What's New in Photon Counting CT? — August 02, 2026
AI-summarised digest of 36 PubMed articles on Photon Counting CT published in the last 7 days.
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What’s New in Photon Counting CT?
August 02, 2026 · 36 articles · 15 research themes · covering July 26, 2026 – August 02, 2026
Overview
Across this week’s set of papers, photon-counting CT (PCCT)—especially ultra-high-resolution (UHR) and spectral modes—is repeatedly shown to improve diagnostic performance where conventional CT is limited by spatial resolution, noise, and blooming from calcification. In vascular imaging, UHR photon-counting CT angiography improved detection of intracranial/carotid stenosis versus standard-resolution reconstructions (with DSA as reference), enhanced post–flow diverter aneurysm assessment, and improved noninvasive detection of in-stent restenosis by mitigating blooming and sharpening detail. Similar advantages extend to coronary CT angiography: multiple studies and guidance documents support better stenosis grading and plaque visualization, with protocol and reconstruction choices (spatial resolution, kernels, and deep-learning quantification reliability) emerging as key determinants of performance.
A second dominant theme is “moving beyond stenosis” toward tissue and vulnerability phenotyping. Reviews and original work on carotid plaque and perivascular adipose tissue (PVAT) emphasize that multimodal plaque biology (e.g., intraplaque hemorrhage, lipid-rich necrotic core, fibrous cap features, inflammation) may better predict stroke risk than luminal narrowing alone. In coronary disease, PCCT’s spectral capability is leveraged for low-attenuation plaque detection and for reducing calcification/contrast-related confounding, while broader coronary plaque reviews integrate DECT/PCCT with AI/radiomics and functional imaging concepts (e.g., FFR-CT/perfusion) for prognostic risk stratification.
Finally, the digest highlights the engineering and translational groundwork needed to make PCCT clinically robust: physics of detector readout and spectral distortion, data-driven threshold selection (CRLB-based approaches), and K-edge multi-material imaging to separate iodine and gadolinium from a single acquisition. Complementing these are practical protocol and dose-optimization studies (contrast-dose “rules,” kernel sharpness/iterative reconstruction tuning in pediatrics and congenital heart disease, and performance in obesity/low-dose settings), plus targeted contrast-agent research (iodine–gadolinium hybrids and high-Z strategies) to preserve vascular contrast on high-energy virtual monoenergetic images. Together, these papers portray PCCT as both a next-generation imaging modality and a maturing platform whose clinical value depends on careful reconstruction, contrast strategy, and spectral calibration.
Photon-counting CT angiography for cerebrovascular disease
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 (UHR) photon-counting detector (PCD) CT angiography versus standard-resolution (SR) CTA in participants with suspected cerebral and carotid artery stenosis, using invasive 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 CT data. These findings support using UHR photon-counting detector CTA to more accurately characterize intracranial and carotid atherosclerotic narrowing in patients referred for CTA and DSA.
Li Z, Jiang H, Zhang Y et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting CT angiography for coronary artery disease
The Accuracy of Photon-Counting CT Angiography of the Coronaries Compared to Invasive Coronary Angiography.
In a retrospective single-center study of 90 adults, photon-counting coronary CT angiography (PCCT-CCTA) performed at standard-resolution or ultra-high resolution was compared against invasive coronary angiography (ICA) for coronary artery stenosis assessment. PCCT-CCTA provided diagnostic accuracy for grading coronary stenosis and supported coronary CAD-RADS 2.0 classification relative to ICA findings. This supports photon-counting CT angiography as a potentially more precise noninvasive alternative for evaluating coronary stenosis severity.
Haag NP, Katz MS, Wiemer M et al. · RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting CT for peripheral vascular disease
Photon-counting detector computed tomography angiogram more accurately characterizes lower extremity runoff than traditional computed tomograph angiogram.
In a single-center retrospective cohort study, the authors 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 determine whether tibial artery (TA) identification for potential lower extremity bypass differed by modality. The key finding was that PCD-CT angiography more accurately characterized the target TA, with fewer discrepancies versus on-table angiography (2/43, 4.6%) than EID-CTA (10/46, 21.7%; P=.03). Clinically, this suggests PCCT angiography may improve procedural planning for bypass by reducing misidentification of runoff vessels in peripheral 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), focusing on how PCCTA may address limitations of conventional CTA such as calcium blooming and beam hardening. The key finding was that emerging evidence indicates PCCTA can improve image quality and diagnostic performance in small, heavily calcified vessels relevant to PAD. This is significant because it consolidates current knowledge to guide adoption and future clinical trials assessing whether PCCTA improves outcomes in PAD diagnosis, intervention planning, and surveillance.
Zivkovic M, Raskin D, Ghibes P et al. · Journal of vascular surgery cases and innovative techniques · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting CT for cardiac structural assessment (LAA/thrombus)
Cardiac photon-counting detector computed tomography in acute ischemic stroke: diagnostic accuracy for detection of left atrial appendage thrombus.
This retrospective diagnostic accuracy study assessed cardiac photon-counting detector CT (PCD-CT) integrated into an acute stroke imaging protocol for detecting left atrial appendage (LAA) thrombus in consecutive patients with acute ischemic stroke or transient ischemic attack, with transesophageal echocardiography (TEE) as the comparator/reference. Cardiac PCD-CT demonstrated clinically useful diagnostic accuracy for LAA thrombus detection in the acute setting. The results suggest photon-counting CT may improve stroke etiologic workup by more reliably identifying cardioembolic sources when TEE is performed.
Kirschfink A, Elhalal M, Seidel S et al. · Therapeutic advances in neurological disorders · (2026) · View on PubMed ↗
Photon-counting CT for stent and post-intervention follow-up
Ultra-High-Resolution Photon-Counting CT Angiography for Noninvasive Detection of Neurovascular In-Stent Restenosis.
In a prospective study of consecutive patients with neurovascular stents (July–Nov 2025), the authors evaluated ultra-high-resolution (UHR) photon-counting detector CTA (PCD-CTA) for noninvasive detection of in-stent restenosis (ISR) and compared it with simulated energy-integrating detector CTA reconstructions. The key finding was that UHR PCD-CTA improved the ability to detect ISR by mitigating blooming artifacts and enhancing spatial resolution relative to conventional CTA reconstructions. This is significant because it supports a noninvasive imaging strategy for monitoring neurovascular stents with potentially higher diagnostic accuracy than standard CTA.
Su CQ, Zhou C, Wu PF et al. · Stroke · (2026) · View on PubMed ↗ · Free PDF ↗
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 (FDs) and compared ultra-high-resolution photon-counting CT angiography (UHR-PCCTA) versus standard-resolution PCCTA (SR-PCCTA) and digital subtraction angiography (DSA) for comprehensive post-FD aneurysm assessment. The study found that UHR-PCCTA improved visualization/assessment of post-treatment parameters (e.g., aneurysm size and occlusion-related measures) compared with SR-PCCTA and aligned with DSA for key outcomes. These results suggest UHR-PCCTA may reduce reliance on invasive DSA for follow-up after FD treatment by improving resolution and artifact handling.
Li R, He N, Cui Y et al. · European journal of radiology · (2026) · View on PubMed ↗
Photon-counting CT for plaque vulnerability and vascular inflammation
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-plaque inserts (LAP5.5 mm, LAP4 mm, LAP7 mm) containing a narrow central LAP strip (~1–1.5 mm, ~75 HU) embedded in fat-equivalent background (-60 HU), with iodinated lumen (600/1000 HU) and calcified arcs (200/800 mg/cc). The key finding was that PCD-CT improved LAP detection performance, and that the presence of calcium and iodine affected detectability, with performance varying by reconstruction energy (virtual monoenergetic 40/70/100/130 keV) and kernel sharpness (soft Qr40 vs sharp Qr72) under quantum iterative reconstruction. Scientifically and clinically, this supports using photon-counting spectral information to better characterize vulnerable low-attenuation coronary plaque in the presence of calcification and contrast material.
Szilveszter B, Kolossváry M, Kubovje A et al. · European heart journal. Imaging methods and practice · (2026) · View on PubMed ↗ · Free PDF ↗
Carotid Imaging: Current Concepts and Advanced Imaging.
This review studied current and advanced carotid imaging approaches in patients with carotid atherosclerosis, contrasting traditional luminal stenosis assessment with multimodal plaque phenotyping. It found that imaging modalities including ultrasound, CTA, MRI, digital subtraction angiography, photon-counting CT (PCCT), and PET provide complementary information on plaque biology such as intraplaque hemorrhage, lipid-rich necrotic core, fibrous cap rupture, ulceration, and perivascular inflammation. This shift is significant because plaque vulnerability markers may better predict ischemic stroke risk than 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 segmentation algorithm for layer-by-layer quantification. It found measurable spatial behavior and variability of PVAT across concentric layers around the carotid artery on PCCT. These findings are significant as they support PCCT-based quantitative PVAT phenotyping, which may relate to vascular inflammation and plaque vulnerability beyond luminal stenosis.
Saba L, Alkadhi H, Maffei E et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
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, moving from purely anatomical assessment to plaque characterization and prognostic implications. It found that CCTA can identify vulnerable plaque features (e.g., low-attenuation plaque, positive remodeling, spotty calcifications, napkin-ring sign) and that dual-energy and photon-counting CT can further improve tissue characterization, with AI/radiomics enabling automated analysis and integration with FFR-CT and perfusion imaging linking vulnerability to ischemia. This is clinically significant because it supports longitudinal monitoring and risk stratification for major adverse cardiovascular events beyond stenosis severity.
Pegoraro N, Muscogiuri G, Carnevale A et al. · Journal of clinical ultrasound : JCU · (2026) · View on PubMed ↗
Photon-counting CT physics, detector readout, and spectral formation
A physics primer on photon-counting detectors in CT: Physics, signal formation, and performance.
This physics-focused article studied the signal formation pathway of photon-counting detector CT (PCD-CT) by describing how threshold-bin data arise from x-ray interactions, charge creation, pulse processing, and threshold decisions rather than direct photon-energy readout. The key finding was that understanding this detector-readout chain is essential to interpret spectral distortion, count loss, and instability under clinical operating conditions. This is significant because it provides a conceptual framework needed to correctly evaluate and troubleshoot PCCT performance and spectral accuracy when translating from research to clinical use.
Chen GH, Lai R, Li K · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting CT material decomposition, thresholding, and K-edge imaging
K-Edge imaging using a clinical dual-source photon-counting CT system.
The 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 key finding was that clinical PCCT K-edge imaging can successfully separate iodine and gadolinium signals using multi-bin decomposition enabled by the thresholded photon-counting data. This supports clinical translation of K-edge multi-material imaging to potentially reduce radiation dose and motion artifacts by enabling dual-contrast imaging from a single PCCT acquisition rather than sequential scans.
Rybertt MV, Liu LP, Sahbaee P et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗
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 in photon-counting CT without requiring full system models. The key finding was that linear and nonlinear approximate CRLB approaches can generate practical threshold-selection look-up tables using threshold-scan measurements from reference slab phantoms that roughly model dominant basis line integrals. This is significant because it offers a feasible, data-driven way to reduce noise in material decomposition by choosing thresholds that are near-optimal for a given scanner and imaging task.
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/engineering study developed and evaluated a scanner-specific power-law spectral photon-counting CT method to estimate voxelwise effective atomic number (Zeff) and electron density (ρe) on a commercial spectral photon-counting CT (SPCCT) system using a power-law model of x-ray attenuation. The method was fitted to NIST cross sections across 7–115 keV and demonstrated applicability for tissue characterization in heterogeneous phantom samples scanned on a MARS Microlab 5120 SPCCT. Quantitative Zeff and ρe imaging from spectral photon-counting CT could enable more specific material/tissue characterization than conventional CT attenuation alone.
Alzaabi M, Behouch A, Tariq B et al. · Physics in medicine and biology · (2026) · View on PubMed ↗ · Free PDF ↗
Contrast media and spectral agents 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 hybrid iodine–gadolinium contrast medium, for photon-counting detector CT (PCD-CT) performance in an anthropomorphic abdominal phantom. It found that BAY3685750 was designed to improve image contrast at high-energy virtual monoenergetic images (VMIs) compared with conventional iodine-based contrast, leveraging the higher k-edge contribution of gadolinium. This is significant because it targets a known limitation of iodine contrast in high-energy PCD-CT reconstructions, potentially improving spectral imaging quality.
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 contrast media for coronary photon-counting detector CT angiography to improve quantification of calcified stenoses. It found that using contrast agents with atomic numbers higher than iodine can better preserve vascular contrast on high-energy VMIs, thereby reducing calcium blooming–related overestimation of stenosis severity. The findings are significant because they address a key barrier to accurate coronary stenosis measurement in calcified disease when using PCD-CT.
Demmert TT, Klambauer K, Schmidt B et al. · Investigative radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Protocol optimization and reconstruction parameters (dose, kernels, resolution)
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, 0.2 mm UHR) and evaluated by two radiologists plus a deep-learning (DL) automated plaque/stenosis quantification tool. The study found that changing spatial resolution affected subjective image quality and the DL-based quantification of coronary stenosis and plaque volumes. This supports selecting reconstruction resolution for PCD-CT CCTA to improve the reliability of automated coronary plaque measurements.
Liu Y, Li R, Zhang H et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗
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 such as stent and heavily calcified plaque assessment. The key finding is that PCD-CT’s direct energy discrimination, higher geometric dose efficiency, and ultrahigh spatial resolution can improve coronary lumen visualization and spectral imaging compared with energy-integrating detector CT (EID-CT), with protocol recommendations spanning acquisition and reconstruction choices (including ultrahigh-resolution modes). This provides an actionable framework for implementing PCD-CT in routine cardiac CT practice and for selecting protocols based on clinical scenarios.
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 provided a step-by-step, decision-tree style guide for performing coronary CT angiography with photon-counting detector CT (PCD-CT) in clinical practice. The central finding is that structured protocol decision-making—covering scan parameters and reconstruction choices—can leverage PCD-CT’s improved plaque component differentiation and potential radiation reduction compared with energy-integrating detector CT (EID-CT). This is significant because it translates emerging PCD-CT capabilities into practical workflow guidance for consistent coronary imaging.
Xie C, Clarke N, Kotronias R et al. · The British journal of radiology · (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 rule-of-thumb to adapt contrast medium dose in photon-counting detector CT (PCD-CT) when lowering reconstructed virtual monoenergetic image (VMI) energy, termed the “10-to-5 rule.” Using spectral abdominal and chest CT phantoms scanned on a first-generation dual-source PCD-CT with iodine-in-water rods, it found that reducing contrast dose according to the 10-to-5 principle can maintain contrast-to-noise ratio (CNR) for parenchymal CT and CTA despite VMI energy reduction. This is clinically significant because it offers a practical method to reduce contrast dose while preserving diagnostic contrast in PCD-CT protocols.
Jeukens CRLPN, Martens B, Vandewall J et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Comparative performance vs energy-integrating CT (diagnostic accuracy/quality)
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 used 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 agreement of Agatston calcium scores and stenosis grading. In 1,147 SCAPIS reexamination participants (51% women, age 65 [IQR 61–69]), PCD-CT CCTA demonstrated improved or comparable diagnostic image quality relative to EID-CT and supported comparability of key quantitative cardiovascular metrics. These results support feasibility and clinical interchangeability of PCD-CT CCTA protocols in large-scale screening/reexamination settings.
Lidén M, Nyberg G, Aurumskjöld ML et al. · European journal of radiology · (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 CT (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., via iodine perfusion mapping in pulmonary embolism) while reducing contrast dose and radiation exposure compared with conventional single-energy CT. These capabilities may be clinically significant for rapid, accurate imaging in the ICU where minimizing contrast exposure can be life- or organ-saving.
Freed A, Bogot NR, Einav S · Journal of critical care · (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 diagnostic performance (detection sensitivity and radiologists’ diagnostic confidence) between PCD-CT and EID-CT across polyp size categories (≤5 mm, 6–9 mm, ≥10 mm). The results are scientifically significant because they provide controlled, histology-verified evidence on whether PCD-CT improves colorectal polyp detectability relative to conventional CT.
Wu X, Gao H, Gao Y et al. · Abdominal radiology (New York) · (2026) · View on PubMed ↗
Dose efficiency and patient-specific optimization (pediatrics/obesity/low-dose)
Obese patient imaging: Potential dose reduction with photon-counting CT.
This phantom study compared cadmium-zinc-telluride (CZT)-based photon-counting CT (PCCT) versus energy-integrating detector CT (EID-CT) for obese patient imaging across increasing phantom sizes (50th, 75th, 85th, and 95th percentile adult waist circumferences) scanned at CTDIvol 0.5–19.4 mGy. The key finding was that PCCT demonstrated improved dose efficiency (better noise performance per dose) relative to EID-CT as phantom size increased. Clinically, this suggests PCCT could maintain diagnostic image quality at lower radiation doses in larger/obese patients where conventional CT noise and dose tradeoffs are most problematic.
Liu LP, Mei K, Sharma S et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Optimizing Photon-counting CT for Congenital Heart Disease: The Value of Ultrasharp Kernels in Neonates and Infants.
In a retrospective study of neonates and infants with congenital heart disease (data acquired Oct 2022–Aug 2023 at two specialized centers), the authors assessed how reconstruction kernel sharpness (KS; 36–60) and iterative reconstruction (IR levels Q1–Q4) affect image quality in high-pitch photon-counting detector CT. The key finding was that selecting ultrasharp kernels (higher KS values) together with appropriate IR settings improved visual image quality ratings for pediatric cardiac imaging. This is significant because it provides practical reconstruction guidance to optimize photon-counting CT for the small anatomy and motion-prone physiology of congenital heart disease in very young patients.
Salam B, Sprinkart AM, Hart C et al. · Radiology. Cardiothoracic imaging · (2026) · View on PubMed ↗
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 systematic differences in quantitative and qualitative image quality metrics across acquisition parameters, supporting dose–image quality trade-offs relative to EID-CT. These findings help optimize emergency NCCT protocols when transitioning from EID-CT to PCD-CT to maintain diagnostic image quality while potentially reducing radiation exposure.
Schoenbeck D, Kroeger JR, Moenninghoff C et al. · Academic radiology · (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.
In an anthropomorphic phantom study of a one-year-old, this comparative work measured dose and image quality for pediatric chest CT using energy-integrating CT (EICT) versus photon-counting CT (PCCT) at 70 kV and 100 kV protocols with tin filtration (100Sn), using thermoluminescent dosimeters (TLDs) and clinical/quantitative dose metrics (CTDIvol, DLP, organ dose coefficients, effective dose). The study found that PCCT enabled radiation dose reduction while maintaining image quality under the tested low- and medium-kVp tin-filtered protocols. These results inform pediatric CT protocol optimization to lower patient exposure without sacrificing diagnostic performance.
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 (LTX) patients undergoing follow-up, 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) using two PCCT dose settings (IQ100 and reduced IQ40). The key finding was that UHR-PCCT could balance image quality and radiation dose, enabling either near-equivalent diagnostic quality at IQ100 or reduced-dose imaging at IQ40 relative to HR-EIDCT. This supports tailoring PCCT dose settings for frequent CT surveillance in LTX patients to reduce cumulative radiation while preserving clinically useful lung detail.
Dubbeldam A, Van Ballaer V, Verschakelen J et al. · JHLT open · (2026) · View on PubMed ↗ · Free PDF ↗
Non-cardiac applications: pulmonary imaging
[The role of photon-counting CT technology in the detection of pulmonary diseases].
This narrative review summarized the role of photon-counting CT technology in detecting pulmonary diseases, contrasting it with conventional energy-integrating detector CT limitations such as noise, spatial resolution constraints, and reduced low-dose image quality. It highlighted that photon-counting detector CT enables improved dose efficiency, reduced image noise, higher spatial resolution, and intrinsic spectral imaging from a single acquisition. The review supports photon-counting CT as a promising next-generation chest imaging approach for pulmonary diagnostics, particularly in scenarios where conventional CT performance may be limited.
Rédei M, Gurza KB, Maurovich-Horvat P et al. · Orvosi hetilap · (2026) · View on PubMed ↗ · Free PDF ↗
Non-cardiac applications: GI oncology
Photon-counting CT in gastrointestinal malignancies: a scoping review.
This scoping review mapped clinical evidence for photon-counting CT (PCCT) in adult gastrointestinal (GI) malignancies by systematically searching major databases (Jan 2017–Dec 2025) and grading study quality using the Newcastle–Ottawa Scale and evidence levels. Across included studies, PCCT was consistently associated with improved spatial resolution and contrast-to-noise characteristics and potential radiation dose advantages compared with conventional CT. The review highlights where PCCT evidence is strongest in GI oncology and identifies gaps to guide future prospective trials and protocol standardization.
Spoto F, Robertis R, Monterubbiano L et al. · European journal of radiology · (2026) · View on PubMed ↗
Non-cardiac applications: musculoskeletal, dental, and trauma
Musculoskeletal Computed Tomography Imaging: A 30-Year Perspective.
This review article studied the evolution of musculoskeletal computed tomography (CT) over a 30-year period, including advances such as spectral CT for crystal characterization and metal artifact reduction, and other specialized CT approaches. The key finding was that CT has remained central to musculoskeletal diagnosis and perioperative assessment while newer technologies expanded capabilities beyond morphology to include spectral and artifact-mitigation functions. Scientifically and clinically, it frames how emerging CT modalities (e.g., spectral CT and weight-bearing cone-beam CT) can improve characterization of bone, cartilage, and implant-related problems.
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 generate virtual monoenergetic imaging (VMI) reconstructions across 70–190 keV (10 keV increments) with and without iterative metal artifact reduction (iMAR). The study found that both the selected VMI energy level and the use of iMAR meaningfully affected diagnostic accuracy, depiction quality of endodontic complications, and metal artifact severity. These findings support optimizing PCD-CT VMI/iMAR settings for improved endodontic diagnostics in the presence of metallic artifacts.
Al-Haj Husain A, Dogan S, Mergen V et al. · International dental journal · (2026) · 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 detecting knee fractures in acute trauma settings. It found that DECT’s spectral capabilities—particularly virtual non-calcium reconstructions for bone marrow edema detection, along with metal artifact reduction and soft-tissue assessment—can support evaluation of complex, subtle, and stress-related fractures and healing. This is clinically significant because DECT may provide faster or more accessible fracture assessment when MRI is unavailable or impractical.
Foti G, Tripodi G, Ocello G et al. · Skeletal radiology · (2026) · 1 citations · View on PubMed ↗
“Trabecular Architecture of the Medullary Cavity: A Comprehensive Review of Radiological Patterns, Pathological Alterations”.
This narrative review studied radiological patterns of trabecular architecture in the medullary cavity and how they change in pathology, evaluating imaging modalities including high-resolution MRI, dual-energy CT, and emerging photon-counting detector CT. It found that characteristic radiological alterations such as thickening, breakage, faintness, rarefaction, and infiltration can be detected and interpreted across these modalities. This is significant because improved radiological characterization of trabecular microarchitecture may enhance diagnosis and monitoring of skeletal disorders.
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 precision study compared a novel photon-counting detector CT (PCD-CT) system with conventional energy-integrating detector CT (EID-CT) for measuring total wrist arthroplasty (TWA) implant migration, using bead-free CT radiostereometric analysis (CT-RSA) as the measurement framework. PCD-CT achieved precision comparable to or improved over EID-CT across different radiation doses for detecting implant migration. Improved precision in implant migration quantification could enhance early detection of loosening after total wrist arthroplasty and refine post-operative surveillance.
Lind G, Tesselaar E, Sandberg O et al. · Skeletal radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Generated automatically on August 02, 2026. Covers PubMed articles published July 26, 2026 – August 02, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.