Photon-Counting CT in Cancer Radiotherapy: Technological Advances and Clinical Benefits

Area of Science:

• Medical Physics
• Radiotherapy Technology
• Diagnostic Imaging

Background:

• Conventional energy-integrating detector (EID) CT systems face limitations in resolution and radiation dose for radiotherapy.
• Accurate tumor delineation, dose calculation, and treatment response monitoring are critical challenges in cancer radiotherapy.

Purpose of the Study:

• To review the advancements and applications of photon-counting computed tomography (PCCT) in cancer radiotherapy.
• To highlight PCCT's potential to overcome limitations of conventional CT systems in radiotherapy workflows.

Main Methods:

• Review of scientific literature on PCCT technology and its applications in radiotherapy.
• Analysis of PCCT's imaging capabilities, including spatial/contrast resolution, dose reduction, and multi-energy imaging.
• Evaluation of PCCT's impact on tumor delineation, dose calculation, treatment monitoring, and artifact reduction.

Main Results:

• PCCT demonstrates superior spatial and contrast resolution, and reduced radiation dose compared to EID CT.
• Enhanced anatomical clarity improves tumor targeting and minimizes damage to healthy tissues.
• Metal artifact reduction (MAR) and quantitative imaging support adaptive radiotherapy and radiomics.

Conclusions:

• PCCT offers significant advantages for radiotherapy, including improved precision, safety, and efficacy.
• Emerging applications in brachytherapy and radiopharmaceutical therapy (RPT) show promise.
• Advancements in AI and dedicated software will further integrate PCCT into clinical practice, transforming cancer treatment.