What's New in Photon Counting CT? — August 03, 2026
AI-summarised digest of 37 PubMed articles on Photon Counting CT published in the last 7 days.
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What’s New in Photon Counting CT?
August 03, 2026 · 37 articles · 15 research themes · covering July 27, 2026 – August 03, 2026
Overview
This week’s set of papers strongly converges on one message: photon-counting CT (PCCT) is moving from “physics promise” to practical clinical workflows, especially in vascular imaging. Multiple studies and reviews focus on coronary CT angiography (CCTA) and plaque phenotyping—showing how ultra-high resolution, spectral reconstructions, and advanced analytics (radiomics/AI, integration with functional imaging like FFR-CT and perfusion) can identify high-risk plaque features beyond luminal stenosis. Complementing this, neurovascular and peripheral vascular work highlights the same theme: improved spatial resolution and reduced artifact/blooming can make noninvasive angiographic assessment more reliable (e.g., carotid/cerebral stenosis, in-stent restenosis surveillance, and post–flow diverter follow-up; tibial runoff mapping for bypass planning).
A second dominant thread is the engineering-to-clinic pipeline that enables these gains. Several physics and methods papers address how PCCT signal formation, threshold behavior, and quantitative spectral decomposition work in real systems—supporting more trustworthy interpretation of spectral outputs. In parallel, protocol and dose-optimization studies (including pediatric and size-dependent phantom work, kernel/iterative reconstruction selection, and contrast-dose reduction strategies) show that PCCT can preserve or improve diagnostic quality while reducing radiation and/or contrast burden. Finally, the evidence base is broadening beyond vessels: GI oncology scoping work maps current PCCT applications, while musculoskeletal and bone-focused reviews/experiments extend spectral CT’s reach (e.g., trauma fracture assessment, implant migration monitoring, and medullary trabecular microarchitecture).
Photon-Counting CT Physics & Signal Formation
A physics primer on photon-counting detectors in CT: Physics, signal formation, and performance.
This physics primer studied the signal formation chain in photon-counting detector CT (PCD-CT), focusing on how threshold-bin outputs 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 pipeline is essential to interpret spectral distortion, count loss, and instability under clinical operating conditions. This is significant for clinicians and researchers because it improves correct interpretation of PCCT spectral data and supports more reliable performance evaluation and troubleshooting.
Chen GH, Lai R, Li K · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Spectral/Material Decomposition & K-edge 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, 90 keV) in phantom experiments. The key finding was that clinically available PCCT energy-bin data can be used to perform unconstrained multi-material K-edge decomposition for I and Gd, supporting dual-contrast imaging concepts aimed at reducing radiation dose and motion artifacts between sequential scans. This is significant because it demonstrates practical translation of K-edge spectral CT to a clinical PCCT platform, enabling more robust material separation for contrast-enhanced imaging.
Rybertt MV, Liu LP, Sahbaee P et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗
Dual-energy and photon-counting computed tomography in critical care.
This narrative review summarizes evidence for dual-energy CT (DECT) and photon-counting CT (PCCT) in critically ill patients, emphasizing rapid, high-contrast material differentiation (e.g., iodine maps and virtual non-contrast reconstructions). It finds that DECT/PCCT reconstructions can improve diagnostic performance while reducing contrast dose and radiation exposure, which is particularly valuable in time-critical ICU scenarios such as pulmonary embolism. The clinical significance is that spectral CT techniques may enable more accurate, lower-burden imaging that can directly affect organ- and life-saving decisions in critical care.
Freed A, Bogot NR, Einav S · Journal of critical care · (2026) · View on PubMed ↗
A Practical Rule-of-Thumb to Adapt Contrast Media Dose in Photon-counting Detector CT: The 10-to-5 Rule.
This phantom-based experimental study developed a contrast-dose adjustment rule for photon-counting detector CT (PCD-CT) called the “10-to-5 rule,” using spectral abdominal and chest CT phantoms scanned on a first-generation dual-source PCD-CT. It tested iodine-in-water concentrations (0.5–15 mg I/mL) and evaluated how reducing reconstructed virtual monoenergetic image (VMI) energy affects contrast-to-noise ratio (CNR) for parenchymal CT and CTA, aiming to maintain CNR while lowering contrast medium dose. The significance is a practical, protocol-level method to reduce contrast exposure in PCD-CT without sacrificing image contrast quality.
Jeukens CRLPN, Martens B, Vandewall J et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
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, in photon-counting detector CT (PCD-CT) using an anthropomorphic abdominal phantom. The key finding is that BAY3685750’s higher k-edge behavior can improve contrast performance in virtual monoenergetic images (VMIs), particularly at higher energies where conventional iodine contrast diminishes. Scientifically, it supports high-k-edge hybrid contrast strategies to extend the diagnostic value of PCD-CT spectral reconstructions.
Haag F, Rink J, Lohrke J et al. · Investigative radiology · (2026) · View on PubMed ↗
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 key finding was that the power-law model (fitted to NIST cross sections across 7–115 keV) enabled quantitative Zeff and ρe imaging and demonstrated applicability for tissue characterization in a QRM spectral CT phantom containing soft-tissue-equivalent, hydroxyapatite, and iodine inserts. This is significant because it advances quantitative material decomposition and tissue characterization using photon-counting CT beyond conventional attenuation-only imaging.
Alzaabi M, Behouch A, Tariq B et al. · Physics in medicine and biology · (2026) · View on PubMed ↗ · Free PDF ↗
Threshold Optimization & Quantitative Spectral Methods
Approximate Cramér-Rao lower bound analyses for semi-optimal energy thresholds selection in photon counting CT.
This study developed approximate Cramér–Rao lower bound (CRLB) methods to select semi-optimal energy thresholds for photon-counting CT (PCCT) without requiring complete system models. The key finding was that linear and nonlinear approximate CRLB approaches can generate practical threshold-selection look-up tables using measured counts from threshold scans of reference slab phantoms that roughly model the largest basis line integrals. This is significant because it provides a feasible, experimentally grounded way to reduce noise in material decomposition by improving threshold choice in real PCCT systems.
Lee O · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Dose Efficiency, Protocol Optimization & Reconstruction Settings
Obese patient imaging: Potential dose reduction with photon-counting CT.
This study compared dose efficiency of cadmium-zinc-telluride (CZT)-based photon-counting CT (PCCT) versus energy-integrating detector CT (EID-CT) across phantom sizes representing adult waist percentiles (50th, 75th, 85th, 95th) using 3D-printed pancreas phantoms and tissue-mimicking inserts. The key finding was that PCCT provides improved noise/dose efficiency relative to EID-CT as patient size increases, with CTDIvol varied from 0.5 to 19.4 mGy to quantify performance. This is clinically significant because it supports using PCCT to maintain diagnostic image quality while reducing radiation dose in obese patients.
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.
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. The key finding was that selecting ultrasharp vascular kernels (tested KS values 36–60) together with appropriate IR levels (Q1–Q4) can optimize visual image quality ratings for neonatal/infant congenital heart CT. This is significant because it provides practical reconstruction guidance for PCCT in a population where motion and small anatomy demand maximal image quality at clinically feasible scan parameters.
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 analysis compared non-contrast head CT image quality and radiation dose between photon-counting detector CT (PCD-CT) at 120 and 140 kVp with varying radiation doses and a modern energy-integrating detector CT (EID-CT) system. The study found systematic differences in image quality metrics and dose performance across PCD-CT acquisition parameters relative to EID-CT. These data support evidence-based protocol selection for pediatric- and adult-relevant emergency NCCT workflows using PCD-CT to balance dose reduction with diagnostic image quality.
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.
This comparative phantom-based study assessed pediatric chest CT dose optimization by comparing energy-integrating CT (EICT) and photon-counting CT (PCCT) using 70 kV and 100 kV protocols with tin filtration (100Sn), while measuring dose with thermoluminescent dosimeters (TLDs) and analyzing CTDIvol, DLP, organ dose coefficients, and effective dose. The results reported differences in radiation dose and maintained or altered image quality under matched protocol conditions between EICT and PCCT. The significance is that it informs pediatric-specific protocol design to reduce dose exposure without compromising diagnostic performance.
Kunert P, Weis M, Schlattl H et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
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 photon-counting detector CT (PCD-CT) with conventional energy-integrating detector CT (EID-CT) for measuring total wrist arthroplasty (TWA) implant migration, using radiostereometric analysis principles and varying radiation doses. The key finding was the precision of PCD-CT relative to EID-CT for detecting implant migration, including dose-dependent performance. Scientifically and clinically, improved precision could enhance monitoring of implant loosening risk after total wrist arthroplasty while potentially enabling lower-dose imaging.
Lind G, Tesselaar E, Sandberg O et al. · Skeletal radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Image Quality Comparisons: PCD-CT vs EID-CT (Non-cardiac)
Photon-counting CT versus energy-integrating CT of the chest in acute respiratory distress syndrome: A retrospective observational study of image quality and radiation exposure.
This retrospective observational study performed an intra-individual comparison of contrast-enhanced chest photon-counting detector CT (PCD-CT) versus energy-integrating detector CT (EID-CT) in patients with acute respiratory distress syndrome (ARDS) who underwent both scans between April 2023 and May 2025. The key findings focused on differences in image quality and radiation exposure (e.g., CTDIvol and related dose measures) between PCD-CT and EID-CT in critically ill patients. Clinically, demonstrating improved or comparable image quality at lower dose would support safer CT monitoring strategies in ARDS where repeated imaging is common.
Rosok D, Opitz M, Bos D et al. · Emergency 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?
This study compared ultra-high-resolution photon-counting CT (UHR-PCCT) with high-resolution energy-integrating detector CT (HR-EIDCT) in 100 lung transplant recipients, testing both normal image quality (IQ100) and reduced radiation dose (IQ40) settings. The investigators evaluated whether UHR-PCCT at 0.4 mm could maintain image quality relative to prior HR-EIDCT (1.0 mm) while reducing dose. If reduced-dose UHR-PCCT preserves diagnostic detail, it could improve longitudinal lung transplant surveillance by lowering cumulative radiation burden.
Dubbeldam A, Van Ballaer V, Verschakelen J et al. · JHLT open · (2026) · View on PubMed ↗ · Free PDF ↗
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 in a sequential scan setup. The key finding is that PCD-CT provides diagnostic performance and image-quality metrics (including detection sensitivity and radiologist confidence) that can be benchmarked against EID-CT across polyp size categories (≤5 mm, 6–9 mm, ≥10 mm). The clinical significance is that it informs whether PCD-CT can improve or match EID-CT for colorectal polyp detection in a controlled, histology-verified setting.
Wu X, Gao H, Gao Y et al. · Abdominal radiology (New York) · (2026) · View on PubMed ↗
Cardiac CT Angiography (CCTA/PCD-CT) — Protocols & Guidance
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, with emphasis on coronary CT angiography (CCTA). It concluded 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 across key applications including stent and heavily calcified plaque assessment. Scientifically and clinically, the document provides a consolidated framework to standardize PCD-CT cardiac protocols and interpret emerging evidence for routine adoption.
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 describes photon-counting detector CT (PCD-CT) coronary CT angiography in clinical practice, focusing on how to choose scanning protocols and parameters using a step-by-step decision tree and illustrative cases. It reports that PCD-CT can improve coronary image quality (including more accurate coronary plaque component differentiation) and reduce radiation compared with energy-integrating detector CT (EID-CT), while acknowledging limited real-world experience and published guidance. Clinically, the proposed decision-tree workflow aims to standardize PCD-CT coronary scanning to support safer, more reliable coronary plaque assessment.
Xie C, Clarke N, Kotronias R et al. · The British journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Coronary Stenosis & Plaque Characterization (CCTA/PCD-CT)
Comparative review of coronary CT angiography versus conventional catheter angiography: diagnostic value, clinical outcomes, and underlying technical principles.
This comparative review studied the diagnostic value, clinical outcomes, and technical principles of coronary CT angiography (CCTA) versus conventional invasive catheter angiography (ICA) across the literature from 2015 to March 2026, including emerging photon-counting detector CT (PCD-CT) concepts. The key finding was that CCTA is increasingly central for noninvasive coronary artery disease risk stratification, while ICA remains important for specific clinical scenarios, with both modalities constrained by physical factors such as image quality and artifacts. This is significant because it synthesizes how advances like PCD-CT may address limitations (e.g., spectral/attenuation-related issues) and refine the role of noninvasive coronary imaging in modern care.
Masri S, Sezdi M · Expert review of medical devices · (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 CCTA (UHR-CCTA), investigators reconstructed datasets at three spatial resolutions (0.6 mm standard resolution, 0.4 mm high resolution, and 0.2 mm ultra-high resolution) and used a deep-learning tool for automated coronary plaque and stenosis quantification. Varying spatial resolution affected subjective image quality and the deep-learning–based quantification outputs for coronary stenosis degree and plaque volumes. This is clinically significant because it identifies how to choose PCD-CT spatial resolution to optimize automated coronary plaque quantification accuracy while maintaining diagnostic image quality.
Liu Y, Li R, Zhang H et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Improved coronary CT angiography image quality using photon-counting detector CT in SCAPIS reexamination: scan protocol and comparative analysis.
This study evaluated photon-counting detector CT (PCD-CT) coronary CT angiography (CCTA) in the SCAPIS reexamination population (15,000 participants; analysis included 1,147 participants) by describing the scan protocol and comparing diagnostic image quality, Agatston score, and stenosis grading against SCAPIS baseline energy-integrating detector CT (EID-CT). PCD-CT CCTA produced diagnostic image quality that was compared directly with EID-CT and assessed for comparability of coronary calcification (Agatston scores) and stenosis severity. If the comparability is strong, PCD-CT could be adopted in large-scale screening/reexamination programs to improve spatial resolution and spectral capabilities without disrupting longitudinal risk stratification.
Lidén M, Nyberg G, Aurumskjöld ML et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
The Role of Computed Tomography in High-Risk Coronary Plaque: From Imaging Assessment to Prognostic Implications.
This review studied how computed tomography—especially coronary CT angiography (CCTA) and advanced spectral CT (dual-energy and photon-counting CT)—can characterize high-risk coronary plaque in patients beyond luminal stenosis assessment. It reports that CCTA can identify vulnerable plaque features (low-attenuation plaque, positive remodeling, spotty calcifications, and napkin-ring sign) and that AI/radiomics plus integration with FFR-CT and CT/MR perfusion can link plaque vulnerability to functional ischemia and enable longitudinal monitoring under therapy. Scientifically and clinically, it positions CT as a tool for prognosis and treatment response tracking by quantifying plaque burden/composition and detecting high-risk remodeling.
Pegoraro N, Muscogiuri G, Carnevale A et al. · Journal of clinical ultrasound : JCU · (2026) · View on PubMed ↗
The Accuracy of Photon-Counting CT Angiography of the Coronaries Compared to Invasive Coronary Angiography.
This retrospective single-center study evaluated photon-counting coronary CT angiography (PCCT-CCTA) for coronary artery stenosis severity using invasive coronary angiography (ICA) as the reference standard in 90 adult patients, comparing standard-resolution and ultra-high-resolution reconstructions. The key finding was the diagnostic accuracy of PCCT-CCTA (including image quality and stenosis severity/CAD-RADS 2.0 classification) relative to ICA. This is significant because it tests whether photon-counting CT can improve coronary stenosis assessment accuracy and classification for clinical decision-making.
Haag NP, Katz MS, Wiemer M et al. · RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · (2026) · View on PubMed ↗ · Free PDF ↗
Coronary Calcification & Low-Attenuation Plaque Detection
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 that varied LAP size (LAP5.5 mm, LAP4 mm, LAP7 mm) and included 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 calcium and iodine content strongly influence low-attenuation plaque detectability, and that PCCT reconstruction choices (e.g., virtual monoenergetic energies and kernel selection such as soft Qr40 vs sharp Qr72 with quantum iterative reconstruction) affect LAP visibility compared with EID-CT. This is scientifically significant because it clarifies how spectral/PCCT physics and plaque composition interact to improve (or limit) detection of vulnerable low-attenuation coronary features.
Szilveszter B, Kolossváry M, Kubovje A et al. · European heart journal. Imaging methods and practice · (2026) · View on PubMed ↗ · Free PDF ↗
High-Z Contrast Media for Coronary Photon-counting Detector CT Angiography: Improved Quantification of Calcified Stenoses.
This phantom study assessed whether high-Z contrast media (higher atomic number than iodine) improve coronary photon-counting detector CT angiography quantification of calcified stenoses when using high-energy VMIs to reduce calcium blooming. It found that using high-Z contrast can preserve vascular contrast at high VMI energies, thereby improving the accuracy of stenosis severity measurements compared with iodine-limited performance at those energies. Clinically, this approach targets a key limitation of coronary PCD-CT—calcification-related blooming that can overestimate stenosis—by optimizing contrast chemistry for better lumen quantification.
Demmert TT, Klambauer K, Schmidt B et al. · Investigative radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Neurovascular CT Angiography (Carotid/Cerebral/Stents/Flow Diverters)
Ultra-High-Resolution Photon-Counting CT Angiography for Noninvasive Detection of Neurovascular In-Stent Restenosis.
This prospective study evaluated ultra-high-resolution photon-counting detector CT angiography (UHR PCD-CTA) in consecutive patients with prior neurovascular stent implantation for noninvasive detection of in-stent restenosis (ISR). UHR PCD-CTA was designed to reduce blooming artifacts and improve spatial resolution compared with conventional energy-integrating CTA reconstructions, enabling more accurate ISR assessment. If confirmed in full results, UHR PCD-CTA could reduce reliance on invasive angiography for neurovascular ISR surveillance and improve diagnostic confidence around stent patency.
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 initial-experience study evaluated ultra-high-resolution photon-counting CT angiography (UHR-PCCTA) for follow-up assessment after flow diverter treatment in 47 participants, comparing UHR-PCCTA and standard-resolution PCCTA reconstructions against digital subtraction angiography (DSA). UHR-PCCTA was assessed for comprehensive post–flow diverter metrics including aneurysm size and occlusion status, neck coverage, and related parameters using blinded image interpretation by two readers. The clinical significance is that UHR-PCCTA could offer a less invasive alternative to DSA for routine post-flow diverter monitoring with improved artifact reduction and spatial resolution.
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 (UHR) photon-counting detector (PCD) CT angiography versus standard-resolution (SR) CTA for detecting cerebral and carotid artery stenosis, using digital subtraction angiography (DSA) as the reference standard. The key finding was that UHR PCD-CTA provided diagnostic performance for stenosis assessment that was directly compared to SR CTA from the same raw data, clarifying whether higher spatial resolution improves accuracy against DSA. This is significant because it informs whether photon-counting CT angiography can more reliably detect clinically relevant carotid/cerebral stenosis for stroke risk stratification.
Li Z, Jiang H, Zhang Y et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗
Cardiac Thrombus Detection (LAA) in Stroke Workup
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, compared against transesophageal echocardiography (TEE) in consecutive patients with acute ischemic stroke or transient ischemic attack. The key finding was the measured diagnostic accuracy of cardiac PCD-CT for LAA thrombus detection in the acute setting. Clinically, this could improve etiologic workup in stroke patients where no cause is identified and may streamline embolic source evaluation by reducing reliance on delayed or incomplete LAA assessment.
Kirschfink A, Elhalal M, Seidel S et al. · Therapeutic advances in neurological disorders · (2026) · View on PubMed ↗ · Free PDF ↗
Peripheral & Lower-Extremity Vascular CTA (Runoff/Bypass Planning)
Photon-counting detector computed tomography angiogram more accurately characterizes lower extremity runoff than traditional computed tomograph angiogram.
This single-center retrospective cohort 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 planning. 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 is clinically significant because improved runoff/tibial vessel mapping can directly affect procedural planning and outcomes in patients undergoing lower extremity bypass.
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 technical advances and clinical impact of photon-counting computed tomography angiography (PCCTA) for peripheral artery disease (PAD), focusing on how PCCTA may overcome limitations of conventional CTA such as calcium blooming, beam hardening, and reduced accuracy in small heavily calcified vessels. The key finding was that current evidence supports improved image quality and diagnostic performance in PAD imaging, with potential downstream benefits for diagnosis, procedural planning, and surveillance. This is significant because it frames PCCTA as a promising next-generation angiographic tool for challenging vascular anatomy where conventional CTA can fail.
Zivkovic M, Raskin D, Ghibes P et al. · Journal of vascular surgery cases and innovative techniques · (2026) · View on PubMed ↗ · Free PDF ↗
Carotid Plaque Biology & Perivascular Adipose Tissue (PVAT)
Carotid Imaging: Current Concepts and Advanced Imaging.
This 2026 review synthesizes current and advanced carotid imaging approaches, contrasting traditional lumen-stenosis–based management with multimodal plaque phenotyping. It highlights that advanced imaging modalities—including photon-counting CT (PCCT)—can characterize plaque vulnerability features such as intraplaque hemorrhage, lipid-rich necrotic core, fibrous cap rupture, ulceration, and perivascular inflammation beyond stenosis alone. The significance is that PCCT and other multimodal techniques may better predict ischemic stroke risk by linking imaging biomarkers of plaque biology to clinical outcomes.
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 preliminary study analyzed photon-counting CT (PCCT) angiography data from 20 asymptomatic patients to quantify carotid perivascular adipose tissue (PVAT) using a custom Python layer-by-layer segmentation algorithm. The key finding is that PVAT can be spatially characterized in concentric layers and shows measurable variability in an asymptomatic cohort. Scientifically, it supports PCCT as a tool for reproducible PVAT quantification, which may help link vascular inflammation/microenvironment to future plaque vulnerability.
Saba L, Alkadhi H, Maffei E et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Bone Microarchitecture & Medullary Trabeculae Imaging
”Trabecular Architecture of the Medullary Cavity: A Comprehensive Review of Radiological Patterns, Pathological Alterations”.
This narrative review examined trabecular bone architecture of the medullary cavity and how radiological patterns change in normal versus pathological states across imaging modalities (including high-resolution MRI, dual-energy CT, and photon-counting detector CT). It summarizes characteristic radiological alterations such as thickening, breakage, faintness, rarefaction, and infiltration and discusses diagnostic precision using indices like the Singh Index. Clinically, it supports improved interpretation of medullary trabecular microarchitecture and helps guide future use of advanced CT (including photon-counting CT) for skeletal disease assessment.
Chapala S, Kiyawat V, Gibson J et al. · The British journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
GI Oncology with Photon-Counting CT
Photon-counting CT in gastrointestinal malignancies: a scoping review.
This scoping review mapped and synthesized clinical evidence on photon-counting CT (PCCT) applications in adult gastrointestinal malignancies using PRISMA-ScR methods and evidence grading. It summarized how PCCT’s improved spatial resolution, contrast-to-noise ratio, and potential radiation dose reduction have been studied across GI oncology indications. The review is significant for identifying current evidence gaps and guiding future prospective trials and protocol development for PCCT in GI cancer imaging.
Spoto F, Robertis R, Monterubbiano L et al. · European journal of radiology · (2026) · View on PubMed ↗
Musculoskeletal Trauma & Orthopedic Imaging (DECT/PCCT)
Musculoskeletal Computed Tomography Imaging: A 30-Year Perspective.
This 30-year perspective review studied the evolution of musculoskeletal computed tomography (CT) imaging, including advances from helical CT to modern dose-efficient and spectral CT approaches. The key finding was that spectral CT enables characterization of crystal deposits and marrow edema and supports metal artifact reduction, while other innovations such as weight-bearing cone-beam CT and CT arthrography expand functional and procedural capabilities. This is significant because it summarizes how technological progress has broadened CT’s role in musculoskeletal diagnosis and pre-/post-operative assessment.
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.
This ex vivo study used photon-counting detector CT (PCD-CT) to determine optimal virtual monoenergetic imaging (VMI) energy levels (70–190 keV) and to test iterative metal artifact reduction (iMAR) for diagnosing simulated endodontic challenges in 16 extracted third molars. The key finding is that diagnostic depiction/accuracy depends on VMI energy and that applying iMAR improves assessment of endodontic complications under simulated metal-related artifacts. Scientifically and clinically, it supports selecting VMI energy and iMAR settings to improve PCD-CT-based endodontic diagnostics at radiation doses comparable to standard-dose cone-beam CT.
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 evaluated dual-energy CT (DECT) as an alternative to MRI for detecting knee fractures in acute trauma, focusing on spectral reconstructions such as virtual non-calcium imaging and metal artifact reduction. It reports that DECT can provide clinically useful information for specific fracture scenarios (e.g., complex articular involvement, subtle impacted fractures, stress fractures/healing assessment) by leveraging bone marrow edema surrogates and improved soft-tissue/bone characterization. The significance is that DECT may reduce reliance on MRI in selected knee trauma cases while maintaining diagnostic performance through spectral imaging capabilities.
Foti G, Tripodi G, Ocello G et al. · Skeletal radiology · (2026) · 1 citations · View on PubMed ↗
Generated automatically on August 03, 2026. Covers PubMed articles published July 27, 2026 – August 03, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.