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Ultra-high-resolution imaging of the shoulder and pelvis using photon-counting-detector CT: a feasibility study in patients

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate ultra-high-resolution (UHR) imaging of large joints using an investigational photon-counting detector (PCD) CT.

Materials and methods

Patients undergoing clinical shoulder or pelvis energy-integrating-detector (EID) CT exam were scanned using the UHR mode of the PCD-CT system. Axial EID-CT images (1-mm sections) and PCD-CT images (0.6-mm sections) were reconstructed using Br62/Br64 and Br76 kernels, respectively. Two musculoskeletal radiologists rated visualization of anatomic structures using a 5-point Likert scale. Wilcoxon rank-sum test was used for statistical analysis of reader scores, and paired t-test was used for comparing bone CT numbers and image noise from PCD-CT and EID-CT.

Results

Thirty-two patients (17 shoulders and 15 pelvis) were prospectively recruited for this feasibility study. Mean age for shoulder exams was 67.3 ± 15.5 years (11 females) and 47.2 ± 15.8 years (11 females) for pelvis exams. The mean volume CT dose index was lower on PCD-CT compared to that on EID-CT (shoulders: 18 mGy vs. 34 mGy, pelvis: 11.6 mGy vs. 16.7 mGy). PCD-CT was rated significantly better than EID-CT (p < 0.001) for anatomic-structure visualization. Trabecular delineation in shoulders (mean score = 4.24 ± 0.73) and femoroacetabular joint visualization in the pelvis (mean score = 3.67 ± 1.03) received the highest scores. PCD-CT demonstrated significant increase in bone CT number (p < 0.001) relative to EID-CT; no significant difference in image noise was found between PCD-CT and EID-CT.

Conclusion

The evaluated PCD-CT system provided improved visualization of osseous structures in the shoulders and pelvises at a 31–47% lower radiation dose compared to EID-CT.

Key Points

• A full field-of-view PCD-CT with 0.151 mm × 0.176 mm detector pixel size (isocenter) facilitates bilateral, high-resolution imaging of shoulders and pelvis.

• The evaluated investigational PCD-CT system was rated superior by two musculoskeletal radiologists for anatomic structure visualization in shoulders and pelvises despite a 31–47% lower radiation dose compared to EID-CT.

• PCD-CT demonstrated significantly higher bone CT number compared to EID-CT, while no significant difference in image noise was observed between PCD-CT and EID-CT despite a 31–47% dose reduction on PCD-CT.

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Abbreviations

EID:

Energy-integrating detector

FOV:

Field of view

PCD:

Photon-counting detector

ROI:

Region of interest

SD:

Standard deviation

UHR:

Ultra-high resolution

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Acknowledgements

Research support for this work was provided, in part, to Mayo Clinic from Siemens Healthcare GmbH. The authors thank Nikkole Weber, Holly Kasten, Boleyn Andrist, and Yong Lee for patient recruitment and scanning.

Funding

Dr. Cynthia H. McCollough and Dr. Joel G. Fletcher receive industry funding to their institution from Siemens Healthineers GmbH.

Author information

Author notes

  1. Francis Baffour and Kishore Rajendran contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Francis I. Baffour, Kishore Rajendran, Katrina N. Glazebrook, Jamison E. Thorne, Shuai Leng, Cynthia H. McCollough & Joel G. Fletcher

  2. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA

    Nicholas B. Larson

Authors
  1. Francis I. Baffour
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  2. Kishore Rajendran
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Corresponding author

Correspondence to Kishore Rajendran.

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Guarantor

The scientific guarantor of this publication is Dr. Joel G. Fletcher, MD.

Conflict of interest

Dr. Kishore Rajendran is an editorial board member of European Radiology. Dr. Cynthia McCollough and Dr. Joel Fletcher receive industry funding to their institution from Siemens Healthineers GmbH, which includes in kind support for the evaluated PCD-CT system.

Statistics and biometry

Dr. Nicholas B. Larson, one of the authors, has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional review board approval was obtained.

Study subjects or cohorts overlap

Study subjects were part of a poster presentation at RSNA annual meeting 2021. The subjects were not previously reported in any publications.

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• prospective

• experimental

• performed at one institution

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Baffour, F.I., Rajendran, K., Glazebrook, K.N. et al. Ultra-high-resolution imaging of the shoulder and pelvis using photon-counting-detector CT: a feasibility study in patients. Eur Radiol 32, 7079–7086 (2022). https://doi.org/10.1007/s00330-022-08925-x

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  • DOI: https://doi.org/10.1007/s00330-022-08925-x

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