Photon-counting CT vs. energy-integrating detector CT: image quality and radiation dose in multi-phase abdominopelvic imaging.

OBJECTIVE

To compare photon-counting detector CT (PCCT) and energy-integrating detector CT (EID-CT) for abdominopelvic imaging regarding radiation dose and image quality.

METHODS

This prospective study enrolled 94 adults undergoing abdominopelvic CT. Objective image quality was assessed by measuring hepatic noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Two blinded radiologists independently scored subjective image quality using a 5-point Likert scale. Radiation exposure was evaluated via CTDIvol, dose-length product (DLP), and scan length-normalized DLP (nDLP).

RESULTS

PCCT significantly reduced radiation dose: CTDIvol by 57%, DLP by 62%, and nDLP by 57% (all P < .001). Concurrently, image quality improved:hepatic noise decreasing by 31% (P < .001), and SNR increased by 40-70% (P < .001); CNR increased 22-45% (P < .05).

CONCLUSION

PCCT achieves substantial radiation dose reduction while improving objective image quality compared with EID-CT in abdominopelvic imaging. These findings support PCCT as a valuable tool for dose-optimised abdominal protocols.