by
Gus Iversen, Editor in Chief | February 04, 2026
Three photon-counting CT systems from Siemens Healthineers
Photon-counting CT significantly reduced radiation exposure and improved image quality compared to conventional CT in a prospective study of 200 adults with lung cancer, according to findings published in Radiology, the journal of the Radiological Society of North America.
The study, conducted between June and December 2024, evaluated contrast-enhanced chest scans using ultrahigh-resolution photon-counting CT versus conventional CT. Researchers divided patients into two matched cohorts of 100 individuals each, accounting for variables such as BMI, age, tumor size, kidney function, and histological type. Both groups had a mean age of 61.
Photon-counting CT, which detects and measures the energy of individual X-ray photons, was associated with a 66% reduction in radiation dose and a 27% decrease in iodine contrast exposure compared to conventional systems. The imaging technique also led to fewer adverse reactions, including contrast-induced acute kidney injury.
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“We believe photon-counting CT might replace conventional CT in the near future due to its improved imaging quality and the diagnostic confidence it offers," said Dr. Songwei Yue, chief physician and professor at the First Affiliated Hospital of Zhengzhou University in Henan, China.
A team of experienced chest radiologists evaluated image quality using a 5-point Likert scale, measuring lesion sharpness, noise, anatomical structure visibility, and diagnostic confidence. Subgroup analysis showed consistent improvements in both low and high BMI patients, and in lesions both larger and smaller than 3 cm.
“Compared with conventional CT, low-dose, ultrahigh-resolution photon-counting CT improves the detection of enhancement-related malignant features across varying BMI and tumor sizes,” said Yue. “It enhanced diagnostic confidence while reducing radiation exposure and contrast media use.”
The authors noted that future studies should include repeat imaging on the same patients to assess photon-counting CT’s performance in long-term monitoring and treatment response.
