What's New in Photon Counting CT? — September 06, 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?
September 06, 2026 · 36 articles · 15 research themes · covering August 30, 2026 – September 06, 2026
Overview
Across this week’s set of studies and reviews, a dominant theme is that photon-counting detector CT (PCD/PCCT) is increasingly moving from “better images” to “better quantitative biomarkers.” Multiple works emphasize spectral capabilities—iodine mapping, virtual monoenergetic reconstructions, virtual non-contrast, and material decomposition—to improve measurement accuracy and diagnostic specificity. Examples include hepatic fat quantification in the presence of iron, improved characterization of bowel ischemia using spectral reconstructions, and more reliable proton stopping-power ratio estimation under realistic beam-hardening conditions. Together, these results highlight how detector-level energy discrimination can reduce known confounds that limit conventional CT quantification.
A second major theme is protocol optimization for clinically meaningful tasks: dose reduction, detectability modeling, and robustness across patient and reconstruction variability. Phantom and clinical studies explore how far dose can be pushed while preserving detectability (temporal bone, pulmonary nodules), how task-based metrics that account for patient size (SSW-d′) can guide low-dose protocol selection, and how reconstruction choices (e.g., kernel selection) can materially change quantitative measurements such as femoral bone marrow attenuation in myeloma. Complementing this, AI denoising work suggests that noise mitigation can be achieved without sacrificing quantitative equivalence—important for longitudinal and cross-platform consistency.
Finally, the digest shows broad clinical expansion of PCCT into vascular and oncology workflows, with attention to small structures and complex hardware. Studies report improved visualization of distal pulmonary vasculature, carotid body identification, and feasibility for noninvasive surveillance after endovascular aneurysm and flow-diverter treatments. In parallel, oncology-focused work (notably breast and pancreas) suggests comparable or improved diagnostic information relative to established modalities, while endovascular-device studies show that PCCT can better detect subtle failures (e.g., small endoleaks, stent wire fractures) through reduced blooming and improved effective spatial resolution. Overall, the field is converging on a practical roadmap: leverage spectral/quantitative strengths, control artifacts and reconstruction effects, and validate performance for specific clinical tasks.
Photon-counting CT physics, detectors, and spectral reconstruction
Simulation and Design Study of Edge-on GaAs:Cr Detector for Clinical Photon Counting CT.
This simulation and design study modeled an edge-on chromium-compensated GaAs:Cr photon-counting detector for clinical photon-counting CT (PCCT) and analyzed spectral response and material-decomposition (MD) noise using a full-chain detector model. The proposed edge-on geometry was designed to mitigate reduced X-ray absorption efficiency caused by limited GaAs:Cr wafer thickness (<1 mm) from chromium-compensation process constraints. If validated experimentally, this detector design could improve clinical PCCT performance by preserving absorption efficiency and reducing MD-related noise in spectral imaging.
Zhong T, Li H, Qin W et al. · IEEE transactions on medical imaging · (2026) · View on PubMed ↗
Phantom evaluation of small-pixel effect in ultra-high-resolution photon-counting CT: Noise texture and high-contrast spatial resolution.
This phantom study systematically evaluated the “small-pixel effect” in ultra-high-resolution (UHR) photon-counting CT by measuring noise texture and high-contrast spatial resolution under varying acquisition and reconstruction conditions. Using an ACR CT accreditation phantom on a clinical PCCT system (Siemens NAEOTOM Alpha.Peak) across dose levels (3 to …) and standard-resolution versus UHR modes, the authors found that small-pixel UHR operation changes noise properties and improves high-contrast spatial resolution depending on imaging conditions. These results help define when UHR PCCT benefits are realized, guiding protocol selection for high-resolution clinical imaging.
Song KH, Shan C, Xu G et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Spectral CT and Photon-counting Detector CT: Principles and Applications in Neuroradiology.
This review studied the principles and neuroradiology applications of spectral CT and photon-counting detector (PCD) CT in clinical imaging. It found that PCD CT (counting individual x-ray photons and measuring their energies) and spectral CT (separating x-ray energies at multiple levels) improve spatial resolution and contrast-to-noise ratio while reducing noise/artifacts versus conventional energy-integrating CT, enabling multienergy imaging from a single acquisition. These detector-based spectral techniques are significant because they can better visualize tissue characteristics and potentially improve diagnostic performance in neuroradiology.
Hayes JC, Srinivasan A, Bapuraj JR · Radiology. Imaging cancer · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting Computed Tomography of Degradable Bone Cement Loaded With Gadolinium Nanoparticles.
This in vitro study synthesized gadolinium nanoparticles (GdNPs) and incorporated them into hydroxyapatite-based degradable bone cement to test whether photon-counting CT (PCCT) improves contrast-to-noise ratio (CNR) versus energy-integrating CT (EID-CT) for distinguishing GdNP-loaded cement from vertebral bone. The key finding was that PCCT provided superior CNR and that PCCT material decomposition could accurately quantify gadolinium concentration in solution and in GdNP-loaded cements. This is clinically significant because it could improve radiopacity and post-implant visualization of absorbable bone cements used in spine/vertebral applications.
Marks AE, Marco KPD, Barcena AJR et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Neuroimaging and temporal bone/inner ear applications
Photon-Counting Detector CT Improves Visualization of the Normal Carotid Body Compared with Energy-Integrating Detector CT.
This retrospective study compared photon-counting detector CT (PCD-CT) versus energy-integrating detector CT (EID-CT) for visualizing carotid bodies in 37 patients (74 carotid bifurcations). PCD-CT improved the likelihood of definitively identifying the carotid body compared with EID-CT and also characterized normal carotid body appearance on PCD-CT. Improved visualization of these small chemoreceptor organs could enhance assessment of carotid body pathology and standardize imaging interpretation in head-and-neck angiography.
LaVere MG, Farnsworth P, Yu L et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗
Association of Superior Semicircular Canal Roof Thickness With Age and Sex on Photon-counting Detector CT in a Japanese Cohort.
This retrospective cross-sectional study quantified superior semicircular canal (SSC) roof thickness using ultra-high-resolution photon-counting detector CT (PCD-CT) in 288 Japanese patients (576 ears) and tested associations with age and sex. The measurement method on Pöschl-plane reconstructions (0.2 mm slice thickness) showed excellent intrarater and interrater reliability (ICC 0.966 and 0.939), and SSC roof thickness varied systematically with demographic factors. Establishing normative thickness patterns could improve interpretation of temporal bone PCD-CT in diagnosing and risk-stratifying SSC-related vestibular disorders.
Sakaida H, Yamada T, Ichikawa Y et al. · Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · (2026) · View on PubMed ↗
Material decomposition, spectral quantification, and virtual reconstructions
Impact of beam hardening on proton stopping-power ratio estimation using photon-counting, dual-energy, and single-energy computed tomography.
This phantom study evaluated how beam hardening affects proton stopping-power ratio (SPR) estimation using photon-counting CT (PCCT), dual-energy CT (DECT), and single-energy CT (SECT) across varying phantom sizes and insert positions. Using PCCT/DECT-derived virtual monoenergetic images (VMIs), the study found that SPR accuracy is sensitive to object size/position due to beam hardening, with differences among PCCT, DECT, and SECT approaches. More robust SPR estimation under clinically realistic geometry could improve proton therapy treatment planning accuracy and reduce range uncertainty.
Bassermann L, Edmund JM, Olech WE et al. · Physics and imaging in radiation oncology · (2026) · View on PubMed ↗ · Free PDF ↗
Photon counting detector CT contrast agent-reduced transcatheter aortic valve reconstruction planning: a comparative study.
This retrospective comparative study evaluated contrast agent-reduced CT protocols for transcatheter aortic valve reconstruction planning using photon-counting detector CT (PCDCT). Among 162 BMI-matched examinations, it compared standard contrast dose (80 mL iohexol 300 mg/mL; SCD) versus reduced contrast dose (50 mL; RCD) and assessed virtual monoenergetic reconstructions at 70, 60, and 50 keV for reconstruction planning. The key significance is that PCDCT may enable lower contrast volumes for TAVR planning while maintaining reconstruction quality, improving patient safety and addressing contrast supply constraints.
Layer YC, Isaak A, Mesropyan N 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.
In a retrospective single-center multireader crossover diagnostic accuracy study, investigators evaluated acute bowel ischemia detection on portal-venous (PV) CT using PV blended images alone versus PV blended images supplemented with spectral reconstructions (40-keV virtual monoenergetic images, iodine maps, and virtual non-contrast) across dual-energy CT (DECT) and photon-counting CT (PCCT). Adding spectral reconstructions improved diagnostic performance for bowel ischemia detection, with effects assessed separately by scanner platform (DECT vs PCCT). Clinically, this suggests that spectral imaging—especially on PCCT—may better characterize ischemic bowel by leveraging iodine and virtual non-contrast information beyond standard blended PV images.
Mankertz F, Berger J, Maalouf N et al. · European radiology · (2026) · 2 citations · View on PubMed ↗
Liver Fat and Iron Quantification With Spectral Localizer Radiographs From Photon-counting Detector CT.
This phantom study evaluated whether liver fat content (LFC) can be accurately quantified with photon-counting detector CT (PCD-CT) spectral localizer radiographs in liver phantoms containing controlled hepatic iron concentrations (LIC 0–6 mg/mL) and fat levels (0–50%). The key finding was that spectral localizer radiographs from PCD-CT can enable feasible and accurate LFC quantification despite the presence of iron, addressing a known confounder for CT-based fat quantification. This supports more reliable noninvasive assessment of hepatic steatosis in settings where iron deposition and/or iodinated contrast would otherwise bias conventional CT measurements.
Tognella A, Flohr T, Froehlich JM et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Task-based image quality metrics and detectability modeling
Size-specific weighted detectability index for computed tomography image characterization.
This study proposed and evaluated a size-specific weighted detectability index (SSW-d’), a task-based image quality metric (d’) that incorporates lesion contrast weighting and water-equivalent diameter variability for low-dose CT. The key finding was that SSW-d’ better characterizes reconstructed image detectability across patient-size variability than size-agnostic task metrics, supporting protocol optimization under low-dose conditions. This could help standardize CT protocol selection by linking reconstruction/acquisition choices to clinically relevant detectability for different body sizes.
Fitton I, Greffier J, Dabli D et al. · Medical physics · (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 compared detectability of pulmonary nodules on an ultra-high-resolution CT system using energy-integrating detectors versus a photon-counting CT (PCCT) system in UHR mode using image quality and anthropomorphic phantoms. Using noise power spectrum/task-based transfer function metrics and detection modeling (d’), the study found differences in noise texture and spatial resolution that translated into altered nodule detectability indices between the two scanner technologies. The work supports objective, task-based evaluation of PCCT versus conventional UHR-CT for optimizing protocols aimed at small pulmonary nodule detection.
Greffier J, Salvat C, Pastor M et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Quantitative imaging reproducibility, harmonization, and workflow
Reconstruction-kernel Dependence of Femoral Bone Marrow Attenuation in Whole-body Dual-source Photon-counting CT of Patients with Multiple Myeloma.
This retrospective clinical study assessed how reconstruction kernel choice affects femoral bone marrow attenuation measurements in 103 patients with multiple myeloma undergoing noncontrast whole-body photon-counting CT (PCCT). In ultrahigh-resolution dual-source mode (96×0.2 mm) at 90 kV/Sn and 150 kV, the authors reconstructed images using body regular kernels Br32–Br68 and corresponding quantitative kernels Qr32–Qr68 and compared resulting marrow attenuation. The results indicate that kernel selection can meaningfully change quantitative marrow attenuation, which is important for reliable longitudinal assessment and harmonization of PCCT-based myeloma imaging.
Huflage H, Scheiner F, Grunz JP et al. · Academic radiology · (2026) · View on PubMed ↗
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 assessed reproducibility and workflow efficiency of a novel software tool for quantitative coronary plaque characterization using photon-counting detector CT (PCD-CT) versus energy-integrating detector CT (EID-CT). Across 170 patients (86 EID-CT, 84 dual-source PCD-CT), it found that the plaque quantification results were reproducible and that the workflow was efficient, with comparable quantitative outputs between detector technologies using dedicated plaque analysis tools (syngo.CT Coronary Coc…). The clinical significance is that standardized, efficient quantitative plaque analysis may improve feasibility and consistency of CCTA-based risk assessment across CT platforms.
Sipos B, Vattay B, Boussoussou M et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Endovascular device surveillance (stents, grafts, endoleaks, aneurysm follow-up)
Detection of structural failure in bridging stent grafts: photon-counting CT versus dual-energy CT in a controlled in vitro study.
In a controlled in vitro phantom experiment, this study compared photon-counting CT (PCCT) with dual-energy CT (DECT) for detecting structural failure (predefined wire fractures) in bridging stent grafts used in fenestrated/branched endovascular aortic repair (f/bEVAR). PCCT improved detectability of stent wire defects relative to DECT by reducing metal-related blooming and/or improving effective spatial resolution. Earlier and more reliable detection of stent graft failure could support timely intervention and improve outcomes after complex endovascular repairs.
Kern M, Dachs TM, Strassl A et al. · The Journal of cardiovascular surgery · (2026) · View on PubMed ↗
Effect of Monoenergetic Reconstructions and Ultra-High-Resolution on the Detection of Small Endoleaks With Photon-counting Detector CT.
Using an aneurysm phantom model, this experimental study assessed how ultra-high-resolution (UHR) mode and monoenergetic reconstructions at different keV (40–60 keV in standard resolution; UHR at 45 and 50 keV) affect detection of small endoleaks with photon-counting detector CT (PCD-CT). The key finding is that endoleak detectability depends on reconstruction energy and resolution mode, with specific monoenergetic/UHR combinations improving performance for small endoleak visualization. This supports protocol optimization for PCCT surveillance after endovascular aortic aneurysm repair to improve sensitivity for clinically important small endoleaks.
Szucs-Farkas Z, Perrin LG, M’Hamdi B et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗
Assessment of image quality and feasibility of Photon-Counting detector CT for the Non-Contemporaneous follow-up of intracranial aneurysms treated with flow diverter stents.
This retrospective cohort study evaluated photon-counting detector CT (PCD-CT) for non-contemporaneous follow-up of intracranial aneurysms treated with flow diverter stents, comparing image quality and feasibility against intraoperative baseline DSA and flat-panel detector CT (VasoCT) in 30 patients (32 aneurysms). The key finding was that PCD-CT provided adequate stent lumen visibility and diagnostic confidence with quantitative image-quality metrics (e.g., signal-to-noise ratio) supporting its feasibility for longer-term surveillance. This is significant because it suggests PCD-CT could improve noninvasive monitoring of flow-diverter-treated aneurysms when follow-up imaging is not performed at the time of the procedure.
Gao JP, Bian Y, Zhang RJ et al. · European journal of radiology · (2026) · View on PubMed ↗
Clinical diagnostic performance in oncology (breast, lung, pancreas, spine)
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 by comparing multiphasic contrast-enhanced PCCT with breast MRI, full-field digital mammography (FFDM), and 18F-FDG PET/CT in women with BI-RADS 4C or higher lesions. The key finding was that PCCT was feasible for breast lesion evaluation and produced diagnostic information comparable to established modalities, supporting its potential role in preoperative staging/characterization. If confirmed in larger cohorts, PCCT could offer improved spatial resolution and contrast with potential dose efficiency for comprehensive breast cancer workup.
Fu Q, Zeng Y, Chang R et al. · Radiology · (2026) · View on PubMed ↗
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 for detecting Modic type 1 changes in lumbar spine photon-counting detector CT images using MRI as the reference standard. In 60 patients with lumbar spine PCD-CT and MRI within one week, it extracted 105 radiomic features from 360 segmented vertebrae and evaluated models using LASSO, Random Forest, XGBoost, and support vector machines. The significance is that it benchmarks which radiomics approach best leverages PCD-CT for MRI-referenced detection of degenerative vertebral marrow changes.
Marth AA, Fritz B, Sutter R · Skeletal radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Quantitative and qualitative evaluation of pancreatic cancer on photon-counting detector CT and dual-energy CT using standard reference images.
In a retrospective single-center study, 124 patients with pathologically proven pancreatic cancer underwent initial dynamic contrast-enhanced upper abdominal CT with either photon-counting detector CT (PCD-CT; n=62) or dual-energy CT (DE-CT; n=62). Using reference images equivalent to clinical practice (70 keV virtual monoenergetic for PCD-CT and 80/Sn150 kVp blended for DE-CT), the study compared tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) to assess depiction performance quantitatively and qualitatively. The results inform whether PCCT provides superior contrast performance for pancreatic tumor assessment under standardized reference conditions.
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 2026 review summarized current guidelines and practical considerations for imaging-based staging and prognostication in renal cell carcinoma (RCC), focusing on how CT and MRI multiphase imaging contribute to T-staging and risk stratification. The key message is that anatomic staging alone is insufficient for capturing tumor biology, and integrating imaging-based prognostic markers can refine preoperative risk assessment across major guidelines (AUA, EAU, NCCN). Clinically, the review provides a framework for selecting appropriate multiphase imaging and interpreting prognostic imaging features to improve RCC management decisions.
Arita Y, Becker A, Leithner D et al. · Abdominal radiology (New York) · (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 (PC-CT) with iodine mapping to differentiate malignant versus benign breast masses and to compare lesion conspicuity and image quality across PC-CT iodine maps, monoenergetic postcontrast images, and virtual noncontrast reconstructions. The key finding was that PC-CT iodine mapping (and related PC-CT reconstructions) provided clinically useful differentiation of breast mass pathology with improved lesion conspicuity and reader preference compared with alternative PC-CT-derived image types. This is significant because it advances PC-CT iodine quantification as a potential imaging biomarker for breast cancer detection and characterization.
Wilpert C, Pichotka MP, Molina-Fuentes MF et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Cardiovascular imaging and plaque/atherosclerosis biology
Tracking the infiltration of gold-labelled monocytes into live human atherosclerotic plaques: Spectral photon counting CT imaging analysis.
This experimental study tracked infiltration of gold-labeled human monocytes into live human atherosclerotic plaques using spectral photon-counting CT (SPCCT) alongside microwave plasma atomic emission spectroscopy (MP-AES) quantification. Monocytes incubated with gold nanoparticles for 24 hours were imaged in excised carotid plaques, and SPCCT provided spectral imaging readouts consistent with gold nanoparticle uptake and monocyte movement into plaque tissue. This approach enables noninvasive, cell-tracking characterization of human plaque biology, potentially advancing translational research on monocyte-driven atherosclerosis progression.
Holmes D, Moghiseh M, Healy J et al. · Atherosclerosis · (2026) · View on PubMed ↗ · Free PDF ↗
Paced QRS morphology and lead location in left bundle branch area pacing assessed by photon-counting cardiac computed tomography.
This retrospective study used contrast-enhanced ultra-high-resolution photon-counting cardiac CT (PC-CT) to evaluate lead-tip location after left bundle branch area pacing (LBBAP) in 20 patients (9 left bundle branch pacing [LBBP], 9 left ventricular septal pacing [LVSP], 2 deep septal pacing [DSP]). PC-CT enabled precise measurement of distances from the lead tip to the left and right ventricular endocardium and to the presumed His bundle, and related these geometric parameters to paced QRS morphology categories. The findings support PC-CT as a high-resolution tool for verifying LBBAP lead position, which may help optimize pacing strategy and improve interpretation of paced ECG outcomes.
Goto K, Miyazaki S, Negishi M et al. · Heart rhythm · (2026) · View on PubMed ↗
Vascular imaging with photon-counting CT (CTA/angiography/perfusion)
Diagnostic Imaging Pathways in Peripheral Artery Disease: A Comparative Review of Duplex Ultrasound Through Computed Tomography Angiography.
This comparative review studied contemporary diagnostic imaging pathways for peripheral artery disease (PAD) in patients across the clinical spectrum, focusing on duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). It found that imaging selection and sequencing depend on goals such as diagnosis, risk stratification, treatment planning, and postprocedural surveillance, with noninvasive modalities guiding escalation from conservative management to endovascular or surgical revascularization. The significance is that it provides an evidence-based framework for choosing the most appropriate vascular imaging strategy in PAD care.
Malangu B, Kotev S · The International journal of angiology : official publication of the International College of Angiology, Inc · (2026) · View on PubMed ↗ · Free PDF ↗
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) versus dual-energy energy-integrating detector CT pulmonary angiography (DE-EID CTPA) in 227 patients undergoing CT pulmonary angiography (n=76 at IQ50, n=76 at IQ25 for UHR-PCD-CTPA; n=75 for DE-EID CTPA). UHR-PCD-CTPA increased peripheral pulmonary artery visibility and improved subjective diagnostic image quality confidence compared with DE-EID CTPA, with quantitative Hounsfield unit measurements and radiologist ratings used to support the findings. These results suggest that photon-counting CT can enhance visualization of distal pulmonary vasculature, potentially improving diagnostic performance for pulmonary embolism assessment in routine CTPA workflows.
Pannenbecker P, Rüth C, Grunz JP et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
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 obtained with photon-counting CT (PCCT) against the standard ventilation/perfusion SPECT (V/Q-SPECT) in 23 patients with suspected or confirmed chronic thromboembolic pulmonary hypertension (CTEPH). PCCT-derived lobar perfusion quantification showed measurable agreement/relationship with V/Q-SPECT perfusion, enabling perfusion assessment with higher anatomical detail in a single CT examination. If validated, PCCT could complement or streamline CTEPH imaging by providing more precise lobar perfusion quantification than V/Q-SPECT alone.
Moeskes MMV, Derlin T, Hunkemöller AM et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
A scoping review of photon-counting detector computed tomography in cardiovascular imaging.
This scoping review synthesized evidence from 59 studies (searched MEDLINE, Embase, and Scopus, Jan 2021–Sep 2025) on photon-counting detector CT (PCD-CT) in cardiovascular imaging across coronary, myocardial, structural/valvular, pulmonary-cardiopulmonary function, and aortic/visceral/peripheral vascular domains. The key finding was that, despite heterogeneity in protocols and endpoints, PCD-CT consistently enables high-resolution, multi-energy cardiovascular imaging with reported improvements in diagnostic performance metrics in several settings (e.g., coronary imaging specificity) while also highlighting ongoing variability in implementation. This is scientifically significant because it maps where PCD-CT has demonstrated benefit and where further standardized clinical validation is needed.
Alis D, Önal MO, Orman M et al. · Diagnostic and interventional radiology (Ankara, Turkey) · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Advancements in imaging for endovascular treatment of peripheral artery disease.
This narrative review summarized advances in imaging used for diagnosis, procedural planning, and follow-up in endovascular treatment of peripheral artery disease (PAD), focusing on duplex ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The key finding was that no single modality is universally optimal; rather, each technique offers distinct advantages and limitations that should be matched to patient-specific factors and clinical goals. This is clinically significant because it supports individualized imaging strategies to improve outcomes in PAD interventions.
Raskin D, Zivkovic M, Kirksey L et al. · VASA. Zeitschrift fur Gefasskrankheiten · (2026) · 1 citations · View on PubMed ↗
Artifact reduction and metal-related imaging optimization
Comparison of Iterative Metal Artifact Reduction Presets In Ultra-high-resolution Photon-counting CT Angiography of Patients with Total Knee Endoprosthesis.
This study evaluated how different iterative metal artifact reduction (IMAR) presets affect ultra-high-resolution photon-counting CT angiography (UHR PCCTA) in patients with total knee endoprostheses. In 25 knee-arthroplasty patients (31 lower extremities) undergoing UHR-PCCTA, the key finding was that IMAR settings meaningfully change image quality and the ability to visualize the popliteal vasculature despite knee prosthesis-related metal artifacts. Clinically, optimizing IMAR in UHR-PCCTA can improve noninvasive assessment of peripheral arteries in patients with knee implants.
Huflage H, Kunz AS, Wech T et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Inflammation and vasculitis imaging
Quantitative iodine-mapping of photon-counting CT detects large-vessel vasculitis: A case report.
This case report studied photon-counting detector CT (PCCT) with retrospectively reconstructed iodine maps for diagnosing large-vessel vasculitis in a 69-year-old woman with severe headache and elevated inflammatory markers. It found that initial CT/MRI/ultrasound were unrevealing, but PCCT demonstrated concentric mural thickening of the aorta and supra-aortic branches and iodine mapping showed increased iodine concentration in the aortic wall. The significance is that PCCT iodine quantification can support detection of active large-vessel vasculitis when conventional imaging is nondiagnostic.
Lückerath S, Euler A · Radiology case reports · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Dose reduction and low-dose protocol performance
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 evaluated the impact of ultra-low-dose scanning on 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 pulmonary nodule models scanned at five dose levels, it found dose-dependent changes in detection rate and quantitative metrics (noise, SNR, CNR) and assessed how accurately an AI nodule software measured nodule volume across doses. The scientific significance is that it informs how far UHR PCD-CT can be pushed to lower dose while preserving quantitative nodule measurement performance.
Wang Y, Zhou Y, Lei L et al. · The British journal of radiology · (2026) · View on PubMed ↗
Appropriate dose reduction using photon-counting detector CT for temporal bone imaging: phantom and clinical studies with helical acquisition.
This phantom and clinical study investigated how much dose can be reduced 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). It compared visual scores and detectability index (d’) across dose levels using a head phantom and clinical temporal bone images, finding a practical PCD-CT dose-reduction limit that preserved detectability relative to standard-dose EID-CT. The significance is that it provides an evidence-based pathway to reduce radiation dose for temporal bone CT without sacrificing diagnostic performance.
Takahashi Y, Higaki F, Nakamura Y et al. · Japanese journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
AI reconstruction/denoising and quantitative robustness
Artificial intelligence denoising in cardiac photon-counting CT: mitigating BMI-related noise degradation while maintaining clinical interchangeability.
This retrospective study evaluated whether an artificial intelligence-based denoising (AID) algorithm can mitigate BMI-related noise degradation in cardiac photon-counting detector CT (PCD-CT) while maintaining quantitative equivalence to quantum iterative reconstruction (QIR). In 100 patients undergoing non-contrast coronary artery calcium (CAC) scoring and contrast-enhanced CCTA on a dual-source PCD-CT, it found that PCD-CT-weighted AID reduced BMI-associated noise while preserving strict quantitative interchangeability with QIR. The significance is that AI denoising can expand the robustness of PCD-CT for patients with higher BMI without compromising clinical quantitative measurements.
Urban L, Berger J, Brendel JM et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Musculoskeletal and bone phenotyping (marrow, microstructure, cement)
Assessing bone microstructure and density with photon-counting CT: emerging applications and challenges.
This 2026 review synthesized preclinical and emerging clinical evidence on photon-counting CT (PCCT) for bone microstructure and mineral density assessment, focusing on how PCCT’s spatial/contrast resolution and material decomposition capabilities compare with conventional energy-integrating CT and high-resolution peripheral quantitative CT (HR-pQCT). The key finding is that PCCT can enable accurate quantification of bone microarchitecture and mineral density with performance approaching HR-pQCT in controlled settings, while translation to in vivo clinical use remains constrained by technical and practical challenges. Scientifically, the review frames PCCT as a promising next-generation platform for noninvasive bone phenotyping and highlights the barriers that must be addressed for routine clinical adoption.
Patzer TS, Schwartz FR, Panta RK et al. · Skeletal radiology · (2026) · View on PubMed ↗
Urolithiasis phenotyping and stone characterization
Photon-counting CT-enabled urolithiasis phenotyping: virtual non-iodine reconstructions, automated measurement, and spectral radiomics.
This review described how photon-counting CT (PCCT) enables urolithiasis phenotyping using virtual non-iodine (VNI) and virtual non-contrast (VNC) reconstructions, automated measurements, and spectral radiomics. The key point is that PCCT’s detector-level energy discrimination and higher spatial resolution allow calcium-preserving reconstructions and quantitative spectral features that can serve as imaging-derived biomarkers for stone composition. This could improve noninvasive stone characterization to guide intervention selection and chemolitholysis decisions.
Drobot RB · Abdominal radiology (New York) · (2026) · 2 citations · View on PubMed ↗
Generated automatically on September 06, 2026. Covers PubMed articles published August 30, 2026 – September 06, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.