Photon-counting CT in cancer radiotherapy: technological advances and clinical benefits.

Journal: Physics in medicine and biology
Published Date: May 16, 2025

Abstract

Photon-counting computed tomography (PCCT) marks a significant advancement over conventional energy-integrating detector (EID) CT systems. This review highlights PCCT's superior spatial and contrast resolution, reduced radiation dose, and multi-energy imaging capabilities, which address key challenges in radiotherapy, such as accurate tumor delineation, precise dose calculation, and treatment response monitoring. PCCT's improved anatomical clarity enhances tumor targeting while minimizing damage to surrounding healthy tissues. Additionally, metal artifact reduction (MAR) and quantitative imaging capabilities optimize workflows, enabling adaptive radiotherapy and radiomics-driven personalized treatment. Emerging clinical applications in brachytherapy and radiopharmaceutical therapy (RPT) show promising outcomes, although challenges like high costs and limited software integration remain. With advancements in artificial intelligence (AI) and dedicated radiotherapy packages, PCCT is poised to transform precision, safety, and efficacy in cancer radiotherapy, marking it as a pivotal technology for future clinical practice.

Authors

  • Keyur Shah
    Radiation Oncology, Emory University, 1365 Clifton Road NE, Building A, Atlanta, Georgia, 30322, UNITED STATES.
  • Jun Zhou
    Department of Clinical Research Center, Dazhou Central Hospital, Dazhou 635000, China.
  • Justin Roper
    Radiology Oncology, Emory University, 1365 Clifton Road, Department of Radiation Oncology, Atlanta, Atlanta, Georgia, 30322, UNITED STATES.
  • Anees Dhabaan
    Department of Radiation Oncology, Emory University, 1365 Clifton Road NE, Department of Radiation Oncology, Atlanta, Atlanta, Georgia, 30322, UNITED STATES.
  • Hania Al-Hallaq
    Emory University School of Medicine, Clifton Road, Atlanta, Georgia, 30322, UNITED STATES.
  • Amir Pourmorteza
    Department of Radiology and Sciences Imaging, Emory University School of Medicine, 1365 Clifton Road, Atlanta, Atlanta, Georgia, 30322, UNITED STATES.
  • Xiaofeng Yang
    Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA.

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