Performance evaluation of single- and dual-contrast spectral imaging on a photon-counting-detector CT

The first commercially available photon-counting-detector CT (PCD-CT) has been introduced for clinical use. However, its spectral performance on single- and dual-contrast imaging tasks has not been comprehensively assessed.

To evaluate the spectral imaging performance of a clinical PCD-CT system for single-contrast material [iodine (I) or gadolinium (Gd)] and dual-contrast materials (I and Gd) in comparison with a dual-source dual-energy CT (DS-DECT).

Iodine (5, 10, and 15 mg/mL) and gadolinium (3.3, 6.6, and 9.9 mg/mL) samples, and their mixtures (I/Gd: 5/3.3 and 10/6.6 mg/mL) were prepared and placed in two torso-shaped water phantoms (lateral dimensions: 30 and 40 cm). These phantoms were scanned on a PCD-CT (NAEOTOM Alpha, Siemens) at 90, 120, and 140 kV. The same phantoms were scanned on a DS-DECT (SOMATOM Force, Siemens) with 70/Sn150, 80/Sn150, 90/Sn150, and 100/Sn150 kV. The radiation dose levels were matched [volume CT dose index (CTDIvol): 10 mGy for the 30 cm phantom and 20 mGy for the 40 cm phantom] across all tube voltage settings and between scanners. Two-material decomposition (I/water or Gd/water) was performed on iodine or gadolinium samples, and three-material decomposition (I/Gd/water) on both individual samples and mixtures. On each decomposed image, mean mass concentration (± standard deviation) was measured in circular region-of-interests placed on the contrast samples. Root-mean-square-error (RMSE) values of iodine and gadolinium concentrations were reported based on the measurements across all contrast samples and repeated on 10 consecutive slices.

For all material decomposition tasks on the DS-DECT, the kV pairs with greater spectral separation (70/Sn150 kV and 80/Sn150 kV) yielded lower RMSE values than other DS-DECT and PCD-CT alternatives. Specifically, for the optimal 70/Sn150 kV, RMSE values were 1.2 ± 0.1 mg/mL (I) for I/water material decomposition, 1.0 ± 0.1 mg/mL (Gd) for Gd/water material decomposition, and 4.5 ± 0.2 mg/mL (I) and 3.7 ± 0.2 mg/mL (Gd), respectively, for I/Gd/water material decomposition. On the PCD-CT, the optimal tube voltages were 120 or 140 kV for I/water decomposition with RMSE values of 2.0 ± 0.1 mg/mL (I). For Gd/water decomposition on PCD-CT, the optimal tube voltage was 140 kV with gadolinium RMSE values of 1.5 ± 0.1 mg/mL (Gd), with the 90 kV setting on PCD-CT generating higher RMSE values for gadolinium concentration compared to all DS-DECT and PCD-CT alternatives. For three material decomposition, both imaging modalities demonstrated substantially higher RMSE values for iodine and gadolinium, with 90 kV being the optimal tube potential for Gd/I quantitation on PCD-CT [5.4 ± 0.3 mg/mL (I) and 3.9 ± 0.2 mg/mL (Gd)], and DS-DECT at 100/Sn150 kV having larger RMSE values for both materials compared to the alternatives for either modality.

Optimal tube voltage for material decomposition on the clinical PCD-CT is task-dependent but inferior to DS-DECT using 70/Sn150 kV or 80/Sn150 kV in two-material decomposition for single-contrast imaging (iodine/water or gadolinium/water). Three material decomposition (iodine/gadolinium/water) in dual-contrast imaging yields substantially higher RMSE for both imaging platforms.