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Construction of a Preclinical Multimodality Phantom Using Tissue-mimicking Materials for Quality Assurance in Tumor Size Measurement

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Optimizing Reconstruction Parameters for Detecting Peripheral In-Stent Restenosis with Photon-Counting Detector CT: A

Yiheng Tan¹, Joost F Hop¹, Magdalena Dobrolinska^2,3

¹Department of Radiology, University Medical Centre Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Diagnostics (Basel, Switzerland)

|May 13, 2026

Summary

Photon-counting detector CT (PCD-CT) in standard-resolution mode with virtual monoenergetic imaging at 40 keV optimizes peripheral in-stent restenosis visualization. This advanced imaging technique significantly outperforms energy-integrated detector CT (EID-CT).

Keywords:

computed tomography in-stent restenosis peripheral arterial disease photon-counting detector CT virtual monoenergetic image

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Area of Science:

Medical Imaging
Radiology
Cardiovascular Imaging

Background:

Accurate visualization of peripheral in-stent restenosis is crucial for patient management.
Photon-counting detector CT (PCD-CT) technology offers potential improvements over conventional energy-integrated detector CT (EID-CT).

Purpose of the Study:

To determine optimal reconstruction parameters for peripheral in-stent restenosis imaging using PCD-CT.
To evaluate the superiority of PCD-CT over EID-CT for visualizing in-stent restenosis.

Main Methods:

Peripheral stents with varying restenosis degrees were scanned using EID-CT and PCD-CT in a phantom study.
PCD-CT data were acquired in standard-resolution (SR) and ultra-high-resolution (UHR) modes, reconstructed with various kernels and matrix sizes.
Quantitative image quality metrics (noise, contrast, CNR) and qualitative reader assessments were performed.

Main Results:

PCD-CT in SR mode at 40 keV virtual monoenergetic imaging (VMI) yielded the highest contrast and CNR, outperforming EID-CT and PCD-CT UHR.
The Bv72 kernel with a 1024 matrix in PCD-CT SR mode was ranked highest by readers for detecting all degrees of restenosis.
PCD-CT demonstrated superior image quality and detectability of restenosis compared to EID-CT.

Conclusions:

PCD-CT in SR mode, utilizing 40 keV VMI, the Bv72 kernel, and a 1024 matrix, is optimal for peripheral in-stent restenosis visualization.
PCD-CT offers significant advantages in image quality and restenosis detection compared to EID-CT.