Ultrahigh-resolution computed tomography of the cervical spine without dose penalty employing a cadmium-telluride photon-counting detector

Nora Conrads; Jan-Peter Grunz; Henner Huflage; Karsten Sebastian Luetkens; Philipp Feldle; Lenhard Pennig; Süleyman Ergün; Thorsten Alexander Bley; Bernhard Petritsch; Andreas Steven Kunz

doi:10.1016/j.ejrad.2023.110718

Ultrahigh-resolution computed tomography of the cervical spine without dose penalty employing a cadmium-telluride photon-counting detector

Eur J Radiol. 2023 Mar:160:110718. doi: 10.1016/j.ejrad.2023.110718. Epub 2023 Jan 27.

Affiliations

¹ Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany. Electronic address: Conrads_N1@ukw.de.
² Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
³ Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany.
⁴ Institute of Anatomy and Cell Biology, University of Würzburg, Koellikerstraße 6, 97070 Würzburg, Germany.

PMID: 36731400
DOI: 10.1016/j.ejrad.2023.110718

Abstract

Purpose: This cadaveric study compared image quality between a third-generation dual-source CT scanner with energy-integrating detector technology (EID) and a first-generation CT system employing a photon-counting detector (PCD) for the cervical spine in ultrahigh-resolution mode.

Methods: The cervical spine of eight formalin-fixed full-body cadaveric specimens was scanned with both CT systems using 140 kVp scan protocols matched for CTDI_vol (full-dose; low-dose; ultralow-dose; 10 mGy; 3 mGy; 1 mGy). Images were reconstructed with 1 mm slice thickness and 0.5 mm increment. Three radiologists rated overall subjective image quality based on an equidistant five-point scale with the intraclass correlation coefficient (ICC) calculated for assessment of interobserver reliability. Contrast-to-noise ratios were calculated individually for bone (CNR_bone) and muscle tissue (CNR_muscle) to provide objective criteria of image analysis.

Results: Subjective image quality, as well as CNR_bone, and CNR_muscle were each superior for PCD-CT compared to EID-CT among dose-matched scan protocol pairs (all p < 0.05). Between full-dose EID-CT and low-dose PCD-CT, subjective image quality was equal (p = 0.903), while superior quantitative results regarding the latter were ascertained (both p < 0.001). Similarly, objective analysis determined higher CNR_bone, and CNR_muscle in ultralow-dose PCD-CT compared to low-dose EID-CT (both p < 0.001), while readers considered the image quality of the respective studies comparable (p > 0.99). Interobserver reliability was good, denoted by an ICC of 0.861 (95 % confidence interval: 0.788 - 0.914; p < 0.001).

Conclusions: In cervical spine examinations, both subjective and objective image quality of PCD-CT were superior to EID-CT in comparison of scan protocols with corresponding dose levels, suggesting potential for significantly reducing the radiation exposure without compromising image quality.

Keywords: Cervical spine; Dose reduction; Photon-counting CT; Spatial resolution.

MeSH terms

Cadaver
Cadmium*
Cervical Vertebrae / diagnostic imaging
Humans
Phantoms, Imaging
Reproducibility of Results
Tomography, X-Ray Computed* / methods

Substances

Cadmium