68-keV monoenergetic CT in thorax phantom: highest CNR for calcium but highest dose, dose-normalized performance comparable

In a thorax phantom, 68-keV monoenergetic CT yielded the highest contrast-to-noise ratio for calcium-mimicking inserts but also the highest radiation dose; dose-normalized performance was comparable to routine-dose and low-dose 120-kVp CT.

• Deep-learning reconstruction showed the most favorable descriptive quantitative results among filtered back projection, iterative reconstruction, and deep learning.
• The larger phantom condition (with extension ring) increased background noise and reduced contrast-to-noise ratio.
• No repeated scans or region-of-interest redraws were performed; findings are descriptive condition-level comparisons without statistical testing.

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