task, VMI: 70 keV); protocol A2 reduced radiation while keeping CM dose constant (210 mgI/kg, IQ-level 117, vascular task, VMI: 55 keV); and protocol A3 reduced CM dose while maintaining radiation (164 mgI/kg, IQ-level 117, non-contrast task, VMI: 55 keV). In the second session, protocols A2 and A3 were repeated as B1 and B2 to assess reproducibility, and protocol B3 further reduced the radiation dose with increased CM dose (252 mgI/kg, IQ-level 81, vascular task, VMI: 55 keV). Aortic CNR was measured; subjective assessments included contrast, noise, IQ, and visibility of intrahepatic arteries using a 4-point discrete visual scale.</p> Results <p>The median CTDIvol was 3.8 mGy (A1, A3), 2.4 mGy (A2, B1), 3.9 mGy (B2), and 1.6 mGy (B3), respectively; median CM doses were 23 mL (A1, A2, B1), 18 mL (A3, B2), and 28 mL (B3), respectively. CNR was comparable across protocols (<i>p</i> = 0.906–0.947). Subjective metrics indicated diagnostic image quality (scores ≥ 2) for all protocols, with A1 and A3 having higher noise (<i>p</i> = 0.007–0.008) and lower vascular contrast (<i>p</i> = 0.003–0.008). Subjective image quality (<i>p</i> = 0.226–0.342) and visibility of intrahepatic arteries (<i>p</i> = 0.604–0.873) were similar.</p> Conclusion <p>Task-based automatic keV selection enables optimization of radiation and CM dose in PCD-CTA while maintaining image quality. Protocols can be balanced to either save radiation or CM dose, depending on individual patient needs.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Balancing radiation and contrast media doses in CT angiography is essential, yet the full potential of photon-counting detector (PCD)CT for dose optimization remains underexplored.</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>Task-based automatic keV selection of PCD-CT enabled a 22% contrast reduction at constant radiation or a 58% radiation dose reduction with a compensatory 20% increase in contrast media.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Task-based automatic keV selection of PCD-CT allows individualized dose optimization by balancing radiation exposure and contrast media volume. This approach can improve patient safety by tailoring protocols to either radiation- or contrast media reduction.</i></p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Contrast media and radiation dose optimization with task-based automatic keV selection: a proof-of-concept study with photon-counting detector CT

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月12日

查看全文
  • Konstantin Klambauer,
  • Thomas Flohr,
  • Lukas Jakob Moser,
  • Victor Mergen,
  • Matthias Eberhard,
  • Andreas Prokein,
  • Hatem Alkadhi,
  • Gregor Jost,
  • Hubertus Pietsch

摘要

Objectives

To evaluate whether task-based automatic keV selection of photon-counting detector (PCD)-CT with optimizing radiation and contrast media (CM) dose yields consistent image quality in CT angiography (CTA).

Materials and methods

PCD-CTA of the aorta was performed in six healthy minipigs across two scan sessions, with virtual monoenergetic images (VMI) reconstructed. In the first session, three protocols were conducted: the reference protocol A1 simulated standard CTA (210 mg iodine/kg CM, image quality (IQ)-level 117, non-contrast task, VMI: 70 keV); protocol A2 reduced radiation while keeping CM dose constant (210 mgI/kg, IQ-level 117, vascular task, VMI: 55 keV); and protocol A3 reduced CM dose while maintaining radiation (164 mgI/kg, IQ-level 117, non-contrast task, VMI: 55 keV). In the second session, protocols A2 and A3 were repeated as B1 and B2 to assess reproducibility, and protocol B3 further reduced the radiation dose with increased CM dose (252 mgI/kg, IQ-level 81, vascular task, VMI: 55 keV). Aortic CNR was measured; subjective assessments included contrast, noise, IQ, and visibility of intrahepatic arteries using a 4-point discrete visual scale.

Results

The median CTDIvol was 3.8 mGy (A1, A3), 2.4 mGy (A2, B1), 3.9 mGy (B2), and 1.6 mGy (B3), respectively; median CM doses were 23 mL (A1, A2, B1), 18 mL (A3, B2), and 28 mL (B3), respectively. CNR was comparable across protocols (p = 0.906–0.947). Subjective metrics indicated diagnostic image quality (scores ≥ 2) for all protocols, with A1 and A3 having higher noise (p = 0.007–0.008) and lower vascular contrast (p = 0.003–0.008). Subjective image quality (p = 0.226–0.342) and visibility of intrahepatic arteries (p = 0.604–0.873) were similar.

Conclusion

Task-based automatic keV selection enables optimization of radiation and CM dose in PCD-CTA while maintaining image quality. Protocols can be balanced to either save radiation or CM dose, depending on individual patient needs.

Key Points

Question Balancing radiation and contrast media doses in CT angiography is essential, yet the full potential of photon-counting detector (PCD)CT for dose optimization remains underexplored.

Findings Task-based automatic keV selection of PCD-CT enabled a 22% contrast reduction at constant radiation or a 58% radiation dose reduction with a compensatory 20% increase in contrast media.

Clinical relevance Task-based automatic keV selection of PCD-CT allows individualized dose optimization by balancing radiation exposure and contrast media volume. This approach can improve patient safety by tailoring protocols to either radiation- or contrast media reduction.

Graphical Abstract