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Rofo 2024; 196(01): 25-35
DOI: 10.1055/a-2119-5802
Review

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

Artikel in mehreren Sprachen: English | deutsch
Florian Hagen 
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Martin Soschynski
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Meike Weis
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Muhammad Taha Hagar
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Patrick Krumm
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Isabelle Ayx
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Jana Taron
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Tobias Krauss
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Manuel Hein
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Philipp Ruile
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Constantin von zur Muehlen
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Christopher L. Schlett
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Jakob Neubauer 
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Ilias Tsiflikas
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Maximilian Frederik Russe
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Philipp Arnold
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Sebastian Faby 
5   Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
,
Matthias F. Froelich 
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Jakob Weiß
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Thomas Stein
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Daniel Overhoff 
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Malte Bongers 
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Konstantin Nikolaou
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Stefan O. Schönberg
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Fabian Bamberg
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Marius Horger
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
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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


Publikationsverlauf

Eingereicht: 03. April 2023

Angenommen: 04. Juni 2023

Artikel online veröffentlicht:
04. Oktober 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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