ArticleEuropean radiology experimental2024
In vitro and in vivo optimized reconstruction for low-keV virtual monoenergetic photon-counting detector CT angiography of lower legs.
Article in European radiology experimental, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Endoleak detection with photon-counting detector CT at various radiation doses after endovascular aneurysm repair: a phantom study.The international journal of cardiovascular imaging · 2026Article
- A scoping review of photon-counting detector computed tomography in cardiovascular imaging.Diagnostic and interventional radiology (Ankara, Turkey) · 2026Article
- Technical advances and clinical impact of photon-counting computed tomography angiography for peripheral artery disease.Journal of vascular surgery cases and innovative techniques · 2026Article
- Effect of quantum iterative reconstruction on coronary stent assessment in ultra-high resolution photon-counting detector CT: a phantom study.European radiology experimental · 2026Article
- Photon-Counting CT Angiography Enables Superior Preoperative Perforator Depiction for Fibular Transplant Surgery Requiring Less Contrast Agent Compared to Energy-Integrating CT.Diagnostics (Basel, Switzerland) · 2026Article
- Photon-counting detector CT: a disrupting innovation in medical imaging.European radiology experimental · 2025Article
- Reducing contrast media and radiation dose in CT angiography at low tube voltage: animal study with photon-counting detector CT.European radiology experimental · 2025Article
- Beam hardening of K-edge contrast agents: a phantom study comparing clinical energy-integrating detector and photon-counting detector CT systems.European radiology experimental · 2025Article
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12 authors.
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Abstract
backgroundLower extremity peripheral artery disease frequently presents with calcifications which reduces the accuracy of computed tomography (CT) angiography, especially below-the-knee. Photon-counting detector (PCD)-CT offers improved spatial resolution and less calcium blooming. We aimed to identify the optimal reconstruction parameters for PCD-CT angiography of the lower legs.
methodsTubes with different diameters (1-5 mm) were filled with different iodine concentrations and scanned in a water container. Images were reconstructed with 0.4 mm isotropic resolution using a quantitative kernel at all available sharpness levels (Qr36 to Qr76) and using different levels of quantum iterative reconstruction (QIR-2-4). Noise and image sharpness were determined for all reconstructions. Additionally, CT angiograms of 20 patients, reconstructed with a medium (Qr44), sharp (Qr60), and ultrasharp (Qr72) kernel at QIR-2-4, were evaluated by three readers assessing noise, delineation of plaques and vessel walls, and overall quality.
resultsIn the phantom study, increased kernel sharpness led to higher image noise (e.g., 16, 38, 77 HU for Qr44, Qr60, Qr72, and QIR-3). Image sharpness increased with increasing kernel sharpness, reaching a plateau at the medium-high level 60. Higher QIR levels decreased image noise (e.g., 51, 38, 25 HU at QIR-2-4 and Qr60) without reducing vessel sharpness. The qualitative in vivo results confirmed these findings: the sharp kernel (Qr60) with the highest QIR yielded the best overall quality.
conclusionThe combination of a sharpness level optimized reconstruction kernel (Qr60) and the highest QIR level yield the best image quality for PCD-CT angiography of the lower legs when reconstructed at 0.4-mm resolution. RELEVANCE STATEMENT: Using high-resolution PCD-CT angiography with optimized reconstruction parameters might improve diagnostic accuracy and confidence in peripheral artery disease of the lower legs. KEY POINTS: Effective exploitation of the potential of PCD-CT angiography requires optimized reconstruction parameters. Too soft or too sharp reconstruction kernels reduce image quality. The highest level of quantum iterative reconstruction provides the best image quality.
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