PCCT achieved lower radiation dose and higher signal-to-noise ratio (SNR) than energy-integrating CT across pediatric head phantom models, demonstrating improved dose efficiency for neuroimaging.
The greatest radiation dose reduction was observed in the 10-year-old phantom (9% lower CTDIvol at clinically relevant IQL 200), while PCCT consistently produced significantly higher SNR for both brain parenchyma and bone.
Image quality improvements were primarily driven by reduced image noise in brain tissue and enhanced bone signal, supporting optimized pediatric head CT protocols with PCCT while adhering to ALARA principles.
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Figure 1. Visualization of the 5 anthropomorphic phantoms and the ROI measurements of brain parenchyma. a: Three pediatric phantoms (adult male, adult female, 10 years, 5 years, and 1 year). b-d: ROI measurements of brain parenchyma tissue equivalent for IQL 10 (b), IQL 100 (c) and IQL 200 (d) of the 1-year-old phantom. IQL: Image Quality Level, ROI: region of interest.
Source: Klüner LV, Zensen S, Peuster H, et al. Radiation dose and signal-to-noise ratio in pediatric head CT: a phantom study comparing photon-counting and energy-integrating detectors. Neuroradiology. 2026. doi:10.1007/s00234-026-04075-9.
Protocol
Detail | Value |
|---|
Scanner | NAEOTOM Alpha (PCCT) vs SOMATOM X.ceed (EID-CT) |
Scan area | Pediatric head CT |
Scan mode | Standard clinical pediatric head protocol |
Acquisition mode | Helical |
Scan direction | Head |
Tube voltage [kV] | PCCT: 70 (EID-CT: 100) |
Effective mAs [mAs] | Image Quality Level (IQL) dependent |
IQ level | IQL 1–300 (clinically relevant: 200–300) |
Dose modulation | CARE keV (PCCT); CARE kV (EID-CT) |
CTDIvol [mGy] | IQL dependent |
DLP [mGy·cm] | IQL dependent |
Temporal resolution [ms] | n.a. |
Rotation time [s] | Standard clinical protocol |
Pitch | Standard clinical protocol |
Matrix | Standard clinical protocol |
Field of view [mm] | Head-specific |
Slice collimation [mm] | Standard clinical protocol |
Slice width [mm] | PCCT: 1.5 (EID-CT: 1.0) |
Reconstruction increment [mm] | n.a. |
Reconstruction kernel | Standard pediatric head kernel |
Iterative reconstruction | Vendor standard iterative reconstruction |
Reconstruction comparison | Photon-counting CT vs Energy-integrating CT |
Contrast agent | None |
Phantom models | Anthropomorphic ATOM phantoms (1-, 5-, and 10-year-old) |
Key Results
Parameter | Main finding |
|---|
Radiation dose | PCCT achieved significantly lower CTDIvol across all pediatric phantoms |
Greatest dose reduction | 10-year-old phantom (9% lower CTDIvol at IQL 200) |
Brain SNR | Significantly higher with PCCT (up to ~20% improvement) |
Bone SNR | Up to ~50% higher with PCCT |
Image noise | Lower with PCCT, particularly in younger phantoms |
Organ dose | Highest in 1-year-old phantom for skin and red bone marrow; no significant system differences |
Clinical implication | Improved pediatric neuroimaging with higher SNR at lower radiation dose |
