ESOC 2026 | How does photon-counting CT differ from conventional CT?
Linda Jacobi-Postma, MD, PhD, Maastricht UMC+, Maastricht, Netherlands, discusses the differences between photon-counting CT and conventional CT, highlighting that photon-counting CT has less noise, better image quality, and higher resolution. This interview took place at the 12th European Stroke Organisation Conference (ESOC) in Maastricht, The Netherlands.
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Transcript
Photon-counting CT is, I think, really different from a normal CT. So you can use this as a normal CT. But if you look how the images are generated, it’s quite different. Because if you have a normal CT, it’s called energy integrating detector CT. You have the x-ray, it’s coming to the patient and then comes onto all those small detector elements. And the X-rays then are converted into light and then the photon diode will collect the light and then it will transform it to an electrical signal...
Photon-counting CT is, I think, really different from a normal CT. So you can use this as a normal CT. But if you look how the images are generated, it’s quite different. Because if you have a normal CT, it’s called energy integrating detector CT. You have the x-ray, it’s coming to the patient and then comes onto all those small detector elements. And the X-rays then are converted into light and then the photon diode will collect the light and then it will transform it to an electrical signal. Whereas in photon counting CT, the photon from the X-rays comes in, changes into a cloud and then the electron clouds are counted. So each photon is counted and represents the energy of the X-ray. So it’s missing one transformation step. So you end up with less noise. So it’s more easy to get beautiful pictures. And also because you have the energy information from each X-ray, you can put it in different sort of bins and then you have different energies and calculate the images in another way. So for example in conventional CT you need dual energy CT to calculate for material characterization and stuff like that but in photon counting you have you have it all you don’t have to choose up front but you also have all those different energies. And one other very important difference is that the resolution in photon counting CT is far more better. Because in energy integrating detector CT, because you have the change in light, you have to have all little, how do you call it, separations between the detector elements because you don’t want the light to spread, but you don’t have to have it in photon counting CT. So instead of all different detector elements, you have one large detector. So next to less noise and more beautiful image quality, we have very high resolution or we have the possibility for very high resolution. So you can imagine that when you have more beautiful images, less noise, it’s easier to look at. But also the way that you have ultra high resolution, for example in CTA, can be very beneficial.
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