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(2025) Opitz | First assessment of photon-counting CT for virtual bronchoscopic navigation
In 40 patients (20 PCCT vs 20 BMI- and sex-matched EID-CT), PCCT successfully provided the high-resolution datasets required for virtual bronchoscopic navigation (VBN) and could be transferred into the navigation system for procedural planning. PCCT achieved an approximately 5–6× radiation-dose reduction: CTDIvol 1.5 vs…
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(2024) Dettmer | Chest X-ray–dose PCCT changes diagnosis in suspected pneumonia
In 27 adults with suspected respiratory infection, an ultra-low-dose PCCT chest protocol achieved a mean effective dose of 0.11 ± 0.04 mSv, essentially matching the German reference dose for a two-view chest radiograph. Despite this very low exposure, PCCT provided substantially more diagnostic information than…
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(2022) Lennartz | Virtual unenhanced images show limitations for adrenal adenoma characterization
PCCT-derived virtual unenhanced (VUE) images showed no significant difference in mean attenuation compared with true unenhanced (TUE) images for adrenal adenomas (9.2 ± 8.6 HU vs 7.3 ± 8.4 HU; P = .07). Despite similar mean values, individual VUE measurements showed both over- and underestimation, resulting in 10 of 36…
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(2023) Schade | Pseudoenhancement of renal cysts on PCCT
In 86 patients with 160 non-enhancing renal cysts, the study assessed how PCCT virtual monoenergetic image (VMI) energy level affects apparent renal cyst enhancement and therefore lesion classification. Low-keV VMI substantially increased apparent cyst attenuation: mean attenuation rose from 4 ± 11 HU at 190 keV to 36 ± 17…
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(2026) Huang | UHR PCCT with low-keV improves preoperative pancreatic cancer assessment
Combining UHR PCCT with low-keV virtual monoenergetic imaging (VMI) improved visualization of pancreatic ductal adenocarcinoma (PDAC), peripancreatic vessels, and fine pancreatic anatomy; the study identified 0.4-mm slices at 45 keV as the best overall reconstruction strategy for preoperative assessment. 40-keV VMI…
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(2022) Mergen | Virtual noncontrast abdominal imaging with PCCT
Virtual noncontrast (VNC) images reconstructed from contrast-enhanced PCCT provided accurate abdominal attenuation values compared with true noncontrast (TNC) imaging, supporting the potential to omit a separate TNC acquisition. Across all measurements, VNC attenuation errors were <5 HU in 76% and <10 HU in 95%; there was…
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(2024) Khanungwanitkul | PCCT reveals pancreatic duct connection of a side-branch IPMN
This case report has been published in Radiology. Access publication Figure 1. Axial photon-counting CT images at (A) 0.4-mm, (C) 2-mm, and (D) 4-mm section thickness demonstrate an incidental hypoattenuating pancreatic lesion (arrowhead). The lesion communicates with the main pancreatic duct via a connection (arrow)…
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(2023) Graafen | Soft Reconstruction Kernels Improve HCC Imaging on a PCCT
In a phantom and clinical study involving 24 patients with viable hepatocellular carcinoma (HCC), Graafen et al. evaluated reconstruction kernels for triple-phase photon-counting detector CT (PCD-CT), using 50-keV virtual monoenergetic images. Image quality was assessed quantitatively through contrast-to-noise ratio (CNR)…
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(2024) Bette | PCCT virtual non-contrast imaging differentiates adrenal adenomas from metastases
PCCT virtual non-contrast (VNC) reconstructions differentiated adrenal adenomas from metastases on portal-venous contrast-enhanced imaging, with adenomas showing significantly lower attenuation on both conventional VNC (VNCConv) and calcium-preserving PureCalcium VNC (VNCPC) (p = 0.007). VNC nevertheless systematically…
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(2022) Bette | Low-keV PCCT improves conspicuity of hypovascularized liver metastases
PCCT virtual monoenergetic imaging (VMI) improved visualization of hypovascularized liver metastases, with the greatest lesion conspicuity and CNR achieved at the low end of the keV spectrum. At 40 keV, tumor-to-liver ratio (TLR) reached 0.37, while CNR peaked at 6.88. Compared with conventional EID-CT, PCCT showed lower…
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(2025) Becker | Spectral PCCT differentiates hyperdense vascular from non-vascular renal lesions
This pilot study demonstrates that spectral information from photon-counting detector CT (PCD-CT) can help differentiate hyperdense renal cysts from vascular renal lesions when conventional portal-venous images are indeterminate. In 26 patients with 42 hyperdense renal lesions, attenuation on standard 70-keV VMI…
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(2026) Pannenbecker | UHR PCCT pulmonary angiography improves pulmonary artery visibility/confidence
Ultra-high-resolution (UHR) photon-counting CT pulmonary angiography significantly improved visualization of peripheral pulmonary arteries and increased radiologists' diagnostic confidence compared with state-of-the-art dual-energy EID-CT. UHR-PCD-CT achieved substantially higher pulmonary arterial enhancement (568–623 HU…
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(2026) Lustermans | PCCT enables robust low-dose proton therapy planning across patient sizes
Photon-counting CT (PCCT) maintained consistent proton range estimation (R80) across different phantom sizes, tissue types, proton beam energies, and imaging doses, whereas dual-energy CT (DECT) became increasingly inaccurate in larger phantoms at reduced radiation dose. Even at low-dose imaging (CTDIvol 5 mGy), PCCT kept…
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(2026) Lamaj | PCCT enables accurate head-and-neck radiotherapy planning using RED and VMI recons
Photon-counting CT enabled clinically acceptable radiotherapy treatment planning for all head-and-neck cancer patients, with dose-volume metrics differing by <5% compared with conventional EID-CT plans. Relative electron density (RED) images required no scanner-specific calibration, while 70 keV virtual monoenergetic…
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(2025) Neubauer | Breast cancer response assessment under NAST using thoracic PCCT
The authors showed that prone thoracic contrast-enhanced PCCT detected reduced tumor burden after neoadjuvant systemic therapy in all 9 patients. Best-practice implication: when thoracic PCCT is clinically indicated anyway, prone positioning can allow opportunistic local breast tumor and axillary assessment without extra…
