Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization
IntroductionMiddle meningeal artery embolization is a treatment option for chronic subdural hematoma (cSDH), but data on post-procedural imaging interpretation remain limited. This study investigates whether specific enhancement patterns can predict radiological outcomes and evaluates the utility of...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1608308/full |
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| author | Christoph J. Maurer Lars Behrens Stefan Schiele Mahmoud Zaki Guilherme Quint Christina Wolfert Björn Sommer Franz J. Stangl Ansgar Berlis |
| author_facet | Christoph J. Maurer Lars Behrens Stefan Schiele Mahmoud Zaki Guilherme Quint Christina Wolfert Björn Sommer Franz J. Stangl Ansgar Berlis |
| author_sort | Christoph J. Maurer |
| collection | DOAJ |
| description | IntroductionMiddle meningeal artery embolization is a treatment option for chronic subdural hematoma (cSDH), but data on post-procedural imaging interpretation remain limited. This study investigates whether specific enhancement patterns can predict radiological outcomes and evaluates the utility of photon-counting computed tomography (PCCT) in distinguishing contrast enhancement from hemorrhage.MethodsWe retrospectively analyzed 105 cSDHs imaged with either PCCT or flat-panel CT immediately after embolization. Two independent raters assessed enhancement patterns; diagnostic confidence and interrater agreement were evaluated.ResultsPCCT demonstrated higher diagnostic confidence and interrater reliability than flat-panel CT. Internal enhancement and fluid–fluid levels were significantly associated with hematoma persistence or recurrence.DiscussionPCCT enhances post-embolization imaging assessment in cSDH. Specific enhancement patterns may serve as imaging biomarkers to identify patients at increased risk for unfavorable radiological outcomes. |
| format | Article |
| id | doaj-art-a759a3bcfbb5472bb9f0c2e0468c33b2 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-a759a3bcfbb5472bb9f0c2e0468c33b22025-08-20T03:49:46ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.16083081608308Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolizationChristoph J. Maurer0Lars Behrens1Stefan Schiele2Mahmoud Zaki3Guilherme Quint4Christina Wolfert5Björn Sommer6Franz J. Stangl7Ansgar Berlis8Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyDiagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyComputational Statistics and Data Analysis, Institute of Mathematics, University of Augsburg, Augsburg, GermanyDiagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyDiagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyNeurosurgery, Faculty of Medicine, University of Augsburg, Augsburg, GermanyNeurosurgery, Faculty of Medicine, University of Augsburg, Augsburg, GermanyDiagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyDiagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, GermanyIntroductionMiddle meningeal artery embolization is a treatment option for chronic subdural hematoma (cSDH), but data on post-procedural imaging interpretation remain limited. This study investigates whether specific enhancement patterns can predict radiological outcomes and evaluates the utility of photon-counting computed tomography (PCCT) in distinguishing contrast enhancement from hemorrhage.MethodsWe retrospectively analyzed 105 cSDHs imaged with either PCCT or flat-panel CT immediately after embolization. Two independent raters assessed enhancement patterns; diagnostic confidence and interrater agreement were evaluated.ResultsPCCT demonstrated higher diagnostic confidence and interrater reliability than flat-panel CT. Internal enhancement and fluid–fluid levels were significantly associated with hematoma persistence or recurrence.DiscussionPCCT enhances post-embolization imaging assessment in cSDH. Specific enhancement patterns may serve as imaging biomarkers to identify patients at increased risk for unfavorable radiological outcomes.https://www.frontiersin.org/articles/10.3389/fneur.2025.1608308/fullphoton counting CTmiddle meningeal artery embolizationchronic subdural hematomacontrast enhancementhemorrhage differentiation |
| spellingShingle | Christoph J. Maurer Lars Behrens Stefan Schiele Mahmoud Zaki Guilherme Quint Christina Wolfert Björn Sommer Franz J. Stangl Ansgar Berlis Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization Frontiers in Neurology photon counting CT middle meningeal artery embolization chronic subdural hematoma contrast enhancement hemorrhage differentiation |
| title | Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| title_full | Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| title_fullStr | Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| title_full_unstemmed | Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| title_short | Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| title_sort | photon counting ct vs flat panel ct in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization |
| topic | photon counting CT middle meningeal artery embolization chronic subdural hematoma contrast enhancement hemorrhage differentiation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1608308/full |
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