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Intracranial Calcification Detection; a Comparison Between Micro-CT, Conventional CT and Ultra-high-resolution Photon-Counting Detector CT

Year: 2025
Type: article
Abstract: RATIONALE AND OBJECTIVES: To evaluate the performance of photon-counting detector CT (PCD-CT) in identifying and quantifying intracranial calcifications compared to conventional energy-integrating CT (EID-CT), utilizing micro-CT (µCT) as benchmark. METHOD: Thirty cross-sectional histopathological samples of the intracranial arteries were scanned using PCD-CT, EID-CT and µCT. Scans were optimized for µCT for maximum image quality, while clinical protocols were followed for PCD-CT and EID-CT. Additional reconstruction kernels (EID-CT: Hv40/Hv49/Hv59, PCD-CT: Hv40/Hv48/Hv56/Hv64/Hv72/Hv89) were used to enhance the spatial resolution. Two observers evaluated calcification presence subjectively, using Cohen's kappa (κ) and concordance percentages. Mass scores were utilized to objectively analyze calcium detection using intraclass correlation coefficients and Bland-Altman plots. RESULTS: Observer 1 detected calcifications in 24 samples and Observer 2 in 23 samples using µCT (90% concordance, κ=0.706). The highest agreement was with EID-CT Hv59 (97% concordance, κ=0.911), but calcium detection rates were low (observer 1; 27%, observer 2: 25%) compared to µCT. The most optimal results of calcium detection were obtained with PCD-CT Hv48 (observer 1: concordance=90%, κ=0.706) and PCD-CT Hv56 (observer 2: concordance 77%, κ=0.314) compared to μCT. Mass scores revealed the highest detection rate with PCD-CT Hv64 but also increased noise levels compared to softer kernels (
Language: English
Open Access status: hybrid
Estimated APC paid: $3,510
OpenAlex ID: W4407410472
FWCI: 1.686
Cites: 29
Cited by: 7
Related to: 10