光子计数探测器CT与锥形束CT在人工耳蜗植入术后成像中的比较

文献信息

中文摘要

目的： 比较光子计数CT（PCD CT）与锥形束CT（CBCT）在人工耳蜗植入（CI）术后成像中的图像质量和辐射剂量。
方法与材料： 这项回顾性研究纳入了2019年7月至2026年2月期间的224个CI术后数据集，包括112次使用三种剂量方案（常规剂量[RD]、低剂量[LD]、超低剂量[ULD]）的PCD CT扫描和112次120-kV CBCT扫描。两名放射科医生使用5点Likert量表独立评估图像质量。客观图像质量通过对比噪声比（CNR）评估。组间比较采用Mann-Whitney U检验和Kruskal-Wallis检验。图像质量的预测因素采用线性混合效应模型分析。
结果： 在来自196名患者（平均年龄58.8±16.5岁；118名女性）的224个数据集中，PCD CT的主观整体图像质量高于CBCT（中位数：4.5 vs. 2.5；p < 0.001；r = 0.82），并且在所有其他成像参数上的评分也更高（p < 0.001；r ≤ 0.66-0.84）。PCD CT不同方案之间的图像质量存在差异（H = 13.05；p = 0.0015；η2_H = 0.10），RD评分更高，而LD和ULD之间无差异。所有PCD CT方案的CNR均高于CBCT（p < 0.001）。估计有效剂量为RD 0.3 mSv、LD 0.24 mSv、ULD 0.16 mSv，CBCT为0.15 mSv。ULD在估计有效剂量接近CBCT的情况下显示出改善的图像质量。
结论： PCD CT与CBCT相比，与更高的图像质量和更少的伪影相关。ULD PCD CT在数值相似的剂量下保持了更高的图像质量评分，可能有利于更精确的术后评估、个性化设备调整以及对辐射敏感或无法移动患者的随访。

英文摘要

PURPOSE: To compare image-quality and radiation dose between photon-counting CT (PCD CT) and cone-beam CT (CBCT) for postoperative cochlear implantation (CI) imaging.
METHODS AND MATERIALS: This retrospective study included 224 postoperative CI datasets from July 2019 to February 2026, including 112 PCD CT scans using three dosage protocols (regular dose [RD], low dose [LD], ultra-low dose [ULD]) and 112 120-kV CBCT scans. Two radiologists independently assessed image-quality using 5-point Likert scales. Objective image-quality was assessed using contrast-to-noise ratio (CNR). Groups were compared using Mann-Whitney U and Kruskal-Wallis tests. Predictors of image-quality were analyzed with linear mixed-effects models.
RESULTS: Among 224 datasets from 196 patients (mean age, 58.8 ± 16.5  years; 118 women), PCD CT showed higher subjective overall image-quality than CBCT (median: 4.5 vs. 2.5; p < 0.001; r = 0.82) and higher ratings across all other imaging parameters (p < 0.001; r ≤ 0.66-0.84). Image-quality differed between PCD CT protocols (H = 13.05; p = 0.0015; η2_H = 0.10), with higher ratings for RD, while LD and ULD did not differ. CNR was higher across all PCD CT protocols than for CBCT (p < 0.001). Estimated effective dose was 0.3  mSv for RD, 0.24  mSv for LD and 0.16  mSv for ULD, and 0.15  mSv for CBCT. ULD showed improved image-quality with an estimated effective dose close to that of CBCT.
CONCLUSION: PCD CT was associated with higher image-quality and fewer artifacts than CBCT. ULD PC DCT retained higher image-quality ratings at a numerically similar dose, and may be advantageous for more precise postoperative evaluation, personalized device adjustments, and follow-up for radiosensitive or immobile patients.