Photon counting spectral CT: improved material decomposition with K-edge-filtered x-rays

Photon counting spectral computed tomography (PCSCT) provides material selective CT imaging at a single CT scan and fixed tube voltage. The PCSCT data are acquired in several energy ranges (bins) arranged over the x-ray spectrum. The quasi-monoenergetic CT images are acquired in these energy bins and are used for material decomposition. The PCSCT exhibits inherent limitations when material decomposition is performed using energy bins. For effective material decomposition, the energy bins used for material decomposition should be sufficiently narrow and well separated. However, when narrow bins are used, a large fraction of the detected x-ray counts is lost and statistical noise is increased. Alternatively, the x-ray spectrum can be split into a few larger bins with no gap in between and all detected x-ray photons can be used for material decomposition. However, in this case the energy bins are too wide and not well separated, which results in suboptimal material decomposition. The above contradictory requirements can be resolved if the x-ray photons are physically removed from the regions of the energy spectrum between the energy bins. Such a selective removal can be performed using filtration of the x-ray beam by high-Z filter materials with appropriate positions of K-edge energies. The K-edge filtration of x-rays can, therefore, provide necessary gaps between the energy bins with no dose penalty to the patient. In the current work, we proposed using selective K-edge filtration of x-rays in PCSCT and performed the first experimental investigation of this approach. The PCSCT system included a cadmium zinc telluride semiconductor detector with 2 x 256 pixels and 1 x 1 mm(2) pixel size, and five energy bins. The CT phantom had 14 cm diameter and included contrast elements of iodine, gold and calcifications with clinically relevant concentrations. The tube voltages of 60, 90 and 120 kVp were used. K-edge filters based on Ba (E-k = 37.44 keV) were used for a 60 kVp tube voltage and Gd (E-k = 50.24 keV) was used for the 90 and 120 kVp tube voltages, respectively. The material selective CT images were also acquired with conventional Al filtration for comparison. The half-value layers of x-ray beams after K-edge and Al filtration were matched. The mean entrance skin exposure was 280 mR for all tube voltages and filters. The contrast-to-noise ratio (CNR) in material-decomposed images was approximately 30%-50% higher when K-edge filters were used instead of Al filters. It was concluded that K-edge filtration of x-rays provides substantial improvement of the CNR in material-selective PCSCT. Further optimization of K-edge filter materials, tube voltages, detector technology and energy bin settings will provide even higher CNR in decomposed images.