Metal artifacts and artifact reduction of neurovascular coils in photon-counting detector CT versus energy-integrating detector CT - in vitro comparison of a standard brain imaging protocol

Objectives Photon-counting detector computed tomography (PCD-CT) is a promising new technique for CT imaging. The aim of the present study was the in vitro comparison of coil-related artifacts in PCD-CT and conventional energy-integrating detector CT (EID-CT) using a comparable standard brain imaging protocol before and after metal artifact reduction (MAR). Methods A nidus-shaped rubber latex, resembling an aneurysm of the cerebral arteries, was filled with neurovascular platinum coils and inserted into a brain imaging phantom. Image acquisition and reconstruction were repeatedly performed for PCD-CT and EID-CT (n = 10, respectively) using a standard brain imaging protocol. Moreover, linear interpolation MAR was performed for PCD-CT and EID-CT images. The degree of artifacts was analyzed quantitatively (standard deviation in a donut-shaped region of interest) and qualitatively (5-point scale analysis). Results Quantitative and qualitative analysis demonstrated a lower degree of metal artifacts in the EID-CT images compared to the total-energy PCD-CT images (e.g., 82.99 +/- 7.89 Hounsfield units (HU) versus 90.35 +/- 6.28 HU; p < 0.001) with no qualitative difference between the high-energy bin PCD-CT images and the EID-CT images (4.18 +/- 0.37 and 3.70 +/- 0.64; p = 0.575). After MAR, artifacts were more profoundly reduced in the PCD-CT images compared to the EID-CT images in both analyses (e.g., 2.35 +/- 0.43 and 3.18 +/- 0.34; p < 0.001). Conclusion PCD-CT in combination with MAR have the potential to provide an improved option for reduction of coil-related artifacts in cerebral imaging in this in vitro study.