{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:01:53Z","timestamp":1781614913437,"version":"3.54.5"},"reference-count":42,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Photon-counting detector (PCD) computed tomography (CT) allows for the reconstruction of virtual monoenergetic images (VMI) at different thresholds. Objective: The aim of our study was to evaluate the optimal arterial contrast in portal venous (pv) scans regarding objective parameters and subjective image quality for different virtual keV levels. Methods: We identified 40 patients that underwent a CT scan with an arterial and pv phase on a PCD-CT (NAEOTOM alpha, Siemens Healthineers, Forchheim, Germany). The attenuation of abdominal arteries on pv phases was measured for different virtual keV levels in a monoenergetic+ application profile and for polychromatic (pc) arterial images. Two independent readers assessed subjective image quality, including vascular contrast in pv scans at different energy levels. Additionally, signal- and contrast-to-noise ratios (SNR and CNR) were measured. Results: Our results showed increasing arterial attenuation levels with decreasing energy levels in virtual monoenergetic imaging on pv scans with the highest attenuation at 40 keV, significantly higher than in the pc arterial phase (439 \u00b1 97 HU vs. 360 \u00b1 97, p &lt; 0.001). Noise, SNR, and CNR were worse at this energy level (p &lt; 0.001). Pv VMI showed less noise at energy levels above 70 keV (all p &lt; 0.001). Subjective image quality was rated best at 70 keV, vascular contrast was best at 40 keV. Conclusions: Our research suggests that virtual monoenergetic images at 40 keV in Mono+ mode derived from a PCD-CT can be a feasible alternative to a true arterial phase for assessment of vessels with worse CNR and SNR.<\/jats:p>","DOI":"10.3390\/diagnostics14060627","type":"journal-article","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T14:05:25Z","timestamp":1710511525000},"page":"627","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Optimizing Arterial Vessel Contrast in Portal Venous Phase with Virtual Monoenergetic Images from Photon-Counting Detector CT Scans of the Abdomen\u2014First Clinical Experiences"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2088-0167","authenticated-orcid":false,"given":"Daniel","family":"Dillinger","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, R\u00fcbenacher Stra\u00dfe 170, 56072 Koblenz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Overhoff","sequence":"additional","affiliation":[{"name":"Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, R\u00fcbenacher Stra\u00dfe 170, 56072 Koblenz, Germany"},{"name":"Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Ayx","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanns L.","family":"Kaatsch","sequence":"additional","affiliation":[{"name":"Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, R\u00fcbenacher Stra\u00dfe 170, 56072 Koblenz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Hagen","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, R\u00fcbenacher Stra\u00dfe 170, 56072 Koblenz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan O.","family":"Sch\u00f6nberg","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Waldeck","sequence":"additional","affiliation":[{"name":"Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, R\u00fcbenacher Stra\u00dfe 170, 56072 Koblenz, Germany"},{"name":"Department of Neuroradiology, University Medical Center Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1007\/s00330-015-3970-2","article-title":"Advanced image-based virtual monoenergetic dual-energy CT angiography of the abdomen: Optimization of kiloelectron volt settings to improve image contrast","volume":"26","author":"Albrecht","year":"2016","journal-title":"Eur. 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