(2023) Becker | Abdominal PCCT: general image quality and dose exposure

Daniel Stromer

In this first clinical routine experience, abdominal PCCT achieved superior overall image quality versus conventional CT, with higher Likert scores for general image quality, lower perceived noise, and fewer artifacts.

Objective image quality was also better with PCCT, with significantly higher SNR in fat, muscle, and air, but this came at the cost of higher radiation exposure in the initial manufacturer-default protocol.

In an ex vivo phantom study, the higher PCCT dose was accompanied by more DNA double-strand break foci than conventional CT, highlighting the need for protocol optimization before routine abdominal PCCT can be considered dose-efficient.

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Figure 3. Example of axial and coronal reconstruction of abdominal conventional CT (A and C) and PCCT (B and D) for the depiction of subjective image impression. DLP was 413.38 and 453.98 mGy*cm for PCCT and conventional CT, respectively. Both examinations were rated “very good” by all examiners (general image quality PCCT: 4.75 ± 0.5; general image quality conventional CT: 4.75 ± 0.5)

Source: Becker et al., European Radiology, 2023

Protocol

Detail	Value
Scanner	NAEOTOM Alpha
Exam type	QuantumPlus Single-phase contrast-enhanced abdominal CT, portal venous phase
Tube voltage	120 kV
PCCT collimation	144 × 0.4 mm
Rotation time	0.5 s
Pitch	0.8
Reconstruction	Axial 1 mm Br40, coronal 3 mm Br40, sagittal 3 mm Br60
Reconstruction algorithm	QIR
mAs preset	IQ145 145 mAs at 120 kV
Mean Doselength product	DLP 419.2 ± 162.2 mGy·cm
Effective dose	5.00 ± 1.95 mSv

Becker BV, Kaatsch HL, Nestler K, et al. Initial experience on abdominal photon-counting computed tomography in clinical routine: general image quality and dose exposure. Eur Radiol. 2023;33:2461-2468.