PT  - JOURNAL ARTICLE
AU  - Benson, J.C.
AU  - Rajendran, K.
AU  - Lane, J.I.
AU  - Diehn, F.E.
AU  - Weber, N.M.
AU  - Thorne, J.E.
AU  - Larson, N.B.
AU  - Fletcher, J.G.
AU  - McCollough, C.H.
AU  - Leng, S.
TI  - A New Frontier in Temporal Bone Imaging: Photon-Counting Detector CT Demonstrates Superior Visualization of Critical Anatomic Structures at Reduced Radiation Dose
AID  - 10.3174/ajnr.A7452
DP  - 2022 Apr 01
TA  - American Journal of Neuroradiology
PG  - 579--584
VI  - 43
IP  - 4
4099  - http://www.ajnr.org/content/43/4/579.short
4100  - http://www.ajnr.org/content/43/4/579.full
SO  - Am. J. Neuroradiol.2022 Apr 01; 43
AB  - BACKGROUND AND PURPOSE: Photon-counting detector CT is a new technology with a limiting spatial resolution of ≤150 μm. In vivo comparisons between photon-counting detector CT and conventional energy-integrating detector CT are needed to determine the clinical impact of photon counting-detector CT in temporal bone imaging.MATERIALS AND METHODS: Prospectively recruited patients underwent temporal bone CT examinations on an investigational photon-counting detector CT system after clinically indicated temporal bone energy-integrating detector CT. Photon-counting detector CT images were obtained at an average 31% lower dose compared with those obtained on the energy-integrating detector CT scanner. Reconstructed images were evaluated in axial, coronal, and Pöschl planes using the smallest available section thickness on each system (0.4 mm on energy-integrating detector CT; 0.2 mm on photon-counting detector CT). Two blinded neuroradiologists compared images side-by-side and scored them using a 5-point Likert scale. A post hoc reassignment of readers’ scores was performed so that the scores reflected photon-counting detector CT performance relative to energy-integrating detector CT.RESULTS: Thirteen patients were enrolled, resulting in 26 image sets (left and right sides). The average patient age was 63.6 [SD, 13.4] years; 7 were women. Images from the photon-counting detector CT scanner were significantly preferred by the readers in all reconstructed planes (P < .001). Photon-counting detector CT was rated superior for the evaluation of all individual anatomic structures, with the oval window (4.79) and incudostapedial joint (4.75) receiving the highest scores on a Likert scale of 1–5.CONCLUSIONS: Temporal bone CT images obtained on a photon-counting detector CT scanner were rated as having superior spatial resolution and better critical structure visualization than those obtained on a conventional energy-integrating detector scanner, even with a substantial dose reduction.EIDenergy-integrating detectorPCDphoton-counting detector