ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1608308
Photon Counting CT Versus Flat-Panel CT in the Evaluation of Enhancement Patterns in Chronic Subdural Hematoma After Middle Meningeal Artery Embolization
Provisionally accepted
Christoph Johannes Maurer1*
Lars Behrens1Stefan Schiele2Mahmoud Zaki1Guilherme Quint1Christina Wolfert1
Björn Sommer1Franz Josef Stangl1Ansgar Berlis1- 1Augsburg University Hospital, Augsburg, Germany
- 2Institute of Mathematics, University of Augsburg, Augsburg, Bavaria, Germany
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
This retrospective observational study aimed to assess whether specific enhancement patterns in chronic subdural hematoma (cSDH) following middle meningeal artery embolization can predict radiological outcomes and to evaluate the utility of photoncounting computed tomography (PCCT) in distinguishing contrast enhancement from hemorrhage. A total of 105 cSDHs were included, with patients undergoing either PCCT or flat-panel computed tomography immediately after embolization. Two independent raters evaluated enhancement patterns, and diagnostic confidence and interrater agreement were assessed. PCCT yielded higher diagnostic confidence and interrater reliability than flat-panel imaging. Internal enhancement and fluid-fluid levels were associated with hematoma persistence or recurrence. These findings suggest that PCCT improves post-embolization assessment in cSDH and that certain enhancement patterns may serve as imaging biomarkers for unfavorable outcomes.
Keywords: Photon counting CT, middle meningeal artery embolization, chronic subdural hematoma, Contrast Enhancement, Hemorrhage Differentiation
Received: 08 Apr 2025; Accepted: 05 May 2025.
Copyright: © 2025 Maurer, Behrens, Schiele, Zaki, Quint, Wolfert, Sommer, Stangl and Berlis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Christoph Johannes Maurer, Augsburg University Hospital, Augsburg, Germany
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.