What’s New in Photon Counting CT?

June 15, 2026 · 5 articles · 5 research themes · covering June 08, 2026 – June 15, 2026

Overview

Across these studies and a narrative review, a dominant theme is the move from qualitative imaging toward quantitative, composition- and energy-aware biomarkers—especially enabled by photon-counting CT (PCCT/PCD-CT) and dual-energy approaches. In musculoskeletal imaging, PCCT-derived virtual noncontrast fat fraction and 70 keV attenuation showed agreement with MRI proton density fat fraction for quantifying paraspinal muscle fat infiltration in low back pain, suggesting a potential CT-based alternative for phenotyping and monitoring. In calcification biology, energy-resolved PCD-DECT demonstrated the potential to distinguish basic calcium phosphate from calcium pyrophosphate meniscal deposits using Raman spectroscopy as the reference, pointing toward noninvasive characterization of degeneration-linked tissue composition.

A second, closely related theme is that photon-counting CT quantification is inherently energy-dependent and may require careful calibration for reliable thresholds. The multiple myeloma study found that femoral bone marrow attenuation varies across reconstructed photon energies, implying that CT-based separation of normal tissue from myeloma infiltration cannot rely on a single universal energy/threshold without energy-specific adjustment.

Finally, the digest also includes work extending biomarker-driven diagnosis beyond CT physics: CSF beta trace protein measured during lateral decubitus myelography was associated with CVF-positive cases, supporting its role as an objective biomarker for spontaneous intracranial hypotension due to CSFs. Complementing these disease-focused advances, the narrative review argues for broader prevention strategies using coronary CT—particularly coronary artery calcium scoring and coronary CT angiography—to shift from risk-factor-only algorithms toward personalized, atherosclerosis-based risk assessment in asymptomatic individuals.

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Photon-Counting CT Quantification of Body Composition

Photon-counting CT for paraspinal muscle fat quantification compared with MRI proton density fat fraction.

This prospective study evaluated photon-counting CT (PCCT)–derived 70 keV attenuation values and virtual noncontrast fat fraction (VNC FF) for quantifying paraspinal muscle fat infiltration in 76 adults with low back pain, using 6-echo q-Dixon MRI proton density fat fraction (PDFF) as the reference. PCCT VNC FF and 70 keV attenuation measurements showed performance for muscle fat quantification against MRI PDFF (with regions of interest drawn in bilateral multifidus muscles). These findings support PCCT as a quantitative alternative to MRI PDFF for assessing paraspinal muscle fat infiltration relevant to low back pain phenotyping and potential treatment monitoring.

Shu D, Wang J, Liang D et al. · BMC medical imaging · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-Counting / Dual-Energy CT for Tissue Composition (Calcification Typing)

Characterizing Meniscal Calcifications with Photon Counting-Based Dual-Energy Computed Tomography.

This study investigated whether photon-counting detector dual-energy CT (PCD-DECT) can distinguish basic calcium phosphate (BCP) from calcium pyrophosphate (CPP) meniscal calcifications in 82 meniscus samples from 41 donors, using Raman spectroscopy as the reference standard. Using PCD-DECT at 120 kVp with two energy bins (20–50 keV and 50–120 keV), the authors assessed energy-resolved attenuation behavior to differentiate calcification types. If validated, PCD-DECT could enable in vivo, noninvasive characterization of calcification composition linked to meniscal degeneration and osteoarthritis.

Nevanranta EA, Karjalainen VP, Brix M et al. · Annals of biomedical engineering · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗

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Energy-Dependence and Calibration in Photon-Counting CT Biomarkers

Energy-resolved attenuation behaviour on dual-source photon-counting CT: Implications for quantitative assessment of femoral bone marrow in multiple myeloma.

This retrospective single-center study assessed how energy-dependent attenuation on dual-source photon-counting CT (PCD-CT) affects quantitative evaluation of femoral bone marrow in 103 patients with multiple myeloma, using virtual monoenergetic images reconstructed at 40–190 keV. The key finding was that femoral bone marrow attenuation varies with photon energy on PCD-CT, which has implications for threshold-based separation of normal tissue versus myeloma infiltration. Clinically, this energy dependence may require energy-specific calibration/thresholding to improve the accuracy and reproducibility of CT-based quantification of myeloma involvement.

Heidemeier A, Scheiner F, Huflage H et al. · European journal of radiology · (2026) · View on PubMed ↗

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CT-Related Diagnostic Biomarkers for CSF Disorders

Elevated CSF Beta Trace Protein Levels in Patients with CSF-Venous Fistulas.

This prospective study measured cerebrospinal fluid (CSF) beta trace protein (BTP) levels in 71 patients undergoing lateral decubitus myelography for suspected CSF-venous fistulas (CVFs) to determine whether BTP can differentiate positive versus negative myelograms. Elevated CSF BTP levels were associated with CVF-positive cases, indicating BTP as a potential objective biomarker for this underdiagnosed condition. If confirmed, CSF BTP could reduce reliance on invasive or equivocal imaging by improving diagnostic stratification for spontaneous intracranial hypotension due to CVFs.

Mark IT, Habibi P, Kim DK et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Coronary CT for Cardiovascular Risk Prevention

The emerging role of coronary computed tomography for prevention of cardiovascular disease in asymptomatic individuals.

This narrative review examined the emerging role of coronary computed tomography (CT) for preventing cardiovascular disease in asymptomatic individuals, focusing on coronary artery calcium scoring (CACS) and coronary CT angiography (CCTA). The key message is that coronary CT enables direct, noninvasive visualization of coronary atherosclerosis, supporting a shift from traditional risk-factor algorithms toward personalized, disease-based risk assessment and targeted prevention. Scientifically and clinically, this framework may improve identification of high-risk patients who would otherwise be missed by standard primary-prevention approaches.

Verpalen VA, Aboyans V, Dweck MR et al. · European journal of preventive cardiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Generated automatically on June 15, 2026. Covers PubMed articles published June 08, 2026 – June 15, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.