Comparison of image quality between spectral photon-counting CT and dual-layer CT for the evaluation of lung nodules:...

To evaluate the image quality (IQ) of a spectral photon-counting CT (SPCCT) using filtered back projection (FBP) and hybrid iterative reconstruction (IR) algorithms (iDose⁴), in comparison with a dual-layer CT (DLCT) system, and to choose the best image quality according to the IR level for SPCCT.

Two phantoms were scanned using a standard lung protocol (120 kVp, 40 mAs) with SPCCT and DLCT systems. Raw data were reconstructed using FBP and 9 iDose⁴ levels (i1/i2/i3/i4/i5/i6/i7/i9/i11) for SPCCT and 7 for DLCT (i1/i2/i3/i4/i5/i6/i7). Noise power spectrum and task-based transfer function (TTF) were computed. Detectability index (d') was computed for detection of 4 mm ground-glass nodule (GGN) and solid nodule. Two chest radiologists performed an IQ evaluation (noise/nodule sharpness/nodule conspicuity/overall IQ) in consensus, and chose the best image for SPCCT.

Noise magnitude was -47% ± 2% lower on average with SPCCT than with DLCT for iDose⁴ range from i1 to i6. Average NPS spatial frequencies increased for SPCCT in comparison with DLCT. TTF also increased, except for the air insert with FBP, and i1/i2/i3. Higher detectability was found for SPCCT for both GGN and solid nodules. IQ for both types of nodule was rated consistently higher with SPCCT than with DLCT for the same iDose⁴ level. For SPCCT and both nodules, the scores for noise and conspicuity improved with increasing iDose⁴ level. iDose⁴ level 6 provided the best subjective IQ for both types of nodule.

Higher IQ for GGN and solid nodules was demonstrated with SPCCT compared with DLCT with better detectability using iDose⁴.

Using spectral photon-counting CT compared with dual-layer CT, noise magnitude was reduced with improvements in spatial resolution and detectability of ground-glass nodules and solid lung nodules. As the iDose⁴ level increased, noise magnitude was reduced and detectability of ground-glass and solid lung nodules was better for both CT systems. For spectral photon-counting CT imaging, two chest radiologists determined iDose⁴ level 6 as the best image quality for detecting ground-glass nodules and solid lung nodules.