Gladys M Arguello Fletes, Wei Zhou, LaDonna J Malone, Andrea I Fuentealba Cargill, Jason P Weinman, Lorna P Browne
{"title":"应用光子计数与能量积分检测器CT对儿童高音高心脏CTA的辐射剂量比较分析。","authors":"Gladys M Arguello Fletes, Wei Zhou, LaDonna J Malone, Andrea I Fuentealba Cargill, Jason P Weinman, Lorna P Browne","doi":"10.1007/s00247-025-06336-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown improved image quality in pediatric cardiac imaging using photon-counting detector CT (PCDCT). However, these studies did not evaluate image quality and radiation dose when utilizing the full spectral capabilities of PCDCT scanners. The full spectral capability of PCDCT scanners allows the generation of the entire array of mono-energetic reconstructions, virtual non-contrast (VNC) images, and iodine maps, which have potential advantages in evaluating complex congenital heart disease. For example, following complex congenital cardiac repairs, when distinguishing intraluminal or soft tissue calcifications from contrast, or when evaluating intrastent thrombus.</p><p><strong>Objective: </strong>To compare image quality and radiation dose between high-pitch cardiac CT using full spectral PCDCT and dual-source energy-integrating detector CT (EIDCT).</p><p><strong>Materials and methods: </strong>This retrospective, IRB-approved study analyzed high-pitch cardiac CTs from January 2021 to October 2023 in pediatric patients (< 18 years). Patients were scanned using either PCDCT with full spectral technique (\"QuantumPlus\") or EIDCT. Radiation doses were measured by CT dose index (CTDI) and dose-length product (DLP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated, and image quality was assessed using a 5-point Likert scale. Statistical analysis included unpaired T-test, Shapiro-Wilk test, Mann-Whitney test, and kappa coefficients for interrater agreement.</p><p><strong>Results: </strong>Two hundred patients were evaluated, with 100 scanned on PCDCT and 100 on EIDCT. In the PCDCT scanner, 47/100 (47%) were male and 53/100 were female (53%) (P = 0.01). In the EIDCT scanner, 65/100 were male (65%) and 35/100 (35%) were female (P = 0.01). In the PCDCT scanner, 68/100 (68%) (P = 0.05) were ≤ 12 months, and 32/100 (32%) (P = 0.05) were > 12 months. In the EIDCT, 80/100 (80%) (P = 0.05) were ≤ 12 months, and 20/100 (20%) (P = 0.05) were > 12 months. In patients ≤ 12 months, the CNR were 31.61 in the PCDCT group and 32.14 in the EIDCT group (P = 0.39). For those > 12 months, CNR were 30.07 for PCDCT and 25.27 for EIDCT (P = 0.17). In patients ≤ 12 months, SNR was significantly lower (P < 0.0001) in PCDCT, compared to EIDCT for the teres minor muscles, while in patients > 12 months, SNR was not significantly lower (P = 0.89); SNR was similar between scanners. Radiation doses were significantly higher for PCDCT across both age groups (P < 0.0001).</p><p><strong>Conclusion: </strong>High-pitch cardiac CT with PCDCT using spectral processing resulted in higher radiation doses and lower SNR in infants compared to EIDCT.</p>","PeriodicalId":19755,"journal":{"name":"Pediatric Radiology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative radiation dose analysis in pediatric high-pitch cardiac CTA using photon-counting versus energy-integrating detector CT.\",\"authors\":\"Gladys M Arguello Fletes, Wei Zhou, LaDonna J Malone, Andrea I Fuentealba Cargill, Jason P Weinman, Lorna P Browne\",\"doi\":\"10.1007/s00247-025-06336-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies have shown improved image quality in pediatric cardiac imaging using photon-counting detector CT (PCDCT). However, these studies did not evaluate image quality and radiation dose when utilizing the full spectral capabilities of PCDCT scanners. The full spectral capability of PCDCT scanners allows the generation of the entire array of mono-energetic reconstructions, virtual non-contrast (VNC) images, and iodine maps, which have potential advantages in evaluating complex congenital heart disease. For example, following complex congenital cardiac repairs, when distinguishing intraluminal or soft tissue calcifications from contrast, or when evaluating intrastent thrombus.</p><p><strong>Objective: </strong>To compare image quality and radiation dose between high-pitch cardiac CT using full spectral PCDCT and dual-source energy-integrating detector CT (EIDCT).</p><p><strong>Materials and methods: </strong>This retrospective, IRB-approved study analyzed high-pitch cardiac CTs from January 2021 to October 2023 in pediatric patients (< 18 years). Patients were scanned using either PCDCT with full spectral technique (\\\"QuantumPlus\\\") or EIDCT. Radiation doses were measured by CT dose index (CTDI) and dose-length product (DLP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated, and image quality was assessed using a 5-point Likert scale. Statistical analysis included unpaired T-test, Shapiro-Wilk test, Mann-Whitney test, and kappa coefficients for interrater agreement.</p><p><strong>Results: </strong>Two hundred patients were evaluated, with 100 scanned on PCDCT and 100 on EIDCT. In the PCDCT scanner, 47/100 (47%) were male and 53/100 were female (53%) (P = 0.01). In the EIDCT scanner, 65/100 were male (65%) and 35/100 (35%) were female (P = 0.01). In the PCDCT scanner, 68/100 (68%) (P = 0.05) were ≤ 12 months, and 32/100 (32%) (P = 0.05) were > 12 months. In the EIDCT, 80/100 (80%) (P = 0.05) were ≤ 12 months, and 20/100 (20%) (P = 0.05) were > 12 months. In patients ≤ 12 months, the CNR were 31.61 in the PCDCT group and 32.14 in the EIDCT group (P = 0.39). For those > 12 months, CNR were 30.07 for PCDCT and 25.27 for EIDCT (P = 0.17). In patients ≤ 12 months, SNR was significantly lower (P < 0.0001) in PCDCT, compared to EIDCT for the teres minor muscles, while in patients > 12 months, SNR was not significantly lower (P = 0.89); SNR was similar between scanners. Radiation doses were significantly higher for PCDCT across both age groups (P < 0.0001).</p><p><strong>Conclusion: </strong>High-pitch cardiac CT with PCDCT using spectral processing resulted in higher radiation doses and lower SNR in infants compared to EIDCT.</p>\",\"PeriodicalId\":19755,\"journal\":{\"name\":\"Pediatric Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00247-025-06336-w\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00247-025-06336-w","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Comparative radiation dose analysis in pediatric high-pitch cardiac CTA using photon-counting versus energy-integrating detector CT.
Background: Previous studies have shown improved image quality in pediatric cardiac imaging using photon-counting detector CT (PCDCT). However, these studies did not evaluate image quality and radiation dose when utilizing the full spectral capabilities of PCDCT scanners. The full spectral capability of PCDCT scanners allows the generation of the entire array of mono-energetic reconstructions, virtual non-contrast (VNC) images, and iodine maps, which have potential advantages in evaluating complex congenital heart disease. For example, following complex congenital cardiac repairs, when distinguishing intraluminal or soft tissue calcifications from contrast, or when evaluating intrastent thrombus.
Objective: To compare image quality and radiation dose between high-pitch cardiac CT using full spectral PCDCT and dual-source energy-integrating detector CT (EIDCT).
Materials and methods: This retrospective, IRB-approved study analyzed high-pitch cardiac CTs from January 2021 to October 2023 in pediatric patients (< 18 years). Patients were scanned using either PCDCT with full spectral technique ("QuantumPlus") or EIDCT. Radiation doses were measured by CT dose index (CTDI) and dose-length product (DLP). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were also calculated, and image quality was assessed using a 5-point Likert scale. Statistical analysis included unpaired T-test, Shapiro-Wilk test, Mann-Whitney test, and kappa coefficients for interrater agreement.
Results: Two hundred patients were evaluated, with 100 scanned on PCDCT and 100 on EIDCT. In the PCDCT scanner, 47/100 (47%) were male and 53/100 were female (53%) (P = 0.01). In the EIDCT scanner, 65/100 were male (65%) and 35/100 (35%) were female (P = 0.01). In the PCDCT scanner, 68/100 (68%) (P = 0.05) were ≤ 12 months, and 32/100 (32%) (P = 0.05) were > 12 months. In the EIDCT, 80/100 (80%) (P = 0.05) were ≤ 12 months, and 20/100 (20%) (P = 0.05) were > 12 months. In patients ≤ 12 months, the CNR were 31.61 in the PCDCT group and 32.14 in the EIDCT group (P = 0.39). For those > 12 months, CNR were 30.07 for PCDCT and 25.27 for EIDCT (P = 0.17). In patients ≤ 12 months, SNR was significantly lower (P < 0.0001) in PCDCT, compared to EIDCT for the teres minor muscles, while in patients > 12 months, SNR was not significantly lower (P = 0.89); SNR was similar between scanners. Radiation doses were significantly higher for PCDCT across both age groups (P < 0.0001).
Conclusion: High-pitch cardiac CT with PCDCT using spectral processing resulted in higher radiation doses and lower SNR in infants compared to EIDCT.
期刊介绍：
Official Journal of the European Society of Pediatric Radiology, the Society for Pediatric Radiology and the Asian and Oceanic Society for Pediatric Radiology
Pediatric Radiology informs its readers of new findings and progress in all areas of pediatric imaging and in related fields. This is achieved by a blend of original papers, complemented by reviews that set out the present state of knowledge in a particular area of the specialty or summarize specific topics in which discussion has led to clear conclusions. Advances in technology, methodology, apparatus and auxiliary equipment are presented, and modifications of standard techniques are described.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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