• Korean Journal of Radiology
• /
• 제23권9호
• /
• pp.854-865
• /
• 2022

Photon-counting detector (PCD) CT is a new CT technology utilizing a direct conversion X-ray detector, where incident X-ray photon energies are directly recorded as electronical signals. The design of the photon-counting detector itself facilitates improvements in spatial resolution (via smaller detector pixel design) and iodine signal (via count weighting) while still permitting multi-energy imaging. PCD-CT can eliminate electronic noise and reduce artifacts due to the use of energy thresholds. Improved dose efficiency is important for low dose CT and pediatric imaging. The ultra-high spatial resolution of PCD-CT design permits lower dose scanning for all body regions and is particularly helpful in identifying important imaging findings in thoracic and musculoskeletal CT. Improved iodine signal may be helpful for low contrast tasks in abdominal imaging. Virtual monoenergetic images and material classification will assist with numerous diagnostic tasks in abdominal, musculoskeletal, and cardiovascular imaging. Dual-source PCD-CT permits multi-energy CT images of the heart and coronary arteries at high temporal resolution. In this special review article, we review the clinical benefits of this technology across a wide variety of radiological subspecialties.

• Korean Journal of Radiology
• /
• 제25권7호
• /
• pp.662-672
• /
• 2024

Since the emergence of the first photon-counting computed tomography (PCCT) system in late 2021, its advantages and a wide range of applications in all fields of radiology have been demonstrated. Compared to standard energy-integrating detector-CT, PCCT allows for superior geometric dose efficiency in every examination. While this aspect by itself is groundbreaking, the advantages do not stop there. PCCT facilitates an unprecedented combination of ultra-high-resolution imaging without dose penalty or field-of-view restrictions, detector-based elimination of electronic noise, and ubiquitous multi-energy spectral information. Considering the high demands of orthopedic imaging for the visualization of minuscule details while simultaneously covering large portions of skeletal and soft tissue anatomy, no subspecialty may benefit more from this novel detector technology than musculoskeletal radiology. Deeply rooted in experimental and clinical research, this review article aims to provide an introduction to the cosmos of PCCT, explain its technical basics, and highlight the most promising applications for patient care, while also mentioning current limitations that need to be overcome.

• Nuclear Engineering and Technology
• /
• 제54권9호
• /
• pp.3380-3389
• /
• 2022

We evaluated the performance of an improved hybrid median filter (IHMF) applied to X-ray computed tomography (CT) images obtained using a high-resolution photon-counting cadmium zinc telluride (CZT) detector. To study how the proposed approach improves the image quality, we measured the noise levels and the overall CT-image quality. We established a CZT imaging system with a detector length of 5.12 cm and thickness of 0.3 cm and acquired phantom images. To evaluate the efficacy of the proposed filter, we first modeled two conventional median filters. Subsequently, we were able to achieve a normalized noise power spectrum result of ~10^-8 mm², and furthermore, the proposed method improved the contrast-to-noise ratio by a factor of ~1.51 and the coefficient of variation by 1.55 relative to the counterpart values of the no-filter image. In addition, the IHMF exhibited the best performance among the three filters considered as regards the peak signal-to-noise ratio and no-reference-based image-quality evaluation parameters. Thus, our results demonstrate that the IHMF approach provides a superior image performance over conventional median filtering methods when applied to actual CZT X-ray CT images.

• 한국의학물리학회지:의학물리
• /
• 제27권3호
• /
• pp.105-110
• /
• 2016

Sparse angular sampling has been studied recently owing to its potential to decrease the radiation exposure from computed tomography (CT). In this study, we investigated the analytic reconstruction algorithm in sparse angular sampling using the sinogram interpolation method for improving image quality and computation speed. A prototype of the spectral CT system, which has a 64-pixel Cadmium Zinc Telluride (CZT)-based photon-counting detector, was used. The source-to-detector distance and the source-to-center of rotation distance were 1,200 and 1,015 mm, respectively. Two energy bins (23~33 keV and 34~44 keV) were set to obtain two reconstruction images. We used a PMMA phantom with height and radius of 50.0 mm and 17.5 mm, respectively. The phantom contained iodine, gadolinium, calcification, and lipid. The Feld-kamp-Davis-Kress (FDK) with the sinogram interpolation method and Maximum Likelihood Expectation Maximization (MLEM) algorithm were used to reconstruct the images. We evaluated the signal-to-noise ratio (SNR) of the materials. The SNRs of iodine, calcification, and liquid lipid were increased by 167.03%, 157.93%, and 41.77%, respectively, with the 23~33 keV energy bin using the sinogram interpolation method. The SNRs of iodine, calcification, and liquid state lipid were also increased by 107.01%, 13.58%, and 27.39%, respectively, with the 34~44 keV energy bin using the sinogram interpolation method. Although the FDK algorithm with the sinogram interpolation did not produce better results than the MLEM algorithm, it did result in comparable image quality to that of the MLEM algorithm. We believe that the sinogram interpolation method can be applied in various reconstruction studies using the analytic reconstruction algorithm. Therefore, the sinogram interpolation method can improve the image quality in sparse-angular sampling and be applied to CT applications.

• Korean Journal of Radiology
• /
• 제24권10호
• /
• pp.1006-1016
• /
• 2023

Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

• 한국방사선학회논문지
• /
• 제13권4호
• /
• pp.523-530
• /
• 2019

본 연구의 목적은 광자계수검출기 기반 스펙트럼 전산화단층촬영을 이용하여 K-각 영상을 획득하고, 이를 통해 3차원 융합진단영상을 구현하여 임상적 이용 가능성을 평가하고자 하였다. 실험을 통한 K-각 영상획득을 위해 스펙트럼 전산화단층촬영 시스템을 이용하였다. 희석된 iodine과 gadolinium 조영제가 주입된 6개의 튜브를 돼지고기에 삽입하여 팬텀을 제작하였다. 100 kVp 관전압과 $500{\mu}A$ 관전류 조건에서 발생된 X-선을 이용하였으며, iodine과 gadolinium의 K-각 흡수에너지를 고려한 35 및 52 keV에 저 에너지 문턱값을 설정하여 K-각 영상을 획득하였다. 융합진단영상은 일반적인 전산화단층촬영 영상과 스펙트럼 전산화단층촬영을 통해 획득한 iodine 및 gadolinium 영상을 정합하여 획득하였다. 두 가지 조영제 기반 융합진단영상의 CNR은 일반적인 CT보다 평균적으로 6.76-14.9배 높았으며, 3차원 융합진단영상은 각 조영제의 물질 지도 정보를 제공할 수 있었다. 따라서 본 연구에서 제안하는 방법을 통해 전산화단층영상의 화질을 향상시킬 수 있으며 특정 물질의 추가적인 정보를 제공을 통해 진단의 효율성을 증가시킬 수 있다.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.411-414
• /
• 2002

The CdTe semiconductor detector has a higher detection efficiency for x-rays and $\square$amma rays and a wider energy band gap compared with Si and Ge semiconductor detectors. Therefore, the size of the detector element can be made small, and can be operated at room temperature. The interaction between a CdTe detector and incident x-rays is mainly photoelectric absorption in the photon energy range of up to 100 keV. In this energy range, Compton effects are almost negligible. We have developed a 256 channel CdTe array detector system for monochromatic x-ray CT using synchrotron radiation. The CdTe array detector system, the element size of which is 1.98 mm (h) x 1.98 mm (w) x 0.5 mm (t), was operated in photon counting mode. In order to improve the spatial resolution, we tilted the CdTe array detector against the incident parallel monochromatic x-ray beam. The experiments were performed at the BL20B2 experimental hutch in SPring-8. The energy of incident monochromatic x-rays was set at 55 keV. Phantom measurements were performed at the detector angle of 0, 30 and 45 degrees against the incident parallel monochromatic x-rays. The linear attenuation coefficients were calculated from the reconstructed CT images. By increasing the detector angle, the spatial resolutions were improved. There was no significant difference between the linear attenuation coefficients which were corrected by the detector angle. It was found that this method was useful for improving the spatial resolution in a parallel monochromatic x-ray CT system.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.379-381
• /
• 2002

A single CdZnTe detector is tested for suitability in a prototype CT/ SPECT system designed to acquire both emission and transmission data. The detector has the size of 1${\times}$l-cm$^2$ with 4${\times}$4 1.5${\times}$l.5mm$^2$ pixellated anodes. Since the detector is smaller than imaged object, we translated it in an arc centered at the x-ray tube to image larger objects. Pulse counting electronics with very short shaping time (50 ns) are used to satisfy high photon rates in x-ray imaging, and response linearity up to 3${\times}$10$\^$5/ counts per second per detector element is achieved. The energy resolution of 122-keV gamma-ray is measured to be 14%. We have characterized the system performance by scanning a radiographic resolution phantom .and the Hoffman brain phantom. The spatial resolution of CT and SPECT are about 1 mm and 7 mm, respectively.

• Korean Journal of Radiology
• /
• 제25권1호
• /
• pp.86-102
• /
• 2024

Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

• 한국의학물리학회지:의학물리
• /
• 제13권4호
• /
• pp.229-233
• /
• 2002

CdZnTe 검출기를 제작하고 CT/SPECT 조합영상 시스템에 설치하여 엑스선 및 감마선검출기로서의 응용가능성을 타진해 보았다. 검출기의 크기는 10$\times$10$\times$5 ㎣ 이었다. 양극은 4$\times$4 픽셀로 설계하였으며 각 픽셀의 크기는 $1.5\times$l.5 $\textrm{mm}^2$ 이었다. 음극은 Au로 전극을 만들어 주었다. 시스템의 성능을 조사하기 위해서 방사선촬영용 분해능팬텀과 호프만 뇌 팬텀을 사용하였다. X선 영상에서 고광자방출율을 만족시키기 위해서 shapping time은 50ns 로 하었으며, 3$\times$$10^{5}$ counts/s 까지 선형성이 유지되었다. Tc-99m의 140 keV 감마선에 대한 에너지 분해능은 50 ㎱와 2 $\mu\textrm{s}$ shaping time을 걸어주었을 때 각각 10.4%와 5.3%이었다. CT와 SPECT의 공간분해능은 각각 1 mm와 9 mm 이었다. 광피이크 효율은 50 ㎱와 2 $\mu\textrm{s}$일 때 각각 41.0%와 72.5%이었다.