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IQon Spectral CT - Research compendium

White Paper
Philips CT Clinical Science Philips Healthcare • USA

Introduction

As the world’s first and only detector-based spectral CT, the Philips IQon Spectral CT delivers multiple layers of retrospective data in a single, low-dose scan. Spectral detector computed tomography (SDCT) is a breakthrough technology that uses two layers of detectors to simultaneously collect low- and high-energy data. The spectral data is used to generate conventional polyenergetic images as well as dedicated spectral images, including virtual monoenergetic (MonoE) and material composition (iodine only, virtual non-contrast, Z effective) images.


The Philips IQon Spectral CT enables important benefits to diagnostic confidence, patient experience, and workflow efficiency:


Diagnostic certainty

  • More accurate diagnosis through improved tissue characterization and visualization to enhance clinical and economic outcomes
  • Potential to decrease time to diagnosis by 34%*
  • Enables up to 20% decrease in repeat scans**


Every scan is a spectral scan

  • Spectral results 100% of the time eliminates patient selection dilemma
  • No upfront clinical decision-making
  • Acquire true conventional and spectral data simultaneously, in a single scan
  • Scan diverse patient populations with full spectral Field of View


Powerful advancements that fit your workflow

  • Acquire, review, and analyze spectral results as part of a routine scan retrospectively anytime, anywhere
  • Simplifies workflow across the enterprise with no compromise in image quality and dose management
  • Full integration of IntelliSpace Portal, PACS, and Spectral Diagnostic Suite allow for the review and analysis of spectral data
  • Simple interface allows on-demand viewing of spectral results with Spectral Magic Glass on PACS app

* Results from case studies are not predictive of results in other cases. Results in other cases may vary.

** TechValidate survey of IQon Spectral CT customers. Source: TechValidate, https://www.techvalidate.com/tvid/15c-0c2-709


Spectral results derived from SDCT include iodine-based results, virtual non-contrast (VNC), virtual monoenergetic images (from 40-200 keV), effective atomic number, and uric acid to assist in clinical decision-making.

The range of spectral reconstructions can add enhanced clinical value to routine clinical diagnoses. The IQon Spectral CT allows for retrospective reconstruction of spectral results and improved diagnostic capabilities, even in patients who would not have been preselected for a spectral scan. Following is a summary of the clinical value of various spectral results across a range of clinical areas.

Vascular imaging1-5
For all vascular imaging, MonoE reconstructions at low keVs increases attenuation measurements and signal-to-noise ratio (SNR). The increased attenuation at low keVs allows for improvement in image quality when the contrast enhancement is suboptimal, salvaging angiographic studies and reducing the need for additional contrast or radiation dose. Also, low MonoE reconstructions allow the user to create angiography studies from a routine contrast-enhanced exam, adding additional diagnostic information to the exam. Low MonoE images are used for the enhanced visualization of pathological structures in pulmonary angiography exams. Carotid in-stent stenosis in high-attenuation metallic stents can be more confidently evaluated using Z Effective spectral results produced by the IQon Spectral CT.

Thoracic imaging6,7
Spectral results offer a range of clinical benefits in thoracic imaging. The low keV MonoE images allow for improved image quality on contrast-enhanced chest and angiographic studies, reducing suboptimal exams. High MonoE spectral results reduce metal artifacts from CT images and improve image quality. Iodine density and Z Effective images provide enhanced visualization of perfusion in lung parenchyma and aid the clinician in assessment of the hemodynamic significance of pulmonary embolism or a perfusion defect caused by a tumor. MonoE images allow for improved assessment of lung tumors and lymph nodes in the mediastinal areas. MonoE and iodine-based spectral results also allow for improved and early assessment of response to therapy, influencing the treatment protocol and overall patient care.

Musculoskeletal (MSK) imaging8
It is very important in musculoskeletal imaging to visualize the bones, tendons, joints, and surrounding areas. Spectral results allow identification of monosodium urate crystals in joints, aiding in the visualization of gout. High MonoE images help to reduce metal artifacts, aiding visualization of tendons and tissues around metal implants.

Genitourinary imaging9,10
Genitourinary applications of spectral CT allow for stone characterization in kidneys. Spectral results aid in material characterization and differentiation of uric acid, calcium, and non-uric acid stones. MonoE, Z Effective, and iodine-based spectral results can assist the user in tumor (renal or adrenal mass) detection and characterization. Virtual non-contrast spectral results allow for reduction of a non-contrast phase in a multi-phase renal exam. Optimal visualization and improvement in image quality of the kidney parenchyma can be achieved on IQon SDCT images with MonoE image reconstruction at 60-70 keV.

Cardiac imaging11-15
Cardiac applications of spectral CT include beam hardening reduction at high MonoE reconstructions and salvaging suboptimal angiography studies using low MonoE images. High MonoE images can be used for reduction in calcium blooming. Virtual non-contrast images can be used to eliminate a non-contrast phase in coronary exams. They can also aid the clinician in virtual calcium score calculation.

Neuro imaging16
Neuroradiological applications of spectral CT include virtual non-contrast imaging and improved differentiation of gray and white matter using low MonoE images. Iodine-based images and Z Effective images allow for improved lesion detection and characterization. Iodine maps and Z Effective also aid in the visualization of perfusion deficit in the brain tissue.

Click the link below to download the full compendium, which summarizes more than 20 clinical studies, whitepapers, and other publications. These publications demonstrate a growing body of evidence that show that the spectral detector technology available on the IQon Spectral CT offers clear diagnostic benefits. Compared with conventional CT, SDCT produces scans with less image noise and lower incidence of beam hardening from artifacts, while requiring a low dose of radiation and fewer repeat scans.

A global spectral research network
Researchers around the world are making significant contributions to the body of knowledge surrounding SDCT. Studies are being conducted in the areas of oncology, orthopedics, cardiology, and pulmonology, among others.

References

  1. Sher A, Ghandour A, Rajiah P. Evaluation of monochromatic energy reconstruction on pulmonary angiography using spectral detector CT. RSNA 2014.
  2. Sher A, Ghandour A, Rong R, Rajiah P. Evaluating optimal monochromatic energy reconstruction on aortic angiography obtained from spectral detector CT. RSNA 2014.
  3. Chalian H, Mansoori B, Chalian M, Rajiah P. Salvage of suboptimal CT angiographic studies using virtual monoenergetic images from novel spectral detector CT scanner. RSNA 2015.
  4. Ben-David E, Gomori JM, Leichter I, Romman Z, Sosna J. Accuracy of carotid in-stent stenosis measurement in a phantom model using effective atomic number imaging produced by dual-layer dual-energy CT. RSNA 2015.
  5. Rong R, Rios C, Li F, Rajiah P, Landeras L. Spectral detector computed tomography (dual-layer CT): clinical applications in thoracic imaging. RSNA 2014.
  6. DiPoce J, Sosna J, Shaham D, Romman Z, Goldberg N. Spot the clot: Improvements in CT detection of thrombus using an in vitro dual-energy based phantom model. RSNA 2015.
  7. Rajiah P. Musculoskeletal applications of spectral CT – Principles, physics and clinical applications. RSNA 2015.
  8. Rajiah P. Genitourinary applications of spectral CT. RSNA 2015.
  9. DiPoce J, Romman Z, Sosna J. Optimal energy for kidney parenchymal visualization in monoenergetic images generated from dual-energy CT. RSNA 2015.
  10. Chailan M, Sher A, Eck B, Wilson D, Gilkeson R, Bezerra H, Rajiah P. Cardiovascular Applications of Spectral CT Using Single-Source Dual-Layer Detector Technique. RSNA 2014.
  11. Leichter I, Lipschuetz T, Vichter T, Romman Z, Sosna J. Automatic quantification of iodine and calcium using monoenergetic virtual images generated by spectral detector dual-layer CT: A phantom study. RSNA 2015.
  12. Chalian M, Mansoori B, Chalian H, Rajiah P. Effect of calcium blooming in coronary arteries at different monoenergetic levels of a novel spectral detector CT and comparison with polyenergetic conventional image. RSNA 2015.
  13. Fahmi R, Eck B, Levi J, Fares A, Dhanantwari A, Vembar M, Bezerra H, Wilson D. Dynamic myocardial perfusion in a porcine ischemia model using spectral detector CT. RSNA 2014.
  14. Rajiah P. Cardiothoracic applications of spectral CT – Physics, principles and clinical applications. RSNA 2015.
  15. Rajiah P. Applications of Spectral CT in neuroimaging. RSNA 2015.
  16. Rong R, Rios C, Li F, Rajiah P, Landeras L. Spectral detector Computed Tomography (Dual-Layer CT): initial experience in abdominal imaging. RSNA 2014


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White Paper
IntelliSpace Portal, IQon Spectral CT
abdomen, artifacts, Body, brain, Brain Perfusion, calcium score, Cardiac, carotids, chest, chest CTA, contrast-enhanced, Effective Z, image quality, implants, iodine density, iodine no water, iodine only, kidney/renal, low dose, lungs, lymph node, Magic Glass, metal artifact reduction, MonoE, Musculoskeletal, Neck, neck CTA, Neuro, non-contrast, Pediatric, pulmonary imaging, retrospective, spectral CT, stenosis, tumor, uric acid, Vascular, virtual non-contrast, workflow
 

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