Advancements in monitoring paranasal sinuses among people with cystic fibrosis using photon-counting CT

BackgroundPeople diagnosed with cystic fibrosis (pwCF) who have chronic rhinosinusitis undergo low-dose computed tomography (LDCT) scans of the paranasal sinuses as a crucial component of their disease management.PurposeTo assess and compare the intra-individual image quality and radiation dose between photon-counting CT (PCCT) and CT scanners utilizing an energy-integrating detector system (EID-CT) with LD protocols for pwCF.Material and MethodsIn this retrospective study, 23 pwCF who underwent LD paranasal sinuses PCCT and who had previously undergone LD paranasal sinuses EID-CT were included. An intra-individual comparison of image quality and radiation dose was carried out. Three blinded radiologists rated overall image quality, image sharpness, and image noise using a 5-point Likert scale. The study measured the dose length product, the volumetric CT dose index, the effective dose, and the signal to noise ratio (SNR).ResultsThe cohort comprised 23 individuals (6 women [26%], 17 men [74%]; mean age = 36.7 years). PCCT achieved superior evaluations for image quality in comparison to EID-CT (mean = 5 vs. 3; <i>P</i> <0.001). Furthermore, PCCT exhibited diminished image noise (mean = 4 vs. 3; <i>P</i> <0.001). The mean SNR of the paranasal sinuses demonstrated an increase in PCCT as opposed to EID-CT (<i>P</i> <0.001). PCCT demonstrated a reduction of approximately 36% in effective dose compared to EID-CT (mean = 0.09 vs. 0.15 mSv; <i>P</i> <0.001).ConclusionPCCT scans of the paranasal sinuses offer superior image quality and substantially reduce radiation dose compared to EID-CT scans in pwCF, offering a safer and more effective imaging alternative compared to EID-CT for managing cystic fibrosis.