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Rofo 2024; 196(01): 25-35
DOI: 10.1055/a-2119-5802
Review

Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology

Article in several languages: English | deutsch
Florian Hagen 
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Martin Soschynski
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Meike Weis
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Muhammad Taha Hagar
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Patrick Krumm
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Isabelle Ayx
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Jana Taron
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Tobias Krauss
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Manuel Hein
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Philipp Ruile
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Constantin von zur Muehlen
4   Department of Cardiology & Angiology, University Heart Center Freiburg – Bad Krozingen, University Hospital Freiburg, Faculty of medicine, 79106 Freiburg, Germany
,
Christopher L. Schlett
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Jakob Neubauer 
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Ilias Tsiflikas
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Maximilian Frederik Russe
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Philipp Arnold
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Sebastian Faby 
5   Computed Tomography, Siemens Healthcare GmbH, Forchheim, Germany
,
Matthias F. Froelich 
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Jakob Weiß
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Thomas Stein
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Daniel Overhoff 
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Malte Bongers 
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Konstantin Nikolaou
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
,
Stefan O. Schönberg
3   Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Fabian Bamberg
2   Department of Diagnostic and Interventional Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
,
Marius Horger
1   Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
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Abstract

Background Photon-counting detector computed tomography (PCD-CT) is a promising new technology with the potential to fundamentally change workflows in the daily routine and provide new quantitative imaging information to improve clinical decision-making and patient management.

Method The contents of this review are based on an unrestricted literature search of PubMed and Google Scholar using the search terms “photon-counting CT”, “photon-counting detector”, “spectral CT”, “computed tomography” as well as on the authors’ own experience.

Results The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCD-CT allows for the counting of every single photon at the detector level. Based on the identified literature, PCD-CT phantom measurements and initial clinical studies have demonstrated that the new technology allows for improved spatial resolution, reduced image noise, and new possibilities for advanced quantitative image postprocessing.

Conclusion For clinical practice, the potential benefits include fewer beam hardening artifacts, a radiation dose reduction, and the use of new or combinations of contrast agents. In particular, critical patient groups such as oncological, cardiovascular, lung, and head & neck as well as pediatric patient collectives benefit from the clinical advantages.

Key Points: 

  • Photon-counting computed tomography (PCD-CT) is being used for the first time in routine clinical practice, enabling a significant dose reduction in critical patient populations such as oncology, cardiology, and pediatrics.

  • Compared to conventional CT, PCD-CT enables a reduction in electronic image noise.

  • Due to the spectral data sets, PCD-CT enables fully comprehensive post-processing applications.

Citation Format

  • Hagen F, Soschynski M, Weis M et al. Photon-counting computed tomography – clinical application in oncological, cardiovascular, and pediatric radiology. Fortschr Röntgenstr 2024; 196: 25 – 34

Key words

photon-counting - computed tomography - diagnostic imaging - photon-counting detector - spectral computed tomography - energy-integrating detector


Publication History

Received: 03 April 2023

Accepted: 04 June 2023

Article published online:
04 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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