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To emulate reality, VITs need models of imaging systems, whose realism depends on simulation parameter choice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate how simulation parameter choice impacts image quality of virtual Computed Tomography (CT) images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Utilizing a validated CT simulator (DukeSim, Duke University), a size\u2010variant and an anthropomorphic computational phantom were imaged emulating a clinical scanner (SOMATOM Force, Siemens Healthineers) and adult abdomen protocol. Simulations varied parameters associated with x\u2010ray source, phantom, and detector: source and detector subsampling (1\u20135, each side), anode heel effect severity (0%\u201340%), x\u2010ray spectrum shape\u00a0(\u00b1\u00a05\u00a0keV effective energy shift), phantom voxel size (0.1\u20130.5\u00a0mm), and detector crosstalk magnitude (0%\u201350%, per dimension). Simulations were reconstructed employing vendor\u2010specific software (ReconCT, Siemens Healthineers). Sensitivity to parameter choice was assessed using modulation transfer function (MTF, spatial resolution), noise magnitude, noise power spectrum (NPS, noise texture), and mean CT number.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      MTF was sensitive to subsampling and crosstalk, with average changes in half\u2010value frequency (\n                      <jats:italic>f<\/jats:italic>\n                      <jats:sub>50<\/jats:sub>\n                      ) up to 0.055and 0.043\u00a0mm\n                      <jats:sup>\u22121<\/jats:sup>\n                      , respectively. NPS was sensitive to crosstalk, with average peak frequency (\n                      <jats:italic>f<\/jats:italic>\n                      <jats:sub>peak<\/jats:sub>\n                      ) changes of 0.045\u00a0mm\n                      <jats:sup>\u22121<\/jats:sup>\n                      . Mean CT number of the bone insert varied\u00a0\u00b1\u00a0103.8 HU with spectrum shifts. In anthropomorphic simulations, trabecular bone CT number varied by 26\u00a0\u00b1\u00a013 HU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Simulation parameter choice impacts virtual CT image quality. Certain parameters exert greater influence and may need extra attention when developing and utilizing VITs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70114","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:34:15Z","timestamp":1762659255000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sensitivity analysis of key CT simulation parameters and their impact on quality of virtual images"],"prefix":"10.1002","volume":"52","author":[{"given":"Isabel","family":"Montero","sequence":"first","affiliation":[{"name":"Center for Virtual Imaging Trials, Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology Duke University  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan","family":"Samei","sequence":"additional","affiliation":[{"name":"Center for Virtual Imaging Trials, Carl E. 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