Search Results (203)

Background/Objectives: Aortic valve calcification is commonly evaluated using 3.0 mm true non-contrast (TNC) computed tomography (CT) images. This study evaluates the reproducibility of virtual non-contrast (VNC) reconstructions at different slice intervals using photon-counting detector CT (PCD-CT). Methods: In this retrospective study, we included 279 consecutive patients, who underwent PCD-CT for evaluation of native aortic valve between February 2023 and December 2023 with both TNC and VNC images at 3.0 and 1.5 mm slice intervals. Aortic valve calcium score (AVCS) and aortic valve calcium volume (AVCV) were compared between the two methods using paired t-tests. Agreement for continuous variables was assessed using inter-class coefficients (ICCs). Cohen’s Kappa (κ) was calculated to evaluate the agreement between different modalities in diagnosing severe AV calcification. Results: Compared to the standard, TNC images at 1.5 mm intervals showed higher AVCS (mean difference: −290 ± 418, p < 0.001), with high reproducibility between techniques (CS: ICC 0.969, [IQR 0.962, 0.975]). Compared with reference, VNC showed no significant differences in AVCS at either slice intervals, with excellent reproducibility (3.0 mm, ICC 0.970 [0.963, 0.976]; 1.5 mm, ICC 0.971 [0.964, 0.977]). Compared to TNC 3.0 mm, strong concordance was observed using other reconstruction techniques in assessing severe AV calcification (κ = 0.81 [95% CI: 0.74–0.88], 0.83 [95% CI: 0.76–0.90], and 0.83 [95% CI: 0.76–0.90] for TNC at 1.5 mm, VNC at 3.0 mm, and 1.5 mm, respectively), with low misclassification rates. Conclusions: Our study highlights high reproducibility in the evaluation of AVCS by VNC reconstruction at 3.0 and 1.5 mm intervals compared with reference offering a reliable alternative with an excellent diagnostic accuracy. Full article

Background: Photon-counting computed tomography (PCCT) represents a major technological advance in clinical CT imaging, offering superior spatial resolution, enhanced material discrimination, and potential radiation dose reduction compared to conventional energy-integrating detector systems. As the first clinically approved PCCT scanner becomes available, establishing a comprehensive characterization of its image quality is essential to understand its performance and clinical impact. Methods: Image quality was evaluated using a commercial quality assurance phantom with acquisition protocols typically used for three anatomical regions—head, abdomen/thorax, and inner ear—representing diverse clinical scenarios. Each region was scanned using both ultra-high-resolution (UHR, 120 × 0.2 mm slices) and conventional (144 × 0.4 mm slices) protocols. Conventional metrics, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), slice thickness accuracy, and uniformity, were assessed following international standards. Task-based analysis was also performed through target transfer function (TTF), noise power spectrum (NPS), and detectability index (d′) to evaluate diagnostic relevance. Results: UHR protocols provided markedly improved spatial resolution, particularly in the inner ear imaging, as confirmed by TTF analysis, though with increased noise and reduced low-contrast detectability in certain conditions. CT numbers showed linear correspondence with known attenuation coefficients across all protocols. Conclusions: This study establishes a detailed technical characterization of the first clinical PCCT scanner, demonstrating significant improvements in terms of spatial resolution and accuracy of the quantitative image analysis, while highlighting the need for noise–contrast optimization in high-resolution imaging. Full article

Background/Objectives: This study evaluates photon-counting CT (PCCT) for the imaging of mouse femurs and investigates how APOE genotype, sex, and humanized nitric oxide synthase (HN) expression influence bone morphology during aging. Methods: A custom-built micro-CT system with a photon-counting detector (PCD) was used to acquire dual-energy scans of mouse femur samples. PCCT projections were corrected for tile gain differences, iteratively reconstructed with 20 µm isotropic resolution, and decomposed into calcium and water maps. PCD spatial resolution was benchmarked against an energy-integrating detector (EID) using line profiles through trabecular bone. The contrast-to-noise ratio quantified the effects of iterative reconstruction and material decomposition. Femur features such as mean cortical thickness, mean trabecular spacing (TbSp_mean), and trabecular bone volume fraction (BV/TV) were extracted from calcium maps using BoneJ. The statistical analysis used 57 aged mice representing the APOE22, APOE33, and APOE44 genotypes, including 27 expressing HN. We used generalized linear models (GLMs) to evaluate the main interaction effects of age, sex, genotype, and HN status on femur features and Mann–Whitney U tests for stratified analyses. Results: PCCT outperformed EID-CT in spatial resolution and enabled the effective separation of calcium and water. Female HN mice exhibited reduced BV/TV compared to both male HN and female non-HN mice. While genotype effects were modest, a genotype-by-sex stratified analysis found significant effects of HN status in female APOE22 and APOE44 mice only. Linear regression showed that age significantly decreased cortical thickness and increased TbSp_mean in male mice only. Conclusions: These results demonstrate PCCT’s utility for femur analysis and reveal strong effects of sex/HN interaction on trabecular bone health in mice. Full article

Microcalcifications (HAp, CaCO₃, and CaC₂O₄) in breast tissue may indicate malignancy. Early-stage breast cancer diagnosis may benefit from the clinical application of dual-energy techniques. Dual-energy cone-beam computed tomography (CBCT) could strongly contribute to an accurate diagnosis, especially in dense breasts. This study focused on photon-counting detector alternatives to the standard cesium iodide (CsI) that CBCT currently relies on and investigated potential advantages over the employed CsI scintillators. Denser detector materials with a higher effective atomic number than CsI could improve image quality. A micro-CBCT was simulated in GATE using seven different detector configurations (CsI, bismuth germanate (BGO), lutetium oxyorthosilicate (LSO), lutetium–yttrium oxyorthosilicate (LYSO), gadolinium aluminum gallium garnet (GAGG), lanthanum bromide (LaBr₃), and cadmium zinc telluride (CZT)) and four breast tissue phantoms containing microcalcifications of both type I and type II. The dual-energy methodology was applied to planar and tomographic acquisition data. Tomographic data were reconstructed using filtered backprojection (FBP) and the ordered-subsets expectation-maximization (OSEM) algorithm. Image quality was measured using contrast-to-noise ratio (CNR) values. Both monoenergetic and polyenergetic models were considered. CZT and GAGG crystals presented higher CNR values than CsI. HAp microcalcifications exhibited the highest CNR values, which, when accompanied by OSEM, could be distinguished for classification. Detector configurations based on CZT or GAGG crystals could be adequate alternatives to CsI in dual-energy CBCT. Full article

This review focuses on the diverse etiologies of secondary spontaneous pneumothorax (SSP) and the crucial role of imaging in their diagnosis. Unlike primary spontaneous pneumothorax (PSP), which is typically due to ruptured blebs, SSP results from a wide array of underlying pulmonary conditions that can pose significant diagnostic challenges. These include infections like tuberculosis, airway diseases such as chronic obstructive pulmonary disease, malignancies (primary and metastatic), interstitial lung diseases like sarcoidosis, cystic lung diseases such as lymphangioleiomyomatosis, and connective tissue disorders. In women, catamenial pneumothorax secondary to endometriosis should be considered. The role of radiologists is crucial in uncovering these underlying conditions. While chest radiography is the initial imaging modality, computed tomography (CT) provides superior sensitivity for detecting subtle parenchymal abnormalities. Advanced techniques like photon-counting detector CT offer further benefits, including enhanced spatial resolution, reduced noise, and lower radiation dose, potentially revealing underlying causes that might be missed with conventional CT. This enhanced visualization of subtle parenchymal changes, small airways, and vascular structures can be the key to diagnosing the underlying cause of pneumothorax. Recognizing the diverse etiologies of SSP and utilizing advanced imaging techniques is paramount for accurate diagnosis, appropriate management, and improved patient outcomes. Full article

This work investigates the impact of scatter correction on photon-counting dual-energy chest radiography using a moving block method, focusing on quantifying improvements with the IEC 62220-2-1 dual-energy metrics. A modified LucAl-based chest phantom with PMMA and aluminum inserts was modeled in three sizes (small, standard, large) to represent different patient sizes. Monte Carlo simulations with MC-GPU and the Photon Counting Toolkit were used to simulate a CdTe photon-counting detector with two energy thresholds at 30 and 70 keV. Scatter was estimated from blocker shadows at 25 positions, interpolated across the field of view, and smoothed with a Gaussian filter ($\sigma =5.0$ mm), then subtracted separately from low- and high-energy images. Performance was evaluated using the per-feature dual-energy contrast (DEC) and the kerma-normalized dual-energy subtraction efficiency (DSE) with all acquisitions normalized to an entrance air kerma of 1 mGy to reflect clinical exposure conditions. In simulations, the moving block estimate reproduced the true scatter distribution with an average pixel-wise error of 0.4%. Scatter contamination introduced visible artifacts in the dual-energy subtraction images, particularly in aluminum-enhanced (Al-enhanced) images, and reduced contrast for target materials by up to 25%, as reflected in both DEC and DSE values at a fixed dose. Scatter correction restored image contrast, increased DEC for target materials while keeping non-target DEC low, and reduced edge artifacts across phantom sizes with the largest gains in the large phantom. These results support the moving block method as a dose-neutral strategy to improve dual-energy subtraction performance in photon-counting chest radiography. Full article

Background: Computed tomography (CT)-based image-guided surgery (IGS) is of great importance in functional endoscopic sinus surgery (FESS) and requires IGS-specific imaging protocols to ensure high intraoperative accuracy. This study aimed to compare photon-counting CT (PCCT), dual-energy dual-source CT (DECT), and spectral detector CT (SDCT) of the paranasal sinuses with respect to image quality, IGS accuracy and radiation dose. Methods: A formalin-fixed cadaver skull was examined using PCCT, DECT and SDCT at 100 kV tube voltage with descending tube currents (mAs). The setup of electromagnetic IGS was evaluated using a visual analog scale. Accuracy was analyzed endoscopically using defined anatomical landmarks. Diagnostic image quality as well as bone and soft tissue noise were assessed qualitatively using a 5-point Likert scale and quantitatively by determination of signal-to-noise ratio. Radiation dose was evaluated using the dose length product. Results: While PCCT datasets could be registered and navigated accurately down to 10 mAs (1.5 mm error at 10 mAs), both DECT and SDCT exhibited significantly increased inaccuracies below 40 mAs (4.35/5.15 mm for DECT/SDCT at 25 mAs). Using PCCT therefore enabled a 45% radiation dose reduction at the minimally required dose length product using PCCT. Quantitative and qualitative image quality were superior for PCCT compared to DECT and SDCT. Conclusions: PCCT provides excellent accuracy of anatomical landmarks in IGS with superior image quality of the paranasal sinuses in low-mA scans and substantially reduced radiation exposure. Full article

Background: Computed tomography (CT) is the standard of reference for diagnosis and follow-up in aortic dissection (AD). Localizing the entry and identifying false and true lumen are as important as differing post-treatment changes from contrast media extravasations. Photon-counting detector CT (PCDCT) allows for virtual monoenergetic (VME) reconstructions, which can augment contrast media effects on lower energy levels, and for virtual non-contrast (VNC) reconstructions. The aim of this study was to analyze the influence of VME reconstructions on contrast media effects in different dissection compartments as well as compare true and VNC series in AD patients. Methods: We retrospectively analyzed PCDCT datasets from 28 patients with aortic dissections, with different dissection types and different treatment statuses. Attenuation and standard deviation values of the ascending and descending aorta, as well as CT values of the false lumen, were measured. These measurements were obtained from VME images at energy levels ranging from 40 to 190 keV in 10 keV increments, as well as from non-contrast (NC) and VNC reconstructions. The signal-to-noise ratio (SNR) was calculated. Additionally, subjective values for dissection assessability and native aspects of the images were acquired for different reconstructions. Results: CT values decreased with higher energy levels in VME imaging. Ascending aorta showed higher attenuation values than descending aorta, which was higher than false lumen (e.g., at 70 keV ascending 357 [310; 419] HU, descending 346 [305; 401] HU and false lumen 298 [248; 363] HU). These differences increased on lower VME reconstructions with statistical significance for the comparisons of ascending and descending aorta with the false lumen on all energy levels. In line with this, SNR showed highest values for ascending aorta compared to descending aorta and false lumen on all energy levels. For NC comparisons, VNC and VME at 190 keV reconstructions showed higher CT values than NC reconstructions (e.g., overall data NC 48 [42; 55] HU, VNC 66 [57; 73] HU, 190 keV 97 [89; 105] HU). Subjective ratings were worse with VNC than with NC images. Conclusions: VME reconstructions on lower energy levels can be helpful in differentiating between true and false lumen in aortic dissections. Full article

Superconducting Transition Edge Sensors (TESs) are a promising technology for fundamental physics applications due to their low dark count rates, excellent energy resolution, and high detection efficiency. On the DESY campus, we have been developing a program to characterize cryogenic quantum sensors for fundamental physics applications, particularly focused on TESs. We currently have two fully equipped dilution refrigerators that enable simultaneous TES characterization and fundamental physics searches. In this paper, we summarize the current status of our TES characterization, including recent calibration efforts and efficiency measurements, as well as simulations to better understand TES behavior and its backgrounds. Additionally, we summarize some physics applications that we are already exploring or planning to explore. We will give preliminary projections on a direct dark matter search with our TES, where exploiting low-threshold electron scattering in superconducting materials allows us to search for sub-MeV-scale dark matter. We are also working toward performing a measurement of the even-number photon distribution (beyond one pair) of a quantum-squeezed light source. Finally, if it proves to meet the requirements, our TES detector may be used as a second, independent detection system to search for an axion signal at the ALPS II experiment. Full article

Material decomposition in X-ray imaging is essential for enhancing tissue differentiation and reducing the radiation dose, but the clinical adoption of photon-counting detectors (PCDs) is limited by their high cost and technical complexity. To address this, we propose Dual-head Pix2Pix, a PCD-guided deep learning framework that enables simultaneous iodine and bone decomposition from single-energy X-ray projections acquired with conventional energy-integrating detectors. The model was trained and tested on 1440 groups of energy-integrating detector (EID) projections with their corresponding iodine/bone decomposition images. Experimental results demonstrate that the Dual-head Pix2Pix outperforms baseline models. For iodine decomposition, it achieved a mean absolute error (MAE) of 5.30 ± 1.81, representing an ~10% improvement over Pix2Pix (5.92) and a substantial advantage over CycleGAN (10.39). For bone decomposition, the MAE was reduced to 9.55 ± 2.49, an ~6% improvement over Pix2Pix (10.18). Moreover, Dual-head Pix2Pix consistently achieved the highest MS-SSIM, PSNR, and Pearson correlation coefficients across all benchmarks. In addition, we performed a cross-domain validation using projection images acquired from a conventional EID-CT system. The results show that the model successfully achieved the effective separation of iodine and bone in this new domain, demonstrating a strong generalization capability beyond the training distribution. In summary, Dual-head Pix2Pix provides a cost-effective, scalable, and hardware-friendly solution for accurate dual-material decomposition, paving the way for the broader clinical and industrial adoption of material-specific imaging without requiring PCDs. Full article

We describe and model a non-cryogenic optical detector designed to count incident photons with metrological accuracy. Our design consists of a semiconductor device operating at $-10$ °C and is predicted to resolve pulses of up to 10 photons with an error rate of 2% in the input number of photons. We present an estimate of the overall device performance using a combination of estimates and simulations of optical loss, discrete electron loss and noise, and electronic noise. Full article

Aberrant internal carotid arteries (ICA) are congenital vascular anomalies that occur from involution of the cervical portion of the ICA, which leads to enlargement of the normally small collateral inferior tympanic and caroticotympanic arteries. The inferior tympanic artery is a branch of the external carotid artery, usually the ascending pharyngeal artery, which extends through the inferior tympanic canaliculus (ITC), a small foramen located along the cochlea promontory. Aberrant ICAs can also be associated with a persistent stapedial artery (PSA), which is an abnormal vessel that arises from the petrous ICA and passes through the obturator foramen of the stapes. An aberrant ICA is a very important anomaly to recognize on imaging. Accurately describing its presence is important to help prevent iatrogenic injury during intervention. It is also important to distinguish an aberrant ICA from a lateralized ICA. The improvement of spatial resolution with photon counting detector (PCD)-CT has been proven to provide higher performance in detection of sub-centimeter vascular lesions compared to conventional energy-integrated detector (EID)-CT. PCD-CT also provides superior visualization of small skull-based foramina such as the inferior tympanic canaliculus, which can aid in more accurately characterizing an aberrant ICA (variant course without ITC involvement). Full article

This article proposes a novel three-dimensional trench electrode detector, named the through-type three-dimensional quasi-hemispherical electrode detector. The detector adopts a trench structure to package each independent unit and achieves complete penetration of trench electrodes with the help of an SOI substrate. The horizontal distances from the center anode of the detector to the trench cathode and the detector thickness are equal. It has a near-spherical structure and exhibits spherical-like electrical performance. In this study, we modeled the device physics of the new structure and conducted a systematic three-dimensional simulation of its electrical characteristics, including the electric field, electric potential, electron concentration distribution of the detector, the inducted current caused by incident ions, and the crosstalk between detector units. Computational and technology computer-aided design (TCAD) simulation results show that the detector has an ultra-small capacitance (2.7 fF), low depletion voltage (1.4 V), and uniform electric field distribution. The trench electrodes electrically isolate the pixel units from each other so that the coherence effect between the units is small and can be applied in high-resolution X-ray photon counting detectors to enhance the contrast-to-noise ratio of low-dose imaging and the detection rate of tiny structures, among other things. Full article

Background/Objectives: Coronary CT angiography (CCTA) is a cornerstone in evaluating stable coronary artery disease (CAD), but conventional energy-integrating detector CT (EID-CT) has limitations, including calcium blooming and limited spatial resolution. Photon-counting detector CT (PCD-CT) may overcome these drawbacks through enhanced spatial resolution and improved tissue characterization. Methods: In this retrospective, propensity score–matched study, we compared CCTA findings from 820 patients (410 per group) who underwent either EID-CT or PCD-CT for suspected stable CAD. Primary outcomes included stenosis severity, high-risk plaque features, and downstream invasive coronary angiography (ICA) referral and yield. Results: The matched cohorts were balanced in demographics and cardiovascular risk factors (mean age 67 years, 63% male). PCD-CT showed a favorable shift in stenosis severity distribution (p = 0.03). High-risk plaques were detected less frequently with PCD-CT (22.7% vs. 30.5%, p = 0.01). Median coronary calcium scores did not differ (p = 0.60). Among patients referred for ICA, those initially evaluated with PCD-CT were more likely to undergo revascularization (62.5% vs. 44.1%), and fewer underwent potentially unnecessary ICA without revascularization (3.7% vs. 8.0%, p = 0.001). The specificity in diagnosing significant stenosis requiring revascularization was 0.74 with EID-CT and 0.81 with PCD-CT (p = 0.04). Conclusions: PCD-CT improved diagnostic specificity for CAD, reducing unnecessary ICA referrals while maintaining detection of clinically significant disease. This advanced CT technology holds promise for more accurate, efficient, and patient-centered CAD evaluation. Full article

Spectroscopic observations of Earth-like exoplanets and ultra-faint galaxies–top scientific priorities for the coming decades–involve measuring broadband signals at rates of only a few photons per square meter per hour. This imposes exceptional requirements on the detector performance, necessitating dark currents below 1 e⁻/pixel/kilo second, read noise under 1 e⁻/pixel/frame, and the ability to handle large-format arrays–capabilities that are not yet met by most existing infrared detectors. In addition, spaceborne LiDAR systems require photodetectors with exceptional sensitivity, compact size, low power consumption, and multi-channel capability to facilitate long-range range finding, topographic mapping, and active spectroscopy without increasing the instrument burden. MCT Avalanche photodiodes arrays offer high internal gain, pixelation, and photon-counting performance across SW to MW wavelengths needed for multi-beam and multi-wavelength measurements, marking them as a critical enabling technology for next-generation planetary and Earth science LiDAR missions. This work reports the latest progress in developing Hg_1−xCd_xTe linear-mode e-APDs at premier industrial research institutions, including relevant experimental data, simulations and major project planning. Related studies are summarized to demonstrate the practical and iterative approach for device fabrication, which have a transformative impact on the evolution of this discipline. Full article