Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media

Abstract Background To assess the potential of virtual monoenergetic images (VMIs) on a photon-counting computed tomography (PCCT) for reducing the amount of injected iodine contrast media compared to an energy-integrating CT (EICT). Methods A multienergy phantom was scanned with a PCCT and EICT at...

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Main Authors: Djamel Dabli, Maxime Pastor, Sebastian Faby, Julien Erath, Cédric Croisille, Fabricio Pereira, Jean-Paul Beregi, Joël Greffier
Format: Article
Language:English
Published: SpringerOpen 2025-03-01
Series:European Radiology Experimental
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Online Access:https://doi.org/10.1186/s41747-025-00573-2
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author Djamel Dabli
Maxime Pastor
Sebastian Faby
Julien Erath
Cédric Croisille
Fabricio Pereira
Jean-Paul Beregi
Joël Greffier
author_facet Djamel Dabli
Maxime Pastor
Sebastian Faby
Julien Erath
Cédric Croisille
Fabricio Pereira
Jean-Paul Beregi
Joël Greffier
author_sort Djamel Dabli
collection DOAJ
description Abstract Background To assess the potential of virtual monoenergetic images (VMIs) on a photon-counting computed tomography (PCCT) for reducing the amount of injected iodine contrast media compared to an energy-integrating CT (EICT). Methods A multienergy phantom was scanned with a PCCT and EICT at 11 mGy with abdomen-pelvis examination parameters. VMIs were generated at 40 keV, 50 keV, 60 keV, and 70 keV. For all VMIs, the contrast-to-noise ratio (CNR) of iodine inserts with concentrations of 1 mg/mL, 2 mg/mL, 5 mg/mL, 10 mg/mL, and 15 mg/mL was calculated by dividing the signal difference between HU in iodine inserts versus solid water by the noise value assessed on solid water. The potential reduction in iodine media was calculated by the rate of reduction in iodine concentration with PCCT while maintaining the same CNR obtained with EICT for the reference concentration. Results Significantly higher CNR values were found with PCCT at all VMI energy levels for iodine concentrations above 1 mg/mL. The highest reduction was observed at 40 keV, with a value of 48.9 ± 1.6% (mean ± standard deviation). It decreased as the energy level increased, by 38.5 ± 0.5%, and 30.8 ± 0.8% for 50 and 60 keV, respectively. For 70 keV, the potential reduction of 24.4 ± 1.1% was found for iodine concentrations above 1 mg/mL. This reduction reached 57 ± 2.3% at 40 keV with PCCT compared to 60 keV with EICT. Conclusion For abdomen-pelvis protocols, the use of VMIs with PCCT significantly improved the CNR of iodine, offering the potential to reduce the required contrast medium. Relevance statement The use of VMIs with PCCT may reduce the quantity of iodine contrast medium to be injected compared with EICT, limiting costs, the risk of adverse effects, and the amount of contrast agent released into the wastewater. Key Points PCCT improves the image quality of VMIs. PCCT offers the potential for reducing the amount of injected contrast medium. PCCT potential for reducing the injected contrast medium depends on energy level. Graphical Abstract
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spelling doaj-art-8d0a67f97d4c40b8baa2c9c8193cd2b22025-08-20T02:51:27ZengSpringerOpenEuropean Radiology Experimental2509-92802025-03-01911810.1186/s41747-025-00573-2Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast mediaDjamel Dabli0Maxime Pastor1Sebastian Faby2Julien Erath3Cédric Croisille4Fabricio Pereira5Jean-Paul Beregi6Joël Greffier7Department of medical imaging, CHU Nîmes, Univ Montpellier, Nîmes Medical Imaging Group, UR UM103 IMAGINEDepartment of medical imaging, CHU Nîmes, Univ Montpellier, Nîmes Medical Imaging Group, UR UM103 IMAGINEDepartment of Computed Tomography, Siemens Healthineers AGDepartment of Computed Tomography, Siemens Healthineers AGDepartment of Computed Tomography, Siemens Healthineers AGMIPA, University of NîmesDepartment of medical imaging, CHU Nîmes, Univ Montpellier, Nîmes Medical Imaging Group, UR UM103 IMAGINEDepartment of medical imaging, CHU Nîmes, Univ Montpellier, Nîmes Medical Imaging Group, UR UM103 IMAGINEAbstract Background To assess the potential of virtual monoenergetic images (VMIs) on a photon-counting computed tomography (PCCT) for reducing the amount of injected iodine contrast media compared to an energy-integrating CT (EICT). Methods A multienergy phantom was scanned with a PCCT and EICT at 11 mGy with abdomen-pelvis examination parameters. VMIs were generated at 40 keV, 50 keV, 60 keV, and 70 keV. For all VMIs, the contrast-to-noise ratio (CNR) of iodine inserts with concentrations of 1 mg/mL, 2 mg/mL, 5 mg/mL, 10 mg/mL, and 15 mg/mL was calculated by dividing the signal difference between HU in iodine inserts versus solid water by the noise value assessed on solid water. The potential reduction in iodine media was calculated by the rate of reduction in iodine concentration with PCCT while maintaining the same CNR obtained with EICT for the reference concentration. Results Significantly higher CNR values were found with PCCT at all VMI energy levels for iodine concentrations above 1 mg/mL. The highest reduction was observed at 40 keV, with a value of 48.9 ± 1.6% (mean ± standard deviation). It decreased as the energy level increased, by 38.5 ± 0.5%, and 30.8 ± 0.8% for 50 and 60 keV, respectively. For 70 keV, the potential reduction of 24.4 ± 1.1% was found for iodine concentrations above 1 mg/mL. This reduction reached 57 ± 2.3% at 40 keV with PCCT compared to 60 keV with EICT. Conclusion For abdomen-pelvis protocols, the use of VMIs with PCCT significantly improved the CNR of iodine, offering the potential to reduce the required contrast medium. Relevance statement The use of VMIs with PCCT may reduce the quantity of iodine contrast medium to be injected compared with EICT, limiting costs, the risk of adverse effects, and the amount of contrast agent released into the wastewater. Key Points PCCT improves the image quality of VMIs. PCCT offers the potential for reducing the amount of injected contrast medium. PCCT potential for reducing the injected contrast medium depends on energy level. Graphical Abstracthttps://doi.org/10.1186/s41747-025-00573-2AbdomenContrast mediaIodine compoundsPelvisTomography (x-ray computed)
spellingShingle Djamel Dabli
Maxime Pastor
Sebastian Faby
Julien Erath
Cédric Croisille
Fabricio Pereira
Jean-Paul Beregi
Joël Greffier
Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
European Radiology Experimental
Abdomen
Contrast media
Iodine compounds
Pelvis
Tomography (x-ray computed)
title Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
title_full Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
title_fullStr Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
title_full_unstemmed Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
title_short Photon-counting versus energy-integrating CT of abdomen-pelvis: a phantom study on the potential for reducing iodine contrast media
title_sort photon counting versus energy integrating ct of abdomen pelvis a phantom study on the potential for reducing iodine contrast media
topic Abdomen
Contrast media
Iodine compounds
Pelvis
Tomography (x-ray computed)
url https://doi.org/10.1186/s41747-025-00573-2
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