Photon-counting CT systems: A technical review of current clinical possibilities - 20/09/24

Doi : 10.1016/j.diii.2024.09.002

Joël Greffier ^a,^{^{1
Both authors contributed equally to this work.},}^⁎ , Anaïs Viry ^b,^{^{1
Both authors contributed equally to this work.}}, Antoine Robert ^c, Mouad Khorsi ^b, Salim Si-Mohamed ^c,^d
^a IMAGINE UR UM 103, Montpellier University, Department of Medical Imaging, Nîmes University Hospital, 30900 Nîmes, France
^b Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, 1007 Lausanne, Switzerland
^c University of Lyon, INSA-Lyon, University Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1206, 69621 Villeurbanne, France
^d Department of Radiology, Louis Pradel Hospital, Hospices Civils de Lyon, 69500 Bron, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Friday 20 September 2024

Highlights

•	The introduction of photon-counting CT into clinical practice has opened a new era in medical imaging.
•	Photon-counting detectors offer better dose efficiency, eliminate electronic noise, improve spatial resolution and have intrinsic spectral sensitivity.
•	Photon-counting CT is expected to provide significant benefits for disease diagnosis, characterization, and staging.
•	Photon-counting CT is expected to offer new diagnostic approaches owing to the use of color K-edge imaging and its dedicated contrast agents.

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Abstract

In recent years, computed tomography (CT) has undergone a number of developments to improve radiological care. The most recent major innovation has been the development of photon-counting detectors. By comparison with the energy-integrating detectors traditionally used in CT, these detectors offer better dose efficiency, eliminate electronic noise, improve spatial resolution and have intrinsic spectral sensitivity. These detectors also allow the energy of each photon to be counted, thus improving the sampling of the X-ray spectrum in multiple energy bins, to better distinguish between photoelectric and Compton attenuation coefficients, resulting in better spectral images and specific color K-edge images. The purpose of this article was to make the reader more familiar with the basic principles and techniques of new photon-counting CT systems equipped with photon-counting detectors and also to describe the currently available devices that could be used in clinical practice.

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Keywords : Computed tomography, Dual-energy CT, Image quality, Photon counting CT, Spectral photon counting CT

Abbreviations : CT, CdTe, CZT, EID, PCCT, PCD, Si