{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T04:18:13Z","timestamp":1773893893767,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005625","name":"RSNA Research and Education Foundation","doi-asserted-by":"publisher","award":["RSCH2302"],"award-info":[{"award-number":["RSCH2302"]}],"id":[{"id":"10.13039\/100005625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dual\u2010contrast imaging of iodine and bismuth has shown promise in previous phantom and animal studies utilizing spectral CT. However, these studies often employed Pepto\u2010Bismol containing bismuth subsalicylate with dosages exceeding the recommended limits for human consumption, limiting their clinical applicability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to improve iodine\u2013bismuth dual\u2010contrast imaging on a clinical photon\u2010counting CT (PCCT) system using a noise\u2010optimized virtual monoenergetic imaging (VMI) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four bismuth samples (0.6, 1.3, 2.5, and 5.1\u00a0mg\/mL) and three iodine rods (1.0, 2.0, and 5.0\u00a0mg\/mL) were inserted into a multi\u2010energy CT phantom and scanned on a PCCT system at 140\u00a0kV. VMIs were generated from 40 to 190\u00a0keV in 10\u00a0keV increments. Iodine and bismuth maps were computed for all possible keV pairs using a generic image\u2010based three\u2010material decomposition method and compared with maps generated from the original low\u2010\/high\u2010energy PCCT images. Mass concentrations, noise levels, and individual as well as joint root\u2010mean\u2010square error (RMSE) for iodine and bismuth were measured to determine the optimal keV pair. The contrast\u2010to\u2010noise ratios (CNRs) of low concentration samples (bismuth: 0.6 and 1.3\u00a0mg\/mL; iodine: 1.0\u00a0mg\/mL) were calculated at the optimal keV pair and compared to the values determined with the original PCCT images. In an IRB\u2010approved feasibility study, a research patient was administered two doses of Pepto\u2010Bismol prior to a routine abdomen\u2010pelvis CT scan. Material decomposition was performed using both the original low\u2010\/high\u2010energy images and the optimal VMI pair identified in the phantom study. Bismuth signals in the stomach and proximal small bowel were assessed qualitatively and quantitatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The VMI pair of 110 and 190\u00a0keV was determined to be optimal, achieving the lowest joint RMSE of 0.49\u00a0mg\/mL, compared to 1.42\u00a0mg\/mL for the original low\u2010\/high\u2010energy pair. It also yielded the highest CNR, representing a 190\u2013318% improvement over the original low\/high\u2010energy decomposition. Qualitatively, both phantom and patient studies demonstrated improved iodine\u2013bismuth separation and reduced noise using the optimized VMI pair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that noise\u2010optimized VMI selection can enhance dual\u2010contrast material decomposition performance on clinical PCCT, supporting its potential for translation into gastrointestinal imaging applications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70254","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:53:43Z","timestamp":1767178423000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Iodine and bismuth dual\u2010contrast imaging on photon\u2010counting CT with noise\u2010optimized virtual monoenergetic imaging: Phantom and patient studies"],"prefix":"10.1002","volume":"53","author":[{"given":"Sophia","family":"Roth","sequence":"first","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diwash","family":"Thapa","sequence":"additional","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afrouz","family":"Ataei","sequence":"additional","affiliation":[{"name":"Department of Radiology &amp; Nuclear Medicine Rush University Medical Center  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasantha","family":"Vasan","sequence":"additional","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard W.","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lifeng","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Xi","sequence":"additional","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liqiang","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Radiology UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201004659\u20109"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20180546"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120692"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41747\u2010017\u20100030\u20105"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554\u2010017\u20101104\u20104"},{"issue":"3","key":"e_1_2_9_7_1","article-title":"Dual\u2010source multienergy CT with triple or quadruple x\u2010ray beams","volume":"5","author":"Yu L","year":"2018","journal-title":"J Med Imag"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15448"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/ab55bf"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13912"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e3182606baf"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/rli.0000000000000687"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/s24113567"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/rli.0000000000000060"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278\u2010025\u201001593\u20105"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212579"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12301"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4922654"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1117\/1.JMI.6.1.013503"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/ab1c34"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.70254","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mp.70254","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mp.70254","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:58:04Z","timestamp":1773885484000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/mp.70254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/mp.70254"],"URL":"https:\/\/doi.org\/10.1002\/mp.70254","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]},"assertion":[{"value":"2025-09-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70254"}}