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Article

Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI

1
Clinic for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany
2
Medical Faculty, Ludwig Maximilian University of Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Hatem Alkadhi
Diagnostics 2022, 12(5), 1231; https://doi.org/10.3390/diagnostics12051231
Received: 9 March 2022 / Revised: 25 April 2022 / Accepted: 26 April 2022 / Published: 14 May 2022
(This article belongs to the Special Issue Advances in Photon Counting Detector Imaging)
In dual-energy CT datasets, the conspicuity of liver metastases can be enhanced by virtual monoenergetic imaging (VMI) reconstructions at low keV levels. Our study investigated whether this effect can be reproduced in photon-counting detector CT (PCD-CT) datasets. We analyzed 100 patients with liver metastases who had undergone contrast-enhanced CT of the abdomen on a PCD-CT (n = 50) or energy-integrating detector CT (EID-CT, single-energy mode, n = 50). PCD-VMI-reconstructions were performed at various keV levels. Identical regions of interest were positioned in metastases, normal liver, and other defined locations assessing image noise, tumor-to-liver ratio (TLR), and contrast-to-noise ratio (CNR). Patients were compared inter-individually. Subgroup analyses were performed according to BMI. On the PCD-CT, noise and CNR peaked at the low end of the keV spectrum. In comparison with the EID-CT, PCD-VMI-reconstructions exhibited lower image noise (at 70 keV) but higher CNR (for ≤70 keV), despite similar CTDIs. Comparing high- and low-BMI patients, CTDI-upregulation was more modest for the PCD-CT but still resulted in similar noise levels and preserved CNR, unlike the EID-CT. In conclusion, PCD-CT VMIs in oncologic patients demonstrated reduced image noise–compared to a standard EID-CT–and improved conspicuity of hypovascularized liver metastases at low keV values. Patients with higher BMIs especially benefited from constant image noise and preservation of lesion conspicuity, despite a more moderate upregulation of CTDI. View Full-Text
Keywords: photon-counting detector CT; virtual monoenergetic imaging; liver metastases; oncologic imaging photon-counting detector CT; virtual monoenergetic imaging; liver metastases; oncologic imaging
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MDPI and ACS Style

Bette, S.; Decker, J.A.; Braun, F.M.; Becker, J.; Haerting, M.; Haeckel, T.; Gebhard, M.; Risch, F.; Woźnicki, P.; Scheurig-Muenkler, C.; Kroencke, T.J.; Schwarz, F. Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI. Diagnostics 2022, 12, 1231. https://doi.org/10.3390/diagnostics12051231

AMA Style

Bette S, Decker JA, Braun FM, Becker J, Haerting M, Haeckel T, Gebhard M, Risch F, Woźnicki P, Scheurig-Muenkler C, Kroencke TJ, Schwarz F. Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI. Diagnostics. 2022; 12(5):1231. https://doi.org/10.3390/diagnostics12051231

Chicago/Turabian Style

Bette, Stefanie, Josua A. Decker, Franziska M. Braun, Judith Becker, Mark Haerting, Thomas Haeckel, Michael Gebhard, Franka Risch, Piotr Woźnicki, Christian Scheurig-Muenkler, Thomas J. Kroencke, and Florian Schwarz. 2022. "Optimal Conspicuity of Liver Metastases in Virtual Monochromatic Imaging Reconstructions on a Novel Photon-Counting Detector CT—Effect of keV Settings and BMI" Diagnostics 12, no. 5: 1231. https://doi.org/10.3390/diagnostics12051231

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