Use tin-prefiltered PCCT to reduce lumbar spine dose while preserving subjective image quality. The authors found markedly lower dose with PCCT, while overall subjective image quality remained unchanged versus tin-filtered EID-CT.
Expect higher bone-to-fat contrast efficiency with PCCT. Compared with EID-CT, PCCT showed significantly higher CNR, while image noise and SNR were not significantly different.
This protocol is especially attractive for younger patients or repeated follow-up imaging. The authors specifically frame lumbar spine CT as a dose-sensitive use case because of proximity to reproductive organs and the frequency of repeat examinations.
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Fig. 2 —Photon-counting detector PCCT reconstructed using bone kernel. A, Axial images of 27-year-old man who underwent PCCT (A–C) . Examinations were performed using tin prefiltration. Axial images reconstructed using bone kernel at three different levels are shown for each examination: L3 vertebral level (A), L4 neuroforaminal level (B), and L5 facet joint level (C). All three readers provided score of 4 (excellent) for subjective overall image quality . CTDIvol was 4.5 mGy for PCD CT.
Source: Marth et al., American Journal of Roentgenology, 2024.
Protocol
Detail | Value |
|---|
Scanner | NAEOTOM Alpha |
Software | n.a. |
Scan area | Lumbar spine |
Scan mode | QuantumSn |
Scan direction | Supine, feet first |
Tube voltage [kV] | 140 |
Effective mAs [mAs] | 134 |
IQ level | CARE keV IQ75 |
Dose modulation | Automatic exposure control, manual voltage setting |
CTDIvol [mGy] | 4.4 ± 1.0 |
SSDE [mGy] | 6.2 ± 1.0 |
Rotation time [s] | 1.00 |
Pitch | 0.8 |
Matrix | 512 × 512 |
Slice collimation [mm] | 144 × 0.4 |
Slice width [mm] | 2.0 |
Reconstruction increment [mm] | 2.0 |
Reconstruction kernel | Br40 | Br60 |
Iterative reconstruction | QIR strength 3 |
keV level [keV] | Default preset 95 |
Contrast agent | n.a. |
Contrast volume | n.a. |
Flow rate | n.a. |
Saline chaser | n.a. |
ECG technique | n.a. |
Acquisition phase | Unenhanced |
Heart rate control | n.a. |
Full citation:
Marth AA, Marcus RP, Feuerriegel GC, Nanz D, Sutter R. Photon-Counting Detector CT Versus Energy-Integrating Detector CT of the Lumbar Spine: Comparison of Radiation Dose and Image Quality. AJR Am J Roentgenol. 2024;222(1). doi:10.2214/AJR.23.29950
