This multicenter retrospective study evaluated 6,464 PCCT examinations in 4,772 pediatric patients across three French institutions and provides practical acquisition/reconstruction protocols across ten body regions.
The cohort had a mean age of 7.9 ± 5.5 years (4 days–17.9 years); nearly one-third of examinations involved children <15 kg and <4 years. Chest and head examinations were the most frequent.
Protocols were explicitly designed to balance radiation-dose reduction, diagnostic image quality, motion reduction, and workflow efficiency, with dose analysis stratified into five weight groups.
The authors conclude that the results support safe clinical integration of pediatric PCCT, while emphasizing that the proposed protocols are a flexible framework for local optimization rather than fixed universal settings.
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Protocols
We created an cheat sheet from the protocol table via AI:
Key Results
Parameter | Result |
|---|
Patients | 4,772 |
PCCT examinations | 6,464 |
Mean age | 7.9 ± 5.5 years |
Age range | 4 days–17.9 years |
Mean weight | 29.6 ± 20.3 kg |
Weight range | 2–79 kg |
Children <15 kg / <4 years | 2,110 examinations (32.64%) |
Most frequent examination | Chest: 2,168 (33.54%) |
Second most frequent | Head: 1,675 (25.91%) |
Noncontrast head CTDIvol | 16.1–24.0 mGy across weight groups |
Noncontrast head DLP | 311–608 mGy·cm |
Noncontrast chest CTDIvol | 0.3–0.8 mGy |
Noncontrast chest DLP | 7–27 mGy·cm |
Temporal bone CTDIvol | 22.7–33.8 mGy |
Dose relationship | CTDIvol and DLP increased with patient weight |
The patient distribution and examination frequencies are reported in the study results. Dose levels varied substantially by examination and patient weight; temporal-bone examinations had particularly high CTDIvol because of UHR/high-kV acquisition, whereas noncontrast chest imaging operated at very low dose levels.
For example, pooled across weight groups, noncontrast chest PCCT had a median CTDIvol of 0.4 mGy and DLP of 11.9 mGy·cm, while the dedicated low-dose chest protocol reached approximately 0.1 mGy and 4.0 mGy·cm, respectively.
Practical take-home
This is primarily a protocol and dose-reference paper, rather than an image-quality superiority study. Its major value is the large real-world pediatric dataset and the detailed, indication-specific protocol framework. PCCT allows aggressive pediatric dose optimization through weight-/task-adapted CARE keV, Sn filtration, fast-pitch acquisition, UHR where spatial resolution is necessary, and spectral reconstructions from contrast-enhanced QuantumPlus scans.
Source: Habib Geryes B, Moalla S, De Saint Etienne E, et al. Photon-counting CT in pediatric patients: A multi-institutional evaluation of protocols and radiation exposure in 4,772 patients. Diagnostic and Interventional Imaging. 2026;107(5):186–197. doi:10.1016/j.diii.2025.11.010.
