What's New in Photon Counting CT? — September 08, 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 08, 2026 · 36 articles · 15 research themes · covering September 01, 2026 – September 08, 2026
Overview
Across this week’s set of studies and reviews, a dominant theme is that photon-counting/spectral CT is moving from “better images” toward controllable, quantitative imaging—enabled by energy discrimination, material decomposition, and task-optimized reconstruction. Multiple works show that choosing the right reconstruction mode (e.g., ultra-high-resolution vs monoenergetic/virtual monoenergetic), leveraging iodine maps/virtual non-contrast, and accounting for physics effects (such as beam hardening) can materially improve lesion conspicuity and diagnostic confidence. This is reflected in applications spanning breast lesion characterization, bowel ischemia assessment with spectral reconstructions, pancreatic tumor depiction, and even proton therapy planning where accurate stopping-power ratio estimation depends on modality- and size-dependent beam-hardening behavior.
A second major thread is protocol robustness and dose efficiency. Phantom and clinical studies quantify how far dose can be reduced in pulmonary nodule detection, temporal bone imaging, and detectability metrics that better reflect patient size (e.g., size-specific detectability index). In parallel, AI-based denoising and kernel/IMAR parameter optimization address real-world variability—such as BMI-related noise changes in cardiac PCD-CT and metal artifact suppression around orthopedic hardware—supporting more consistent quantitative performance across heterogeneous patient populations.
Finally, the clinical adoption narrative is strengthened by domain-specific evidence in cardiovascular and vascular imaging, where PCCT is repeatedly benchmarked against energy-integrating CT/DECT and established standards. Reviews and studies highlight improved spatial/energy information for cardiovascular and aortic/endovascular surveillance (including endoleaks and stent graft failure), while peripheral artery disease and pulmonary embolism/perfusion work emphasize how modality choice and reconstruction strategy can tailor imaging to clinical needs. Complementing these are mechanistic and translational directions—such as tracking monocyte infiltration into human plaques ex vivo and advancing detector hardware design—suggesting that both clinical workflows and the underlying technology are converging toward more reliable, quantitative imaging biomarkers.
Liver Fat & Hepatic Quantification (MASLD/LFC)
Robust Liver Steatosis Quantification Using Photon-Counting CT in Comparison to PDFF: Validation across Protocols and Cohorts.
This prospective study evaluated robustness and liver fat grading performance of photon-counting CT (PCCT) fat fraction (CTFF) across different scan protocols and cohorts, using proton density fat fraction (PDFF) as the reference in 297 participants including volunteers and clinical cohorts with MASLD and heterogeneous liver diseases. PCCT-derived CTFF showed validated performance across 120-kVp vs 140-kVp and high- vs low-dose technical subgroups, supporting consistent liver steatosis quantification despite protocol and cohort variability. These findings support PCCT as a more robust, protocol-tolerant imaging approach for quantitative assessment of steatosis in MASLD and other liver conditions.
Xu X, Yuan J, Cai X et al. · Academic radiology · (2026) · View on PubMed ↗
Liver Fat and Iron Quantification With Spectral Localizer Radiographs From Photon-counting Detector CT.
This phantom study evaluated whether spectral localizer radiographs from photon-counting detector CT (PCD-CT) can quantify liver fat content (LFC) accurately when hepatic iron is present, using 16 liver phantoms spanning LFC levels (0%, 10%, 30%, 50%) and liver iron concentration (LIC: 0, 1.5, 3, 6 mg/mL). The key finding was that PCD-CT spectral localizer–based quantification of LFC remained feasible and more accurate in the presence of iron than approaches that do not account for iron, demonstrating robustness across iron concentrations. Clinically, this could improve noninvasive assessment of fatty liver by reducing confounding from iron deposition and thereby supporting better patient stratification and monitoring.
Tognella A, Flohr T, Froehlich JM et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Photon-Counting CT Detector Hardware & Physics
Simulation and Design Study of Edge-on GaAs:Cr Detector for Clinical Photon Counting CT.
This simulation and design study investigated an edge-on structure GaAs:Cr photon-counting detector intended for clinical photon-counting CT, addressing limitations from chromium-compensated GaAs:Cr wafer thickness (<1 mm) that reduce X-ray absorption efficiency. Full-chain modeling predicted improved spectral response and quantified material decomposition (MD) noise using a detector model to evaluate feasibility for clinical PCCT. The work is significant for advancing practical PCCT detector hardware by optimizing GaAs:Cr geometry to improve clinical CT performance.
Zhong T, Li H, Qin W et al. · IEEE transactions on medical imaging · (2026) · View on PubMed ↗
Neuroradiology & Temporal Bone/Anatomical Metrics
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) with energy-integrating detector CT (EID-CT) for visualization of the normal carotid body in 37 patients (74 carotid bifurcations). PCD-CT improved the ability to definitively identify carotid bodies compared with EID-CT, which has reported detection rates of only 62%–91% on conventional CT angiography. Improved visualization on PCCT could enhance assessment of carotid body anatomy in research and potentially support more consistent imaging-based evaluation of carotid body–related conditions.
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 study reported excellent intrarater and inter-rater reliability for SSC roof thickness measurements on Pöschl-plane reconstructions and identified cross-sectional relationships with demographic factors. These findings are clinically relevant for establishing normative anatomical metrics and improving interpretation of temporal bone imaging in otologic evaluation.
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 ↗
Photon-Counting CT Reconstruction & Spectral Optimization
Impact of beam hardening on proton stopping-power ratio estimation using photon-counting, dual-energy, and single-energy computed tomography.
This phantom-based physics 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. SPR estimation accuracy differed by modality and was influenced by object size/position due to beam hardening, with PCCT and DECT approaches using virtual monoenergetic images (VMIs) showing different sensitivities than SECT. These results are clinically important for improving proton therapy treatment planning accuracy by selecting CT acquisition/processing strategies that mitigate beam-hardening–driven SPR errors.
Bassermann L, Edmund JM, Olech WE et al. · Physics and imaging in radiation oncology · (2026) · View on PubMed ↗ · Free PDF ↗
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 photon-counting CT (UHR PCCT) 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 characterized how small pixels influence noise properties and spatial resolution. These results are important for optimizing UHR PCCT protocols and reconstruction settings to maximize image quality in clinical practice.
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 article studied the principles and clinical/scientific applications of spectral CT and photon-counting detector (PCD) CT in neuroradiology, focusing on how energy discrimination and photon counting differ from conventional energy-integrating CT. It found that both modalities can improve spatial resolution and contrast-to-noise ratio while reducing noise/artifacts and enabling multienergy imaging from a single acquisition. The review’s significance is that it consolidates evidence supporting PCD/spectral CT as a next-generation neuroradiology platform for better tissue characterization and more reliable imaging.
Hayes JC, Srinivasan A, Bapuraj JR · Radiology. Imaging cancer · (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 affects detection rate, image quality, and volumetric accuracy of different pulmonary nodule subtypes using ultra-high-resolution photon-counting detector CT (UHR PCD-CT). Across five dose levels of a thoracic phantom with 15 pulmonary nodule models, quantitative metrics (e.g., noise, SNR/CNR) and AI-based volumetry were used to determine performance limits under dose reduction. The scientific significance is defining dose–performance tradeoffs for PCD-CT pulmonary nodule assessment to enable safer imaging while preserving quantitative measurements.
Wang Y, Zhou Y, Lei L et al. · The British journal of radiology · (2026) · View on PubMed ↗
Dose Reduction & Task-Based Image Quality Metrics
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 characterization. The key finding was that SSW-d’ better accounts for patient-size variability than conventional detectability metrics, enabling more clinically relevant comparisons of reconstructed image performance across imaging conditions. This is significant for protocol optimization and for standardizing CT image quality evaluation in size-diverse patient populations.
Fitton I, Greffier J, Dabli D et al. · Medical physics · (2026) · View on PubMed ↗ · Free PDF ↗
Appropriate dose reduction using photon-counting detector CT for temporal bone imaging: phantom and clinical studies with helical acquisition.
This study investigated 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). Using a head phantom and clinical temporal bone images, it compared visual scores and detectability index (d′) across multiple PCD-CT dose levels versus EID-CT at standard dose. The significance is establishing evidence-based dose reduction limits for PCD-CT in temporal bone imaging, supporting lower-radiation protocols without loss of diagnostic detectability.
Takahashi Y, Higaki F, Nakamura Y et al. · Japanese journal of radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Musculoskeletal & Bone/Implant Quantification
Reconstruction-kernel Dependence of Femoral Bone Marrow Attenuation in Whole-body Dual-source Photon-counting CT of Patients with Multiple Myeloma.
This retrospective study examined how reconstruction-kernel choice affects femoral bone marrow attenuation on noncontrast whole-body photon-counting CT (PCCT) in 103 consecutive patients with multiple myeloma. The authors found that femoral bone marrow attenuation varied with kernel selection across standard body regular kernels (Br32–Br68) and corresponding quantitative kernels (Qr32–Qr68) at 90 kV/Sn 150 kV in ultrahigh-resolution dual-source mode. The results are important for harmonizing quantitative PCCT measurements in multiple myeloma and for reducing kernel-related bias in longitudinal or multi-site assessments.
Huflage H, Scheiner F, Grunz JP et al. · Academic radiology · (2026) · View on PubMed ↗
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 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, though in vivo translation remains challenging. The review highlights technical and clinical barriers (e.g., validation, standardization, and dose/scan protocol considerations) that must be addressed before widespread adoption.
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 study synthesized gadolinium nanoparticle–loaded absorbable bone cement (GdNP-loaded hydroxyapatite-based cement) and compared photon-counting CT (PCCT) versus energy-integrating CT (EID-CT) for contrast-to-noise ratio (CNR) against vertebral bone, also testing PCCT material decomposition accuracy for gadolinium concentration. PCCT provided superior CNR between GdNP-loaded cement and vertebral bone and enabled accurate quantification of gadolinium concentration in solution and in the loaded cements. These results support using GdNP-enhanced degradable bone cements with PCCT to improve radiopacity and enable quantitative imaging of implant composition.
Marks AE, Marco KPD, Barcena AJR et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Aortic & Endovascular Surveillance (EVAR/f/bEVAR)
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) versus 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 fractures relative to DECT by reducing metal-related blooming and improving effective spatial resolution. This is significant for earlier identification of stent graft failure, potentially improving surveillance and patient outcomes after f/bEVAR.
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.
This experimental study used an aortic aneurysm phantom to test photon-counting detector CT (PCD-CT) reconstruction parameters, comparing ultra-high-resolution (UHR) mode and monoenergetic reconstructions at 40–60 keV for detecting small endoleaks after endovascular aneurysm repair. UHR and specific monoenergetic keV reconstructions improved the detectability of small endoleaks compared with standard-resolution reconstructions, with performance varying by keV. These findings support optimizing PCD-CT acquisition/reconstruction to enhance surveillance sensitivity for clinically important post-EVAR endoleaks.
Szucs-Farkas Z, Perrin LG, M’Hamdi B et al. · Investigative radiology · (2026) · 1 citations · View on PubMed ↗
Oncology Imaging (Breast, Pancreas, RCC, Spine ML)
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 lesions classified as BI-RADS 4C or higher, comparing PCCT against MRI, full-field digital mammography (FFDM), and 18F-FDG PET/CT. The key finding was that PCCT was feasible and showed diagnostic performance relative to established modalities for characterizing breast lesions prior to treatment. This supports PCCT as a potential imaging option that could improve spatial resolution and contrast while integrating with current breast cancer diagnostic workflows.
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, radiomic features from segmented vertebrae were used to train and evaluate LASSO, Random Forest, XGBoost, and support vector machine models. The significance is that PCD-CT–based radiomics may provide an MRI-referenced, noninvasive approach to identify Modic type 1 changes using advanced machine learning.
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.
This retrospective single-center study compared photon-counting detector CT (PCD-CT) and dual-energy CT (DE-CT) for depicting pancreatic cancer in 124 patients with pathologically proven disease, using reference conditions equivalent to 120 kVp. Using 70 keV virtual monoenergetic images for PCD-CT and 80/Sn150 kVp linearly blended images for DE-CT, the study evaluated tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) to quantify lesion conspicuity. The results inform how PCCT may match or improve contrast depiction of pancreatic tumors under clinically relevant reference imaging 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 review article summarized current guidelines and practical considerations for staging and imaging-based prognostication in renal cell carcinoma (RCC), focusing on CT and MRI multiphase imaging and how imaging biomarkers refine preoperative risk. The key finding is that anatomic TNM labels alone are insufficient for capturing tumor biology, and integrating imaging-based prognostic markers can improve risk stratification across major guideline frameworks. Clinically, the review provides actionable guidance on when to perform chest and ancillary imaging and how to interpret multiphase imaging for better prognostic assessment.
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.
In a prospective single-center study (Dec 2021–Aug 2023), prone-positioned photon-counting CT (PC-CT) with iodine mapping was used to differentiate malignant from benign breast masses, evaluating iodine maps, postcontrast monoenergetic images, and virtual noncontrast reconstructions derived from PC-CT. The study found that iodine mapping and related PC-CT reconstructions improved lesion conspicuity and diagnostic discrimination between malignant and benign masses, with reader preference supporting the clinical utility of the iodine-based approach. This is significant because it suggests PC-CT iodine quantification may enhance breast imaging performance while potentially reducing reliance on conventional contrast-based assessment.
Wilpert C, Pichotka MP, Molina-Fuentes MF et al. · Investigative radiology · (2026) · 2 citations · View on PubMed ↗
Atherosclerosis Mechanisms & Cellular Tracking
Tracking the infiltration of gold-labelled monocytes into live human atherosclerotic plaques: Spectral photon counting CT imaging analysis.
The study investigated how human monocytes infiltrate live human atherosclerotic plaques by labeling peripheral-blood monocytes with gold nanoparticles and tracking their uptake in excised carotid plaque samples using spectral photon-counting CT (SPCCT) and microwave plasma atomic emission spectroscopy (MP-AES). Gold nanoparticle–labeled monocytes showed measurable uptake and spatial infiltration signals within the plaque on SPCCT, enabling visualization of monocyte movement into human atherosclerotic tissue ex vivo. This provides a human-relevant imaging approach to study monocyte-driven plaque progression using photon-counting CT, potentially improving mechanistic understanding of atherosclerosis beyond animal models.
Holmes D, Moghiseh M, Healy J et al. · Atherosclerosis · (2026) · View on PubMed ↗ · Free PDF ↗
Peripheral Artery Disease Imaging Pathways & Surveillance
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), specifically duplex ultrasound (DUS) versus computed tomography angiography (CTA), across the disease spectrum from intermittent claudication to chronic limb-threatening ischemia and acute limb ischemia. It found that imaging choice and sequencing depend on clinical presentation and the need for accurate vascular mapping to guide risk stratification and revascularization planning. The significance is that it provides a practical framework for selecting DUS or CTA to optimize diagnosis and surveillance in PAD.
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 narrative review summarized advances in imaging for endovascular treatment of peripheral artery disease (PAD), focusing on duplex ultrasound, computed tomography angiography (CTA), and magnetic resonance angiography (MRA) and how they are used for diagnosis, procedural planning, and post-treatment monitoring. The key finding was that no single modality is universally optimal; instead, each technique offers distinct strengths and limitations that should be matched to patient-specific factors and clinical goals. Clinically, this supports individualized imaging strategies to improve endovascular planning and surveillance outcomes in PAD.
Raskin D, Zivkovic M, Kirksey L et al. · VASA. Zeitschrift fur Gefasskrankheiten · (2026) · 1 citations · View on PubMed ↗
Metal Artifact Reduction & Implant/Hardware Imaging
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 image quality of ultra-high-resolution photon-counting CT angiography (UHR PCCTA) in patients with total knee endoprostheses. In 25 knee-arthroplasty patients (31 lower extremities), varying IMAR settings altered the degree of metal artifact suppression and thereby the visualization of the popliteal vasculature. Clinically, optimizing IMAR parameters can improve noninvasive peripheral vascular assessment in patients where knee prostheses otherwise degrade PCCTA.
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 comparative study evaluated contrast agent–reduced CT protocols for transcatheter aortic valve reconstruction (TAVR) planning on photon-counting detector CT (PCDCT) in 162 BMI-matched examinations using iohexol 300 mg/mL (standard dose 80 mL vs reduced dose 50 mL). Reduced-contrast protocols combined with virtual monoenergetic reconstructions (70/60/50 keV) on PCDCT maintained sufficient image quality for TAVR reconstruction planning while lowering contrast volume. The findings support safer, more supply-resilient contrast use for PCCT-based structural heart planning without sacrificing clinically relevant reconstruction performance.
Layer YC, Isaak A, Mesropyan N et al. · European radiology · (2026) · View on PubMed ↗ · Free PDF ↗
Inflammation & Vasculitis Detection
Quantitative iodine-mapping of photon-counting CT detects large-vessel vasculitis: A case report.
This case report studied a 69-year-old woman with suspected large-vessel vasculitis using photon-counting detector CT (PCCT) and retrospective iodine mapping. PCCT demonstrated concentric mural thickening of the aorta and supra-aortic branches, and iodine maps showed increased iodine concentration in the vessel wall compared with earlier negative standard imaging. The significance is that quantitative iodine mapping on PCCT may support earlier or more confident detection of large-vessel vasculitis when conventional CT/MRI/ultrasound are nondiagnostic.
Lückerath S, Euler A · Radiology case reports · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Cardiovascular PCCT Applications & Coronary Plaque Quantification
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 the reproducibility and workflow efficiency of a novel software tool for quantitative coronary plaque characterization using both photon-counting detector CT (PCD-CT) and energy-integrating detector CT (EID-CT). Among 170 patients (84 PCD-CT, 86 EID-CT), plaque quantification results from the dedicated tool were assessed for reproducibility and time efficiency, and performance was compared between detector types. The clinical significance is that standardized, efficient quantitative plaque analysis may improve feasibility and consistency of CCTA-based plaque characterization across CT platforms.
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 study investigated whether an artificial intelligence denoising (AID) algorithm can mitigate BMI-related noise degradation in cardiac photon-counting detector CT (PCD-CT) while maintaining quantitative interchangeability with quantum iterative reconstruction (QIR). In 100 patients undergoing non-contrast coronary artery calcium (CAC) scoring and contrast-enhanced CCTA on dual-source PCD-CT, images reconstructed with a PCD-CT-weighted AID algorithm were compared against QIR for subjective image quality and quantitative equivalence. The significance is that AI denoising could enable more consistent cardiac PCD-CT image quality across patients with different BMI without compromising diagnostic quantitative metrics.
Urban L, Berger J, Brendel JM et al. · European journal of 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, stratified into left bundle branch pacing (LBBP), left ventricular septal pacing (LVSP), and deep septal pacing (DSP). The study quantified 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 clarifying how intra-septal lead position influences paced ECG morphology, PC-CT can improve procedural targeting and post-implant assessment of LBBAP.
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, covering coronary, myocardial, structural/valvular, pulmonary-cardiopulmonary function, and aortic/visceral/peripheral arterial applications. Across heterogeneous protocols and endpoints, the review reported generally improved spatial/energy information enabling better diagnostic performance in multiple cardiovascular domains, while also highlighting variability in acquisition strategies and outcome measures. The significance is that it maps the current clinical and technical landscape of PCD-CT, guiding future standardization and study design for cardiovascular adoption.
Alis D, Önal MO, Orman M et al. · Diagnostic and interventional radiology (Ankara, Turkey) · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Pulmonary Imaging (Nodules, CTPA, 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) with dual-energy energy-integrating detector CT (DE-EID) CTPA in 227 examinations (after exclusions) across image quality indices (IQ50 and IQ25). UHR-PCD-CTPA improved pulmonary artery visibility and diagnostic confidence, with higher IQ yielding greater peripheral pulmonary artery conspicuity than DE-EID CTPA. These results suggest that UHR photon-counting CTPA can enhance detection and interpretation of pulmonary embolism-related vascular findings, potentially improving diagnostic accuracy in routine practice.
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 compared detectability of pulmonary nodules between an ultra-high-resolution CT scanner using energy-integrating detectors and a photon-counting CT (PCCT) system in UHR mode. Using matched low-dose settings (7.5/2.5/0.4 mGy) and quantitative metrics (noise power spectrum, task-based transfer function, and detectability index d’), the study found differences in noise texture and spatial resolution that translated into measurable changes in nodule detectability between the two scanner types. The work provides early, physics-based evidence to guide scanner selection and protocol optimization for high-sensitivity nodule detection.
Greffier J, Salvat C, Pastor M 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) versus ventilation/perfusion SPECT (V/Q-SPECT) in 23 patients with suspected or confirmed chronic thromboembolic pulmonary hypertension (CTEPH). PCCT provided lobar perfusion quantification that could be directly compared with the standard V/Q-SPECT approach, aiming to improve anatomical localization and quantitative assessment in CTEPH. If validated, PCCT could complement or refine first-line imaging by delivering high-resolution perfusion and vascular information in a single modality.
Moeskes MMV, Derlin T, Hunkemöller AM et al. · European radiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗
Quantitative Material Decomposition & Iodine/Virtual Reconstructions
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 assessed acute bowel ischemia detection on portal venous CT by comparing portal-venous (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 evaluated separately by scanner platform (DECT vs PCCT). Clinically, the results support using spectral reconstructions—especially on PCCT—to better characterize ischemic bowel findings while potentially reducing reader uncertainty.
Mankertz F, Berger J, Maalouf N et al. · European radiology · (2026) · 2 citations · View on PubMed ↗
Photon-counting CT-enabled urolithiasis phenotyping: virtual non-iodine reconstructions, automated measurement, and spectral radiomics.
This narrative review summarized emerging photon-counting CT (PCCT) approaches for urolithiasis phenotyping, emphasizing virtual non-iodine (VNI) and virtual non-contrast (VNC) reconstructions, automated measurements, and spectral radiomics. The key theme is that PCCT’s detector-level energy discrimination and higher spatial resolution enable calcium-preserving reconstructions and quantitative spectral analytics that may function as imaging-derived biomarkers for stone composition. This could shift stone characterization from laboratory-based endpoints toward noninvasive, imaging-guided management decisions.
Drobot RB · Abdominal radiology (New York) · (2026) · 2 citations · View on PubMed ↗
Generated automatically on September 08, 2026. Covers PubMed articles published September 01, 2026 – September 08, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.