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Peer-reviewedCC BYDiagnostics (Basel, Switzerland)

Dual-Source Photon-Counting CT for Thoracic Arteries: Enhancing Image Quality and Diagnostic Assessability with Low-Energy Virtual Monoenergetic Imaging.

  • Andreea I Nica1,2
  • Christian Booz1,2
  • Giuseppe M Bucolo3
  • Leona S Alizadeh1,2,4
  • Thomas J Vogl1,2
  • Katrin Eichler1,2
  • Vitali Koch1,2
  • Leon D Gruenewald1,2
  • Ibrahim Yel1,2
  • Scherwin Mahmoudi1,2
  • Philipp Reschke1,2
  • Jennifer Gotta1,2
5 more authors
  • Daniel Dillinger5
  • Hanns L Kaatsch4
  • Stephan Waldeck4,6
  • Daniel Overhoff4,7
  • Tommaso D'Angelo3
7 affiliations
  1. 1Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt Am Main, Germany.
  2. 2Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt Am Main, Germany.
  3. 3Diagnostic and Interventional Radiology Unit, BIOMORF Department, University Hospital "Policlinico G. Martino", Via Consolare Valeria 1, 98100 Messina, Italy.
  4. 4Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany.
  5. 5Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany.
  6. 6Department of Neuroradiology, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany.
  7. 7Department of Radiology and Nuclear Medicine, Medical Faculty Mannheim, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
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Abstract

Background/Objectives: This study aimed to investigate the impact of low-energy virtual monoenergetic imaging (VMI) on quantitative and qualitative image characteristics, as well as its effect on the diagnostic assessability of thoracic arteries in photon-counting computed tomography angiography (CTA). Methods: We retrospectively evaluated 125 patients who underwent dual-source photon-counting CTA scans of thoracic arteries. We reconstructed standard CT images at 120 kV and VMI series at 15 keV intervals, ranging from 40 to 100 keV, and conducted quantitative and qualitative image analyses. For quantitative analysis, we assessed vascular CT numbers and contrast-to-noise ratio (CNR). For qualitative evaluation, three board-certified radiologists independently rated image quality, vascular contrast, and diagnostic assessability of the thoracic arteries using a five-point scale. Results: Quantitative image analysis revealed that 40 keV VMI reconstructions exhibited the highest mean CT value (HU: 1205 ± 286) and CNR (29.22 ± 9.13), followed by the 55 keV series (HU: 679 ± 161, CNR: 22.54 ± 7.36), significantly improved compared to higher keV levels and the standard 120 kV CT series (p < 0.001). Qualitative analysis showed the highest rating scores for 55 keV reconstructions, significantly higher than those of VMI series at higher energy levels and the standard 120 kV series (p < 0.001). Conclusions: VMI reconstructions at low energy levels (40-55 keV) significantly enhance vascular CTvalue and CNR, offering superior image quality and diagnostic assessability for thoracic arteries compared to standard CT series in photon-counting CTA.

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Cite

BibTeXRIS
BibTeX
@article{nica2026dualsource,
  title = {{Dual-Source Photon-Counting CT for Thoracic Arteries: Enhancing Image Quality and Diagnostic Assessability with Low-Energy Virtual Monoenergetic Imaging.}},
  author = {Andreea I Nica and Christian Booz and Giuseppe M Bucolo and Leona S Alizadeh and Thomas J Vogl and Katrin Eichler and Vitali Koch and Leon D Gruenewald and Ibrahim Yel and Scherwin Mahmoudi and Philipp Reschke and Jennifer Gotta and Daniel Dillinger and Hanns L Kaatsch and Stephan Waldeck and Daniel Overhoff and Tommaso D'Angelo},
  journal = {Diagnostics (Basel, Switzerland)},
  year = {2026},
  month = sep,
  doi = {10.3390/diagnostics16193145},
  url = {https://europepmc.org/article/MED/42882300},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Dual-Source Photon-Counting CT for Thoracic Arteries: Enhancing Image Quality and Diagnostic Assessability with Low-Energy Virtual Monoenergetic Imaging.
AU  - Andreea I Nica
AU  - Christian Booz
AU  - Giuseppe M Bucolo
AU  - Leona S Alizadeh
AU  - Thomas J Vogl
AU  - Katrin Eichler
AU  - Vitali Koch
AU  - Leon D Gruenewald
AU  - Ibrahim Yel
AU  - Scherwin Mahmoudi
AU  - Philipp Reschke
AU  - Jennifer Gotta
AU  - Daniel Dillinger
AU  - Hanns L Kaatsch
AU  - Stephan Waldeck
AU  - Daniel Overhoff
AU  - Tommaso D'Angelo
PY  - 2026
DA  - 2026/09/28
JO  - Diagnostics (Basel, Switzerland)
DO  - 10.3390/diagnostics16193145
UR  - https://europepmc.org/article/MED/42882300
AB  - Background/Objectives: This study aimed to investigate the impact of low-energy virtual monoenergetic imaging (VMI) on quantitative and qualitative image characteristics, as well as its effect on the diagnostic assessability of thoracic arteries in photon-counting computed tomography angiography (CTA). Methods: We retrospectively evaluated 125 patients who underwent dual-source photon-counting CTA scans of thoracic arteries. We reconstructed standard CT images at 120 kV and VMI series at 15 keV intervals, ranging from 40 to 100 keV, and conducted quantitative and qualitative image analyses. For quantitative analysis, we assessed vascular CT numbers and contrast-to-noise ratio (CNR). For qualitative evaluation, three board-certified radiologists independently rated image quality, vascular contrast, and diagnostic assessability of the thoracic arteries using a five-point scale. Results: Quantitative image analysis revealed that 40 keV VMI reconstructions exhibited the highest mean CT value (HU: 1205 ± 286) and CNR (29.22 ± 9.13), followed by the 55 keV series (HU: 679 ± 161, CNR: 22.54 ± 7.36), significantly improved compared to higher keV levels and the standard 120 kV CT series (p < 0.001). Qualitative analysis showed the highest rating scores for 55 keV reconstructions, significantly higher than those of VMI series at higher energy levels and the standard 120 kV series (p < 0.001). Conclusions: VMI reconstructions at low energy levels (40-55 keV) significantly enhance vascular CTvalue and CNR, offering superior image quality and diagnostic assessability for thoracic arteries compared to standard CT series in photon-counting CTA.
SN  - 2075-4418
ER  -