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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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(2025) Zhang | UHR PCCT versus 40-keV VMI for abdominal artery visualization
This prospective study compared 0.2-mm ultra-high-resolution (UHR) PCCT with 1-mm standard-resolution 40-keV VMI for abdominal CTA in 94 participants, equally divided between full-dose and low-dose protocols. Standard-resolution 40-keV VMI provided significantly higher SNR and CNR than all UHR reconstructions. UHR…
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(2024) Wang | Low-dose ultra-high-resolution PCCT for visceral artery CTA
Prospective study testing whether low-dose (LD) ultra-high-resolution (UHR) photon-counting CT can preserve diagnostic image quality for visceral artery CTA. The study included 57 patients in the full-dose group and 57 in the low-dose group. Each acquisition was reconstructed two ways: 0.2 mm / Bv48 / QIR 4 and 1 mm / Bv40…
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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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(2024) Huflage | Submillisievert PCCT for urinary calculi detection
Retrospective single-center study of 507 patients undergoing unenhanced abdominal CT for suspected urinary calculi, comparing PCCT (n = 229) with optimized EID-CT (n = 278). PCCT achieved a 44% lower effective radiation dose than EID-CT: 0.79 mSv vs 1.39 mSv, while maintaining excellent diagnostic confidence. Despite the…
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(2024) Rau | PCCT virtual non-contrast imaging accurately characterizes uncomplicated renal cysts
PCCT-derived virtual non-contrast (VNC) images provided renal cyst attenuation measurements comparable to true non-contrast imaging, with no significant difference across true non-contrast, arterial VNC, and portal-venous VNC (p = 0.301). In contrast, dual-energy EID-CT VNC showed a significant difference from true…
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(2024) Lin | PCCT enables protocol-independent liver fat quantification
PCCT-derived fat fraction (CTFF) showed excellent agreement with MRI proton density fat fraction (PDFF), supporting quantitative liver fat assessment using standardized PCCT attenuation values. A single conversion formula—MRI PDFF (%) = −0.58 × CT (HU) + 43.1—remained accurate across 90, 120, and 140 kVp and both standard-…
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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) Dillinger | Low-keV VMI from portal venous PCCT enhances abdominal arterial contrast
This retrospective study of 40 patients evaluated whether virtual monoenergetic images (VMI) reconstructed from portal venous PCCT could provide sufficient arterial vessel contrast and potentially serve as an alternative when a dedicated arterial phase is unavailable or suboptimal. 40-keV VMI produced the highest arterial…
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(2022) Decker | PCCT enables anemia detection from routine contrast-enhanced CT
This proof-of-concept study demonstrates that spectral PCCT data from routine contrast-enhanced oncologic staging examinations can be used to detect and quantify anemia by measuring blood-pool attenuation on virtual non-contrast (VNC) images. Mean blood-pool VNC attenuation showed a strong positive correlation with…
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(2024) Dane | Pancreatic cyst prevalence and detection with PCCT compared with EID-CT
In a retrospective single-center study of 2,494 patients, photon-counting CT (PCCT) demonstrated a significantly higher pancreatic cyst detection rate than conventional energy-integrating detector CT (EIDCT): 4.9% (49/1,009) vs 3.0% (44/1,485), p = 0.017. The largest difference occurred with CT angiography, where cysts…
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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…
