Work

Image quality and radiation dose comparison for abdominopelvic CT studies performed using photon-counting CT and dual-energy CT: a clinical study

Year: 2026

Type: article

Abstract: Objectives To compare radiation dose and image quality of abdominopelvic CT studies performed on dual-energy energy-integrating detector CT (EID-CT) and photo-counting CT (PCCT) for the same patient cohort with clinically aligned protocols. Methods An IRB-approved retrospective cohort study included 49 patients who underwent portal venous phase abdominopelvic CT exams using both dual-energy CT and PCCT scanners within a maximum interval of 3 months. Images reconstructed included virtual monoenergetic images at 50, 60, and 70 keV and mixed images. CTDIvol values were recorded to assess radiation dose. Regions of interest were drawn in the 6 anatomical locations for quantitative analysis. The overall image quality, contrast enhancement, image noise, and presence of artifacts were evaluated using a 5-point Likert scale. Results No significant differences were observed in image quality scores between PCCT and EID-CT for most comparisons. Calculated contrast-to-noise ratios (CNR) were significantly higher on PCCT except for 70 keV. PCCT demonstrated a significantly lower radiation dose, with an average reduction of 20% ± 15%, up to 51%. Conclusion For abdominopelvic CT exams with our institutional protocol settings, PCCT has demonstrated a significant reduction in radiation dose while maintaining similar image quality as EID-CT. Advances in knowledge With clinically aligned protocols for the same cohort of patients, the results provided robust evidence for understanding the benefits of PCCT. It also provided a possible pathway to transit from EID-CT to PCCT in the abdominopelvic imaging.

Source: BJR|Open

DOI: 10.1093/bjro/tzag012