Photon-counting detector of the ophthalmic artery: impact of virtual monoenergetic levels, reconstruction kernel, and quantum iterative reconstruction (QIR) on image quality
Abstract
Background: The ophthalmic artery (OA), a major branch of the internal carotid artery that supplies orbital vital structures and can serve as a potential biomarker for ocular and systemic diseases, is challenging to visualize due to its small diameter, tortuous course, and complex anatomy. Photon-counting detector computed tomography (PCD-CT) outperforms conventional energy-integrating detector computed tomography (CT) in orbital vascular imaging; however, relevant key reconstruction parameters for OA visualization have yet to be investigated. This study aimed to identify the optimal PCD-CT reconstruction parameters, including virtual monoenergetic imaging (VMI) level, reconstruction kernel, and quantum iterative reconstruction (QIR), for maximizing OA image quality.
Methods: A total of 17 patients (33 OAs) underwent ultra-high-resolution carotid PCD-CT angiography. Axial images were reconstructed at 40-120 keV (20 keV increments), using reconstruction kernels [body vascular convolution (Bv) 40, 48, 56, 64, and 72] and QIR levels 3 and 4. For objective analysis, two blinded radiologists placed standardized regions of interest (ROIs) in the OA, intraorbital fat, and medial rectus muscle belly, respectively. Mean arterial signal intensity attenuation (MA), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) were measured. Two blinded radiologists subjectively assessed overall image quality, vessel sharpness, and diagnostic assess-ability (using 5-point Likert scales).…
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