Automated Lung Texture Analysis (LTA) performed robustly on low-dose PCCT despite the algorithm having been trained on conventional EID-CT data. For detecting ILD, LTA achieved a higher AUC with PCCT than with EID-CT (0.846 vs. 0.772).
PCCT showed consistently higher AUCs for individual ILD features, particularly reticulation (0.846 vs. 0.743) and honeycombing (0.882 vs. 0.733), supporting the transferability of quantitative lung analysis to PCCT datasets.
Importantly, PCCT achieved these results at a substantially lower radiation dose (CTDI 0.70 vs. 2.30 mGy) while maintaining comparable SNR and providing markedly better subjective image quality; 79.7% of PCCT scans were rated excellent vs. 20.3% with EID-CT.
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Figure 2. Examples of representative CALIPER analyses.
Image A depicts ground-glass opacities (GGO), while image B shows predominant honeycombing pattern (H) in EID-CT (left column) and PCD-CT (right column). The scans correspond to different subjects with comparable ILD severity. Upper rows show HRCT slices, lower rows show color-coded 3D texture rendering maps from LTA (blue = hyperlucent lung, green = ground-glass opacity, orange = reticular pattern, purple = honeycombing). Image A demonstrates that the predominant ground-glass opacity was accurately identified by the CALIPER technology. Similarly, image B shows the correct detection of honeycombing in both patients.
Protocol
Detail | Value |
|---|
Scanner (PCCT) | NAEOTOM Alpha |
Scanner (EID-CT) | SOMATOM Force |
Scan area | Chest / lungs |
Application | Systemic sclerosis-associated ILD |
Scan protocol | Standard low-dose HRCT QuantumSn with tin-filtration |
Patient position | Prone |
Breathing | Inspiration |
Tube voltage [kV] | 100 |
Tube current | Automatic tube current modulation |
Reconstruction kernel | Bl64 |
Iterative reconstruction | QIR 3 |
Comparison protocol | EID-CT: 100 kVp, automatic tube current modulation, Bl64, ADMIRE 3 |
Image analysis | Lung Texture Analysis (LTA), CALIPER-based |
LTA features | Normal lung, ground-glass opacity, reticulation, honeycombing, hyperlucency, pulmonary vascular structures |
Reference standard | Consensus visual assessment by expert thoracic radiologists |
Key Results
Parameter | Main finding |
|---|
ILD detection | AUC 0.846 PCCT vs. 0.772 EID-CT |
Ground-glass opacity | AUC 0.830 vs. 0.818 |
Reticulation | AUC 0.846 vs. 0.743 |
Honeycombing | AUC 0.882 vs. 0.733 |
Extensive ILD >20% | EID-CT performed better: 0.978 vs. 0.842 |
Radiation dose | CTDI 0.70 mGy PCCT vs. 2.30 mGy EID-CT |
Image quality | Excellent in 79.7% PCCT vs. 20.3% EID-CT |
Main implication | EID-trained LTA remained robust on PCCT despite substantially lower radiation exposure |
Source:
Happe J, Bruni C, Jungblut L, et al. Automated lung texture analysis for assessing interstitial lung disease in systemic sclerosis: Diagnostic accuracy in photon-counting-detector and conventional energy-integrating-detector CT. European Journal of Radiology. 2026;195:112605. doi:10.1016/j.ejrad.2025.112605.
