Spectral CT: A technology primer for contrast agent development

Recent developments in spectral CT systems featuring binned photon-counting detector technology have enabled an imaging concept on a pre-clinical level that has been coined K-edge imaging. This exciting concept allows the selective and quantitative imaging of contrast media by exploiting the K-edge discontinuity in the photo-electric component of X-ray absorption. An ideal application for K-edge imaging is CT imaging of target-specific and conventional contrast agents that have been designed to be spectral-CT-visible. Current limitations in detector hardware, however, result in typically high noise levels that hamper the application of K-edge imaging. In order to battle noise and assure sufficient sensitivity, the development of dedicated K-edge contrast media in combination with advanced image processing techniques is imperative. This work attempts a comprehensive overview on how the concert of dedicated contrast media, optimized data acquisition and innovative data processing techniques improve sensitivity of K-edge imaging which will foster clinical translation of the technology.