Photon-counting CT in neuroradiology: a comprehensive SWOT analysis.

Photon-counting-detector computed tomography (PCD-CT) is a disruptive technology in neuroradiology, as evidenced by the unprecedented excitement surrounding its potential clinical applications and the field's growing number of publications. By employing photon-counting detectors capable of capturing information about individual photons and measuring their energy levels, PCD-CT offers benefits over conventional energy-integrating detector (EID) CT, including a higher contrast-to-noise ratio, reduced metal artifacts, improved spatial resolution, and decreased radiation and iodine dose necessary to achieve the highest resolution images seen to date. The currently available whole-body clinical PCD-CT scanner applications in neuroradiology range from optimized bone assessment to discrimination of fine details in neurovascular evaluation. However, intrinsic barriers such as cost and technical complexity, and external factors, including a lack of protocol standardization and direct competition with other technologies, hinder the widespread adoption of PCD-CT. To analyze the current state of evidence for PCD-CT in neuroradiology, we conducted a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, which may help readers and researchers to make a picture of this disruptive technology. KEY POINTS: Question A SWOT analysis of PCD-CT in neuroradiology may be useful to objectively assess its technical strengths, implementation challenges, opportunities, and threats for clinical adoption. Findings Photon-counting detector CT demonstrates superior spatial resolution, reduced artifacts, and lower radiation doses compared to conventional CT, enhancing neuroradiological imaging quality. Clinical relevance PCD-CT offers enhanced diagnostic accuracy and safety in neuroradiology, enabling better visualization of fine structures and vascular abnormalities while minimizing radiation exposure and reducing contrast agent requirements for sensitive populations.

Duke Scholars

Author Timothy James Amrhein Radiology, Neuroradiology