Photon-counting CT versus conventional CT for COPD quantifications: intra-scanner optimization and inter-scanner...

Area of Science:

• Medical Imaging
• Radiology
• Pulmonology

Background:

• Chronic obstructive pulmonary disease (COPD) is a significant global health issue.
• Quantitative CT is crucial for assessing COPD severity and heterogeneity.
• Advancements in CT technology, like photon-counting detectors, offer potential improvements.

Purpose of the Study:

• To compare the quantification performance of photon-counting CT (PCCT) against conventional energy-integrating detector (EID) CT for COPD.
• To evaluate the impact of various protocol settings on lung density quantification in COPD patients.

Main Methods:

• Utilized a virtual imaging platform with COPD-XCAT phantoms and DukeSim.
• Simulated CT images on EID (Flash, Force) and PCCT (NAEOTOM Alpha) scanners.
• Assessed quantification accuracy using Lung MAE, LAA -950, Perc 15, and Lung mass biomarkers against ground truth.

Main Results:

• PCCT demonstrated superior qualitative and quantitative performance over conventional EID scanners.
• Significant improvements in mean lung MAE (21.01-22.74%) and LAA -950 error (53.97-68.13%) with PCCT.
• Higher mAs, thinner slices, smoother kernels, and iterative reconstruction improved quantification accuracy.

Conclusions:

• PCCT offers substantial qualitative and quantitative benefits for COPD assessment compared to EID CT.
• Optimal protocol selection is vital for maximizing accuracy and precision in CT-based COPD quantification.
• This study highlights PCCT's potential to advance COPD research and clinical practice.