Abstract

Background

With the emergence of photon-counting CT, ultrahigh-resolution (UHR) imaging can be performed without dose penalty. This study aims to directly compare the image quality of UHR and standard resolution (SR) scan mode in femoral artery angiographies.

Methods

After establishing continuous extracorporeal perfusion in four fresh-frozen cadaveric specimens, photon-counting CT angiographies were performed with a radiation dose of 5 mGy and tube voltage of 120 kV in both SR and UHR mode. Images were reconstructed with dedicated convolution kernels (soft: Body-vascular (Bv)48; sharp: Bv60; ultrasharp: Bv76). Six radiologists evaluated the image quality by means of a pairwise forced-choice comparison tool. Kendall’s concordance coefficient (W) was calculated to quantify interrater agreement. Image quality was further assessed by measuring intraluminal attenuation and image noise as well as by calculating signal-to-noise ratio (SNR) and contrast-to-noise ratios (CNR).

Results

UHR yielded lower noise than SR for identical reconstructions with kernels ≥ Bv60 (p < 0.001). UHR scans exhibited lower intraluminal attenuation compared to SR (Bv60: 406.4 ± 25.1 versus 418.1 ± 30.1 HU; p < 0.001). Irrespective of scan mode, SNR and CNR decreased while noise increased with sharper kernels but UHR scans were objectively superior to SR nonetheless (Bv60: SNR 25.9 ± 6.4 versus 20.9 ± 5.3; CNR 22.7 ± 5.8 versus 18.4 ± 4.8; p < 0.001). Notably, UHR scans were preferred in subjective assessment when images were reconstructed with the ultrasharp Bv76 kernel, whereas SR was rated superior for Bv60. Interrater agreement was high (W = 0.935).

Conclusions

Combinations of UHR scan mode and ultrasharp convolution kernel are able to exploit the full image quality potential in photon-counting CT angiography of the femoral arteries.

Relevance statement

The UHR scan mode offers improved image quality and may increase diagnostic accuracy in CT angiography of the peripheral arterial runoff when optimized reconstruction parameters are chosen.

Key points

• UHR photon-counting CT improves image quality in combination with ultrasharp convolution kernels.

• UHR datasets display lower image noise compared with identically reconstructed standard resolution scans.

• Scans in UHR mode show decreased intraluminal attenuation compared with standard resolution imaging.

Details

Title
Comparison of ultrahigh and standard resolution photon-counting CT angiography of the femoral arteries in a continuously perfused in vitro model
Author
Gruschwitz, Philipp 1   VIAFID ORCID Logo  ; Hartung, Viktor 1 ; Ergün, Süleyman 2 ; Peter, Dominik 3 ; Lichthardt, Sven 3 ; Huflage, Henner 1 ; Hendel, Robin 1 ; Pannenbecker, Pauline 1 ; Augustin, Anne Marie 1 ; Kunz, Andreas Steven 1 ; Feldle, Philipp 1 ; Bley, Thorsten Alexander 1 ; Grunz, Jan-Peter 1 

1  University Hospital of Würzburg, Department of Diagnostic and Interventional Radiology, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891) 
2  University of Würzburg, Institute of Anatomy and Cell Biology, Würzburg, Germany (GRID:grid.8379.5) (ISNI:0000 0001 1958 8658) 
3  University Hospital of Würzburg, Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, Würzburg, Germany (GRID:grid.411760.5) (ISNI:0000 0001 1378 7891) 
Pages
83
Publication year
2023
Publication date
Dec 2023
Publisher
Springer Nature B.V.
e-ISSN
25099280
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s41747-023-00398-x
ProQuest document ID
2903151141
Copyright
© The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.