What’s New in Photon Counting CT?

August 01, 2026 · 35 articles · 15 research themes · covering July 25, 2026 – August 01, 2026

Overview

Across this week’s set of studies and reviews, photon-counting CT (PCCT) is repeatedly shown to deliver a consistent “triad” of advantages—higher spatial resolution, improved dose efficiency/noise behavior, and intrinsic spectral information—translating into better diagnostic performance in vascular imaging and more informative tissue characterization. Multiple clinical cohorts and phantom/experimental works in coronary, carotid, and peripheral vascular beds report improved stenosis assessment and/or fewer discrepancies versus energy-integrating CT (EID-CT) and, where available, angiographic reference standards. In parallel, reconstruction choices (slice thickness, kernel sharpness, iterative reconstruction settings) and protocol parameters (kVp, energy thresholds, and dose targets) emerge as key determinants of whether PCCT’s theoretical gains become measurable clinical improvements.

A second dominant theme is the move from “better pictures” to “quantitative, material-specific imaging.” Physics and methodological papers address how threshold-bin data arise and how to select energy thresholds for more reliable material decomposition, while imaging studies leverage these capabilities for quantitative effective atomic number/electron density mapping and for separating iodine and gadolinium via K-edge approaches. In cardiovascular plaque research, PCCT (and related spectral CT approaches) is used to better characterize vulnerable features—such as low-attenuation plaque and calcification-related blooming—supporting risk stratification beyond luminal stenosis. Complementing this, several contrast-agent and protocol studies (including high‑k-edge hybrid agents and contrast-dose adaptation rules) aim to preserve contrast-to-noise while reducing contrast dose and improving performance in challenging scenarios.

Finally, the digest highlights broader clinical translation beyond cardiovascular imaging: dose and image-quality optimization in pediatric and longitudinal contexts (e.g., congenital heart disease, lung transplant follow-up), and emerging applications in GI oncology/screening, pulmonary disease detection, and musculoskeletal/dental diagnostics. Together, the evidence suggests PCCT is progressing along a continuum—from system physics and reconstruction optimization, to spectral/quantitative methods and contrast strategies, to real-world clinical workflows—supported by guidance and decision-tree style protocol papers intended to accelerate adoption.

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Photon-counting CT angiography for cerebrovascular disease

Ultra-high resolution Photon-Counting CTA for follow-up assessment of intracranial aneurysms after flow diverter: Initial experience.

This prospective study enrolled 47 participants treated with flow diverters and compared ultra-high-resolution photon-counting CT angiography (UHR-PCCTA) versus standard-resolution PCCTA and digital subtraction angiography (DSA) for post-treatment aneurysm assessment. Readers evaluated aneurysm size, occlusion status, and neck coverage, with the study demonstrating whether UHR-PCCTA could match or improve diagnostic performance relative to SR-PCCTA and DSA. The results are significant for safer, less invasive follow-up imaging after flow diverter therapy by leveraging PCCTA’s higher resolution and artifact reduction.

Li R, He N, Cui Y et al. · European journal of radiology · (2026) · View on PubMed ↗

Diagnostic Performance of Photon-Counting Detector CT Angiography in the Detection of Cerebral and Carotid Artery Stenosis.

This prospective cohort study evaluated ultra-high-resolution photon-counting detector CT angiography (UHR PCD-CTA) versus standard-resolution (SR) CTA in participants with suspected cerebral and carotid artery stenosis, using digital subtraction angiography (DSA) as the reference standard. UHR PCD-CTA showed improved diagnostic performance for detecting cerebral and carotid stenosis compared with SR-CTA when reconstructed from the same raw photon-counting data. These findings support using UHR photon-counting CT angiography to more accurately characterize intracranial and carotid atherosclerotic narrowing, potentially improving triage and treatment planning when DSA is not available.

Li Z, Jiang H, Zhang Y et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT angiography for coronary artery disease

Improved coronary CT angiography image quality using photon-counting detector CT in SCAPIS reexamination: scan protocol and comparative analysis.

This study described the photon-counting detector CT (PCD-CT) coronary CT angiography (CCTA) scan protocol in the SCAPIS reexamination population-based cohort (15,000 participants) and compared diagnostic image quality with energy-integrating detector CT (EID-CT) at SCAPIS baseline, including Agatston score and stenosis degree comparability. In 1,147 SCAPIS reexamination participants (51% women, age 65 [IQR 61–69]), PCD-CT CCTA produced improved diagnostic image quality and enabled assessment of whether Agatston scores and stenosis grading were comparable to baseline EID-CT. The results support the scientific and clinical transition to PCD-CT for large-scale coronary imaging studies and longitudinal risk stratification.

Lidén M, Nyberg G, Aurumskjöld ML et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗

The Accuracy of Photon-Counting CT Angiography of the Coronaries Compared to Invasive Coronary Angiography.

This retrospective single-center study assessed photon-counting coronary CT angiography (PCCT-CCTA) for coronary artery stenosis in 90 adult patients, comparing standard-resolution and ultra-high-resolution reconstructions against invasive coronary angiography (ICA). PCCT-CCTA demonstrated diagnostic accuracy for coronary stenosis severity and CAD-RADS 2.0 classification that correlated with ICA findings, with radiologists blinded to ICA results. The results indicate that photon-counting CT angiography could improve noninvasive coronary stenosis assessment relative to conventional CT approaches, aiding clinical decision-making for suspected coronary artery disease.

Haag NP, Katz MS, Wiemer M et al. · RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT angiography for peripheral/tibial artery disease

Photon-counting detector computed tomography angiogram more accurately characterizes lower extremity runoff than traditional computed tomograph angiogram.

In a single-center retrospective cohort, this study compared lower extremity photon-counting detector CT angiography (PCD-CT; n=43) with conventional energy-integrating detector CT angiography (EID-CTA; n=46) against on-table angiography to assess tibial artery (TA) characterization for potential bypass. The key finding was that PCD-CT more accurately identified the target TA, with fewer discrepancies versus angiography (4.6%) than EID-CTA (21.7%; P=.03). This suggests PCCT angiography may improve preprocedural planning by reducing misidentification of runoff vessels in patients with lower extremity arterial disease.

MacArthur TA, Rajiah PS, Schaller MS · Journal of vascular surgery cases and innovative techniques · (2026) · View on PubMed ↗ · Free PDF ↗

Technical advances and clinical impact of photon-counting computed tomography angiography for peripheral artery disease.

This narrative review studied the technical advances and clinical impact of photon-counting computed tomography angiography (PCCTA) for peripheral artery disease (PAD) by synthesizing evidence on image quality and diagnostic performance. The review highlights that PCCTA may mitigate limitations of conventional CTA—such as calcium blooming and beam hardening—thereby improving visualization of small, heavily calcified vessels. Clinically, the article positions PCCTA as a promising next-generation CTA approach for diagnosis, procedural planning, and postintervention surveillance in PAD.

Zivkovic M, Raskin D, Ghibes P et al. · Journal of vascular surgery cases and innovative techniques · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT for vascular stents and restenosis

Ultra-High-Resolution Photon-Counting CT Angiography for Noninvasive Detection of Neurovascular In-Stent Restenosis.

This prospective study enrolled consecutive patients with neurovascular stents to evaluate ultra-high-resolution (UHR) photon-counting detector CTA (PCD-CTA) for noninvasive detection of in-stent restenosis (ISR). The key finding was that UHR PCD-CTA improved ISR detection accuracy by addressing conventional CTA challenges such as blooming artifacts and limited spatial resolution, using reconstituted simulated energy-integrating datasets for comparison. This is clinically significant because it supports a noninvasive imaging strategy for ISR surveillance with potentially higher reliability than standard CTA.

Su CQ, Zhou C, Wu PF et al. · Stroke · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT for non-contrast head CT and emergency imaging

Photon Counting CT of the Head: Retrospective Analysis of Image Quality and Dose in Comparison to Energy Integrating Detector CT.

This retrospective study compared non-contrast head CT (NCCT) performed with photon-counting detector CT (PCD-CT) at 120 and 140 kVp across varying radiation doses versus NCCT performed on a modern energy-integrating detector CT (EID-CT) system. PCD-CT showed differences in quantitative and qualitative image quality across acquisition parameters, supporting the feasibility of dose–image-quality optimization under PCD-CT protocols. These findings are clinically relevant for emergency NCCT practice by informing how PCD-CT settings may reduce dose while maintaining diagnostic image quality.

Schoenbeck D, Kroeger JR, Moenninghoff C et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT reconstruction optimization (resolution, kernels, IR)

Optimizing Photon-counting CT for Congenital Heart Disease: The Value of Ultrasharp Kernels in Neonates and Infants.

This retrospective study analyzed photon-counting detector CT data from neonates and infants with congenital heart disease to determine how reconstruction kernel sharpness (KS) and iterative reconstruction (IR) settings affect image quality in high-pitch pediatric cardiac imaging. Using vascular kernels with KS values 36–60 and IR levels Q1–Q4 at 1-mm thickness, the study found that selecting ultrasharp kernels (higher KS) together with appropriate IR improved visual image quality ratings. Clinically, optimizing KS/IR for PCCT can help achieve the spatial/contrast performance needed for neonatal and infant congenital heart assessments while preserving image quality at pediatric dose constraints.

Salam B, Sprinkart AM, Hart C et al. · Radiology. Cardiothoracic imaging · (2026) · View on PubMed ↗

Deep Learning-Based Automated Coronary Plaque Quantification with Ultra-high Resolution Photon-Counting Detector CT at Different Spatial Resolutions.

In a prospective single-center study of 70 patients with suspected coronary artery disease undergoing ultra-high-resolution photon-counting detector CT coronary CT angiography (UHR-CCTA), datasets were reconstructed at three spatial resolutions (0.6 mm SR, 0.4 mm HR, and 0.2 mm UHR slice thickness). Deep learning–based automated quantification of coronary stenosis and plaque volumes was evaluated alongside subjective image quality by two radiologists, showing how spatial resolution affects both appearance and automated measurements. This is significant for optimizing PCD-CT reconstruction parameters to improve quantitative coronary plaque assessment while balancing image quality and resolution demands.

Liu Y, Li R, Zhang H et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Dose efficiency and dose reduction strategies in photon-counting CT

Obese patient imaging: Potential dose reduction with photon-counting CT.

This phantom study compared cadmium-zinc-telluride (CZT) photon-counting CT (PCCT) versus energy-integrating detector CT (EID-CT) for dose efficiency across patient sizes using 3D-printed pancreas phantoms and tissue-mimicking inserts in extension rings representing adult waist percentiles (50th, 75th, 85th, 95th). Across CTDIvol values from 0.5 to 19.4 mGy, PCCT demonstrated improved noise performance (dose efficiency) relative to EID-CT, particularly as phantom size increased. These findings indicate PCCT may reduce radiation dose for obese patients by maintaining diagnostic image quality under higher attenuation conditions.

Liu LP, Mei K, Sharma S et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗ · Free PDF ↗

Dose optimization for pediatric chest CT: a comparative study of energy-integrating and photon-counting detector CT using 70 kV and 100 kV protocols with tin filtration regarding image quality and dose exposure.

This comparative phantom-and-clinical study evaluated pediatric chest CT dose and image quality between energy-integrating CT (EICT) and photon-counting CT (PCCT) using 70 kV and 100 kV protocols with tin filtration (100Sn), with measurements including CTDIvol, DLP, organ dose coefficients, and effective dose (ICRP 103). Using an anthropomorphic phantom of a 1-year-old and thermoluminescent dosimeter (TLD) measurements at constant image quality, the study assessed whether PCCT could reduce radiation exposure without degrading diagnostic image quality. The findings are important for pediatric imaging optimization by quantifying potential dose savings from PCCT under clinically relevant low- and medium-kVp tin-filtered protocols.

Kunert P, Weis M, Schlattl H et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗

Ultra-high resolution photon-counting CT of the lung after lung transplantation: should we go for optimal image quality or reduced radiation dose?

In a cohort of 100 lung transplant recipients, this study compared ultra-high-resolution photon-counting CT (UHR-PCCT, 0.4 mm) with prior high-resolution energy-integrating detector CT (HR-EIDCT, 1.0 mm) performed within <14 months, using two PCCT image-quality targets (IQ100 and reduced-dose IQ40). The key finding was how UHR-PCCT performance differed between standard-dose and reduced-dose settings relative to prior EIDCT, addressing the trade-off between maximal spatial detail and radiation reduction. This is clinically significant because lung transplant patients require frequent follow-up, making dose–quality optimization particularly impactful for longitudinal care.

Dubbeldam A, Van Ballaer V, Verschakelen J et al. · JHLT open · (2026) · View on PubMed ↗ · Free PDF ↗

A Practical Rule-of-Thumb to Adapt Contrast Media Dose in Photon-counting Detector CT: The 10-to-5 Rule.

This experimental phantom study developed a practical contrast-dose adaptation rule for photon-counting detector CT (PCD-CT) using the “10-to-5 rule” when lowering reconstructed virtual mono-energetic image (VMI) energy while maintaining contrast-to-noise ratio (CNR). Using spectral abdominal and chest CT phantoms scanned on a first-generation dual-source PCD-CT with iodine-in-water equivalent rods (0.5–15 mg I/mL) and ICRU muscle tissue, it found that the proposed rule-of-thumb can guide contrast medium dose reduction under VMI energy changes. This is significant because it offers a simple, implementable strategy to reduce contrast exposure in PCD-CT protocols without sacrificing diagnostic contrast performance.

Jeukens CRLPN, Martens B, Vandewall J et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗

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Spectral/material decomposition and quantitative tissue characterization

A physics primer on photon-counting detectors in CT: Physics, signal formation, and performance.

This physics primer studied the signal formation and performance limits of photon-counting detector CT (PCD-CT) by describing how threshold-bin data arise from the full detector-readout chain rather than direct photon-energy measurement. The authors emphasize that x-ray interactions create charge, which is processed into electrical pulses and then subjected to threshold decisions, producing effects such as spectral distortion, count loss, and instability under clinical operating conditions. Understanding this chain is scientifically significant because it enables more accurate interpretation of PCCT spectral images and more reliable evaluation of system performance.

Chen GH, Lai R, Li K · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗

Approximate Cramér-Rao lower bound analyses for semi-optimal energy thresholds selection in photon counting CT.

This methodological study developed approximate Cramér–Rao lower bound (CRLB) analyses to select semi-optimal energy thresholds for photon-counting CT (PCCT) without requiring complete system models. The proposed linear and nonlinear approaches use look-up tables generated from threshold-scan measurements on reference slab phantoms to approximate the largest basis line integrals in the object. This provides a practical route to improve noise in material decomposition by guiding threshold selection when full detector/physics models are unavailable.

Lee O · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗

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

This physics-in-medicine-and-biology 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) images on a commercial spectral photon-counting CT system. The method fit x-ray attenuation as a power-law combination of photoelectric and Compton components (with empirical correction terms) using NIST cross sections across 7–115 keV, and demonstrated applicability for tissue characterization in a QRM spectral-CT phantom containing soft-tissue-equivalent, hydroxyapatite, and iodine inserts. The approach is significant because it enables quantitative material-specific imaging from photon-counting CT, potentially improving differentiation of tissues and contrast agents in heterogeneous samples.

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

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K-edge and multi-contrast spectral imaging

K-Edge imaging using a clinical dual-source photon-counting CT system.

This study evaluated the feasibility and performance of K-edge imaging for iodine (I) and gadolinium (Gd) using a dual-source clinical photon-counting CT (PCCT) system with four energy thresholds (20, 55, 72, and 90 keV) in phantom experiments. The authors report that clinically available PCCT K-edge imaging can separate I and Gd signals using multi-bin material decomposition without relying on constrained physical assumptions. This supports translation of K-edge dual-contrast PCCT toward dose and motion-artifact reduction by enabling more informative single-session spectral imaging.

Rybertt MV, Liu LP, Sahbaee P et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗

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Contrast agent development for photon-counting CT

Experimental Evaluation of a Hybrid Iodine-Gadolinium Contrast Medium in Photon-counting Detector CT.

This in vitro experimental study evaluated BAY3685750, a novel iodine–gadolinium hybrid contrast medium, for photon-counting detector CT (PCD-CT) performance in an anthropomorphic abdominal phantom. It found that BAY3685750 was designed to improve contrast in high-energy VMIs by leveraging a higher effective k-edge than conventional iodine-only agents, and it measured relaxivity (r1) at 1.41 T to characterize the agent. The scientific significance is that high-k-edge hybrid contrast media could expand the spectral utility of PCD-CT, improving visualization when high-energy VMIs are needed.

Haag F, Rink J, Lohrke J et al. · Investigative radiology · (2026) · View on PubMed ↗

High-Z Contrast Media for Coronary Photon-counting Detector CT Angiography: Improved Quantification of Calcified Stenoses.

This phantom study assessed high-Z (atomic number higher than iodine) contrast media for coronary photon-counting detector CT angiography to improve quantification of calcified stenoses. It found that using high VMI energy levels with high-Z contrast can preserve vascular contrast while reducing calcium blooming that otherwise obscures the lumen and leads to stenosis overestimation. The clinical significance is improved accuracy of coronary stenosis severity measurement in calcified disease, which can affect downstream decision-making and risk stratification.

Demmert TT, Klambauer K, Schmidt B et al. · Investigative radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Clinical translation and protocol/guidance for photon-counting CT

Photon-counting CT in cardiac imaging: multi-institutional guidance on technical principles, clinical evidence, and practical protocols.

This multi-institutional guidance article synthesized technical principles, clinical evidence, and practical protocols for photon-counting detector CT (PCD-CT) in cardiac imaging, focusing on coronary CT angiography (CCTA) and related applications. It concludes that PCD-CT’s direct energy discrimination, higher geometric dose efficiency, and ultrahigh spatial resolution can improve coronary lumen visualization and enable intrinsic spectral imaging compared with energy-integrating detector CT (EID-CT). The review is significant because it provides actionable protocol and reconstruction recommendations to standardize PCD-CT use in routine cardiac practice and research.

Hagar MT, Vecsey-Nagy M, Kravchenko D et al. · European journal of radiology · (2026) · 2 citations · View on PubMed ↗

Pictorial review: a step-by-step guide to coronary CT angiography with photon-counting detector CT.

This pictorial review presented a step-by-step, decision-tree approach for performing coronary CT angiography with photon-counting detector CT (PCD-CT) in clinical practice. It highlights that PCD-CT can improve coronary plaque component differentiation and reduce radiation dose compared with energy-integrating detector CT (EID-CT), while emphasizing protocol selection and parameter decision-making. The review is significant because it translates emerging PCD-CT capabilities into practical workflow guidance for clinicians with limited prior experience.

Xie C, Clarke N, Kotronias R et al. · The British journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Diagnostic performance in GI and colorectal imaging

Photon-counting CT in gastrointestinal malignancies: a scoping review.

This scoping review mapped and synthesized clinical evidence (PRISMA-ScR; searches from January 2017 to December 2025) on photon-counting CT (PCCT) applications in adult gastrointestinal malignancies. Across included studies, PCCT was reported to offer improved spatial resolution and contrast-to-noise ratio with potential radiation dose reduction compared with conventional CT, while the review graded levels of evidence and assessed study quality using the Newcastle–Ottawa Scale. The work is significant for identifying where PCCT is already clinically promising in GI oncology and where higher-quality comparative trials are still needed.

Spoto F, Robertis R, Monterubbiano L et al. · European journal of radiology · (2026) · View on PubMed ↗

Diagnostic performance of photon-counting detector CT versus energy-integrating detector CT for colorectal polyp detection: a phantom study.

This phantom study compared photon-counting detector CT (PCD-CT) versus energy-integrating detector CT (EID-CT) for colorectal polyp detection using 84 histopathologically confirmed polyps from resected specimens. It found differences in image quality metrics (including SNR/CNR) and detection performance between PCD-CT and EID-CT across polyp size categories (≤5 mm, 6–9 mm, ≥10 mm), with radiologists blinded to modality. The clinical significance is that PCD-CT may improve or refine colorectal polyp detection performance relative to conventional CT, supporting potential translation to screening and diagnostic colon imaging.

Wu X, Gao H, Gao Y et al. · Abdominal radiology (New York) · (2026) · View on PubMed ↗

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Photon-counting CT for pulmonary imaging

[The role of photon-counting CT technology in the detection of pulmonary diseases].

This narrative review discussed how photon-counting CT technology may improve detection of pulmonary diseases compared with conventional energy-integrating detector CT. It highlights physical advantages of photon-counting CT—individual photon detection with energy discrimination—leading to improved dose efficiency, reduced image noise, higher spatial resolution, and intrinsic spectral imaging that can enhance diagnostic accuracy in selected low-dose or challenging scenarios. Clinically, the review supports further adoption and evaluation of photon-counting CT for pulmonary imaging where conventional CT limitations may affect sensitivity and specificity.

Rédei M, Gurza KB, Maurovich-Horvat P et al. · Orvosi hetilap · (2026) · View on PubMed ↗ · Free PDF ↗

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Advanced plaque characterization and cardiovascular risk prediction (DECT/PCCT/CCTA)

Mixed coronary plaque phantom analysis by photon-counting CT: impact of calcium and iodine on low-attenuation plaque detection.

This phantom study compared photon-counting detector CT (PCD-CT) with energy-integrating detector CT (EID-CT) for detecting low-attenuation plaque (LAP) using mixed coronary plaque inserts containing iodinated lumen (600/1000 HU), calcified arcs (200/800 mg/cc), and a narrow LAP strip (1–1.5 mm, ~75 HU) embedded in fat-equivalent background (-60 HU). The key finding was that PCD-CT improved LAP detection relative to EID-CT, with performance influenced by calcium/iodine composition and by reconstruction choices such as virtual monoenergetic energies (40/70/100/130 keV) and kernel sharpness (Qr40 soft vs Qr72 sharp) under quantum iterative reconstruction. This supports the use of spectral PCCT to better characterize vulnerable low-attenuation coronary plaque in the presence of calcification and iodine-related contrast.

Szilveszter B, Kolossváry M, Kubovje A et al. · European heart journal. Imaging methods and practice · (2026) · View on PubMed ↗ · Free PDF ↗

Dual-energy and photon-counting computed tomography in critical care.

This review studied the clinical evidence for dual-energy computed tomography (DECT) in critically ill patients, focusing on DECT reconstructions such as iodine maps and virtual non-contrast images. It found that DECT can improve diagnostic performance (e.g., in pulmonary embolism via iodine perfusion mapping) while reducing contrast dose and radiation exposure compared with conventional single-energy CT. These capabilities are clinically significant because they support faster, more accurate imaging in unstable patients with lower contrast exposure, potentially improving outcomes in life-threatening conditions.

Freed A, Bogot NR, Einav S · Journal of critical care · (2026) · View on PubMed ↗

Carotid Imaging: Current Concepts and Advanced Imaging.

This review studied current and advanced carotid imaging approaches in patients with carotid atherosclerosis, emphasizing how plaque biology (e.g., intraplaque hemorrhage, lipid-rich necrotic core, fibrous cap rupture, ulceration, and inflammation) can be assessed beyond luminal stenosis. It found that multimodal imaging—ultrasound, CTA, MRI, digital subtraction angiography, photon-counting CT (PCCT), and PET—enables complementary plaque phenotyping relevant to vulnerability. The scientific significance is that these techniques may better stratify ischemic stroke risk by targeting pathologic plaque features rather than relying on stenosis severity alone.

Saba L, Pinna A, Suri JS et al. · Seminars in neurology · (2026) · View on PubMed ↗

Photon-counting CT characterization of carotid perivascular adipose tissue: a layer-by-layer quantitative analysis. A preliminary analysis in an asymptomatic population.

This retrospective study evaluated photon-counting CT (PCCT) characterization of carotid perivascular adipose tissue (PVAT) in 20 asymptomatic patients using PCCT angiography and a custom Python layer-by-layer segmentation algorithm. It found that carotid PVAT can be quantitatively characterized with spatial layer behavior and measurable inter-/intra-subject variability in an asymptomatic cohort. This is significant because PVAT metrics may provide additional biomarkers of vascular vulnerability that could complement traditional luminal stenosis and plaque composition assessments.

Saba L, Alkadhi H, Maffei E et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗

Dual-energy CT for detection of knee fractures as alternative to MRI.

This narrative review studied dual-energy CT (DECT) as an alternative to MRI for acute knee fracture evaluation, focusing on DECT’s spectral reconstructions such as virtual non-calcium imaging for bone marrow edema and metal artifact reduction. It found that DECT can address multiple clinical scenarios where MRI is traditionally used, including complex articular fractures, subtle impacted fractures, stress fractures, and healing assessment. The significance is that DECT may provide a faster, more widely available imaging option for knee trauma when MRI access or timing is limited.

Foti G, Tripodi G, Ocello G et al. · Skeletal radiology · (2026) · 1 citations · View on PubMed ↗

The Role of Computed Tomography in High-Risk Coronary Plaque: From Imaging Assessment to Prognostic Implications.

This review studied the role of computed tomography in high-risk coronary plaque, linking imaging assessment to prognostic implications beyond luminal stenosis. It found that CCTA and advanced CT techniques—especially dual-energy and photon-counting CT—can characterize vulnerable plaque features (e.g., low-attenuation plaque, positive remodeling, spotty calcifications, napkin-ring sign) and that integration with AI/radiomics and functional tests such as FFR-CT and perfusion imaging supports risk prediction and therapy monitoring. The clinical significance is improved identification of patients at higher risk of major adverse cardiovascular events and better longitudinal tracking of plaque stabilization under treatment.

Pegoraro N, Muscogiuri G, Carnevale A et al. · Journal of clinical ultrasound : JCU · (2026) · View on PubMed ↗

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Photon-counting CT in musculoskeletal and dental imaging

Musculoskeletal Computed Tomography Imaging: A 30-Year Perspective.

This perspective article reviewed 30 years of musculoskeletal computed tomography (CT) developments, focusing on how advances in spatial resolution, dose efficiency, and spectral CT have expanded clinical capabilities. It emphasizes that spectral CT can characterize crystal deposits and marrow edema and reduce metal artifacts, while other innovations (e.g., weight-bearing cone-beam CT and CT arthrography) broaden assessment of alignment and intra-articular pathology. The scientific significance is that it frames how evolving CT technologies have progressively improved diagnostic specificity in musculoskeletal imaging.

Omoumi P, Pastor M, Demehri S et al. · Seminars in musculoskeletal radiology · (2026) · View on PubMed ↗

Photon-Counting Detector CT-Based Virtual Monoenergetic Imaging With Metal Artifact Reduction for Endodontic Diagnostics.

In an ex vivo study of 16 extracted third molars with simulated endodontic diagnostic challenges, photon-counting detector CT (PCD-CT) was used to determine optimal virtual monoenergetic imaging (VMI) energy levels (70–190 keV in 10 keV increments) and to test iterative metal artifact reduction (iMAR). The study evaluated diagnostic accuracy and depiction quality of endodontic complications across VMI energies with and without iMAR, identifying how energy selection and artifact reduction affect visualization. This is significant for improving endodontic diagnostics by optimizing PCD-CT reconstruction settings to better manage metal-related artifacts.

Al-Haj Husain A, Dogan S, Mergen V et al. · International dental journal · (2026) · View on PubMed ↗ · Free PDF ↗

“Trabecular Architecture of the Medullary Cavity: A Comprehensive Review of Radiological Patterns, Pathological Alterations”.

This comprehensive narrative review studied radiological patterns of trabecular architecture in the medullary cavity and how they change in pathology, integrating imaging evidence across modalities. It found that radiological manifestations such as thickening, breakage, faintness, rarefaction, and infiltration can be assessed using techniques including high-resolution MRI, dual-energy CT, and emerging photon-counting detector CT. The scientific significance is that improved radiological characterization of trabecular microarchitecture may enhance diagnosis and monitoring of bone disorders using noninvasive imaging biomarkers.

Chapala S, Kiyawat V, Gibson J et al. · The British journal of radiology · (2026) · View on PubMed ↗

Precision of photon-counting detector CT compared to conventional CT for total wrist arthroplasty migration: a cadaveric and clinical study.

This cadaveric and clinical study compared the precision of a novel photon-counting detector CT (PCD-CT) against conventional energy-integrating detector CT (EID-CT) for measuring total wrist arthroplasty (TWA) implant migration using bead-free CT radiostereometric analysis (CT-RSA) at different radiation doses. PCD-CT provided higher measurement precision for implant migration than EID-CT across the tested dose conditions. Improved precision in migration quantification is scientifically significant because it can better detect early implant loosening and refine post-arthroplasty surveillance and implant evaluation.

Lind G, Tesselaar E, Sandberg O et al. · Skeletal radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Generated automatically on August 01, 2026. Covers PubMed articles published July 25, 2026 – August 01, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.