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Low-keV Virtual Monoenergetic Imaging for Bronchial Artery Visualization on Photon-Counting Detector Computed Tomography

Sun X, Niwa T, Nomura T, Yoshida R, Koyanagi K, Hashimoto J

Diagnostics (Basel, Switzerland), 2025

34 participants · 1 citation

Abstract

Background/Objectives: This study aims to determine the optimal use of virtual monoenergetic imaging (VMI) for visualizing the bronchial artery on photon-counting detector computed tomography (PCD-CT). Methods: We evaluated the visibility of the bronchial artery on PCD-CT in 34 consecutive patients with esophageal cancer (twenty-eight men, six women; mean age, 70.2 years) prior to surgery. Region-of-interest measurements were taken at the right bronchial artery at the tracheal bifurcation level, mediastinal fat, and the erector spinae muscles on contrast-enhanced early-phase CT. We compared the CT attenuation of the bronchial artery, image noise, and contrast-to-noise ratio (CNR) across VMI at 40, 50, 60, and 70 keV. Additionally, two radiologists performed a subjective image quality assessment by comparing VMI at 40, 50, and 60 keV with 70 keV, rating bronchial artery enhancement, border clarity, peripheral visibility, and image noise. Results: CT attenuation, image noise, and CNR significantly differed across VMI energy levels (p p p Conclusions: Low-keV (40-50 keV) VMI on PCD-CT enhances bronchial artery visualization.

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