Photon-Counting CT 3D Volume Rendering Shows Good Agreement with 2D for Aneurysm Sizing

Photon-counting CT 3D volume rendering agreed well with 2D for intracranial aneurysm dome (ICC 0.83) and neck size (ICC 0.82), but inter-reader reliability was moderate (neck ICC 0.55).

• Retrospective study of 32 aneurysms in 21 patients, with two neurosurgeons evaluating 2D ultrahigh-resolution and 3D volume rendering datasets.
• Agreement between 2D-CTA and 3DVR was good: dome intraclass correlation coefficient (ICC) 0.83 (95% CI 0.66–0.92), neck ICC 0.82 (95% CI 0.59–0.92), both p<0.01.
• Inter-reader reliability on 3DVR reconstructions was moderate (dome ICC 0.74, neck ICC 0.55), suggesting reader-related factors may influence measurement differences.

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