Photon-counting CT: An updated review of clinical results

Photon-counting computed tomography (PCD-CT) is an advancing imaging technology that offers improved spatial resolution, energy-resolved imaging, and spectral post-processing compared to conventional CT. These advantages contribute to increased contrast-to-noise ratio, reduction of metal artifacts and radiation dose and the elimination of electronic noise. Since the introduction of clinical PCD-CT, research topics have expanded beyond technical feasibility to evaluation of the impact on patient care. A previous review outlined the technological principles, early clinical results of PCD-CT and early applications in clinical practice. Since then, photon-counting technology has made significant progress, leading to a growing number of clinical applications across various specialties. This review builds upon prior work by summarizing the latest clinical applications of PCCT, including cardiovascular, thoracic, abdominal, musculoskeletal, neuro and pediatric imaging, while addressing current challenges and future directions for clinical implementation.