Low-keV Virtual Monoenergetic Imaging for Bronchial Artery Visualization on Photon-Counting Detector Computed...

Area of Science:

• Medical Imaging
• Radiology
• Computed Tomography

Background:

• Accurate visualization of the bronchial artery is crucial for surgical planning, particularly in patients with esophageal cancer.
• Photon-counting detector computed tomography (PCD-CT) offers advanced imaging capabilities, including virtual monoenergetic imaging (VMI).

Purpose of the Study:

• To determine the optimal virtual monoenergetic imaging (VMI) energy levels for visualizing the bronchial artery using photon-counting detector computed tomography (PCD-CT).
• To evaluate the impact of different VMI energy levels on image quality metrics, including CT attenuation, image noise, and contrast-to-noise ratio (CNR).

Main Methods:

• Retrospective analysis of contrast-enhanced early-phase PCD-CT scans in 34 esophageal cancer patients.
• Quantitative assessment of CT attenuation, image noise, and CNR at various VMI energy levels (40, 50, 60, 70 keV).
• Subjective image quality evaluation by two radiologists, rating bronchial artery enhancement, border clarity, and peripheral visibility.

Main Results:

• Lower VMI energy levels (40-50 keV) demonstrated significantly higher CT attenuation and contrast-to-noise ratio (CNR) for the bronchial artery compared to higher keV levels.
• Subjective assessments revealed superior bronchial artery enhancement, border clarity, and peripheral visibility at 40 and 50 keV compared to 70 keV.
• While some increased noise was noted at lower keV levels, the overall image quality and visualization of the bronchial artery were enhanced.

Conclusions:

• Low-kilovoltage peak (40-50 keV) virtual monoenergetic imaging (VMI) on photon-counting detector computed tomography (PCD-CT) significantly improves bronchial artery visualization.
• These findings suggest that optimizing VMI energy settings can enhance diagnostic confidence and aid in surgical planning for thoracic pathologies.