Perera Molligoda Arachchige AS, Dashiell A, Jesuraj AS, D’Urso AI, Fiore B, Cattaneo M, Pierzynska E, Szydelko S, Centini FR, Verma Y. Applications of photon-counting CT in oncologic imaging: A systematic review. World J Radiol 2025; 17(8): 107732 [PMID: 40901346 DOI: 10.4329/wjr.v17.i8.107732]
Corresponding Author of This Article
Arosh S Perera Molligoda Arachchige, MD, Emergency Service, GHOL-Hopital de Nyon, Chemin Monastier 10, Nyon 1260, Vaud, Switzerland. aroshperera@outlook.it
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Aug 28, 2025; 17(8): 107732 Published online Aug 28, 2025. doi: 10.4329/wjr.v17.i8.107732
Applications of photon-counting CT in oncologic imaging: A systematic review
Arosh S Perera Molligoda Arachchige, Anna Dashiell, Anton Shiraan Jesuraj, Antonia Immacolata D’Urso, Benedetta Fiore, Martina Cattaneo, Emilia Pierzynska, Sandra Szydelko, Francesca Romana Centini, Yash Verma
Arosh S Perera Molligoda Arachchige, Emergency Service, GHOL-Hopital de Nyon, Nyon 1260, Vaud, Switzerland
Anna Dashiell, Anton Shiraan Jesuraj, Antonia Immacolata D’Urso, Benedetta Fiore, Martina Cattaneo, Emilia Pierzynska, Sandra Szydelko, Francesca Romana Centini, Faculty of Medicine, Humanitas University, Pieve Emanuele 20072, Lombardy, Italy
Yash Verma, Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States
Co-first authors: Arosh S Perera Molligoda Arachchige and Anna Dashiell.
Author contributions: Arachchige ASPM contributed to the conceptualization, methodology, investigation, writing the original draft, and supervision; Dashiell A contributed to methodology, data curation, reviewing, and editing; Jesuraj AS, D’Urso AI, Fiore B, Cattaneo M, Szydelko S, Centini FR, and Verma Y contributed to reviewing and editing; Pierzynska E contributed to the investigation and validation; All authors read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Received: March 28, 2025 Revised: May 4, 2025 Accepted: July 18, 2025 Published online: August 28, 2025 Processing time: 153 Days and 10.6 Hours
Abstract
BACKGROUND
Photon-counting detector (PCD) CT represents a transformative advancement in radiological imaging, offering superior spatial resolution, enhanced contrast-to-noise ratio, and reduced radiation dose compared with the conventional energy-integrating detector CT.
AIM
To evaluate PCD CT in oncologic imaging, focusing on its role in tumor detection, staging, and treatment response assessment.
METHODS
We performed a systematic PubMed search from January 1, 2017 to December 31, 2024, using the keywords “photon-counting CT”, “cancer”, and “tumor” to identify studies on its use in oncologic imaging. We included experimental studies on humans or human phantoms and excluded reviews, commentaries, editorials, non-English, animal, and non-experimental studies. Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Out of 175 initial studies, 39 met the inclusion criteria after screening and full-text review. Data extraction focused on study type, country of origin, and oncologic applications of photon-counting CT. No formal risk of bias assessment was performed, and the review was not registered in PROSPERO as it did not include a meta-analysis.
RESULTS
Key findings highlighted the advantages of PCD CT in imaging renal masses, adrenal adenomas, ovarian cancer, breast cancer, prostate cancer, pancreatic tumors, hepatocellular carcinoma, metastases, multiple myeloma, and lung cancer. Additionally, PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology. Despite its promising capabilities challenges related to data processing, storage, and accessibility remain.
CONCLUSION
As PCD CT technology evolves, its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.
Core Tip: Photon-counting detector (PCD) CT represents a paradigm shift in oncologic imaging, offering superior spatial resolution, reduced radiation dose, and enhanced material decomposition compared with conventional CT. This study highlighted the potential of PCD CT in tumor detection, characterization, and therapy response assessment, underscoring its role in advancing precision oncology. By leveraging energy-resolved photon detection, PCD CT enhances lesion conspicuity and quantification, paving the way for improved diagnostic accuracy and personalized treatment strategies.
