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Optimal Spectral Performance on Pediatric Photon-Counting CT: Investigating Phantom-Based Size-Dependent kV Selection

Wei Zhou¹, Afrouz Ataei, Donglai Huo

¹From the Department of Radiology, University of Colorado, Anschutz Medical Campus, Aurora, CO (W.Z., D.H., L.P.B., J.P.W.); Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX (A.A., L.R.); Department of Radiology, Children's Hospital Colorado, Aurora, CO (L.P.B., J.P.W.); Department of Bioinformatics and Computational Biology, University of Minnesota, St Paul, MN (X.Z.); and Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora, CO (X.Z.).

Investigative Radiology

|August 19, 2024

Summary

High kV settings (120/140 kV) on photon-counting CT (PCCT) provide superior image quality and iodine quantification for pediatric patients compared to low kV settings (70/90 kV). This study recommends high kV for general body imaging on PCCT.

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Area of Science:

Medical Imaging
Radiology
Photon-Counting Computed Tomography (PCCT)

Background:

Photon-counting computed tomography (PCCT) offers advanced imaging capabilities.
Optimal kV selection for pediatric body imaging on PCCT remains unevaluated.
Understanding kV effects is crucial for image quality and diagnostic accuracy.

Purpose of the Study:

To comprehensively evaluate kV selection for pediatric patients on a PCCT system.
To determine optimal kV settings for variable pediatric body sizes.

Main Methods:

Utilized four phantoms representing pediatric sizes (newborn to adult).
Scanned phantoms with iodine inserts using a PCCT system at 70, 90, 120, and 140 kV.
Reconstructed virtual monoenergetic images (VMIs) and iodine maps (IMs); analyzed image noise, iodine accuracy (APE), and quantification (RMSE, bias).

Main Results:

High kV (120/140 kV) demonstrated better absolute percent error (APE) for iodine quantification across pediatric sizes compared to low kV (70/90 kV).
For instance, at adult size, APE was significantly higher for 70 kV (18.0%) versus 120 kV (1.4%) or 140 kV (0.8%).
High kV also yielded lower RMSE and bias in iodine quantification across all conditions.

Conclusions:

High kV options (120/140 kV) on PCCT provide superior performance for VMI and IM image quality.
The study recommends utilizing high kV settings for general body imaging on PCCT.
Optimized kV selection enhances diagnostic accuracy in pediatric imaging.