What's New in Photon Counting CT? — September 07, 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 07, 2026 · 36 articles · 13 research themes · covering August 31, 2026 – September 07, 2026
Overview
Across this week’s set of studies and reviews, photon-counting detector CT (PCD/PCCT/UHR-PCCT) is repeatedly shown to deliver practical gains in spectral imaging and quantitative imaging biomarkers—especially when conventional CT is confounded by factors like coexisting iron, metal hardware, or patient size. Multiple works emphasize that detector-level energy discrimination enables more reliable material separation (e.g., liver fat quantification despite iron deposition; iodine maps and virtual non-contrast reconstructions for breast lesion characterization; spectral reconstructions that improve acute bowel ischemia detection). Reviews further consolidate the physics rationale: improved spatial resolution and contrast-to-noise ratio, with reduced noise/artifacts versus energy-integrating CT, can translate into more robust diagnostic workflows.
A second dominant theme is “quality under constraints”: dose reduction, detectability limits, and reconstruction choices. Phantom and task-based studies quantify how low-dose strategies affect detectability (using d′ and related metrics), how small-pixel effects alter noise texture and spatial resolution, and how iterative metal artifact reduction presets or reconstruction kernels can materially change quantitative measurements (e.g., femoral marrow attenuation in multiple myeloma). Clinically, AI denoising is shown to mitigate BMI-related noise while preserving quantitative equivalence, and UHR-PCD-CT approaches improve visualization in challenging settings such as pulmonary angiography and knee arthroplasty.
Finally, the clinical translation thread spans multiple vascular and oncologic domains. Cardiovascular and vascular surveillance applications (coronary plaque quantification reproducibility, TAVR planning with reduced contrast, endovascular aneurysm surveillance for small endoleaks, and detection of stent graft wire fractures) highlight PCD-CT’s potential for more sensitive, noninvasive follow-up. Neuroradiology and inflammation studies (flow-diverter aneurysm surveillance; large-vessel vasculitis detection via iodine mapping when standard imaging is unrevealing) underscore the value of quantitative spectral signals. Together, these findings suggest that the field is moving from “better images” toward standardized, reproducible, and protocol-optimized quantitative imaging pathways.
Photon-Counting CT Physics & Detector Design
Simulation and Design Study of Edge-on GaAs:Cr Detector for Clinical Photon Counting CT.
This simulation and design study evaluated an edge-on chromium-compensated gallium arsenide photon-counting detector (GaAs:Cr) for clinical photon-counting CT (PCCT) using a full-chain detector model. The authors modeled spectral response and material-decomposition (MD) noise and found that the proposed edge-on geometry can mitigate the X-ray absorption efficiency limitations caused by sub–1 mm GaAs:Cr wafer thickness from the Cr-compensation process. This supports a practical detector architecture for improving clinical PCCT performance where conventional GaAs:Cr thickness constraints would otherwise degrade spectral imaging and material decomposition.
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) in STD versus UHR modes across multiple dose levels, the authors characterized how small detector pixels change noise properties and spatial resolution. The findings guide optimization of UHR PCCT protocols to achieve better resolution while managing noise texture for high-contrast tasks.
Song KH, Shan C, Xu G et al. · Journal of applied clinical medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Cardiovascular Imaging (Coronary, Valves, Vascular Beds)
Photon-Counting Detector CT Improves Visualization of the Normal Carotid Body Compared with Energy-Integrating Detector CT.
This retrospective clinical study compared photon-counting detector CT (PCD-CT) versus energy-integrating detector CT (EID-CT) for visualizing the normal carotid body in 37 patients (74 carotid bifurcations). PCD-CT improved the definitive identifiability of the carotid body compared with EID-CT, which has reported detection rates of 62%–91% on conventional scanners. Improved carotid body visualization with PCD-CT could enhance assessment of this small chemoreceptor organ in head-and-neck angiography and related clinical research.
LaVere MG, Farnsworth P, Yu L et al. · AJNR. American journal of neuroradiology · (2026) · View on PubMed ↗ · Free PDF ↗
Diagnostic Imaging Pathways in Peripheral Artery Disease: A Comparative Review of Duplex Ultrasound Through Computed Tomography Angiography.
This comparative review studied contemporary noninvasive diagnostic imaging pathways for peripheral artery disease (PAD), focusing on duplex ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). It found that imaging selection should be guided by clinical presentation (intermittent claudication to chronic limb-threatening ischemia/acute limb ischemia) and the need for diagnosis, risk stratification, treatment planning, and postprocedural surveillance. The review is significant because it consolidates evidence to help clinicians choose the most appropriate modality for PAD management and follow-up.
Malangu B, Kotev S · The International journal of angiology : official publication of the International College of Angiology, Inc · (2026) · View on PubMed ↗ · Free PDF ↗
Photon counting detector CT contrast agent-reduced transcatheter aortic valve reconstruction planning: a comparative study.
This comparative retrospective 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) versus reduced contrast dose (50 mL) and assessed virtual monoenergetic reconstructions (VMI) at 70, 60, and 50 keV. The key finding was that reduced contrast volume could be used for TAVR planning with maintained reconstruction quality by leveraging PCDCT spectral/VMI capabilities, supporting safer and more resource-resilient imaging.
Layer YC, Isaak A, Mesropyan N et al. · European radiology · (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, 9 left ventricular septal pacing, 2 deep septal pacing). The investigators measured distances from the lead tip to the left and right ventricular endocardium and to the presumed His bundle, relating these anatomical positions to paced QRS morphology patterns. By enabling precise, patient-specific lead localization, PC-CT can improve understanding of how LBBAP target position influences electrical outcomes and may guide procedural optimization.
Goto K, Miyazaki S, Negishi M et al. · Heart rhythm · (2026) · View on PubMed ↗
A scoping review of photon-counting detector computed tomography in cardiovascular imaging.
This scoping review synthesized evidence from 59 studies (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 imaging with reported improvements in diagnostic performance metrics in several cardiovascular applications (e.g., coronary imaging specificity and image quality outcomes). This is significant because it maps current capabilities and gaps, guiding future clinical trials and protocol optimization for cardiovascular PCD-CT use.
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 of endovascular treatment in peripheral artery disease (PAD), focusing on duplex ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA). The key finding was that individualized selection of imaging modality based on patient factors and clinical goals can optimize outcomes by balancing strengths (e.g., anatomic detail) against limitations (e.g., contrast considerations and artifacts). This is significant because it provides a practical framework for choosing imaging strategies that improve endovascular PAD management.
Raskin D, Zivkovic M, Kirksey L et al. · VASA. Zeitschrift fur Gefasskrankheiten · (2026) · 1 citations · View on PubMed ↗
Proton Therapy Planning & Stopping-Power Ratio Estimation
Impact of beam hardening on proton stopping-power ratio estimation using photon-counting, dual-energy, and single-energy computed tomography.
This phantom study assessed 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 and DECT to generate virtual monoenergetic images (VMIs), the authors compared a DECT-based SPR method with a SECT-based Hounsfield look-up approach and quantified SPR errors driven by beam hardening. The results clarify which CT modality/estimation strategy yields more accurate SPR for proton therapy planning under clinically relevant geometry-dependent beam-hardening conditions.
Bassermann L, Edmund JM, Olech WE et al. · Physics and imaging in radiation oncology · (2026) · View on PubMed ↗ · Free PDF ↗
Task-Based Image Quality, Detectability Metrics & Dose Optimization
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, enabling more robust protocol optimization for low-dose acquisitions. This provides a clinically actionable framework for comparing CT reconstruction/acquisition strategies while accounting for how patient size changes detectability.
Fitton I, Greffier J, Dabli D et al. · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
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 how ultra-low-dose scanning with ultra-high-resolution photon-counting detector CT (UHR PCD-CT) affects detection rate, image quality, and volumetric accuracy across pulmonary nodule subtypes. Using a thoracic phantom with 15 pulmonary nodule models scanned at five dose levels, it found dose-dependent changes in quantitative metrics (e.g., noise, SNR, CNR) and corresponding effects on nodule diameter and AI-based volume measurement accuracy. The scientific significance is that it supports evidence-based dose reduction strategies for PCD-CT pulmonary nodule assessment while preserving measurement reliability.
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 the extent of dose reduction possible 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 found that PCD-CT detectability (using the detectability index d’) and visual scoring could be maintained at reduced dose levels relative to standard-dose EID-CT, defining practical dose-reduction limits. This is significant because it provides a pathway to lower radiation exposure 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 ↗
Artificial intelligence denoising in cardiac photon-counting CT: mitigating BMI-related noise degradation while maintaining clinical interchangeability.
This retrospective study assessed whether AI-based denoising in cardiac photon-counting detector CT (PCD-CT) can mitigate BMI-related noise degradation while preserving quantitative diagnostic equivalence and interchangeability versus 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, the key finding was that the PCD-CT-weighted AI denoising algorithm reduced BMI-associated noise while maintaining strict quantitative equivalence to QIR. This is significant because it can improve image quality for higher-BMI patients without compromising quantitative clinical measurements.
Urban L, Berger J, Brendel JM et al. · European journal of 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 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. The investigators quantified noise power spectrum, task-based transfer function, and detection performance (d’) for three chest nodules at matched dose levels (7.5/2.5/0.4 mGy) to determine which detector approach better supports nodule visualization. The results provide early, physics-based evidence to guide selection and optimization of UHR CT platforms for small pulmonary nodule detection.
Greffier J, Salvat C, Pastor M et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Quantitative Biomarkers & Reproducibility/Workflow Efficiency
Reconstruction-kernel Dependence of Femoral Bone Marrow Attenuation in Whole-body Dual-source Photon-counting CT of Patients with Multiple Myeloma.
This retrospective patient study investigated 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 using body regular kernels Br32–Br68 and corresponding quantitative kernels Qr32–Qr68 and evaluated kernel-dependent attenuation differences. The findings indicate that kernel selection can materially change quantitative femoral marrow attenuation on PCCT, which is important for standardizing imaging biomarkers in multiple myeloma assessment.
Huflage H, Scheiner F, Grunz JP et al. · Academic radiology · (2026) · View on PubMed ↗
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 authors reported excellent measurement reliability (intrarater ICC 0.966; interrater ICC 0.939) and found systematic cross-sectional differences in SSC roof thickness by age and sex. These results support using PCD-CT-derived SSC roof thickness as a reproducible morphometric marker relevant to vestibular anatomy and age/sex-related variation.
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 ↗
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 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 tool produced reproducible results and improved workflow efficiency while maintaining consistency between detector technologies. The clinical significance is that standardized, time-efficient quantitative plaque analysis may support broader adoption of CCTA-based risk stratification.
Sipos B, Vattay B, Boussoussou M et al. · European journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Metal Artifact Reduction & Implant/Hardware Imaging
Detection of structural failure in bridging stent grafts: photon-counting CT versus dual-energy CT in a controlled in vitro study.
This controlled in vitro 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). The key finding was that PCCT improved detectability of stent wire fractures relative to DECT by reducing metal-related blooming and improving effective spatial resolution. Earlier and more reliable detection of stent graft structural defects could improve surveillance and decision-making for patients at risk of endograft failure.
Kern M, Dachs TM, Strassl A et al. · The Journal of cardiovascular surgery · (2026) · View on PubMed ↗
Comparison of Iterative Metal Artifact Reduction Presets In Ultra-high-resolution Photon-counting CT Angiography of Patients with Total Knee Endoprosthesis.
This study investigated 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 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-joint metal artifacts. This is clinically significant because optimizing IMAR can improve noninvasive assessment of peripheral arteries in patients with knee arthroplasty.
Huflage H, Kunz AS, Wech T et al. · Academic radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Photon-counting Computed Tomography of Degradable Bone Cement Loaded With Gadolinium Nanoparticles.
This in vitro/experimental study tested whether adding gadolinium nanoparticles (GdNPs) to degradable (absorbable) bone cement improves radiopacity and whether photon-counting CT (PCCT) yields superior contrast-to-noise ratio (CNR) and accurate material decomposition for quantifying gadolinium concentration versus energy-integrating CT (EID-CT). The key finding was that PCCT provided improved CNR between GdNP-loaded bone cement and vertebral bone and more accurate gadolinium concentration estimation using PCCT material decomposition. This is clinically significant because it could improve visualization and quantitative monitoring of degradable bone cements in spine applications.
Marks AE, Marco KPD, Barcena AJR et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Oncology Imaging (Breast, Pancreas, Spine, Other Tumor Imaging)
Performance of Photon-counting CT for Assessing Pretreatment Breast Cancer: Comparison with Mammography, MRI, and 18F-FDG PET/CT.
This prospective clinical study evaluated the feasibility of photon-counting CT (PCCT) for pretreatment breast cancer assessment by comparing it with MRI, full-field digital mammography (FFDM), and 18F-FDG PET/CT. In women with breast lesions classified as BI-RADS 4C or higher, multiphasic contrast-enhanced PCCT was performed and compared with reference imaging modalities for lesion characterization and staging-relevant performance. If PCCT demonstrates comparable or superior lesion assessment, it could provide a more efficient alternative or complement to existing breast imaging pathways.
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 PCD-CT and MRI within one week, it found that model performance differed across LASSO, Random Forest, XGBoost, and support vector machine approaches based on extracted radiomic features from segmented vertebrae. The scientific significance is that it benchmarks radiomics/ML strategies for leveraging PCD-CT to identify MRI-defined degenerative inflammatory 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 of 124 patients with pathologically proven pancreatic cancer, investigators compared photon-counting detector CT (PCD-CT) and dual-energy CT (DECT) using reference-equivalent images (70 keV virtual monoenergetic for PCD-CT and 80/Sn150 kVp linearly blended for DECT). They evaluated tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) to determine which technique better depicts pancreatic cancer under clinically matched reference conditions. The findings inform how to select and standardize PCCT versus DECT reconstruction settings for improved pancreatic tumor conspicuity.
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 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 supports T-staging and risk stratification. It emphasized that anatomic staging alone is insufficient for tumor biology and highlighted how imaging-derived prognostic markers can refine preoperative risk assessment across major guidelines (American Urological Association, European Association of Urology, and National Comprehensive Cancer Network). The review provides a clinically actionable framework for integrating CT/MRI staging with 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 whether prone photon-counting CT (PC-CT) with iodine mapping can differentiate malignant from benign breast masses and improve lesion conspicuity and reader preference using iodine maps, monoenergetic postcontrast images, and virtual noncontrast reconstructions. The key finding was that PC-CT iodine mapping and related reconstructions provided clinically useful differentiation of breast mass pathology with improved lesion conspicuity and image quality compared with conventional approaches (as evaluated against MRI/anatomic correlation and reader assessments). 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 ↗
Translational/Experimental Molecular & Cellular Imaging
Tracking the infiltration of gold-labelled monocytes into live human atherosclerotic plaques: Spectral photon counting CT imaging analysis.
This experimental study tracked the infiltration of gold-labeled human monocytes into live human atherosclerotic plaques using spectral photon-counting CT (SPCCT). Monocytes incubated with gold nanoparticles were quantified by microwave plasma atomic emission spectroscopy (MP-AES) and imaged in excised carotid plaques with SPCCT to visualize and analyze monocyte movement into plaque tissue. The work provides a translational imaging approach to study human plaque biology in real tissue using gold nanoparticle labeling and spectral photon-counting CT.
Holmes D, Moghiseh M, Healy J et al. · Atherosclerosis · (2026) · View on PubMed ↗ · Free PDF ↗
Spectral/Multienergy Reconstruction & Material Decomposition
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 practice. It found that both techniques—energy separation in spectral CT and per-photon energy counting in PCD CT—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 advances are significant because they can enhance visualization of tissue characteristics and support more accurate, artifact-resistant diagnostic neuroradiology workflows.
Hayes JC, Srinivasan A, Bapuraj JR · Radiology. Imaging cancer · (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 compared portal-venous (PV) blended dual-energy CT (DECT) and photon-counting CT (PCCT) 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. Adding spectral reconstructions to PV blended images improved diagnostic performance for acute bowel ischemia, with performance assessed across scanner platform (DECT vs PCCT) and multiple readers against a composite surgical/clinical reference standard. This supports spectral imaging workflows on DECT/PCCT to enhance ischemia detection on portal-venous CT, potentially improving timely diagnosis and management.
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 on photon-counting detector CT (PCD-CT) using spectral localizer radiographs in liver phantoms containing controlled levels of fat and liver iron concentration (LIC). The key finding was that PCD-CT spectral localizer radiographs enabled feasible and accurate LFC quantification despite hepatic iron deposition, addressing confounding from iron and iodinated contrast. This supports more reliable noninvasive CT-based liver fat measurement in settings where iron coexists, improving the scientific basis for CT liver fat quantification workflows.
Tognella A, Flohr T, Froehlich JM et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Inflammation & Vasculitis Imaging
Quantitative iodine-mapping of photon-counting CT detects large-vessel vasculitis: A case report.
This case report studied whether photon-counting detector CT (PCCT) with retrospectively reconstructed iodine maps can detect large-vessel vasculitis when conventional imaging is initially unrevealing. In a 69-year-old woman with severe headache and elevated inflammatory markers, PCCT demonstrated concentric mural thickening of the aorta and supra-aortic branches, and iodine mapping showed increased iodine concentration in the aortic wall. The finding is significant because PCCT iodine quantification may improve diagnostic detection of large-vessel vasculitis when standard CT/MRI/ultrasound findings are nonspecific.
Lückerath S, Euler A · Radiology case reports · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Pulmonary Imaging (Nodules, Angiography, Perfusion)
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 analyzed examinations from patients evaluated for pulmonary vascular disease. UHR-PCD-CTPA increased peripheral pulmonary artery visibility and improved subjective diagnostic confidence while providing quantitative image-quality gains (e.g., higher peripheral pulmonary artery visibility and radiologist-rated image quality at specified image quality indices). These findings support UHR photon-counting CTPA as a potentially more accurate, higher-confidence alternative to conventional dual-energy CTPA for detecting pulmonary vascular pathology.
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 derived from photon-counting CT (PCCT) with those from ventilation/perfusion SPECT (V/Q-SPECT) in 23 patients with suspected or confirmed chronic thromboembolic pulmonary hypertension (CTEPH). PCCT provided perfusion quantification that could be directly compared to the V/Q-SPECT standard, aiming to improve anatomical localization and quantitative assessment of lobar perfusion. If validated, PCCT could complement or refine CTEPH imaging by combining high-resolution perfusion assessment with anatomical detail in a single modality.
Moeskes MMV, Derlin T, Hunkemöller AM et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
CT-Based Phenotyping & Composition Classification (Urolithiasis, Bone, etc.)
Assessing bone microstructure and density with photon-counting CT: emerging applications and challenges.
This 2026 review synthesized preclinical and emerging evidence on photon-counting CT (PCCT) for bone microstructure and mineral density assessment, focusing on how PCCT’s spatial/contrast advantages and material decomposition enable quantitative microarchitecture imaging. Across summarized studies, PCCT showed potential for accurate quantification of bone microarchitecture and mineral density with performance comparable to high-resolution peripheral quantitative CT (HR-pQCT), while also outlining key translation challenges for in vivo clinical use. The review highlights PCCT as a promising next-generation tool for noninvasive bone quality biomarkers, but emphasizes the need for standardization and clinical validation.
Patzer TS, Schwartz FR, Panta RK et al. · Skeletal radiology · (2026) · View on PubMed ↗
Photon-counting CT-enabled urolithiasis phenotyping: virtual non-iodine reconstructions, automated measurement, and spectral radiomics.
This review article discussed photon-counting CT–enabled urolithiasis phenotyping, emphasizing how detector-level energy discrimination supports calcium-preserving virtual non-iodine (VNI) and virtual non-contrast (VNC) reconstructions plus automated measurements and spectral radiomics. The key theme is that PCCT-derived spectral features can serve as imaging-derived biomarkers to noninvasively classify stone composition and potentially guide management decisions such as selective chemolitholysis. The review frames PCCT as a translational step toward more accurate, noninvasive stone characterization beyond conventional CT attenuation alone.
Drobot RB · Abdominal radiology (New York) · (2026) · 2 citations · View on PubMed ↗
Neuroradiology & Cerebrovascular Applications
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 monoenergetic reconstructions at different keV and ultra-high-resolution (UHR) mode on photon-counting detector CT (PCD-CT) affect detection of small endoleaks after endovascular aortic aneurysm repair. The investigators reconstructed monoenergetic images at 40–60 keV (standard resolution) and evaluated UHR reconstructions (e.g., at 45 and 50 keV) to determine which settings maximize small endoleak detectability. These results aim to establish practical PCD-CT acquisition/reconstruction parameters to improve surveillance 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 the image quality and feasibility of photon-counting detector CT (PCD-CT) for non-contemporaneous follow-up of intracranial aneurysms treated with flow diverter stents, comparing PCD-CT with 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 and related measures) supporting its feasibility for routine surveillance. This is clinically significant because it supports PCD-CT as a noninvasive option for long-term monitoring of flow-diverter-treated aneurysms.
Gao JP, Bian Y, Zhang RJ et al. · European journal of radiology · (2026) · View on PubMed ↗
Generated automatically on September 07, 2026. Covers PubMed articles published August 31, 2026 – September 07, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.