Photon-Counting Computed Tomography – Basic Principles, Potenzial Benefits, and Initial Clinical Experience

Abstract Background  Photon-counting computed tomography (PCCT) is a promising new technology with the potential to fundamentally change today’s workflows in the daily routine and to provide new quantitative imaging information to improve clinical decision-making and patient management. Method  The content of this review is based on an unrestricted literature search on PubMed and Google Scholar using the search terms “Photon-Counting CT”, “Photon-Counting detector”, “spectral CT”, “Computed Tomography” as well as on the authors’ experience. Results  The fundamental difference with respect to the currently established energy-integrating CT detectors is that PCCT allows counting of every single photon at the detector level. Based on the identified literature, PCCT phantom measurements and initial clinical studies have demonstrated that the new technology allows 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, radiation dose reduction, and the use of new contrast agents. In this review, we will discuss basic technical principles and potential clinical benefits and demonstrate first clinical use cases. Key Points:   Photon-counting computed tomography (PCCT) has been implemented in the clinical routine Compared to energy-integrating detector CT, PCCT allows the reduction of electronic image noise PCCT provides increased spatial resolution and a higher contrast-to-noise ratio The novel detector technology allows the quantification of spectral information Citation Format Stein T, Rau A, Russe MF et al. Photon-Counting Computed Tomography – Basic Principles, Potenzial Benefits, and Initial Clinical Experience. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2018-3396