Abstract No. 454 Photon counting C-arm computed tomography for thoracoabdominal interventional imaging: an in vivo porcine feasibility study

Abstract

Prior studies on conventional CT demonstrate improved contrast resolution and radiation dose efficiency using direct conversion and energy-resolving photon counting detectors (PCD). The objective of this study was to determine the feasibility of using a prototype C-arm based PCD-CT system for thoracoabdominal interventional imaging and assess the potential benefits in comparison to flat panel detector-based cone-beam CT (FPD-CBCT). A 51 cm × 0.6 cm CdTe-based PCD strip with 100 μm pixel size was mounted to the front of the FPD of a Siemens Artis Zee interventional system. The PCD has a max frame rate of 150 fps and two adjustable energy thresholds for high-speed dual energy imaging. Eight-second rotational FPD-CBCT and PCD-CT acquisitions of the upper abdomen and lower thorax were performed in three female domestic swine (49.3 ± 2.5 kg). Acquisitions in one of the animals were performed after a stent graft was placed during a TIPS procedure. To assess radiation dose reduction potential, PCD-CT scans were performed at 25% (7.5 mGy) of the standard CTDIvol level (30 mGy) used by the conventional FPD-CBCT protocol. Images were assessed for artifacts, noise, contrast and spatial resolution. PCD-CT images had lower noise due to rejection of electronic noise by the PCD. This resulted in higher spatial and contrast resolution for PCD-CT, even at a lower radiation dose (25% of the FPD-CBCT). Blooming and streak artifacts from iodine accumulated in the kidney and bone were lower on the PCD images. Increased soft tissue contrast on the PCD images improved visualization of visceral detail, especially of bowel. Blooming and shading artifacts near the TIPS stent graft were suppressed in PCD-CT images. In this preliminary study, a prototype C-arm based PCD-CT system demonstrated potential benefits in image quality and radiation dose efficiency when compared to FDP-CBCT. Further investigation of C-arm PCD-CT is warranted in order to assess the potential for applying this technology in improving thoracoabdominal interventions.