Abstract：
OBJECTIVE: This study aims to demonstrate reduced iodine contrast media (CM) in routine abdominal CT scans in portal venous phase (PVP) using a photon-counting detector CT (PCD-CT) compared to total body weight (TBW) and kV-adapted CM injection protocols on a state-of-the-art energy-integrating detector CT (EID-CT) while maintaining sufficient image quality (IQ).
METHODS: Consecutive contrast-enhanced abdominal PVP CT scans from an EID-CT (Nov 2022-March 2024) and a PCD-CT (Sep 2023-Dec 2023) were compared. CM parameters (total iodine load (TIL), iodine delivery rate (IDR) and dosing factor (DF)) were reported. An individualized acquisition and CM injection protocol based on TBW and kV was applied for the EID-CT and a TBW adapted CM injection protocol was used for the PCD-CT. Objective IQ was evaluated with mean attenuation (Hounsfield Units, HU), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)). Subjective IQ was assessed via a 5-point Likert scale by 2 expert readers based on diagnostic confidence.
RESULTS: Based on 91 EID-CT scans and 102 PCD-CT scans a TIL reduction of 20.1 % was observed for PCD-CT. PCD-CT demonstrated significantly higher SNR (9.9 ± 1.7 vs. 9.1 ± 1.8, p < 0.001) and CNR (5.1 ± 1.7 vs. 4.3 ± 1.3, p < 0.001) compared to EID-CT. Subjective IQ assessment showed that all scans had sufficient diagnostic IQ.
CONCLUSIONS: PCD-CT allows for CM reduction while providing higher SNR and CNR compared to EID-CT, using clinical individualized scan and CM injection protocols.
METHODS: Consecutive contrast-enhanced abdominal PVP CT scans from an EID-CT (Nov 2022-March 2024) and a PCD-CT (Sep 2023-Dec 2023) were compared. CM parameters (total iodine load (TIL), iodine delivery rate (IDR) and dosing factor (DF)) were reported. An individualized acquisition and CM injection protocol based on TBW and kV was applied for the EID-CT and a TBW adapted CM injection protocol was used for the PCD-CT. Objective IQ was evaluated with mean attenuation (Hounsfield Units, HU), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)). Subjective IQ was assessed via a 5-point Likert scale by 2 expert readers based on diagnostic confidence.
RESULTS: Based on 91 EID-CT scans and 102 PCD-CT scans a TIL reduction of 20.1 % was observed for PCD-CT. PCD-CT demonstrated significantly higher SNR (9.9 ± 1.7 vs. 9.1 ± 1.8, p < 0.001) and CNR (5.1 ± 1.7 vs. 4.3 ± 1.3, p < 0.001) compared to EID-CT. Subjective IQ assessment showed that all scans had sufficient diagnostic IQ.
CONCLUSIONS: PCD-CT allows for CM reduction while providing higher SNR and CNR compared to EID-CT, using clinical individualized scan and CM injection protocols.
摘要：
目的：本研究旨在证明使用光子计数探测器CT（PCD-CT）在门静脉期（PVP）的常规腹部CT扫描中，碘对比剂（CM）与总重量相比减少（TBW）和在最新的能量积分探测器CT（EID-CT）上适应kV的CM注射方案，同时保持足够的图像质量（IQ）。
方法：比较了EID-CT（2022年11月-2024年3月）和PCD-CT（2023年9月-2023年12月）的连续对比增强腹部PVPCT扫描。CM参数(总碘负荷(TIL)，报告了碘递送率（IDR）和给药因子（DF）。基于TBW和kV的个性化采集和CM注入协议应用于EID-CT,并且TBW适应的CM注入协议用于PCD-CT。用平均衰减评估客观智商(Hounsfield单位，HU),信噪比(SNR)和对比噪声比(CNR))。2位专家读者根据诊断信心通过5点Likert量表评估主观智商。
结果：根据91次EID-CT扫描和102次PCD-CT扫描，观察到PCD-CT的TIL降低20.1%。PCD-CT显示出较高的SNR（9.9±1.7与9.1±1.8，p<0.001）和CNR（5.1±1.7vs.4.3±1.3，p<0.001）与EID-CT相比。主观智商评估显示，所有扫描均具有足够的诊断智商。
结论：与EID-CT相比，PCD-CT可以降低CM，同时提供更高的SNR和CNR，使用临床个性化扫描和CM注射方案。
方法：比较了EID-CT（2022年11月-2024年3月）和PCD-CT（2023年9月-2023年12月）的连续对比增强腹部PVPCT扫描。CM参数(总碘负荷(TIL)，报告了碘递送率（IDR）和给药因子（DF）。基于TBW和kV的个性化采集和CM注入协议应用于EID-CT,并且TBW适应的CM注入协议用于PCD-CT。用平均衰减评估客观智商(Hounsfield单位，HU),信噪比(SNR)和对比噪声比(CNR))。2位专家读者根据诊断信心通过5点Likert量表评估主观智商。
结果：根据91次EID-CT扫描和102次PCD-CT扫描，观察到PCD-CT的TIL降低20.1%。PCD-CT显示出较高的SNR（9.9±1.7与9.1±1.8，p<0.001）和CNR（5.1±1.7vs.4.3±1.3，p<0.001）与EID-CT相比。主观智商评估显示，所有扫描均具有足够的诊断智商。
结论：与EID-CT相比，PCD-CT可以降低CM，同时提供更高的SNR和CNR，使用临床个性化扫描和CM注射方案。
