Neuroimaging with photon-counting computed tomography: A review of clinical applications

Figure 1 A comparison of traditional energy integrating vs photon-counting detector systems. A: Energy integrating; B: Photon-counting detector.

Figure 2 Cerebrospinal fluid-venous fistulas are challenging to detect using conventional computed tomography imaging. NAEOTOM Alpha makes Cerebrospinal fluid-venous fistulas visible (orange coloured arrow). Copyright ©Siemens Healthineers AG 2024. The authors have obtained the permission (Supplementary material).

Figure 3 Image showing a conventional image of a head computed tomography angiogram (on the left) and its corresponding photon-counting computed tomography version (on the right), which clearly shows a middle cerebral artery stent with in-stent thrombosis. EID-CT: Energy-integrating detector-computed tomography; PCD-CT: Photon-counting detector-computed tomography; MCA: Middle cerebral artery. Image courtesy of Professor Cynthia H McCollough, Mayo Clinic, Rochester, MN, United States.

Figure 4 On the lumbar spine images acquired on the photon-counting computed tomography (on the left), the metallic artifacts are less evident when compared with conventional computed tomography (on the right).

Figure 5 Direct visualization of the DBS electrode with photon-counting computed tomography without having to rely on streak artifacts that overlap each other with multiple electrodes. CT: Computed tomography; EID-CT: Energy-integrating detector-computed tomography. Image courtesy of Professor Erik H Middlebrooks, Mayo Clinic, Jacksonville, FL, United States.

Figure 6 Axial high-resolution computed tomography image of the right temporal bone. On the photon-counting computed tomography image on the right is clearly evident a focus of otospongiosis that cannot be clearly identified on the traditional computed tomography image on the left. Visualized in the form of a hypodense demineralized otosclerotic plaque is noted in the fissula ante fenestram.