A medical physicist's role in enhancing clinical applications of multi-energy CT

Multi-Energy Computed Tomography (MECT) and now Photon Counting Computed Tomography (PCCT) have been commercialized to provide physicians with material maps giving additional functional information that may contribute directly to the diagnosis,indirectly improving patient outcome. However, feedback from radiologists and preliminary research have reflected issues with our current vendor recommended settings for Macroparticles used at our institution. Given that this has large impacts on the clinical course of the patient, it is imperative that medical physicists in collaboration with radiologists,technologists, and other personnel optimize the accuracy of MECT images along with image quality. Large academic centers which may be equipped with such technologies can be unfamiliar with the process of optimizing such protocols due to their complexity. This results in physicians hesitating to order MECT protocols due to poor associated image quality with the current vendor recommended settings. We performed further research to streamline protocol optimization for these technologies and enable medical physicists to gain insight to navigate such challenges. Image quality measurements of Contrast-to-Noise-Ratio (CNR),Task-Transfer Function (Ttf) and Noise Power Spectrum (Nps) using MECT protocols,along with radiologist feedback on current vendor recommended settings led to recommendations for changes. This optimization requires knowledge of MECT protocol selection, navigating skepticism radiologists may have, and understanding limitations of the scanners through conversations with technologists, radiologists, and the vendor. Addressing these aspects has led to a better integration of MECT in the clinic. (author)