Neuroradiologists are won over by photon-counting CT

The improved resolution offered by photon-counting technology is a game changer for neurologists at Erasmus Medical Center Rotterdam, says lead researcher Professor Aad van der Lugt.¹

“Resolution is crucial in neuroradiology” , says Professor Aad van der Lugt, neuroradiologist and head of Research & Education at the Department for Radiology and Nuclear Medicine at the Erasmus Medical Center Rotterdam. Which is why he believes NAEOTOM Alpha with its photon-counting technology is a true “game changer”.¹

NAEOTOM Alpha arrived at Erasmus Medical Center Rotterdam in March 2021. To evaluate the first findings, an interdisciplinary team of technicians, radiologists, physicists, and students was formed under Van der Lugt’s lead. More than 4,500 scans have since been performed in several medical domains. The team has been struck by the advantages of the new technology, “which is why we have the ambition to replace all previous SOMATOM scanners with NAEOTOM Alpha”, says the researcher.¹

In neuroradiology the higher resolution is the main advantage at present, he points out. But that could change in the future. “It might well be that other advantages will take over. But for now, the higher resolution alone is sufficient to say that we should use only this scanner, wherever available.” ¹

Specific applications for ultra-high-resolution scans are examinations of inner ear implants, or patients with otosclerosis or otospongiosis, a disease where spongy bone causes inflammation and symptoms such as hearing loss and tinnitus. 

Apart from the higher resolution with a slice thickness as low as 0.2 millimeters, van der Lugt highlights the much-reduced noise in all imaging conducted. This enables radiologists to achieve optimized results with a lower radiation dose – a plus for many if not all neuroradiological imaging applications. Now it is also possible to examine the surroundings of flow diverters or metal implants in detail with hardly any artifacts, which was not the case with previous high-end CT scanners.

What is more, while there were difficulties in the past in the early detection of, for instance, ischemic stroke risk due to rather low resolutions in CT-angiography, these are reduced using NAEOTOM Alpha’s high-resolution spectral imaging capability.  And in the case of acute stroke, photon-counting CT not only helps with the initial diagnosis, but also in post-thrombectomy follow-up reviews. Furthermore, it is possible to differentiate between white and grey matter with great precision at low kV levels, van der Lugt points out.

For the neurologist, having spectral imaging as a more than welcome “byproduct” is another major asset. “With dual energy CT scanners, there was a necessity to choose if you wanted to go for it or not. Now spectral imaging is inherently available without additional scans or effort.” ¹

For now, the team has much to do processing the newly generated data and results, and a lot to learn about the many functions and applications of NAEOTOM Alpha’s spectral imaging capabilities. “We will be kept busy for the coming ten years exploring all the new possibilities,” says van der Lugt. “But we love to do that, because we constantly see the benefits not only in our clinical routine, but most importantly for our patients.” ¹

Florian Bayer, journalist in Vienna