Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging
Abstract Background Excellent image quality is crucial for workup of hepatocellular carcinoma (HCC) in patients with liver cirrhosis because a signature tumor signal allows for non-invasive diagnosis without histologic proof. Photon-counting detector computed tomography (PCD-CT) can enhance abdomina...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Cancer Imaging |
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| Online Access: | https://doi.org/10.1186/s40644-023-00592-5 |
| _version_ | 1797773947357364224 |
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| author | Dirk Graafen Fabian Stoehr Moritz C. Halfmann Tilman Emrich Friedrich Foerster Yang Yang Christoph Düber Lukas Müller Roman Kloeckner |
| author_facet | Dirk Graafen Fabian Stoehr Moritz C. Halfmann Tilman Emrich Friedrich Foerster Yang Yang Christoph Düber Lukas Müller Roman Kloeckner |
| author_sort | Dirk Graafen |
| collection | DOAJ |
| description | Abstract Background Excellent image quality is crucial for workup of hepatocellular carcinoma (HCC) in patients with liver cirrhosis because a signature tumor signal allows for non-invasive diagnosis without histologic proof. Photon-counting detector computed tomography (PCD-CT) can enhance abdominal image quality, especially in combination with a novel iterative reconstruction algorithm, quantum iterative reconstruction (QIR). The purpose of this study was to analyze the impact of different QIR levels on PCD-CT imaging of HCC in both phantom and patient scans. Methods Virtual monoenergetic images at 50 keV were reconstructed using filtered back projection and all available QIR levels (QIR 1–4). Objective image quality properties were investigated in phantom experiments. The study also included 44 patients with triple-phase liver PCD-CT scans of viable HCC lesions. Quantitative image analysis involved assessing the noise, contrast, and contrast-to-noise ratio of the lesions. Qualitative image analysis was performed by three raters evaluating noise, artifacts, lesion conspicuity, and overall image quality using a 5-point Likert scale. Results Noise power spectra in the phantom experiments showed increasing noise suppression with higher QIR levels without affecting the modulation transfer function. This pattern was confirmed in the in vivo scans, in which the lowest noise levels were found in QIR-4 reconstructions, with around a 50% reduction in median noise level compared with the filtered back projection images. As contrast does not change with QIR, QIR-4 also yielded the highest contrast-to-noise ratios. With increasing QIR levels, rater scores were significantly better for all qualitative image criteria (all p < .05). Conclusions Without compromising image sharpness, the best image quality of iodine contrast optimized low-keV virtual monoenergetic images can be achieved using the highest QIR level to suppress noise. Using these settings as standard reconstruction for HCC in PCD-CT imaging might improve diagnostic accuracy and confidence. |
| first_indexed | 2024-03-12T22:13:39Z |
| format | Article |
| id | doaj.art-4b0d13ba3891493ca182a3609543e5aa |
| institution | Directory Open Access Journal |
| issn | 1470-7330 |
| language | English |
| last_indexed | 2024-03-12T22:13:39Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Cancer Imaging |
| spelling | doaj.art-4b0d13ba3891493ca182a3609543e5aa2023-07-23T11:25:38ZengBMCCancer Imaging1470-73302023-07-0123111010.1186/s40644-023-00592-5Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imagingDirk Graafen0Fabian Stoehr1Moritz C. Halfmann2Tilman Emrich3Friedrich Foerster4Yang Yang5Christoph Düber6Lukas Müller7Roman Kloeckner8Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDepartment of Medicine I, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzDiagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg-University MainzAbstract Background Excellent image quality is crucial for workup of hepatocellular carcinoma (HCC) in patients with liver cirrhosis because a signature tumor signal allows for non-invasive diagnosis without histologic proof. Photon-counting detector computed tomography (PCD-CT) can enhance abdominal image quality, especially in combination with a novel iterative reconstruction algorithm, quantum iterative reconstruction (QIR). The purpose of this study was to analyze the impact of different QIR levels on PCD-CT imaging of HCC in both phantom and patient scans. Methods Virtual monoenergetic images at 50 keV were reconstructed using filtered back projection and all available QIR levels (QIR 1–4). Objective image quality properties were investigated in phantom experiments. The study also included 44 patients with triple-phase liver PCD-CT scans of viable HCC lesions. Quantitative image analysis involved assessing the noise, contrast, and contrast-to-noise ratio of the lesions. Qualitative image analysis was performed by three raters evaluating noise, artifacts, lesion conspicuity, and overall image quality using a 5-point Likert scale. Results Noise power spectra in the phantom experiments showed increasing noise suppression with higher QIR levels without affecting the modulation transfer function. This pattern was confirmed in the in vivo scans, in which the lowest noise levels were found in QIR-4 reconstructions, with around a 50% reduction in median noise level compared with the filtered back projection images. As contrast does not change with QIR, QIR-4 also yielded the highest contrast-to-noise ratios. With increasing QIR levels, rater scores were significantly better for all qualitative image criteria (all p < .05). Conclusions Without compromising image sharpness, the best image quality of iodine contrast optimized low-keV virtual monoenergetic images can be achieved using the highest QIR level to suppress noise. Using these settings as standard reconstruction for HCC in PCD-CT imaging might improve diagnostic accuracy and confidence.https://doi.org/10.1186/s40644-023-00592-5Photon-counting detector CTHepatocellular carcinomaQuantum iterative reconstruction |
| spellingShingle | Dirk Graafen Fabian Stoehr Moritz C. Halfmann Tilman Emrich Friedrich Foerster Yang Yang Christoph Düber Lukas Müller Roman Kloeckner Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging Cancer Imaging Photon-counting detector CT Hepatocellular carcinoma Quantum iterative reconstruction |
| title | Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging |
| title_full | Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging |
| title_fullStr | Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging |
| title_full_unstemmed | Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging |
| title_short | Quantum iterative reconstruction on a photon-counting detector CT improves the quality of hepatocellular carcinoma imaging |
| title_sort | quantum iterative reconstruction on a photon counting detector ct improves the quality of hepatocellular carcinoma imaging |
| topic | Photon-counting detector CT Hepatocellular carcinoma Quantum iterative reconstruction |
| url | https://doi.org/10.1186/s40644-023-00592-5 |
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