A Narrative Review of Photon-Counting CT and Radiomics in Cardiothoracic Imaging: A Promising Match?

Area of Science:

• Medical Imaging
• Radiology
• Quantitative Imaging

Background:

• Photon-counting computed tomography (PCCT) offers superior spatial resolution, reduced noise, and spectral capabilities over conventional CT.
• Radiomics extracts quantitative features from medical images, offering insights into disease characteristics.

Purpose of the Study:

• To review the current evidence on the synergy between PCCT and radiomics in cardiothoracic imaging.
• To explore the impact of PCCT's unique data outputs on radiomics performance.

Main Methods:

• Narrative review of existing literature on PCCT and radiomics in cardiothoracic applications.
• Analysis of phantom studies and early clinical investigations.

Main Results:

• PCCT demonstrates high intra-scanner repeatability but reduced reproducibility compared to conventional CT.
• PCCT-derived radiomic features show potential for improved lung nodule characterization and cardiac tissue analysis.
• Spectral reconstructions in PCCT enhance plaque characterization and capture myocardial aging patterns.

Conclusions:

• A growing synergy exists between PCCT and radiomics, with emerging applications in lung and cardiac imaging.
• PCCT enhances the reproducibility and richness of quantitative features, expanding radiomics' clinical potential in CT.