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Diagnostics
Special Issues
Photon-Counting CT in Clinical Application
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Photon-Counting CT in Clinical Application

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 June 2026 | Viewed by 3033

Special Issue Editor

Dr. Philipp Gruschwitz

E-Mail Website
Guest Editor
Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, 97080 Würzburg, Germany
Interests: photon-counting CT; spektral imaging; tissue characterization; cardiovascular imaging

Special Issue Information

Dear Colleagues,

The Special Issue “Photon-Counting CT in Clinical Application” focuses on the use of photon-counting technology in clinical application and the resulting possibilities for optimized patient care.

Photon-counting CT has now been applied in many institutions in everyday routine care, and studies are becoming increasingly patient-oriented as a result. The main topic of the research is on the various application possibilities of spectral imaging, tissue characterization, and the advantages of higher spatial resolution made possible by the new detector principle.

The purpose of this Special Issue is to bundle innovative photon-counting CT patient studies or studies with a direct link to patient care, regardless of the specialist discipline.

Dr. Philipp Gruschwitz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • protocol development and optimization
  • spectral imaging
  • tissue characterization
  • lesion classification
  • benefits of special resolution
  • radiation dose optimization
  • contrast agent

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Published Papers (3 papers)

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Research

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13 pages, 1890 KB  
Article
Photon-Counting CT Angiography Enables Superior Preoperative Perforator Depiction for Fibular Transplant Surgery Requiring Less Contrast Agent Compared to Energy-Integrating CT
by Ramin Saam Dazeh, Jan-Lucca Hennes, Tobias Prester, Viktor Hartung, Henner Huflage, Andreas Vollmer, Thorsten Alexander Bley, Philipp Gruschwitz and Kristina Krompaß
Diagnostics 2026, 16(5), 798; https://doi.org/10.3390/diagnostics16050798 - 8 Mar 2026
Viewed by 654
Abstract
Background/Objectives: The objective of this study was to ascertain whether photon-counting CT angiography (PCD-CTA) can optimize image quality for the visualization of perforating arteries for planning fibular transplant procedures in comparison to energy-integrating CT angiography (EID-CTA). Methods: In this retrospective single-center [...] Read more.
Background/Objectives: The objective of this study was to ascertain whether photon-counting CT angiography (PCD-CTA) can optimize image quality for the visualization of perforating arteries for planning fibular transplant procedures in comparison to energy-integrating CT angiography (EID-CTA). Methods: In this retrospective single-center study, all patients who underwent preoperative CT of the peripheral runoff for planning between October 2021 and July 2023 were consecutively included. PCD-CTA was performed in standard resolution mode as 55 keV images with 90 mL of iodine-containing contrast agent or alternatively, an EID-CTA as a low-kV scan with 110 mL of contrast agent. The raw data were reformatted using comparable soft vascular and sharp regular convolution kernels, slice thickness/increment, and field of view. Contrast-to-noise ratio was calculated for objective image quality. Subjective evaluation was based on a rating by three radiologists using a five-point Likert scale (criteria: overall image quality, luminal attenuation, vessel sharpness, and perforator depiction). Results: Of the 26 patients who were screened, 9 could be included in each group, while 8 were excluded due to incomplete reconstructions. The reduction in contrast agent dose resulted in a non-significant decrease in luminal attenuation on PCD-CTA (452.5 ± 53.6 HU vs. 465.5 ± 99.6 HU; p = 0.375). The image noise was considerably lower for PCD-CTA (21.1 ± 1.0 HU vs. 32.9 ± 1.6 HU; p < 0.001). This resulted in a significantly higher contrast-to-noise ratio (CNR) for sharp kernel reconstructions (22.4 ± 3.5 vs. 14.5 ± 3.8; p < 0.001). No significant differences were observed for the soft vascular kernel. Subjective evaluation revealed a significant enhancement in overall image quality, vascular sharpness, and perforator depiction for PCD-CTA with sharp reconstructions. In contrast, soft kernel reconstructions and luminal attenuation demonstrated no substantial difference. Interrater agreement was good to excellent. Conclusions: PCD-CTA with sharp kernel reformatting has been demonstrated to yield superior image quality and perforator delineation of the fibular artery in comparison to standard EID-CTA. Full article
(This article belongs to the Special Issue Photon-Counting CT in Clinical Application)
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13 pages, 1259 KB  
Article
Photon-Counting CT Enables Higher Image Quality at a Lower Radiation Dose Compared with a 256-Slice Energy-Integrating Detector CT in Pediatric Patients with Congenital Heart Disease
by André Lollert, Fabio Souschek, Tariq Abu-Tair, Frank Dette, Georg Daniel Duerr, Christoph Kampmann, Tobias Bäuerle and Gundula Staatz
Diagnostics 2026, 16(5), 735; https://doi.org/10.3390/diagnostics16050735 - 1 Mar 2026
Cited by 1 | Viewed by 574
Abstract
Background/Objectives: There is an increasing need for cross-sectional imaging in pediatric patients with congenital heart disease. This patient group is highly sensitive to ionizing radiation. The purpose of this article was to evaluate differences in radiation dose and image quality between a [...] Read more.
Background/Objectives: There is an increasing need for cross-sectional imaging in pediatric patients with congenital heart disease. This patient group is highly sensitive to ionizing radiation. The purpose of this article was to evaluate differences in radiation dose and image quality between a first-generation photon-counting (PC)-CT system and a 256-slice single-source energy-integrating detector (EID)-CT in these patients. Methods: We retrospectively assessed effective dose, CT dose index-volume (CTDIvol), dose length product (DLP), and image quality of all prospectively electrocardiography-gated CTs of the thorax in all patients < 18 years of age examined between February 2021 and August 2024 (n = 43). Two independent observers subjectively scored image quality, vascular contrast, and noise on a 5-point Likert scale. In addition, we assessed the signal-to-noise-ratio (SNR) and contrast-to-noise-ratio (CNR) quantitatively. Results: All dose parameters were significantly lower in the PC-CT (n = 27) versus the EID-CT (n = 16) group (mean effective dose: 0.8 ± 0.64 versus 2.2 ± 0.88 mSv, p < 0.001; mean CTDIvol: 1.22 ± 0.96 versus 4.8 ± 1.08 mGy, p < 0.001; mean DLP: 30.7 ± 31.9 versus 73.7 ± 50.7 mGy*cm, p < 0.001). Overall subjective image quality and contrast were rated higher in the PC-CT group (p = 0.046 and < 0.001, respectively). Quantitative CNR was significantly higher in the PC-CT group (mean 39.1 ± 12.9 versus 26.2 ± 10.8, p = 0.002). Conclusions: PC-CT enables high-quality examinations for the evaluation of congenital heart disease with a highly significant dose reduction compared with a 256-slice single-source EID-CT. Full article
(This article belongs to the Special Issue Photon-Counting CT in Clinical Application)
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Other

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5 pages, 2987 KB  
Interesting Images
Aberrant ICA and Associated Skull Base Foramina Visualized on Photon Counting Detector CT: Interesting Images
by Ahmed O. El Sadaney, John C. Benson, Felix E. Diehn, John I. Lane and Paul J. Farnsworth
Diagnostics 2025, 15(17), 2213; https://doi.org/10.3390/diagnostics15172213 - 31 Aug 2025
Viewed by 1022
Abstract
Aberrant internal carotid arteries (ICA) are congenital vascular anomalies that occur from involution of the cervical portion of the ICA, which leads to enlargement of the normally small collateral inferior tympanic and caroticotympanic arteries. The inferior tympanic artery is a branch of the [...] Read more.
Aberrant internal carotid arteries (ICA) are congenital vascular anomalies that occur from involution of the cervical portion of the ICA, which leads to enlargement of the normally small collateral inferior tympanic and caroticotympanic arteries. The inferior tympanic artery is a branch of the external carotid artery, usually the ascending pharyngeal artery, which extends through the inferior tympanic canaliculus (ITC), a small foramen located along the cochlea promontory. Aberrant ICAs can also be associated with a persistent stapedial artery (PSA), which is an abnormal vessel that arises from the petrous ICA and passes through the obturator foramen of the stapes. An aberrant ICA is a very important anomaly to recognize on imaging. Accurately describing its presence is important to help prevent iatrogenic injury during intervention. It is also important to distinguish an aberrant ICA from a lateralized ICA. The improvement of spatial resolution with photon counting detector (PCD)-CT has been proven to provide higher performance in detection of sub-centimeter vascular lesions compared to conventional energy-integrated detector (EID)-CT. PCD-CT also provides superior visualization of small skull-based foramina such as the inferior tympanic canaliculus, which can aid in more accurately characterizing an aberrant ICA (variant course without ITC involvement). Full article
(This article belongs to the Special Issue Photon-Counting CT in Clinical Application)
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