학술논문
Photon-counting CT of elbow joint fractures: image quality in a simulated post-trauma setting with off-center positioning
Original Article
Original Article
Document Type
Academic Journal
Author
Source
European Radiology Experimental. December 2023, Vol. 7 Issue 1
Subject
Language
English
Abstract
Author(s): Lena Sonnow [sup.1], Nigar Salimova [sup.1], Lea Behrendt [sup.1], Frank K. Wacker [sup.1], Marcus Örgel [sup.2], Jochen Plagge [sup.3], Friederike Weidemann [sup.2] Author Affiliations: (1) grid.10423.34, 0000 0000 9529 [...]
Background Photon-counting detector computed tomography (PCD-CT) has the potential to provide superior image quality compared to energy-integrating detector computed tomography (EID-CT). We compared the two systems for elbow imaging in off-center arm positioning, 90° flexion, and cast fixation in a simulated post-trauma setting. Methods The institutional review board approved the study protocol. In a cadaver study, an olecranon fracture was artificially created in ten whole arm specimens. Two different scanning positions were evaluated: (a) arm overhead; and (b) arm on top of the abdomen of a whole-body phantom. The ultra-high resolution mode with three dose protocols and two reconstruction kernels was applied. Two blinded radiologists independently evaluated fracture and trabecular bone delineation. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and cortical sharpness measurements were performed. Cohen [kappa] correlations, Mann-Whitney U and Wilcoxon signed rank tests were used. A p value lower than 0.05 was considered statistically significant. Results Dose-equivalent PCD-CT scans were rated better for fracture and trabecular bone evaluation (p < 0.001). SNR, CNR, and cortical sharpness were higher for all diagnostic (Br76) PCD-CT images (p < 0.001). The arm position had less effect on image quality in the PCD-CT compared to the EID-CT. The use of a sharp bone kernel (Br89) improved image quality ratings for PCD-CT. In the low-dose scan mode, PCD-CT resulted in more diagnostic scans (75%) compared to EID-CT (19%). Conclusions PCD-CT provided superior objective and subjective image quality for fracture and trabecular bone structures delineation of the elbow compared to EID-CT in a typical post-trauma setting. Key points * Photon-counting detector computed tomography (PCD-CT) preserved high image quality in elbow imaging with off-center positions. * PCD-CT was advantageous for bone evaluation in trauma elbows. * PCD-CT ultra-high-resolution mode and very sharp reconstruction kernels facilitated higher image quality.
Background Photon-counting detector computed tomography (PCD-CT) has the potential to provide superior image quality compared to energy-integrating detector computed tomography (EID-CT). We compared the two systems for elbow imaging in off-center arm positioning, 90° flexion, and cast fixation in a simulated post-trauma setting. Methods The institutional review board approved the study protocol. In a cadaver study, an olecranon fracture was artificially created in ten whole arm specimens. Two different scanning positions were evaluated: (a) arm overhead; and (b) arm on top of the abdomen of a whole-body phantom. The ultra-high resolution mode with three dose protocols and two reconstruction kernels was applied. Two blinded radiologists independently evaluated fracture and trabecular bone delineation. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and cortical sharpness measurements were performed. Cohen [kappa] correlations, Mann-Whitney U and Wilcoxon signed rank tests were used. A p value lower than 0.05 was considered statistically significant. Results Dose-equivalent PCD-CT scans were rated better for fracture and trabecular bone evaluation (p < 0.001). SNR, CNR, and cortical sharpness were higher for all diagnostic (Br76) PCD-CT images (p < 0.001). The arm position had less effect on image quality in the PCD-CT compared to the EID-CT. The use of a sharp bone kernel (Br89) improved image quality ratings for PCD-CT. In the low-dose scan mode, PCD-CT resulted in more diagnostic scans (75%) compared to EID-CT (19%). Conclusions PCD-CT provided superior objective and subjective image quality for fracture and trabecular bone structures delineation of the elbow compared to EID-CT in a typical post-trauma setting. Key points * Photon-counting detector computed tomography (PCD-CT) preserved high image quality in elbow imaging with off-center positions. * PCD-CT was advantageous for bone evaluation in trauma elbows. * PCD-CT ultra-high-resolution mode and very sharp reconstruction kernels facilitated higher image quality.