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Photon-Counting CT in the Head and Neck: Current Applications and Future Prospects

John C. Benson, Norbert G. Campeau, Felix E. Diehn, John I. Lane, Shuai Leng and Gul Moonis on behalf of the ASHNR Research Committee
American Journal of Neuroradiology July 2024, DOI: https://doi.org/10.3174/ajnr.A8265
John C. Benson
aFrom the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
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  • ORCID record for John C. Benson
Norbert G. Campeau
aFrom the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
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  • ORCID record for Norbert G. Campeau
Felix E. Diehn
aFrom the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
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John I. Lane
aFrom the Department of Neuroradiology (J.C.B., N.G.C., F.E.D., J.I.L.), Mayo Clinic, Rochester, MN USA
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Shuai Leng
bDepartment of Radiology (S.L.), Mayo Clinic, Rochester, MN USA
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Gul Moonis
cDepartment of Radiology (G.M.), Columbia University Irving Medical Center, New York, New York.
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Article Figures & Data

Figures

  • FIG 1.
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    FIG 1.

    Utility of iodine map in detecting invasion of tracheal cartilage in metastatic melanoma. PCD-CT scan of the neck with contrast (A, W/L = −350/−40) and VNC image (B) show a metastatic mass (short arrow in A) with no visible cartilage invasion. On corresponding iodine map image (C), there is involvement of the left first tracheal ring (arrow). Subsequent follow-up image on an EID scanner (D) shows tumor progression at the site of the cartilage invasion with a fistula (arrow). VNC indicates virtual non-contrast. Figure courtesy of Dr. Nitesh Shekrajka.

  • FIG 2.
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    FIG 2.

    Visualization of the chorda tympani nerve on PCD-CT. Reformatted sagittal images of the left temporal bone show the mastoid segment of the left facial nerve canal (asterisks). From this arises the chorda tympani: first in its posterior canaliculus segment (solid arrow), and then its tympanic segment in the middle ear (dashed arrows), where it transverses between the malleus and incus. W/L = 1000/4000.

  • FIG 3.
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    FIG 3.

    PCD-CT in the evaluation of SSCD. Reformatted coronal EID-CT (A) and PCD-CT (B) images are shown. EID-CT image is highly suggestive of SSCD. PCD-CT image, however, shows a tiny ridge of bone overlying the SSCD (curved arrows on both). W/L = 1000/4000.

  • FIG 4.
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    FIG 4.

    Comparison of PCD-CT to EID-CT in paranasal sinus imaging. Although both are useful for the relatively larger anatomic structures of the paranasal sinuses, PCD-CT image (A) has substantially greater spatial resolution at less radiation doses than EID-CT image (B). For example, the anterior ethmoidal artery notch is seen much clearer on PCD-CT image (curved arrows). W/L = 575/3630.

  • FIG 5.
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    FIG 5.

    Example of an adenoid cystic carcinoma with invasion of the skull base in a 69-year-old man. A large soft tissue mass was seen centered in the right parotid gland (asterisk). Coronal bone kernel images demonstrated invasion into the right temporal bone with involvement of the external auditory canal (arrows), abutting the tympanic membrane (dashed arrows), and abutting the handle of the malleus. A = soft tissue kernel, W/L = 51/337. B and C = bone kernel, W/L = 1000/4000.

  • FIG 6.
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    FIG 6.

    Evaluation of a central retinal artery on PCD-CT. Coronal CTA image of the midleft orbit from a PCD-CT scanner demonstrates both the central retinal artery in the distal optic nerve (solid arrow) and branches of the posterior ciliary artery (dashed arrows). W/L = 219/48.

  • FIG 7.
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    FIG 7.

    Arteries in multiple skull base foramina on PCD-CT. A reformatted coronal CTA image through the sphenoid sinuses exemplifies the ability of PCD-CT to evaluate the left ophthalmic artery (solid white arrow), foramen rotundum artery (dashed white arrow), and pterygoid canal artery (solid black arrows). W/L = 262/88.

  • FIG 8.
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    FIG 8.

    Example of improved vessel lumen conspicuity in the setting of a calcified atherosclerotic plaque. Blooming artifact–related densely calcified plaque at the origin of the right ICA (arrow) somewhat obscures the adjacent lumen (dashed arrow) on EID-CT, scanned with 0.6 slice thickness (A). PCD-CT image (at 0.2 mm slice thickness) provides substantially better evaluation of the lumen (B). W/L = 810/216 on EID-CT, 868/2220 on PCD-CT.

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Cite this article
John C. Benson, Norbert G. Campeau, Felix E. Diehn, John I. Lane, Shuai Leng, Gul Moonis
Photon-Counting CT in the Head and Neck: Current Applications and Future Prospects
American Journal of Neuroradiology Jul 2024, DOI: 10.3174/ajnr.A8265

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Photon-Counting CT in the Head and Neck: Current Applications and Future Prospects
John C. Benson, Norbert G. Campeau, Felix E. Diehn, John I. Lane, Shuai Leng, Gul Moonis
American Journal of Neuroradiology Jul 2024, DOI: 10.3174/ajnr.A8265
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  • Article
    • SUMMARY:
    • ABBREVIATIONS:
    • TEMPORAL BONE
    • Facial Bones, Skull Base, Paranasal Sinuses
    • HEAD AND NECK ARTERIAL VASCULATURE
    • CONCLUSIONS
    • Footnotes
    • References
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