CT systems equipped with photon-counting detectors (PCDs), referred to as photon-counting CT (PCCT), are beginning to change imaging in several subspecialties, such as cardiac, vascular, thoracic, and musculoskeletal radiology. Evidence has been building in the literature underpinning the many advantages of PCCT for different clinical applications. These benefits derive from the distinct features of PCDs, which are made of semiconductor materials capable of converting photons directly into electric signal. PCCT advancements include, among the most important, improved spatial resolution, noise reduction, and spectral properties. PCCT spatial resolution on the order of 0.25 mm allows for the improved visualization of small structures (eg, small vessels, arterial walls, distal bronchi, and bone trabeculations) and their pathologies, as well as the identification of previously undetectable anomalies. In addition, blooming artifacts from calcifications, stents, and other dense structures are reduced. The benefits of the spectral capabilities of PCCT are broad and include reducing radiation and contrast material dose for patients. In addition, multiple types of information can be extracted from a single data set (ie, multiparametric imaging), including quantitative data often regarded as surrogates of functional information (eg, lung perfusion). PCCT also allows for a novel type of CT imaging, K-edge imaging. This technique, combined with new contrast materials specifically designed for this modality, opens the door to new applications for imaging in the future. 

Clinical Applications of Photon-counting CT: A Review of Pioneer Studies and a Glimpse into the Future.

Improvement of Spatial Resolution on Coronary CT Angiography by Using Super-Resolution Deep Learning Reconstruction.

In recent years, computed tomography (CT) has undergone a number of developments to improve radiological care. The most recent major innovation has been the development of photon-counting detectors. By comparison with the energy-integrating detectors traditionally used in CT, these detectors offer better dose efficiency, eliminate electronic noise, improve spatial resolution and have intrinsic spectral sensitivity. These detectors also allow the energy of each photon to be counted, thus improving the sampling of the X-ray spectrum in multiple energy bins, to better distinguish between photoelectric and Compton attenuation coefficients, resulting in better spectral images and specific color K-edge images. The purpose of this article was to make the reader more familiar with the basic principles and techniques of new photon-counting CT systems equipped with photon-counting detectors and also to describe the currently available devices that could be used in clinical practice. 

Photon-counting CT systems: A technical review of current clinical possibilities

To demonstrate the feasibility and potential of using a second-generation prototype photon-counting computed tomography (CT) system to provide simultaneous high spatial resolution images and high spectral resolution material information across a range of routine imaging tasks using clinical patient exposure levels.The photon-counting system employs an innovative silicon-based photon-counting detector to provide a balanced approach to ultra-high-resolution spectral CT imaging. An initial cohort of volunteer subjects was imaged using the prototype photon-counting system. Acquisition technique parameters and radiation dose exposures were guided by routine clinical exposure levels used at the institution. Images were reconstructed in native slice thickness using an early version of a spectral CT reconstruction algorithm Samples of images across a range of clinical tasks were selected and presented for review.Clinical cases are presented across inner ear, carotid angiography, chest, and musculoskeletal imaging tasks. Initial reconstructed images illustrate ultra-high spatial resolution imaging. The fine detail of small structures and pathologies is clearly visualized, and structural boundaries are well delineated. The prototype system additionally provides concomitant spectral information with high spatial resolution.This initial study demonstrates that routine imaging at clinically appropriate patient exposure levels is feasible using a novel deep-silicon photon-counting detector CT system. Furthermore, a deep-silicon detector may provide a balanced approach to photon-counting CT, providing high spatial resolution imaging with simultaneous high-fidelity spectral information. 

Initial Clinical Images From a Second-Generation Prototype Silicon-Based Photon-Counting Computed Tomography System.

Scritter is a system that enables one the superimposition of invisible messages and comments on a large screen while sharing a movie. By putting other information on an image that only users who wear special glasses (named "IP(Information Polarized)-Glasses") can see, a multiplex of image media can be realized. By selecting the glasses, visible images can be changed into a movie or a message.

A multiplexed image system for a public screen

Wide-coverage detector CT and ultra-high-resolution (UHR) detector CT are two important features for current cardiac imaging modalities. The former one enables the scanner to finish a whole heart image scan in one bed position; the latter one gives superior resolution in fine structures such as stenoses, calcifications, implemented stents, and small vessel boundaries. However, no commercially available scanner has both these features in one scanner as of today. Herein, we propose to use existing UHR-CT data to train a super resolution (SR) neural network and apply the network in a wide-coverage detector CT system. The purpose of the network is to enhance the system resolution performance and reduce the noise while maintaining its wide-coverage feature without additional hardware changes. Thirteen UHR-CT patient datasets and their simulated-normal-resolution pairs were used for training a 3D residual-block U-Net. The modulation transfer function (MTF) measured from Catphan phantom scans showed the proposed super-resolution aided deep learning-based reconstruction (SR-DLR) improved the MTF resolution by relative ~30% and ~10% as compared to filtered-back projection and model-based iterative reconstruction approaches. In real patient cases, the SR-DLR images show better noise texture and enhanced spatial resolution along with better aortic valve, stent, calcification, and soft tissue features as compared to other reconstruction approaches.

/pdf/deep-learning-enabled-wide-coverage-high-resolution-cardiac-2lv0pep0.pdf

Deep learning enabled wide-coverage high-resolution cardiac CT

In this paper, we will be introducing a technological solution enabling the use of multiplex imaging technique on the living room television screen. FamiLinkTV allows all the family members to enjoy an experience that goes far beyond the simple screen sharing together: instead of having different family members watching their own contents in their own rooms, or on separate time slots, FamiLinkTV aims to get people to sit on the same couch at the same time. The sharing of physical space will allow family bonding to take place by acting as a catalyst for social interaction. In order to involve more developers and artists in the search for innovative interaction-enhancing content, we opened the field for content creators by proposing a Unity3D plug-in that enables multiplex imaging on 3D flat panels. Current development allows contents such as games, movies and camera feeds to be displayed on the screen, and be seen independently in real-time, either on the naked eye (main content) or through cheap polarizing glasses (hidden content). The implementation of image hiding is likely to have a great impact on the current multiplex technologies.

FamiLinkTV: expanding the social value of the living room with multiplex imaging technology

Photon counting CT (PCCT) has been a research focus in the last two decades. Recent studies and advancements have demonstrated that systems using semiconductor-based photon counting detectors (PCDs) have the potential to provide better contrast, noise and spatial resolution performance compared to conventional scintillator-based systems. With multi-energy threshold detection, PCD can simultaneously provide the photon energy measurement and enable material decomposition for spectral imaging. In this work, we report a performance evaluation of our first CdZnTe-based prototype full-size photon counting CT system through various phantom imaging studies. This prototype system supports a 500 mm scan field-of-view (FOV) and 10 mm cone coverage at isocenter. Phantom scans were acquired using 120 kVp from 50 to 400 mAs to assess the imaging performance on: CT number accuracy, uniformity, noise, spatial resolution, material differentiation and quantification. Both qualitative and quantitative evaluations show that PCCT has superior imaging performance with lower noise and improved spatial resolution compared to conventional energy integrating detector (EID)-CT. Using projection domain material decomposition approach with multiple energy bin measurements, PCCT virtual monoenergetic images (VMIs) have lower noise, and superior performance in quantifying iodine and calcium concentrations. These improvements lead to increased contrast-to-noise ratio (CNR) for both high and low contrast study objects compared to EID-CT. PCCT can also generate super-high resolution (SHR) images using much smaller detector pixel size than EID-CT and dramatically improve image spatial resolution.

pdf/comprehensive-evaluations-of-a-prototype-full-field-of-view-3fzuwb3a.pdf

Comprehensive evaluations of a prototype full field-of-view photon counting CT system through phantom studies

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Deep learning enabled wide-coverage high-resolution cardiac CT

FamiLinkTV: expanding the social value of the living room with multiplex imaging technology

Comprehensive evaluations of a prototype full field-of-view photon counting CT system through phantom studies