What’s New in Photon Counting CT?

July 18, 2026 · 7 articles · 7 research themes · covering July 11, 2026 – July 18, 2026

Overview

Across this week’s set of studies and reviews, a dominant theme is the expanding clinical and quantitative potential of spectral photon-counting CT (PCCT/PCD-CT). Multiple works focus on how photon-counting detectors and spectral information can improve detection and characterization—ranging from diagnosing treatable spinal arteriovenous fistulas to enhancing myocardial late iodine enhancement (LIE) scar contrast. In parallel, technical papers emphasize that performance depends strongly on acquisition and reconstruction choices (e.g., spectral analysis settings and kernels), and that scanner-specific calibration/physics-informed modeling can enable quantitative tissue maps such as effective atomic number (Zeff) and electron density (ρe).

A second major theme is translation toward precision imaging for therapy and risk stratification. Theoretical/feasibility work shows that higher-dimensional material decomposition from PCCT energy measurements can improve proton stopping power ratio (SPR) and range estimation—key for reducing range uncertainty in proton therapy planning. Complementing this, an oncology study in multiple myeloma demonstrates that dual-source photon-counting CT with low-keV virtual monoenergetic images can broaden skeletal pathophysiological characterization, potentially supporting better whole-body assessment and risk stratification.

Finally, the digest also includes non-CT innovation: an AI-driven reconstruction feasibility study for faster, radiation-free knee bone MRI using IR-UTE sequences. Together, the articles illustrate a broader trajectory in imaging—combining advanced detector physics, optimized reconstruction, quantitative modeling, and machine learning—to improve both diagnostic confidence and downstream clinical decision-making.

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Photon-Counting CT (PCCT) for Vascular/Spinal Pathology

Utility of Photon Counting Detector CT Angiography for Detecting Spinal Arteriovenous Fistulas.

This retrospective two-institution case series studied photon-counting detector CT angiography in eight patients with suspected spinal arteriovenous fistulas. The authors found that photon-counting spinal CT angiography enabled detection and characterization of spinal arteriovenous fistulas in this clinical population. This supports photon-counting CT angiography as a potentially higher-contrast, higher-resolution imaging option for diagnosing a treatable cause of myelopathy.

Madhavan AA, Bathla G, Hauck EF et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗

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Photon-Counting CT (PCCT) for Oncology & Whole-Body Imaging

Ultra-High-Resolution Dual-Source Photon-Counting CT for Expanded Characterization of Pathophysiological Imaging Patterns in Multiple Myeloma.

This retrospective study evaluated dual-source photon-counting CT (DS-PCCT) in 84 patients with multiple myeloma (53 therapy-naïve and 31 with precursor conditions) at initial diagnosis. Using low-keV virtual monoenergetic images derived from spectral attenuation of soft tissue and fat, the technique enabled expanded characterization of axial and appendicular skeletal pathophysiological imaging patterns. This could improve whole-body assessment and risk stratification in multiple myeloma by leveraging DS-PCCT’s spectral and ultra-high spatial resolution capabilities.

Heidemeier A, Huflage H, Rasche L et al. · Investigative radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-Counting CT (PCCT) Spectral Quantification (Zeff/ρe/Material Decomposition)

Power law spectral photon-counting CT for quantitative effective atomic number and electron density imaging.

This study developed and evaluated a scanner-specific power-law spectral photon-counting CT method to generate voxelwise effective atomic number (Zeff) and electron density (ρe) maps on a commercial spectral photon-counting CT system. Using fitted power-law attenuation coefficients based on NIST cross sections (Z=6–21; 7–115 keV) and a QRM spectral-CT phantom with soft-tissue-equivalent, hydroxyapatite, and iodine inserts, the method enabled quantitative tissue characterization in heterogeneous samples. This is important because Zeff/ρe imaging from spectral photon-counting CT can support improved material discrimination for quantitative imaging and potential radiotherapy/biomaterial assessment.

Alzaabi M, Behouch A, Tariq B et al. · Physics in medicine and biology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-Counting CT (PCCT) for Radiotherapy/Proton Planning

Optimal dimensionality and fundamental limits of proton stopping power estimation with photon-counting CT material decomposition.

This theoretical/feasibility work assessed the fundamental limits of proton stopping power ratio (SPR) and range estimation from photon-counting CT (PCCT) using photon-counting CT material decomposition, including evaluation of higher-dimensional decomposition. The key finding was that increasing the dimensionality of material decomposition with PCCT energy measurements can improve SPR and range estimation accuracy, with quantifiable fundamental limits. This is significant for proton therapy planning because more accurate SPR/range estimation can reduce range uncertainty and treatment margins.

Larsson K, Näsmark T, Andersson J et al. · Physics in medicine and biology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-Counting CT (PCD-CT) Reconstruction Optimization (Cardiac/Other)

Image-quality optimization for late iodine enhancement with photon-counting CT: impact of spectral analysis and reconstruction parameters.

This single-center retrospective study evaluated photon-counting detector CT (PCD-CT) for late iodine enhancement (LIE) myocardial scar imaging in 74 patients, focusing on how spectral analysis and reconstruction parameters affect image quality. The key finding was that specific combinations of spectral analysis settings and reconstruction kernels/slice thickness (e.g., Qr40 vs Qr36 and 0.4-mm vs 2-mm) significantly impacted LIE contrast-to-noise ratio. This is clinically relevant because optimizing PCD-CT reconstruction can improve the detectability of myocardial scar using LIE despite low baseline CNR.

Bruno E, Palmisano A, Pisu F et al. · La Radiologia medica · (2026) · View on PubMed ↗

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AI-Accelerated MRI for Musculoskeletal Imaging

Fast MRI of bones in the knee - An AI-driven reconstruction approach for adiabatic inversion recovery prepared ultra-short echo time sequences.

This feasibility study investigated an AI-driven reconstruction method for accelerating 3D radial inversion recovery ultra-short echo time (IR-UTE) MRI of knee bone using data from eight healthy subjects to train a denoising convolutional neural network (DnCNN). The key finding was that undersampled IR-UTE knee data could be reconstructed with improved signal-to-noise and faster acquisition while preserving bone visualization. Clinically, this supports faster radiation-free bone MRI for the knee by combining IR-UTE sequences with supervised deep-learning reconstruction and CG-SENSE.

Nunn PH, Huflage H, Grunz JP et al. · Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) · (2026) · View on PubMed ↗ · Free PDF ↗

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Computed Tomography in Cardiology (CCTA Clinical Use & Plaque Characterization)

[Computed tomography in cardiology: its necessity and developments].

This narrative review summarized the role and recent developments of computed tomography in cardiology, with emphasis on cardiac CT angiography (CCTA) in clinical practice. The key finding was that CCTA is established as a first-line test for ruling out coronary artery disease in low-to-intermediate pretest probability patients and can also be used in selected acute settings to rapidly exclude disease. Scientifically and clinically, the review highlights how CCTA extends beyond stenosis assessment to comprehensive characterization of coronary atherosclerosis (e.g., plaque metrics), supporting broader diagnostic utility.

Breitbart P, Giokoglu E, Yikit E et al. · Innere Medizin (Heidelberg, Germany) · (2026) · View on PubMed ↗ · Free PDF ↗

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Generated automatically on July 18, 2026. Covers PubMed articles published July 11, 2026 – July 18, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.