What’s New in Photon Counting CT?

September 15, 2026 · 6 articles · 6 research themes · covering September 08, 2026 – September 15, 2026

Overview

Across this week’s PubMed set, photon-counting detector CT (PCD-CT) research clusters around two practical goals: improving quantitative reliability of spectral/VMI outputs and enabling safer, lower-dose clinical imaging.

On the quantitative side, studies address how acquisition parameters and reconstruction choices affect measurable image values. Work on VMI physics shows that virtual monoenergetic CT numbers in photon-counting CT retain a reduced—but not absent—dependence on tube voltage, implying that kV selection can still be tuned to optimize contrast-to-noise ratio for specific VMI energies and patient/phantom conditions. In parallel, a reconstruction-focused paper proposes a self-adaptive ring artifact reduction strategy that targets ring artifacts driven by spatially varying detector spectral response and propagation errors from material decomposition—directly improving VMI quality and interpretability.

Clinically, the dominant theme is radiation dose reduction without sacrificing diagnostic performance. A retrospective cohort comparing photon-counting CT myelography with energy-integrating CT myelography in spontaneous intracranial hypotension reports substantially lower dose-length product for PCD-CT myelography while preserving the ability to detect cerebrospinal fluid–venous fistulas. Complementing this, a pediatric feasibility study demonstrates that an ultra-low-dose chest PCD-CT protocol can be implemented with images adequate for detecting gross lung abnormalities, aiming for doses comparable to chest radiographs. Finally, biomarker-oriented applications extend the clinical promise of photon-counting CT: pericoronary fat attenuation index measured on photon-counting CT correlates with high-risk coronary plaque features, supporting its role as a quantitative risk stratification biomarker. Outside clinical imaging, multispectral photon-counting CT is also being leveraged to non-destructively track cryoprotectant permeation during cryopreservation, illustrating how improved material discrimination can accelerate biomedical process validation and optimization.

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Virtual monoenergetic imaging (VMI) physics & quantitative calibration

Influence of X-ray Tube Voltage on Computed Tomography Values and Contrast-Noise Ratios in Virtual Monoenergetic Images in routine clinical Photon Counting Detector Computed Tomography: Does kV Still Matter?

This study evaluated how X-ray tube voltage (kV) affects virtual monoenergetic image (VMI) CT values and contrast-to-noise ratio (CNR) in routine clinical photon-counting detector CT (PCD-CT) across multiple tissue types, VMI keV levels, kV settings, and phantom sizes. The key finding was that VMI CT values in PCD-CT show reduced (but not necessarily zero) dependence on kV, and specific kV settings can be chosen to optimize CNR for a given VMI energy and phantom. This matters because it supports more quantitative, cross-scan comparisons in spectral/PCD-CT by clarifying when kV selection still influences VMI-based measurements.

Jeukens CRLPN, Pinckaers FME, Martens B et al. · Investigative radiology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT myelography & neurovascular applications

Photon-Counting Detector vs Energy-Integrating Detector CT Myelography for Detecting CSF-Venous Fistulas in Spontaneous Intracranial Hypotension: Substantially Lower Radiation Dose.

This retrospective single-center cohort study compared photon-counting detector CT myelography (PCD-CTM) versus energy-integrating detector CT myelography (EID-CTM) for detecting cerebrospinal fluid–venous fistulas (CVFs) in patients with spontaneous intracranial hypotension (SIH). The key finding was that PCD-CTM achieved substantially lower session dose-length product (DLP) than EID-CTM while maintaining the ability to detect CVFs. Clinically, this supports using photon-counting CT to reduce radiation exposure in SIH patients undergoing multiacquisition CT myelography.

Christensen S, Kranz PG, Malinzak MD et al. · AJNR. American journal of neuroradiology · (2026) · 1 citations · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT coronary imaging & plaque risk biomarkers

Association Between Pericoronary Fat Attenuation Index and High-Risk Plaque Features Assessed by Photon-Counting CT.

This prospective cross-sectional study assessed whether the pericoronary fat attenuation index (pFAI) correlates with high-risk plaque (HRP) features on photon-counting CT coronary CT angiography (PCCT-CCTA) in 119 consecutive patients with suspected coronary artery disease. The key finding was that pFAI was associated with the presence and characteristics/number of HRP features identified on PCCT-CCTA. Scientifically and clinically, this suggests pFAI measured on photon-counting CT may serve as a quantitative imaging biomarker for plaque risk stratification.

Kong L, Li B, Han Y et al. · Journal of inflammation research · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT multispectral imaging for biomedical processes

Photon counting multi-spectral x-ray computed tomography of multi-component cryoprotectant diffusion into tissue surrogate.

This physics study used photon-counting multi-spectral X-ray CT to quantify how multi-component cryoprotectant chemicals permeate into a tissue surrogate during cryopreservation-related loading. The key finding was that multi-spectral photon-counting CT can resolve and track cryoprotectant distribution/permeation in situ with improved material discrimination compared with conventional approaches. This is significant for validating and optimizing vitrification protocols by enabling more reliable, non-destructive measurement of cryoprotectant loading that governs toxicity versus freezing risk.

Ali AM, Ali A, Parker JT et al. · Physics in medicine and biology · (2026) · View on PubMed ↗ · Free PDF ↗

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Photon-counting CT reconstruction & artifact reduction

Self-Adaptive Ring Artifact Reduction Method for Spectral Photon Counting CT.

This paper proposed a self-adaptive ring artifact reduction method for spectral photon-counting CT (PCCT) that addresses ring artifacts arising from pixel-wise variations in detector spectral response and from errors in material decomposition that propagate into virtual monoenergetic images (VMI). The key finding was that the self-adaptive approach reduces ring artifacts in reconstructed images and improves VMI quality by compensating for spatially varying spectral/material decomposition inaccuracies. This is important for clinical translation of PCCT because ring artifacts and VMI degradation can otherwise hinder diagnostic interpretation.

Su M, Kan S, Qin W et al. · IEEE transactions on medical imaging · (2026) · View on PubMed ↗

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Radiation dose reduction & low-dose protocols

Next-gen paediatric imaging: ultra-low dose chest photon-counting CT approaching chest radiograph doses.

This feasibility study developed and qualitatively evaluated an ultra-low-dose (ULD) chest photon-counting CT (PCD-CT) protocol in children (<16 years), aiming for radiation doses comparable to chest radiographs. The key finding was that an ultra-low-dose PCD-CT chest protocol could be implemented and produced images sufficient to detect gross lung abnormalities in 24 consecutive pediatric patients. Clinically, this supports the potential of photon-counting CT to substantially reduce pediatric radiation exposure while preserving clinically useful diagnostic information.

Limantoro I, Torfs K, Binst J et al. · European radiology experimental · (2026) · View on PubMed ↗ · Free PDF ↗

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Generated automatically on September 15, 2026. Covers PubMed articles published September 08, 2026 – September 15, 2026. Summaries are AI-generated; always consult the original publication for clinical or research decisions.