What's New in Photon Counting CT? — September 01, 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?
September 01, 2026 · 37 articles · 15 research themes · covering August 25, 2026 – September 01, 2026
Overview
Across this week’s PubMed set, a dominant theme is the rapid maturation of photon-counting detector CT (PCD-CT/PCCT) from “better images” toward quantitative, task-specific biomarkers. Multiple studies and reviews emphasize the same core advantages—higher spatial resolution, improved contrast-to-noise, reduced metal/stent blooming, and richer spectral information from a single acquisition—while also tackling the practical constraints that determine real-world performance (dose, reconstruction settings, pre-filtration, and noise texture). Foundational work on acquisition/reconstruction physics (e.g., dose/resolution tradeoffs, small-pixel effects, and material decomposition under different pre-filters) is being directly linked to clinical tasks such as bone microstructure quantification, liver fat measurement in the presence of iron, and noninvasive tissue characterization.
Clinically, the cardiovascular and pulmonary domains show particularly strong momentum. In cardiovascular imaging, PCCT is being explored for structural conduction-system remodeling in atrial fibrillation, for more precise lead-tip/anatomy assessment in conduction pacing, and for improved coronary and myocardial perfusion imaging (including post–arterial switch surveillance). In parallel, pulmonary studies highlight UHR-PCD-CTPA improvements for peripheral pulmonary artery visualization and diagnostic confidence, plus quantitative lung perfusion approaches for CTEPH that aim to overcome limitations of SPECT’s anatomy. Vascular surveillance work (endoleaks after EVAR and structural wire fractures in bridging stent grafts) further underscores PCCT’s value in detecting subtle findings obscured by blooming on conventional CT.
Finally, several studies illustrate how spectral reconstructions and AI are being operationalized for diagnostic decision-making. Breast imaging papers show the clinical utility of iodine mapping and multiphasic PCCT for lesion characterization and pre-treatment assessment, while urolithiasis work frames PCCT-derived virtual non-contrast/virtual non-iodine reconstructions and spectral radiomics as a route to more actionable stone phenotyping. Machine-learning efforts span radiomics for spine pathology and AI denoising to preserve quantitative equivalence in higher-BMI patients, reinforcing the broader trend: PCCT is increasingly paired with quantitative pipelines to make imaging outputs more reproducible, scalable, and clinically interpretable.
Photon-Counting CT (PCCT/PCD-CT) Technology & Quantification Methods
Phantom evaluation of small-pixel effect in ultra-high-resolution photon-counting CT: Noise texture and high-contrast spatial resolution.
This phantom study investigated the “small-pixel effect” in ultra-high-resolution (UHR) photon-counting CT (PCCT) by measuring noise texture and high-contrast spatial resolution across varying acquisition and reconstruction conditions. Using an ACR CT accreditation phantom on a clinical PCCT system (Siemens NAEOTOM Alpha.Peak) in standard-resolution versus UHR modes and across multiple dose levels, the authors found that detector pixel size meaningfully influenced noise behavior and spatial resolution under different settings. These results help optimize UHR PCCT protocols and reconstruction parameters to maximize resolution while controlling noise for high-contrast imaging tasks.
Song KH, Shan C, Xu G et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Tracking the infiltration of gold-labelled monocytes into live human atherosclerotic plaques: Spectral photon counting CT imaging analysis.
The study tracked infiltration of gold-labeled human monocytes into live human atherosclerotic plaques using spectral photon-counting CT (SPCCT) alongside gold nanoparticle quantification. Gold nanoparticle uptake by monocytes was measured (with microwave plasma atomic emission spectroscopy) and SPCCT imaging was used to visualize/quantify monocyte movement and accumulation within excised carotid plaque samples. This provides a human ex vivo imaging framework linking cellular infiltration to spectral photon-counting CT readouts, supporting translational research into plaque biology and potential imaging biomarkers.
Holmes D, Moghiseh M, Healy J et al. · Atherosclerosis · (2026) · View on PubMed ↗ · Free PDF ↗
Spectral CT and Photon-counting Detector CT: Principles and Applications in Neuroradiology.
This narrative review summarized the principles and clinical/scientific applications of spectral CT and photon-counting detector CT (PCD-CT) in neuroradiology. It highlighted that photon-counting and spectral energy discrimination enable higher spatial resolution, improved contrast-to-noise ratio, reduced artifacts/noise, and multienergy imaging from a single acquisition compared with conventional energy-integrating CT. The review supports broader adoption of PCD-CT/spectral CT techniques for neuroradiologic diagnosis and artifact-resistant visualization of intracranial and skull-base structures.
Hayes JC, Srinivasan A, Bapuraj JR · Radiology. Imaging cancer · (2026) · View on PubMed ↗ · Free PDF ↗
A scoping review of photon-counting detector computed tomography in cardiovascular imaging.
This scoping review studied the state of photon-counting detector CT (PCD-CT) in cardiovascular imaging by synthesizing 59 studies published between January 2021 and September 2025. It found that, despite heterogeneity in protocols and endpoints, PCD-CT has been explored across coronary, myocardial, structural/valvular, pulmonary-cardiopulmonary function, and aortic/peripheral vascular domains, with reported diagnostic performance metrics such as high specificity in coronary cohorts. The review’s significance is to map where PCCT may improve cardiovascular imaging (e.g., multi-energy, high-resolution) and to identify gaps needed for standardization and clinical adoption.
Alis D, Önal MO, Orman M et al. · Diagnostic and interventional radiology (Ankara, Turkey) · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Material-dependent effects of x-ray pre-filtration on material decomposition in photon-counting CT.
This phantom study characterized how x-ray pre-filtration affects material decomposition (MD) performance in photon-counting CT (PCCT) across different filter materials and thicknesses using contrast agents spanning low-Z (iodine, barium) and high-Z (tantalum) compositions. Scanning single-contrast and dual-contrast phantoms on a CdZnTe PCCT system under multiple pre-filtration conditions showed that MD basis-map performance depended on the pre-filter material and thickness, with different effects for iodine/barium versus tantalum. The findings provide practical guidance for selecting pre-filtration to improve quantitative material decomposition accuracy in PCCT applications.
Aubrey JD, Perkinson EP, Wang G et al. · Physics in medicine and biology · (2026) · View on PubMed ↗
Coronary Artery Disease & Coronary CT Angiography (CCTA)
Diagnostic performance and clinical impact of photon-counting detector computed tomography in coronary artery disease.
This narrative review assessed the diagnostic performance and clinical impact of photon-counting detector CT (PCD-CT) for coronary artery disease (CAD) compared with conventional energy-integrating detector CT (EID-CT). Across recent studies, PCD-CT demonstrated improved spatial resolution, higher contrast-to-noise ratio, and reduced calcium blooming and stent-related artifacts, translating into better coronary lesion visualization and interpretation. Clinically, the review positions PCD-CT as a next-generation coronary imaging modality that may improve accuracy and decision-making in CAD evaluation.
Parikh R, Shin D, Ali ZA et al. · Current opinion in cardiology · (2026) · View on PubMed ↗
Detection and Characterization of Infundibula and Aneurysms: A Clinical Report-Based Comparison of PCD- and EID-CTA.
This retrospective clinical report comparison evaluated concordance between photon-counting detector CTA (PCD-CTA) and energy-integrating detector CTA (EID-CTA) for detecting and characterizing arterial outpouchings (aneurysm versus infundibulum versus uncertain) in adults with paired head/neck scans. Using paired reports within 2 years and excluding previously treated lesions and EID-CTA slice thickness >0.6 mm, the study compared lesion detection and characterization performance between the two modalities. The results inform how improved spatial resolution from PCD-CTA may affect real-world radiology reporting and diagnostic confidence for head/neck vascular lesions.
Jacobson Z, El Sadaney AO, Yu L et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗
Cardiac Electrophysiology & Structural Conduction System Imaging
Paced QRS morphology and lead location in left bundle branch area pacing assessed by photon-counting cardiac computed tomography.
This retrospective study used ultra-high-resolution photon-counting cardiac CT (PC-CT) to evaluate lead-tip location and its relationship to paced QRS morphology after left bundle branch area pacing (LBBAP) in 20 patients (9 left bundle branch pacing [LBBP], 9 left ventricular septal pacing [LVSP], and 2 deep septal pacing [DSP]). The key finding was that PC-CT–based measurements of lead-tip distances to the LV/RV endocardium and presumed His bundle, along with septal thickness, could characterize differences in lead position across LBBAP subtypes. Clinically, this supports more precise anatomical assessment of LBBAP lead placement, which may help optimize pacing strategy and interpret paced QRS patterns.
Goto K, Miyazaki S, Negishi M et al. · Heart rhythm · (2026) · View on PubMed ↗
Quantification of Atrial Fibrillation-Related Imaging Markers Using Spectral Photon-Counting Computed Tomography.
This study used spectral photon-counting computed tomography (PCCT) to quantify interatrial septum (IAS) fibrosis and tissue density along the anterior internodal bundle and the sinoatrial (SA) node and its vascular supply in 65 patients with atrial fibrillation (AF) versus 65 controls in sinus rhythm. Patients with AF showed higher IAS fibrosis scores and altered IAS/SA-node density and SA-artery anatomy/length compared with controls, indicating structural conduction-system remodeling detectable by PCCT. These findings support PCCT-derived imaging markers as potential tools for identifying AF-related conduction abnormalities and improving risk stratification beyond conventional coronary CT angiography.
Bilgeri V, Spitaler P, Kindl B et al. · Heart rhythm · (2026) · View on PubMed ↗ · Free PDF ↗
Cardiac Perfusion & Myocardial Imaging
Stress CT myocardial perfusion imaging after arterial switch operation for transposition of the great arteries.
This study assessed feasibility and diagnostic performance of stress CT myocardial perfusion imaging (CT-MPI) in adults after arterial switch operation for transposition of the great arteries (ASO-TGA). Patients underwent regadenoson stress CT-MPI using either dynamic energy-integrating detector CT (EID-CT) with quantitative myocardial blood-flow mapping or static photon-counting detector CT (PCCT) with qualitative/semquantitative iodine-map assessment, and the authors evaluated diagnostic performance against the reference standard described in the full text. If validated, PCCT-based stress CT-MPI could offer a higher-resolution alternative for detecting late coronary complications after ASO-TGA.
Gkizas C, Longere B, Domanski O et al. · European heart journal. Imaging methods and practice · (2026) · View on PubMed ↗ · Free PDF ↗
Pulmonary Embolism, Pulmonary Vessels & Lung Perfusion
Impact of ultra-low-dose imaging on image quality and volumetric accuracy of different subtypes of pulmonary nodules using photon-counting detector CT: a phantom study.
This phantom study assessed how ultra-low-dose scanning affects detection rate, image quality, and volumetric accuracy of different pulmonary nodule subtypes using ultra-high-resolution photon-counting detector CT (UHR PCD-CT). Using a thoracic phantom with 15 nodule models scanned at five dose levels, the authors quantified detection rate and measured diameter/volumetric accuracy with nodule AI software while tracking noise, SNR, and CNR. The results are important for defining safe dose-reduction limits for PC-CT pulmonary nodule evaluation without compromising quantitative measurements.
Wang Y, Zhou Y, Lei L et al. · The British journal of radiology · (2026) · View on PubMed ↗
Increasing pulmonary artery visibility and diagnostic confidence with ultra-high resolution photon-counting detector CT pulmonary angiography.
This retrospective single-center study compared ultra-high-resolution photon-counting detector CT pulmonary angiography (UHR-PCD-CTPA) with dual-energy energy-integrating detector CT (EID) CTPA in 227 examinations, assessing pulmonary artery visibility and diagnostic confidence. The key finding was that UHR-PCD-CTPA improved peripheral pulmonary artery visibility and increased radiologist diagnostic confidence, particularly at lower image quality index settings (IQ50 and IQ25). This is significant because it suggests UHR-PCD-CTPA can enhance diagnostic performance for pulmonary embolism evaluation while potentially enabling dose or protocol optimization.
Pannenbecker P, Rüth C, Grunz JP et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Comparing the detectability of pulmonary nodules on two ultra-high resolution CT scanners: a preliminary phantom study.
This preliminary phantom study objectively and subjectively compared pulmonary nodule detectability between an ultra-high-resolution CT scanner using energy-integrating detectors and a photon-counting CT (PCCT) in UHR mode using image quality and anthropomorphic phantoms. The key finding was that detectability indices (d’) derived from noise power spectrum, task-based transfer function, and spatial resolution measures differed between the two UHR platforms, reflecting differences in noise texture and resolution affecting nodule detection. Scientifically, it provides early evidence that PCCT may offer detectability advantages for small pulmonary nodules under UHR conditions.
Greffier J, Salvat C, Pastor M et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Bowel ischemia detection on portal venous CT: multireader evaluation of dual-energy and photon-counting spectral imaging.
This retrospective single-center multireader crossover diagnostic accuracy study compared portal-venous (PV) blended CT images alone versus PV blended images supplemented with spectral reconstructions (40-keV virtual monoenergetic images, iodine maps, and virtual non-contrast) for detecting acute bowel ischemia, stratified by dual-energy CT (DECT) versus photon-counting CT (PCCT). The key finding was that adding spectral reconstructions improved diagnostic performance over PV blended images alone, with effects evaluated separately for DECT and PCCT platforms. Clinically, this supports using spectral reconstructions on PCCT/DECT to better identify bowel ischemia when timely diagnosis is critical.
Mankertz F, Berger J, Maalouf N et al. · European radiology · (2026) · 2 citations · View on PubMed ↗
Photon-counting CT vs V/Q SPECT for lobar perfusion quantification in chronic thromboembolic pulmonary hypertension.
This retrospective single-center study compared quantitative lobar lung perfusion measurements from photon-counting CT (PCCT) versus ventilation/perfusion SPECT (V/Q-SPECT) in 23 patients with suspected or confirmed chronic thromboembolic pulmonary hypertension (CTEPH). The key finding was that PCCT provided lobar perfusion quantification that could be directly compared with the V/Q-SPECT reference standard, aiming to address V/Q-SPECT’s limited anatomical detail. This is significant because PCCT may enable more integrated, high-resolution perfusion assessment that could improve characterization and potentially diagnostic accuracy in CTEPH.
Moeskes MMV, Derlin T, Hunkemöller AM et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Oncology Imaging (Breast, Pancreas, Prostate/Other Solid Tumors)
Quantitative and qualitative evaluation of pancreatic cancer on photon-counting detector CT and dual-energy CT using standard reference images.
This retrospective single-center study compared photon-counting detector CT (PCD-CT) versus dual-energy CT (DE-CT) for depicting pancreatic cancer in 124 patients with pathologically proven disease, using reference images equivalent to 120 kVp (70 keV virtual monoenergetic images for PCD-CT and 80/Sn150 kVp linearly blended images for DE-CT). The key finding was the relative performance of PCD-CT and DE-CT in tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) under clinically matched reference conditions. If PCD-CT shows superior or comparable contrast performance, it could improve detection and characterization of pancreatic tumors while leveraging PCCT’s spectral capabilities.
Niiyama T, Naruto N, Nishikawa K et al. · Abdominal radiology (New York) · (2026) · View on PubMed ↗
Staging and imaging-based prognostication in renal cell carcinoma: current guidelines and practical considerations.
This narrative review studied current guideline-based and practical approaches to staging and imaging-based prognostication in renal cell carcinoma (RCC) using multiphase CT and MRI across major urologic oncology guidelines. It found that anatomic TNM labels alone are insufficient for tumor biology and that integrating imaging-based prognostic markers can refine preoperative risk assessment while highlighting common pitfalls in imaging interpretation. Scientifically and clinically, this supports more personalized RCC management by using imaging biomarkers alongside standard staging to better predict outcomes.
Arita Y, Becker A, Leithner D et al. · Abdominal radiology (New York) · (2026) · View on PubMed ↗
Uro-Oncology & Urinary Stone (Urolithiasis) Phenotyping
Photon-counting CT-enabled urolithiasis phenotyping: virtual non-iodine reconstructions, automated measurement, and spectral radiomics.
This review studied how photon-counting computed tomography (PCCT) can enable urolithiasis phenotyping using calcium-preserving virtual non-iodine (VNI) and virtual non-contrast (VNC) reconstructions plus automated quantitative spectral radiomics for stone characterization. It reports that detector-level energy discrimination and higher spatial resolution may shift stone characterization toward imaging-derived biomarkers that better guide acute intervention, secondary prevention, and selective chemolitholysis. Clinically, improved noninvasive stone phenotyping with PCCT could reduce reliance on invasive/laboratory endpoints and improve personalized management of urinary stones.
Drobot RB · Abdominal radiology (New York) · (2026) · 2 citations · View on PubMed ↗
Vascular Disease, Aneurysm & Endovascular Repair Surveillance
Detection of structural failure in bridging stent grafts: photon-counting CT versus dual-energy CT in a controlled in vitro study.
The study compared photon-counting detector CT (PCCT) versus dual-energy CT (DECT) for detecting predefined structural wire fractures in commercially available bridging stent grafts (BSGs) using a controlled in vitro phantom model. PCCT improved detectability of stent-wire structural defects relative to DECT by mitigating limitations of conventional CT such as effective spatial resolution and metal blooming artifacts. This supports PCCT as a more sensitive imaging tool for early surveillance of f/bEVAR bridging stent graft failure before clinical deterioration.
Kern M, Dachs TM, Strassl A et al. · The Journal of cardiovascular surgery · (2026) · View on PubMed ↗
Quantitative iodine-mapping of photon-counting CT detects large-vessel vasculitis: A case report.
This case report described a 69-year-old woman with suspected large-vessel vasculitis in whom repeat photon-counting detector CT (PCCT) demonstrated concentric mural thickening of the aorta and supra-aortic branches. Retrospective iodine mapping from PCCT showed increased iodine concentration in the aortic wall, supporting active inflammatory involvement when earlier CT/MRI/ultrasound were unrevealing. The report suggests PCCT-based iodine quantification can improve diagnostic confidence for large-vessel vasculitis in challenging presentations.
Lückerath S, Euler A · Radiology case reports · (2026) · View on PubMed ↗ · Free PDF ↗
Effect of Monoenergetic Reconstructions and Ultra-High-Resolution on the Detection of Small Endoleaks With Photon-counting Detector CT.
This experimental phantom study evaluated photon-counting detector CT (PCD-CT) for detecting small aortic endoleaks after endovascular aneurysm repair, testing ultra-high-resolution (UHR) mode and monoenergetic reconstructions at 40–60 keV. The key finding was how changing monoenergetic keV and enabling UHR affected endoleak detectability in a medium/large patient–mimicking aneurysm phantom. If optimized parameters improve sensitivity for small endoleaks, PC-CT could enhance post-EVAR surveillance and reduce missed clinically important endoleaks.
Szucs-Farkas Z, Perrin LG, M’Hamdi B et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗
Peripheral Artery Disease (PAD) Imaging Pathways
Diagnostic Imaging Pathways in Peripheral Artery Disease: A Comparative Review of Duplex Ultrasound Through Computed Tomography Angiography.
This comparative review synthesized contemporary diagnostic imaging pathways for peripheral artery disease (PAD), focusing on duplex ultrasound (DUS) through computed tomography angiography (CTA) and related noninvasive strategies. It emphasized how imaging selection supports diagnosis, risk stratification, treatment planning, and postprocedural surveillance across PAD clinical stages. The work is significant for guiding evidence-based imaging choices in PAD care, particularly when moving from ultrasound-based assessment to CTA when needed.
Malangu B, Kotev S · The International journal of angiology : official publication of the International College of Angiology, Inc · (2026) · View on PubMed ↗ · Free PDF ↗
Advancements in imaging for endovascular treatment of peripheral artery disease.
This review studied advances in imaging used for diagnosis, procedural planning, and follow-up in peripheral artery disease (PAD), focusing on modalities relevant to endovascular treatment. It found that duplex ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA) each have distinct strengths and limitations, supporting individualized imaging strategies to optimize outcomes. Clinically, selecting the appropriate imaging modality can improve lesion characterization and procedural success while reducing unnecessary risks such as contrast exposure.
Raskin D, Zivkovic M, Kirksey L et al. · VASA. Zeitschrift fur Gefasskrankheiten · (2026) · 1 citations · View on PubMed ↗
Neuroradiology & Skull Base/Temporal Bone Imaging
Appropriate dose reduction using photon-counting detector CT for temporal bone imaging: phantom and clinical studies with helical acquisition.
This study determined the maximum dose reduction achievable with photon-counting detector CT (PCD-CT) for temporal bone imaging while maintaining image quality comparable to standard-dose energy-integrating detector CT (EID-CT). In both a head phantom and clinical temporal bone datasets, the authors compared visual scores and used detectability index (d’) across dose levels to establish a dose-reduction limit for subsequent clinical use. The findings are significant because they support protocol optimization for temporal bone imaging that reduces radiation dose while preserving diagnostic detectability.
Takahashi Y, Higaki F, Nakamura Y et al. · Japanese journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
The angular trajectory of the vestibular aqueduct: evaluation using photon-counting CT.
This retrospective study used photon-counting CT (PCCT) temporal bone scans from 64 patients (128 ears) to directly visualize and measure the angular trajectory of the vestibular aqueduct (ATVA) as a potential radiographic marker for developmental endotypes of Menière’s disease. Two independent readers measured ATVA directly on PCCT, yielding mean ATVA values consistent with prior proxy-based measurements and enabling additional vestibular aqueduct morphometric parameters. The ability to image the proximal vestibular aqueduct with PCCT may improve patient-specific ATVA assessment and support more precise phenotyping in Menière’s disease.
Van den Kerkhof F, Boomgaert L, Cockmartin L et al. · Insights into imaging · (2026) · View on PubMed ↗ · Free PDF ↗
Musculoskeletal Bone Microstructure & Bone Biomaterials
Assessing bone microstructure and density with photon-counting CT: emerging applications and challenges.
This narrative review synthesized emerging evidence on using photon-counting CT (PCCT) for bone microstructure and density assessment, focusing on technical capabilities such as superior spatial/contrast resolution and material decomposition. The key finding was that preclinical studies suggest PCCT can quantify bone microarchitecture and mineral density with performance comparable to high-resolution peripheral quantitative CT (HR-pQCT), while highlighting challenges for in vivo translation. Scientifically, it frames how PCCT could expand quantitative bone imaging beyond conventional CT, but emphasizes the need for clinical validation and standardization.
Patzer TS, Schwartz FR, Panta RK et al. · Skeletal radiology · (2026) · View on PubMed ↗
Photon-counting Computed Tomography of Degradable Bone Cement Loaded With Gadolinium Nanoparticles.
This preclinical study examined photon-counting CT (PCCT) of degradable hydroxyapatite-based bone cement loaded with gadolinium nanoparticles (GdNPs), comparing PCCT contrast-to-noise ratio (CNR) against energy-integrating CT (EID-CT) and testing material decomposition accuracy for gadolinium concentration. The key finding was that PCCT can provide improved CNR between GdNP-loaded cement and vertebral bone and can accurately quantify gadolinium concentration in solution and within the cement. Scientifically and translationally, this supports using PCCT spectral decomposition to optimize radiopacity and quantify contrast-agent loading in absorbable bone cements.
Marks AE, Marco KPD, Barcena AJR et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Assessment of trabecular microstructure using photon-counting CT: Influence of dose, spatial resolution and reconstruction algorithms.
This ex vivo study evaluated how radiation dose, spatial resolution, noise, and reconstruction algorithms affect photon-counting CT (PCCT) measurements of trabecular microstructure—bone mineral density (BMD), bone volume fraction (BV/TV), and trabecular separation (Tb.Sp)—in seven excised human vertebral bodies. Using a clinical PCCT scanner (Naeotom Alpha, Siemens Healthineers) with scans at 6–20 mGy and reconstructions including filtered back projection (FBP) and iterative QIR3, the authors found that PCCT-derived microstructural metrics varied systematically with dose and reconstruction settings. These results are important for optimizing PCCT acquisition and reconstruction to enable reliable quantitative skeletal microstructure assessment at clinically relevant radiation exposures.
Peña JA, Thomsen F, Damm T et al. · Bone · (2026) · View on PubMed ↗
Liver & Hepatic Spectral Quantification (Fat/Metal Confounding)
Liver Fat and Iron Quantification With Spectral Localizer Radiographs From Photon-counting Detector CT.
This phantom study investigated whether liver fat content (LFC) can be quantified with spectral localizer radiographs from photon-counting detector CT (PCD-CT) despite confounding hepatic iron deposition. It found that LFC quantification remained feasible and accurate across multiple simulated fat levels (0%, 10%, 30%, 50%) and liver iron concentrations (LIC 0–6 mg/mL) using PCD-CT spectral localizer data. Clinically, this could enable more reliable noninvasive assessment of fatty liver by disentangling fat and iron effects that commonly bias conventional CT fat measurements.
Tognella A, Flohr T, Froehlich JM et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Breast Imaging & Pre-treatment Assessment
Performance of Photon-counting CT for Assessing Pretreatment Breast Cancer: Comparison with Mammography, MRI, and 18F-FDG PET/CT.
This prospective clinical study evaluated photon-counting CT (PCCT) for pretreatment breast cancer assessment in women with Breast Imaging Reporting and Data System (BI-RADS) category 4C or higher lesions, comparing multiphasic contrast-enhanced PCCT with breast MRI, full-field digital mammography (FFDM), and 18F-FDG PET/CT. PCCT demonstrated feasibility for lesion assessment and showed diagnostic performance relative to MRI/FFDM and metabolic characterization from 18F-FDG PET/CT in the subset undergoing PET/CT. If validated, PCCT could improve pre-treatment breast imaging by leveraging higher spatial resolution and contrast-to-noise characteristics while potentially reducing dose versus conventional CT-based approaches.
Fu Q, Zeng Y, Chang R et al. · Radiology · (2026) · View on PubMed ↗
Prone Photon-counting Computed Tomography With Iodine Mapping for Differentiating Breast Masses: A Prospective Study.
This prospective single-center study assessed prone-positioned photon-counting CT with iodine mapping to differentiate malignant versus benign breast masses, evaluating PC-CT iodine maps, monoenergetic postcontrast images (PC-CT C+), and virtual noncontrast reconstructions (PC-CT VNC) for lesion conspicuity and image quality. The key finding was the diagnostic utility of iodine mapping and related PC-CT reconstructions for improving differentiation of breast lesions while correlating with MRI anatomy and reader preference. If validated, prone PC-CT iodine mapping could improve breast imaging specificity by leveraging quantitative iodine contrast rather than relying solely on conventional attenuation.
Wilpert C, Pichotka MP, Molina-Fuentes MF et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Machine Learning, Radiomics & AI Reconstruction/Denoising
Reproducibility and workflow efficiency of a novel software for quantitative coronary plaque characterization using photon-counting and energy-integrating detector computed tomography.
This retrospective study evaluated reproducibility and workflow efficiency of a novel quantitative coronary plaque characterization software in 170 patients undergoing coronary CT angiography (86 with energy-integrating detector CT [EID-CT] and 84 with photon-counting detector CT [PCD-CT]). The key finding was that the dedicated plaque quantification tool produced reproducible quantitative plaque metrics and enabled efficient analysis, with results comparable between EID-CT and PCD-CT despite different detector technologies. Clinically, this supports more standardized and scalable quantitative coronary plaque assessment across CT platforms, potentially improving adoption of CCTA-based plaque quantification.
Sipos B, Vattay B, Boussoussou M et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Artificial intelligence denoising in cardiac photon-counting CT: mitigating BMI-related noise degradation while maintaining clinical interchangeability.
This retrospective study assessed an artificial intelligence-based denoising (AID) algorithm for cardiac photon-counting detector CT (PCD-CT) in 100 patients undergoing non-contrast coronary artery calcium (CAC) scoring and contrast-enhanced coronary CT angiography (CCTA), comparing reconstructions using PCD-CT-weighted AID versus quantum iterative reconstruction (QIR). The key finding was that the AID method mitigated BMI-related noise degradation while maintaining strict quantitative diagnostic equivalence and clinical interchangeability with QIR. This is significant because it could improve image quality and quantitative reliability of PCD-CT in higher-BMI patients without sacrificing diagnostic performance.
Urban L, Berger J, Brendel JM et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Comparison of radiomics-based models for detection of Modic type 1 changes in photon-counting detector CT images of the lumbar spine.
This retrospective single-center study compared four radiomics-based machine-learning models (LASSO, Random Forest, XGBoost, and support vector machine) for detecting Modic type 1 changes in 60 lumbar spine patients imaged with photon-counting detector CT (PCD-CT), using MRI as the reference standard. The key finding was that model performance differed across algorithms, with radiomics features extracted from segmented vertebrae enabling discrimination of Modic type 1 changes on PCD-CT. Scientifically, this supports the feasibility of using PCD-CT radiomics for spine pathology detection, potentially offering an alternative when MRI is unavailable or delayed.
Marth AA, Fritz B, Sutter R · Skeletal radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Device/Implant Imaging & Procedural Planning (Non-oncologic)
Comparison of Iterative Metal Artifact Reduction Presets In Ultra-high-resolution Photon-counting CT Angiography of Patients with Total Knee Endoprosthesis.
This patient study evaluated how different iterative metal artifact reduction (IMAR) presets affect image quality of ultra-high-resolution photon-counting CT angiography (UHR-PCCTA) in people with total knee endoprostheses. In 25 knee arthroplasty patients (31 lower extremities) undergoing UHR-PCCTA, varying IMAR settings were compared for visualization of the popliteal vasculature despite prosthesis-related metal artifacts. The findings are clinically relevant because they identify which IMAR configuration best preserves vascular assessment accuracy in the presence of knee implants.
Huflage H, Kunz AS, Wech T et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Photon counting detector CT contrast agent-reduced transcatheter aortic valve reconstruction planning: a comparative study.
This retrospective monocentric study evaluated contrast agent–reduced CT protocols for transcatheter aortic valve reconstruction planning on photon-counting detector CT (PCD-CT) in 162 BMI-matched examinations, comparing standard contrast dose (SCD; 80 mL iohexol 300 mg/mL) versus reduced contrast dose (RCD; 50 mL). The key finding was that reduced-contrast protocols using virtual monoenergetic reconstructions (VMI at 70, 60, and 50 keV) could support TAVR planning while reducing contrast volume. Clinically, this may improve patient safety and address contrast supply constraints while preserving the quantitative/visual requirements for valve planning.
Layer YC, Isaak A, Mesropyan N et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Computed tomography of three smaller-sized supraglottic airway device prototypes in stillborn low-birth-weight neonates.
This study evaluated three smaller supraglottic airway device prototypes (including Neo i-gel sizes 0.65, 0.75, and 0.85 alongside i-gel size 1.0) in stillborn low-birth-weight neonates using photon-counting CT to assess anatomical positioning. The key finding was the measured placement relative to perilaryngeal landmarks and the impact of device positioning on adjacent structures across the tested prototypes. Scientifically, this supports using PCCT-based anatomical assessment to guide design and selection of neonatal airway devices where conventional sizing options are limited.
Dempsey T, Brismar TB, Svensson-Marcial A et al. · British journal of anaesthesia · (2026) · View on PubMed ↗ · Free PDF ↗
Generated automatically on September 01, 2026. Covers PubMed articles published August 25, 2026 – September 01, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.