%0 Journal Article
%T Ultra-high Versus Standard Resolution Photon-Counting Detector CT Angiography for Imaging of Femoral Stents in a Cadaveric Perfusion Model.
%A Hartung V
%A Hendel R
%A Huflage H
%A Augustin AM
%A Grunz JP
%A Kleefeldt F
%A Peter D
%A Lichthardt S
%A Ergün S
%A Bley TA
%A Gruschwitz P
%J Acad Radiol
%V 0
%N 0
%D 2024 Aug 6
%M 39112296
%F 5.482
%R 10.1016/j.acra.2024.07.038
%X <B>OBJECTIVE: </B>The aim of this study was to investigate the imaging performance and quality differences of PCD-CT in standard resolution mode (SR) versus ultra-high resolution mode (UHR) in the lower extremity runoff of dose-matched CTAs in a human cadaveric model.<BR><B>METHODS: </B>Extracorporeal perfusion of the upper leg was established in one fresh-frozen human cadaver via inguinal and popliteal accesses using a peristaltic pump. Seven peripheral stents were deployed in the SFA. Photon-counting CTAs were performed under contrast perfusion in SR and UHR mode with dose-equivalent 120kVp acquisition protocols (low-/ medium-/ high-dose: CTDIVol=3, 5, 10 mGy) and reconstructed with four vascular convolution kernels. Lumen visibility and contrast-to-noise ratio were compared using analyses of variance. Subjective image quality was assessed using a pairwise, forced-choice comparison software.<BR><B>RESULTS: </B>Lumen visibility was equal for SR and UHR at the used dose levels. CNR increase by UHR was significant for (ultra-)sharp convolution kernels BV60 (3 mGy; UHR vs. SR, 19.9 ± 1.9 vs. 15.7 ± 1.6, p < 0.046) and BV76 (8.0 ± 0.6 vs. 5.4 ± 0.3, p < 0.001). The relative CNR increase was higher for low-dose than high-dose scans (BV76: 48% vs. 36% at high dose, p < 0.033). The CNR of the low-dose scan in UHR mode was comparable to the high-dose scan in SR mode when the ultra-sharp kernel was used (8.0 ± 0.6 vs. 9.1 ± 1.1, p > 0.760). Among UHR examinations, a significant increase in CNR could only be measured in BV76 (8.0 ± 0.6 (3 mGy) vs. 12.4 ± 0.9 (10 mGy), p < 0.001). Readers preferred subjective image quality of UHR for all kernels with BV76 being ranked highest.<BR><B>CONCLUSIONS: </B>The CNR increase in UHR mode is highest when combining low radiation dose and ultra-sharp reconstructions. Meanwhile, the subjective image quality in UHR mode generally supersedes SR images, suggesting further dose reduction potential.