Whole-body PCD-CT provided significantly better subjective and objective image quality than standard EID-CT in patients with multiple myeloma.
Image quality improved across overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence, while radiation dose was substantially lower.
Clinical relevance. PCD-CT appears well suited for whole-body myeloma imaging, combining better lesion depiction with lower dose and simultaneous access to spectral data for future advanced post-processing.
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Figure 4. Exemplary images of patients with multiple myeloma who underwent CT imaging using the PCCT (left) and EID-CT (right) systems (bone window level 500 and width of 2000). The images in the first row were obtained from a 59-year-old male patient. Here, PCCT shows equal image quality with a significantly lower radiation dose than a dual-energy EID-CT scanner in the dual-energy scan mode (tube A 100 kVp and tube B 150 kVp with tin filtration) (CTDIvol 3.67 mGy vs. 5.24 mGy, 295 days delay between studies). The second row of images depicts the lytic lesions in a 64-year-old male patient with a BMI of 25 kg/m2. Image quality and edge sharpness were rated higher for PCCT vs. EID-CT while image noise was substantially reduced at a similar radiation dose (CTDIvol 2.51 mGy vs. 1.75 mGy, 197 days delay between studies). The third row shows a comparison between the PCCT data and single-energy EID-CT in a 70-year-old male (BMI 26.5 km/m2) with multiple lytic lesions in the pelvic skeleton, higher edge sharpness, and less noise (176 days delay between studies). Soft tissue reconstructions of the medullary cavity of the right femur of an 84-year-old male are presented in the bottom row and show substantially lower image noise for PCD-CT with higher edge sharpness compared with dual-energy EID-CT in the dual-energy scan mode (tube A 100 kVp and tube B 150 kVp with tin-filtration, 130 days delay between studies). PCCT = photon-counting detector computed tomography, EID-CT = energy-integrating detector computed tomography, BMI = body mass index, CT = computed tomography.
Source: Rau et al, 2023, Korean J Radiology.
Protocol
Detail | Value |
|---|
Scanner | NAEOTOM Alpha |
Software | n.a. |
Scan area | Whole-body CT |
Scan mode | QuantumPlus |
Scan direction | n.a. |
Tube voltage [kV] | 120 |
Effective mAs [mAs] | 59 |
IQ level | IQ 65 |
Dose modulation | CARE Dose4D |
CTDIvol [mGy] | 3.33 ± 0.82 (EID = 7.19) |
DLP [mGy*cm] | n.a. |
Effective dose [mSv] | n.a. |
Rotation time [s] | 0.5 |
Pitch | 0.6 |
Matrix | n.a. |
Slice collimation [mm] | 144 × 0.4 |
Slice width [mm] | 2 |
Reconstruction increment [mm] | 2 |
Reconstruction kernel | Br60 axial bone series |
Iterative reconstruction | QIR 2 axial bone series |
keV level [keV] | 70 |
Rau A, Neubauer J, Taleb L, Stein T, Schuermann T, Rau S, Faby S, Wenger S, Engelhardt M, Bamberg F, Weiss J. Impact of Photon-Counting Detector Computed Tomography on Image Quality and Radiation Dose in Patients With Multiple Myeloma. Korean J Radiol. 2023;24(10):1006-1016. doi:10.3348/kjr.2023.0211
