Visualization of bone details in a novel photon-counting dual-source CT scanner-comparison with energy-integrating CT

Objectives Photon-counting detector CT (PCD-CT) promises a leap in spatial resolution due to smaller detector pixel sizes than implemented in energy-integrating detector CTs (EID-CT). Our objective was to compare the visualization of smallest bone details between PCD-CT and EID-CT using a mouse as a specimen. Materials and methods Two euthanized mice were scanned at a 20-slice EID-CT and a dual-source PCD-CT in single-pixel mode at various CTDIVol values. Image noise and signal-to-noise ratio (SNR) were evaluated using repeated ROI measurements. Edge sharpness of bones was compared by the maximal slope within CT value plots along sampling lines intersecting predefined bones of the spine. Two readers evaluated bone detail visualization at four regions of the spine on a three-point Likert scale at various CTDIVol's. Two radiologists selected the series with better detail visualization among each of 20 SNR-matched pairs of EID-CT and PCD-CT series. Results In CTDIVol-matched scans, PCD-CT series showed significantly lower image noise (Noise(CTDI=5 mGy): 16.27 +/- 1.39 vs. 23.46 +/- 0.96 HU, p < 0.01), higher SNR (SNRCTDI=5 mGy: 20.57 +/- 1.89 vs. 14.00 +/- 0.66, p < 0.01), and higher edge sharpness (Edge Slope(lumbar spine): 981 +/- 160 vs. 608 +/- 146 HU/mm, p < 0.01) than EID-CT series. Two radiologists considered the delineation of bone details as feasible at consistently lower CTDIVol values at PCD-CT than at EID-CT. In comparison of SNR-matched reconstructions, PCD-CT series were still considered superior in almost all cases. Conclusions In this head-to-head comparison, PCD-CT showed superior objective and subjective image quality characteristics over EID-CT for the delineation of tiniest bone details. Even in SNR-matched pairs (acquired at different CTDIVol's), PCD-CT was strongly preferred by radiologists.