Several studies have documented the improved appearance of bone structures when applying Quantum HD on NAEOTOM Alpha as compared to comb-induced UHR on EID-CT. For example, cadaver experiments showed that “PCD-CT allows for a twofold higher visibility of bone structure sharpness and an overall improved image quality of the wrist compared to images obtained from an UHR EID-CT. Even at half dose, Quantum HD yielded superior image quality, both in quantitative measures and as evaluated by radiologists” [14].
This improved sharpness extends to the evaluation of elbow fractures as shown in a different cadaver study [15]. According to the authors, “Quantum HD provided superior objective and subjective image quality for fracture and trabecular bone structure delineation of the elbow compared to UHR EID-CT in a typical post-trauma setting.” This view was reinforced in a patient study touting Quantum HD’s superior fracture visibility and overall image quality [16]. Indeed, the quality of Quantum HD has even been compared to microCT [17].
Figure 17 illustrates the application of Quantum HD in a pediatric case of osteochondritis dissecans of the capitellum.
Figure 17: MPR 0.2 mm (Fig 17a) | Cinematic VRT (Fig 17b–d) | Br89 | 120 kV | CTDIvol 4.5 mGy. Courtesy of Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
Combining UHR and functional imaging: Quantum HD and Bone Marrow Edema
The Bone Marrow Edema (BME) application is particularly valuable in situations where fractures are so subtle that they may be hard to detect on conventional CT. In these cases, it may be possible to indirectly diagnose trauma through the suggestion of edema [18]. However, the potential of combining the increased resolution of Quantum HD with the spectral analysis of BME shows significant promise. Figure 18 illustrates the clinical potential of combining Quantum HD with BME.
Figure 18: Quantum HD fused with Bone Marrow Edema visualization. Sn 150 kV / 70 kV | CTDI 4.7 mGy. Courtesy of University Hospital Minden, Minden, Germany.