Zhu TT, Zhu XY, Yang M, Liu WM, Yang WJ, Liu X. Photon-counting computed tomography enables low-dose, high-quality abdominal imaging: A comparative study with energy-integrating detector computed tomography. World J Radiol 2026; 18(5): 119048 [PMID: 42238226 DOI: 10.4329/wjr.v18.i5.119048]
Corresponding Author of This Article
Xiao Liu, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Road, Huangpu District, Shanghai 200025, China. liuxiao.1988.02@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
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research-article
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Zhu TT, Zhu XY, Yang M, Liu WM, Yang WJ, Liu X. Photon-counting computed tomography enables low-dose, high-quality abdominal imaging: A comparative study with energy-integrating detector computed tomography. World J Radiol 2026; 18(5): 119048 [PMID: 42238226 DOI: 10.4329/wjr.v18.i5.119048]
World J Radiol. May 28, 2026; 18(5): 119048 Published online May 28, 2026. doi: 10.4329/wjr.v18.i5.119048
Photon-counting computed tomography enables low-dose, high-quality abdominal imaging: A comparative study with energy-integrating detector computed tomography
Ting-Ting Zhu, Xiao-Yun Zhu, Min Yang, Wan-Min Liu, Wen-Jie Yang, Xiao Liu
Ting-Ting Zhu, Wan-Min Liu, Wen-Jie Yang, Xiao Liu, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Xiao-Yun Zhu, Min Yang, Department of Radiology, Taicang Loujiang New City Hospital (Ruijin Hospital), Taicang 215400, Jiangsu Province, China
Author contributions: Zhu TT and Zhu XY participated in the conception and design of the study and were involved in the acquisition, analysis, and interpretation of data; Zhu TT, Yang M, and Liu WM wrote the manuscript; Yang WJ and Liu X accessed and verified the study data. All authors critically reviewed and provided final approval of the manuscript, all authors were responsible for the decision to submit the manuscript for publication.
AI contribution statement: ChatGPT was used only for grammar checking (detecting grammatical errors in the manuscript). No other AI tools were used.
Supported by the National Key Research and Development Program of China, No. 2022YFC2401604.
Institutional review board statement: The study protocol was approved by the Ethics Committee of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine (approval No. 2025-250).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data are available from the corresponding author upon request.
Corresponding author: Xiao Liu, Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Road, Huangpu District, Shanghai 200025, China. liuxiao.1988.02@163.com
Received: January 19, 2026 Revised: February 23, 2026 Accepted: April 15, 2026 Published online: May 28, 2026 Processing time: 129 Days and 2.6 Hours
Abstract
BACKGROUND
Although photon-counting computed tomography (PCCT) has demonstrated superior dose efficiency and image quality compared with conventional energy-integrating detector computed tomography (EID-CT) in theory and in some clinical fields, systematic evaluations of its performance in abdominal imaging, particularly comprehensive studies incorporating both radiation dose and image quality, remain very limited.
AIM
To compare radiation dose and image quality between PCCT and conventional EID-CT in abdominal imaging, and to evaluate the potential of PCCT for low-dose, high-quality clinical applications.
METHODS
Eighty participants were included, comprising 40 subjects who underwent prospective abdominal PCCT and 40 subjects retrospectively matched who underwent routine abdominal EID-CT. Radiation dose parameters [computed tomography dose index (CTDIvol), dose-length product, and effective dose] were recorded. Objective image quality was assessed using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), dose-normalized metrics [SNR/(CTDIvol)1/2 and CNR/(CTDIvol)1/2], noise ratio, and excellent image index. Subjective image quality was evaluated by two experienced radiologists using a five-point Likert scale. Intergroup comparisons were performed using appropriate parametric or nonparametric statistical tests.
RESULTS
Compared with EID-CT, PCCT achieved an approximate 50% reduction in CTDIvol, dose-length product, and effective dose (all P < 0.001). PCCT demonstrated significantly higher SNR, CNR, SNR/(CTDIvol)1/2, CNR/(CTDIvol)1/2, and excellent image index, along with a lower noise ratio, indicating superior noise uniformity (all P < 0.001). Subjective assessment showed that 77.5% of PCCT images were rated as excellent (Likert score = 5), compared with 10.0% in the EID-CT group (P < 0.001).
CONCLUSION
PCCT provides substantially improved dose efficiency and image quality compared with conventional EID-CT in abdominal imaging, supporting its potential role in low-dose clinical computed tomography protocols.
Core Tip: Photon-counting computed tomography (PCCT) is an emerging technology that offers superior dose efficiency and image quality compared to conventional energy-integrating detector computed tomography. In this abdominal imaging study, PCCT achieved approximately 50% reduction in radiation dose while significantly improving both objective and subjective image quality. These findings highlight the potential of PCCT to enable low-dose, high-quality clinical protocols, representing a significant advancement in diagnostic imaging.
