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The promise of spectral photon-counting CT (SPCCT)

November 18, 2020
CT X-Ray
From the November 2020 issue of HealthCare Business News magazine

In the study, we are performing follow-up SPCCT scans of patients who have a stent implanted in the coronary artery to check if there is re-stenosis in the stent. We also plan to use the technology to look at lung disease, where we expect to be able, at a lower dose, to characterize much smaller lesions much more precisely than we can with conventional CT.

SPCCT of the lungs, for example, could be used to triage COVID-19 patients, because you may be able to detect the disease very early on. COVID-19 patients not only have lung disease but also vascular disease within the lung and you will be able to assess that vascular disease more easily. It could be macrovascular disease, such as occlusion of a large arterial branch such as a pulmonary artery, but SPCCT’s combined spatial and spectral resolution should also make it possible to check the perfusion of the lungs at the microvascular level. Sometimes COVID-19 patients develop hyperemia within the “ground glass opacities” because of inflammation, and we will be able to diagnose that with that spectral part of SPCCT using iodine perfusion mapping.

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Contrast media for molecular imaging
For molecular imaging, we have already demonstrated proof-of-concept in animal models using a new type of contrast agent based on gadolinium or gold. For example, we have shown that we can use SPCCT with this type of contrast agent to target atherosclerotic parts of the aorta in vivo. We are also investigating the efficacy of gold nanoparticles as a contrast media. A big part of the project is therefore developing new contrast agents to take advantage of SPCCT’s K-edge imaging. We are also investigating the ability of artificial intelligence to improve image quality, reduce contrast agent dose, and provide quantitative information about lesions and molecular functions.

Philippe Douek
Science, technology and medical research often take their own pathway, but occasionally they combine at a single point to produce something revolutionary. I believe that the development of spectral photon-counting CT, linking technology development by industry with the expertise of radiologists, clinical applied biologists, physicists, chemists and healthcare economists is one of those moments. From the moment in 2010 when I visited the Philips Research labs in Hamburg to capture the very first SPCCT images, the project has come a remarkably long way in a relatively short time. By building a dedicated consortium to develop the concept, we expect that affordable, easily deployable, effective SPCCT could be delivering faster and better diagnoses to large populations within the next few years.

About the author: Philippe C. Douek is a professor of cardiovascular radiology and former chairman of a consortium of 10 departments of radiology and nuclear medicine in Lyon, France.

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