Spectral Photon-Counting CT Technology in Chest Imaging

International audienceThe X-ray imaging field is currently undergoing a period of rapid technological innovation in diagnostic imaging equipment. An important recent development is the advent of new X-ray detectors, i.e., photon-counting detectors (PCD), which have been introduced in recent clinical prototype systems, called PCD computed tomography (PCD-CT) or photon-counting CT (PCCT) or spectral photon-counting CT (SPCCT) systems. PCD allows a pixel up to 200 microns pixels at iso-center, which is much smaller than that can be obtained with conventional energy integrating detectors (EID). PCDs have also a higher dose efficiency than EID mainly because of electronic noise suppression. In addition, the energy-resolving capabilities of these detectors allow generating spectral basis imaging, such as the mono-energetic images or the water/iodine material images as well as the K-edge imaging of a contrast agent based on atoms of high atomic number. In recent years, studies have therefore been conducted to determine the potential of PCD-CT as an alternative to conventional CT for chest imaging

Spectral Photon-Counting Computed Tomography (SPCCT): in-vivo single-acquisition multi-phase liver imaging with a dual contrast agent protocol

International audienceAbstract Background Optimal treatment of prosthetic joint infection and chronic osteomyelitis consists of surgical removal of biofilm-embedded bacteria, followed by a 6–12 week course of antimicrobial therapy. However, when optimal surgery is not feasible, oral prolonged suppressive antibiotic therapy (PSAT) is recommended to prevent prosthesis loosening and/or relapse of infection. Since 2010, we have used infection salvage therapy using off-label subcutaneous (sc) injection of a β-lactam as PSAT for patients in whom oral PSAT is not possible. Methods A single-centre prospective cohort study (2010–18) reporting treatment modalities, efficacy and safety in all patients receiving sc PSAT. NCT03403608. Results The 10 included patients (median age 79 years) had polymicrobial (n = 5) or MDR bacterial (n = 4) prosthetic joint infection (knee, n = 4; hip, n = 3) or chronic osteomyelitis (n = 3). After initial intensive therapy, seven patients received ertapenem, three patients received ceftriaxone and one patient received ceftazidime by sc injection (one patient received 8 days of ceftriaxone before receiving ertapenem). In one patient, sc PSAT failed with recurrent signs of infection under treatment. In three patients, sc PSAT had to be discontinued due to side effects; in only one of these was the sc route implicated (skin necrosis following direct sc injection and not gravity infusion). Median treatment duration was 433 days. In six patients, sc PSAT was successful with favourable outcome at the time of writing. Interestingly, three patients with MDR bacterial carriage at baseline lost this under PSAT during follow-up. Conclusions As salvage therapy, sc PSAT delivered by gravity infusion is a safe and interesting alternative when an optimal surgical strategy is not feasible and no oral treatment is available

In Vivo Molecular K-Edge Imaging of Atherosclerotic Plaque Using Photon-counting CT

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Coronary CT Angiography with Photon-counting CT: First-In-Human Results

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Growth-inhibitory effect of cyclic GMP- and cyclic AMP-dependent vasodilators on rat vascular smooth muscle cells: effect on cell cycle and cyclin expression

1. The possibility that the antiproliferative effect of cyclic GMP- and cyclic AMP-dependent vasodilators involves an impaired progression of vascular smooth muscle cells (VSMC) through the cell cycle and expression of cyclins, which in association with the cyclin-dependent kinases control the transition between the distinct phases of the cell cycle, was examined. 2. FCS (10%) stimulated the transition of quiescent VSMC from the G0/G1 to the S phase (maximum within 18–24 h and then to the G2/M phase (maximum within 22–28 h). Sodium nitroprusside and 8-Br-cyclic GMP, as well as forskolin and 8-Br-cyclic AMP markedly reduced the percentage of cells in the S phase after FCS stimulation. 3. FCS stimulated the low basal protein expression of cyclin D1 (maximum within 8–24 h) and E (maximum within 8–38 h) and of cyclin A (maximum within 14–30 h). The stimulatory effect of FCS on cyclin D1 and A expression was inhibited, but that of cyclin E was only minimally affected by the vasodilators. 4. FCS increased the low basal level of cyclin D1 mRNA after a lag phase of 2 h and that of cyclin A after 12 h. The vasodilators significantly reduced the FCS-stimulated expression of cyclin D1 and A mRNA. 5. These findings indicate that cyclic GMP- and cyclic AMP-dependent vasodilators inhibit the proliferation of VSMC by preventing the progression of the cell cycle from the G0/G1 into the S phase, an effect which can be attributed to the impaired expression of cyclin D1 and A