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Войти в исследования European journal of radiology open · 2026
High performance of low-dose ultrahigh-resolution photon-counting detector CT for sacroiliac joint assessment in axial spondyloarthritis.
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Wang Hanqi, Chen Liuping, Wei Gang, Huang Yufei, Zhou Zhuochao, Dong Haipeng, Chang Rui, Xu Zhihan, Wu Jingyi, Yu Anrui, Zeng Dan, Li Jia, Wang Yan, Du Lianjun, Yan Fuhua, Ye Junna, Lu Yong, Qin Le
Аннотация
OBJECTIVES: To compare the performance of low-dose (LD) ultrahigh-resolution (UHR) photon-counting detector (PCD) CT with energy-integrating detector (EID) CT for sacroiliac joint assessment in axial spondyloarthritis (axSpA).
MATERIALS AND METHODS: This was a prospective randomized study. AxSpA patients were enrolled and assigned to LD or clinical dose (CD) groups. Patients underwent UHR PCD-CT of the sacroiliac joints at low radiation dose (IQ level, 30), followed by EID-CT scanning using either LD (matched to PCD-CT dose) or CD protocols (108 quality reference mAs). Image noise, signal-to-noise ratio, interobserver reproducibility, subjective image quality, diagnostic confidence, and structural damage scores were evaluated by two radiologists and compared.
RESULTS: In total, 40 patients were enrolled (LD group: n = 20, 36.5 ± 9.8 years, 8 females; CD group, n = 20, 35.5 ± 8.8 years, 8 females). Compared with CD EID-CT, PCD-CT delivered lower effective dose (0.63 ± 0.23 mSv vs. 1.79 ± 1.05 mSv, p < 0.001), and exhibited higher image noise (p < 0.001) and lower SNR (p < 0.001). Interobserver reproducibility of subjective image quality and diagnostic confidence on PCD-CT (substantial to almost perfect) was higher than LD EID-CT. PCD-CT provided better subjective image quality, diagnostic confidence, and structural lesion scores than LD EID-CT. PCD-CT showed higher subjective image quality for erosions and joint space changes while yielding higher erosion and sclerosis scores than CD EID-CT.
CONCLUSION: LD UHR PCD-CT reduced radiation dose by 65% compared with CD EID-CT, and improved structural lesion visualization and diagnostic confidence compared with both LD and CD EID-CT.
MATERIALS AND METHODS: This was a prospective randomized study. AxSpA patients were enrolled and assigned to LD or clinical dose (CD) groups. Patients underwent UHR PCD-CT of the sacroiliac joints at low radiation dose (IQ level, 30), followed by EID-CT scanning using either LD (matched to PCD-CT dose) or CD protocols (108 quality reference mAs). Image noise, signal-to-noise ratio, interobserver reproducibility, subjective image quality, diagnostic confidence, and structural damage scores were evaluated by two radiologists and compared.
RESULTS: In total, 40 patients were enrolled (LD group: n = 20, 36.5 ± 9.8 years, 8 females; CD group, n = 20, 35.5 ± 8.8 years, 8 females). Compared with CD EID-CT, PCD-CT delivered lower effective dose (0.63 ± 0.23 mSv vs. 1.79 ± 1.05 mSv, p < 0.001), and exhibited higher image noise (p < 0.001) and lower SNR (p < 0.001). Interobserver reproducibility of subjective image quality and diagnostic confidence on PCD-CT (substantial to almost perfect) was higher than LD EID-CT. PCD-CT provided better subjective image quality, diagnostic confidence, and structural lesion scores than LD EID-CT. PCD-CT showed higher subjective image quality for erosions and joint space changes while yielding higher erosion and sclerosis scores than CD EID-CT.
CONCLUSION: LD UHR PCD-CT reduced radiation dose by 65% compared with CD EID-CT, and improved structural lesion visualization and diagnostic confidence compared with both LD and CD EID-CT.