PCCT provides high-resolution, spectral imaging with improved tissue/material differentiation and reduced radiation exposure compared to conventional CT.
Long-term stability and quantitative accuracy of PCCT were demonstrated over two years using phantom studies with multiple tissue-mimicking inserts.
PCCT spectral maps (e.g., virtual monoenergetic images and iodine density maps) are always available without specific protocol selection, facilitating clinical translation.
Guideline-Based Recommendations
Diagnosis
Use PCCT for enhanced detection and monitoring of oncologic recurrences, infectious disease treatment response, and chronic disease progression.
Employ spectral imaging capabilities of PCCT to differentiate tissues and materials for improved diagnostic accuracy.
Management
Incorporate PCCT in longitudinal surveillance protocols to leverage its quantitative stability and reduced radiation dose.
Utilize iodine density maps and virtual monoenergetic images routinely for clinical assessment without additional protocol adjustments.
Monitoring & Follow-up
Perform regular quality assurance using phantoms to ensure long-term quantitative stability of PCCT systems.
Monitor system performance especially after software and hardware updates to maintain accuracy.
Risks
Be aware of new sensitivities in PCCT technology such as cooling requirements and system temperature management that may affect quantitative accuracy.
Consider potential impacts of software and hardware changes on image quality and quantitative measurements.
Patient & Prescribing Data
Patients undergoing repeated CT imaging for oncologic, infectious, chronic pulmonary, or cardiovascular conditions
PCCT allows for consistent, reliable quantitative imaging over extended periods, enabling safer longitudinal monitoring with lower radiation exposure and improved image quality.
Clinical Best Practices
Use standardized phantom protocols to assess and ensure PCCT quantitative stability over time.
Leverage spectral imaging features of PCCT routinely in clinical workflows without additional protocol complexity.
Schedule regular system performance evaluations, particularly after software or hardware updates.
Optimize reconstruction parameters (e.g., quantum iterative reconstruction levels) to balance noise reduction and image quality.
Maintain awareness of PCCT system-specific operational requirements such as cooling and temperature control.
by Leening P. Liu, Pouyan Pasyar, Fang Liu, Quy Cao, Olivia F. Sandvold, Martin V. Rybertt, Pooyan Sahbaee, Russell T. Shinohara, Harold I. Litt, Peter B. Noël
