Photon-Counting Computertomographie – klinische Anwendungen in der onkologischen, kardiovaskulären und pädiatrischen Radiologie

Zusammenfassung

Hintergrund Die Technologie der photonenzählenden Computertomografie (PCD-CT) hat Einzug in die klinische Praxis gehalten und wird erstmals in der klinischen Routine eingesetzt. Während die ersten Erfahrungen mit diesem Verfahren in bestimmten Patientengruppen gemacht werden, hat die Technologie das Potenzial, bestehende Arbeitsabläufe zu verändern und neue Möglichkeiten in der diagnostischen Bildgebung zu öffnen.

Methode Der Inhalt dieser Übersicht basiert auf einer uneingeschränkten Literaturrecherche in den Datenbanken PubMed und Google Scholar unter der Verwendung der Suchwörter „Photon-Counting CT“, „Photon-Counting detector“, „spectral CT“, „Computed Tomography“ sowie auf den Erfahrungen der Autoren.

Ergebnisse Der grundlegende Unterschied zu den derzeit etablierten energieintegrierenden CT-Detektoren besteht darin, dass die PCD-CT die Zählung jedes einzelnen Photons auf Detektorebene ermöglicht. Basierend auf der identifizierten Literatur haben PCD-CT-Phantommessungen und erste klinische Studien gezeigt, dass die neue Technologie eine verbesserte räumliche Auflösung, ein reduziertes Bildrauschen, Potenzial zur erheblichen Dosisreduktion und neue Möglichkeiten für quantitative Bildnachbearbeitung ermöglicht.

Schlussfolgerung PCD-CT ist eine neuartige, innovative Technologie mit dem Potenzial, viele der derzeitigen Einschränkungen der CT-Bildgebung in der klinischen Praxis zu überwinden. Insbesondere kritische Patientengruppen, wie onkologische, kardiovaskuläre, pneumologische als auch pädiatrische Patientenkollektive profitieren von den klinischen Vorteilen.

Kernaussagen: 

• Die PCD-CT wird erstmals in der klinischen Routine eingesetzt und ermöglicht in kritischen Patientenkollektiven, wie der Onkologie, Kardiologie, Pulmonologie und Pädiatrie eine signifikante Dosisreduktion.

• Im Vergleich zur herkömmlichen CT ermöglicht die PCD-CT eine Reduzierung des elektronischen Bildrauschens.

• Durch die spektralen Datensätze ermöglicht das PCD-CT vollumfängliche Nachbearbeitungs-Applikationen.

Zitierweise

• Hagen F, Soschynski M, Weis M et al. Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology. Fortschr Röntgenstr 2024; 196: 25 – 35

Key words

photon-counting - computed tomography - diagnostic imaging - photon-counting detector - spectral computed tomography - energy-integrating detector

Publication History

Received: 03 April 2023

Accepted: 04 June 2023

Article published online:
04 October 2023

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